Even before COVID-19 swept across the world, healthcare workers in the United States were experiencing severe burnout – a state of emotional exhaustion that’s often associated with anxiety and depression. In 2019, the National Academies of Medicine reported that burnout had reached ‘crisis’ levels, with up to 54% of nurses and physicians, and up to 60% of medical students and residents, suffering from burnout.

The pandemic only served to further exacerbate the problem in the U.S., where more than 50% of public health workers reported symptoms of at least one mental health condition, such as anxiety, depression, and increased levels of post-traumatic stress disorder.

The potential ramifications of burnout are wide-reaching, from the individual health and wellbeing of the workers to the patients they’re working with, and the infrastructure of the healthcare system itself. The U.S. Bureau of Labor and Statistics estimates that the country needs at least 1.1 million nurses within the next five years to fill gaps in the current system.

But now, as the country reels from the Supreme Court’s decision to overturn Roe V Wade, some are wondering if the case will cause further harm to U.S. healthcare workers.

“We already have a massive nursing shortage,” says Sara Bowsky, Palladium Head of Nursing. “Will this decision push them over the edge and force them out of the sector altogether?” She worries that many healthcare providers may choose to leave, as nursing continues to become more political.

A recent survey of nurses in the U.S. found that 64% are looking to leave the healthcare profession, a near 40% increase from a similar survey from a year ago in 2021.

Already since the Supreme Court decision, stories have dominated the headlines of doctors in areas with blanket abortion bans unable to provide services to women until it’s nearly too late, or instances where women are unable to access routine medications because one of its potential side effects are miscarriage.

As Clint Cavanaugh, Palladium Senior Director of Global Health Security adds this can take a major toll on healthcare workers who put their patients first. “Healthcare workers come at this from a Hippocratic Oath perspective, and that means do no harm, and in many cases these decisions make them feel handicapped to fully serve their communities in the roles in which they are trained to serve.”

Bowsky explains that it’s been three difficult years for the healthcare sector. “Think about the burnout we already have; the same staff that have had to work through a pandemic are now being faced with the overturning of Roe, which is in effect a policy choice that could harm healthcare workers.”

She notes that this goes well-beyond frontline workers and women’s health and extends to those in public health and those who provide mental health services. “Have you tried to book an appointment with a doctor or specialist recently?” she asks. “They’re all overbooked and overburdened right now and it’s only going to get worse.”

“If you’re not worried about our healthcare workforce, you’re not paying attention. It’s that simple,” she concludes.

Beyond Domestic – International Healthcare Workers

Cavanaugh adds that the decision reflects how major policy shifts like this can affect healthcare workers in the developing world and that it’s not necessarily a new problem. “Looking more broadly at international development, regardless of what the policy is, it’s the service providers on the ground that are on the front line.”

As an example, he notes the Mexico City Policy, named for the 1984 International Conference on Population which was held in Mexico City. The Policy blocks U.S. federal funding for non-governmental organisations that provide abortion counselling or referrals or expanded abortion services. Prior to the policy, foreign organisations could use non-U.S. funds to engage in abortion-related activities and still work with the U.S., as long as they maintained separate accounts for U.S. funds. But when the policy is in place, they cannot if they want to continue to receive U.S. funds for family planning assistance.

It’s not unusual with a change in administration for the Policy to be either ‘switched on’ or ‘switched off’ and has been in effect for 21 of the past 36 years since its inception. “It’s a significant pivot,” Cavanaugh adds. “Think of the human resources that goes into that switch and the impact it has on the personnel delivering services and the resources required in changing what’s provided.”

He draws the parallel between the Mexico City Policy and the overturning of Roe V Wade. “These policy shifts can be quite jarring and can really affect morale. It can also affect the receptivity of clients to the providers. The healthcare workers don’t influence the decision, they just act on it and have to face the clients daily,” he adds.

Because the Supreme Court’s ruling leaves the decision up to the states, the laws will differ across the country, leaving healthcare workers in some states in the position of having to either interpret the law around what kind of care they can give their patients or if they’ll face a lawsuit of even jail time if they do.

In recent years, the term ‘moral injury’, has come to the fore to describe how conflicted many frontline healthcare workers feel as they are thrust into life or death situations without the resources or support structures needed to do their job. And while it emerged in the midst of the worst of the pandemic, its parallels with the current situation many healthcare workers are finding themselves in are clear.

And as states continue to report nursing shortages across the country, concerns are mounting that overworked healthcare workers will choose to leave or that fears of repercussions from simply doing their job may keep others from joining the field. “More than ever, healthcare workers are stretched thin after the pandemic, not to mention the added stresses that they have to incur as part of their day-to-day role in health services,” Cavanaugh concludes.

But both Cavanaugh and Bowsky agree, it’s the resiliency of the healthcare workforce that give them hope. “We’ve seen that for most providers working in women’s healthcare, they’re doing it because they love it, and they believe in the mission and will find different ways to continue to support that mission,” Bowsky adds.

For more, read We Already Know the Impact of Restricting Abortions or contact info@thepalladiumgroup.com.