Work stress and burnout

قَالَتۡ إِحۡدَىٰهُمَا يَٰٓأَبَتِ ٱسۡتَـٔۡجِرۡهُۖ إِنَّ خَيۡرَ مَنِ ٱسۡتَـٔۡجَرۡتَ ٱلۡقَوِيُّ ٱلۡأَمِينُ

One of the women said, ‘Father, hire him: a strong, trustworthy man is the best to hire.’

إِنَّمَا جَزَٰٓؤُاْ ٱلَّذِينَ يُحَارِبُونَ ٱللَّهَ وَرَسُولَهُۥ وَيَسۡعَوۡنَ فِي ٱلۡأَرۡضِ فَسَادًا أَن يُقَتَّلُوٓاْ أَوۡ يُصَلَّبُوٓاْ أَوۡ تُقَطَّعَ أَيۡدِيهِمۡ وَأَرۡجُلُهُم مِّنۡ خِلَٰفٍ أَوۡ يُنفَوۡاْ مِنَ ٱلۡأَرۡضِۚ ذَٰلِكَ لَهُمۡ خِزۡيࣱ فِي ٱلدُّنۡيَاۖ وَلَهُمۡ فِي ٱلۡأٓخِرَةِ عَذَابٌ عَظِيمٌ

Those who wage war against God and His Messenger and strive to spread corruption in the land should be punished by death, crucifixion, the amputation of an alternate hand and foot, or banishment from the land: a disgrace for them in this world, and then a terrible punishment in the Hereafter

أَمۡ كُنتُمۡ شُهَدَآءَ إِذۡ حَضَرَ يَعۡقُوبَ ٱلۡمَوۡتُ إِذۡ قَالَ لِبَنِيهِ مَا تَعۡبُدُونَ مِنۢ بَعۡدِيۖ قَالُواْ نَعۡبُدُ إِلَٰهَكَ وَإِلَٰهَ ءَابَآئِكَ إِبۡرَٰهِـۧمَ وَإِسۡمَٰعِيلَ وَإِسۡحَٰقَ إِلَٰهࣰ ا وَٰحِدࣰ ا وَنَحۡنُ لَهُۥ مُسۡلِمُونَ

Were you [Jews] there to see when death came upon Jacob? When he said to his sons, ‘What will you worship after I am gone?’ they replied, ‘We shall worship your God and the God of your fathers, Abraham, Ishmael, and Isaac, one single God: we devote ourselves to Him.’

يَٰٓأَيُّهَا ٱلَّذِينَ ءَامَنُواْ كُلُواْ مِن طَيِّبَٰتِ مَا رَزَقۡنَٰكُمۡ وَٱشۡكُرُواْ لِلَّهِ إِن كُنتُمۡ إِيَّاهُ تَعۡبُدُونَ

You who believe, eat the good things We have provided for you and be grateful to God, if it is Him that you worship

وَإِذۡ أَخَذۡنَا مِيثَٰقَ بَنِيٓ إِسۡرَٰٓءِيلَ لَا تَعۡبُدُونَ إِلَّا ٱللَّهَ وَبِٱلۡوَٰلِدَيۡنِ إِحۡسَانࣰ ا وَذِي ٱلۡقُرۡبَىٰ وَٱلۡيَتَٰمَىٰ وَٱلۡمَسَٰكِينِ وَقُولُواْ لِلنَّاسِ حُسۡنࣰ ا وَأَقِيمُواْ ٱلصَّلَوٰةَ وَءَاتُواْ ٱلزَّكَوٰةَ ثُمَّ تَوَلَّيۡتُمۡ إِلَّا قَلِيلࣰ ا مِّنكُمۡ وَأَنتُم مُّعۡرِضُونَ

Remember when We took a pledge from the Children of Israel: ‘Worship none but God; be good to your parents and kinsfolk, to orphans and the poor; speak good words to all people; keep up the prayer and pay the prescribed alms.’ Then all but a few of you turned away and paid no heed

قُلۡ أَتَعۡبُدُونَ مِن دُونِ ٱللَّهِ مَا لَا يَمۡلِكُ لَكُمۡ ضَرࣰّ ا وَلَا نَفۡعࣰ اۚ وَٱللَّهُ هُوَ ٱلسَّمِيعُ ٱلۡعَلِيمُ

Say, ‘How can you worship something other than God, that has no power to do you harm or good? God alone is the All Hearing and All Knowing.’

(The only reward of those who make war upon Allah and His messenger�) [5:33]. Abu Nasr Ahmad ibn �Ubayd Allah al-Makhladi informed us> Abu �Amr ibn Nujayd> Muslim> �Abd al-Rahman ibn Hammad> Sa�id ibn Abi �Arubah> Qatadah> Anas who related that a group of people from �Ukal and �Uraynah went to see the Messenger of Allah, Allah, bless him and give him peace. They said: �O Messenger of Allah, we were never people of agriculture, and before we settled around Medina we used to be people who looked after cattle�. The Messenger of Allah, Allah bless him and give him peace, ordered that they be given a flock of camels, a shepherd and commanded them to set off with them, with a dispensation to drink their milk and urine. When they reached the region of al-Harrah, they killed the shepherd of the Messenger of Allah, Allah bless him and give him peace, and took off with the camels. The Messenger of

(Or were ye present when death came to Jacob�) [2:133]. This was revealed about the Jews when they said: �Do you not know that when Jacob was about to die he advised his sons to follow Judaism?�

One of the two women the one that had been sent by her father either the elder or the younger said ‘O my father hire him employ him in return for a wage that he may tend our flock instead of us. Surely the best man you can hire is the strong the trustworthy man’ in other words hire him on account of his strength and trustworthiness. He Shu‘ayb asked her about him and she told him as mentioned above how he had lifted the rock off the well and that he had said to her ‘Walk behind me’ in addition to his lowering his head when he realised that she was coming towards him refusing to lift it until she left. He Shu‘ayb therefore was keen to have him marry one of his daughters.

The following was revealed when the ‘Arniyyūn came to Medina suffering from some illness and the Prophet s gave them permission to go and drink from the camels’ urine and milk. Once they felt well they slew the Prophet’s shepherd and stole the herd of camels Truly the only requital of those who fight against God and His Messenger by fighting against Muslims and hasten about the earth to do corruption there by waylaying is that they shall be slaughtered or crucified or have their hands and feet cut off on opposite sides that is their right hands and left feet or be banished from the land the aw ‘or’ is used to indicate the separate application of each of the cases listed; thus death is for those that have only killed; crucifixion is for those that have killed and stolen property; the cutting off of limbs on opposite sides is for those that have stolen property but have not killed; while b

Then there came to him one of them, walking shyly. She said: "Verily, my father calls you that he may reward you for having watered (our flocks) for us." So when he came to him and narrated the story, he said: "Fear you not. You have escaped from the people who are wrongdoers. (25)And said one of them (the two women): "O my father! Hire him! Verily, the best of men for you to hire is the strong, the trustworthy. (26)He said: "I intend to wed one of these two daughters of mine to you, on condition that you serve me for eight years; but if you complete ten years, it will be (a favor) from you. But I intend not to place you under a difficulty. If Allah wills, you will find me one of the righteous. (27)He (Musa) said: "That (is settled) between me and you: whichever of the two terms I fulfill, there will be no injustice to me, and Allah is Surety over what we say. (28) Musa, the Father of t

And mention when We made a covenant with the Children of Israel in the Torah where We said ‘You shall not worship a variant reading for lā ta‘budūna has third person plural lā ya‘budūn ‘they shall not worship’ any other than God lā ta‘budūna illā Llāha is a predicate denoting a prohibition; one may also read lā ta‘budū Worship you not; and to be good and righteous to parents and the near of kin here kinship is adjoined to parents; and to orphans and to the needy; and speak well good words to men commanding good and forbidding evil being truthful with regard to the status of Muhammad (s) and being kind to them sc. orphans and the needy a variant reading for hasanan has husnan the verbal noun used as a hyperbolic description; and observe prayer and pay the alms’ which you actually accepted but then you turned away refusing to fulfil these obligations here the second person address is used

حَدَّثَنَا يَحْيَى بْنُ بُكَيْرٍ، حَدَّثَنَا اللَّيْثُ، عَنْ عُقَيْلٍ، قَالَ ابْنُ شِهَابٍ فَأَخْبَرَنِي عُرْوَةُ بْنُ الزُّبَيْرِ، أَنَّ عَائِشَةَ ـ رضى الله عنها ـ زَوْجَ النَّبِيِّ صلى الله عليه وسلم قَالَتْ وَاسْتَأْجَرَ رَسُولُ اللَّهِ صلى الله عليه وسلم وَأَبُو بَكْرٍ رَجُلاً مِنْ بَنِي الدِّيلِ، هَادِيًا خِرِّيتًا وَهْوَ عَلَى دِينِ كُفَّارِ قُرَيْشٍ، فَدَفَعَا إِلَيْهِ رَاحِلَتَيْهِمَا، وَوَاعَدَاهُ غَارَ ثَوْرٍ بَعْدَ ثَلاَثِ لَيَالٍ بِرَاحِلَتَيْهِمَا صُبْحَ ثَلاَثٍ‏.‏

Narrated Aisha:(the wife of the Prophet) Allah's Messenger (ﷺ) and Abu Bakr hired a man from the tribe of Bani-Ad-Dil as an expert guide who was a pagan (follower of the religion of the pagans of Quraish). The Prophet (ﷺ) and Abu Bakr gave him their two riding camels and took a promise from him to bring their riding camels in the morning of the third day to the Cave of Thaur

حَدَّثَنَا يَعْقُوبُ بْنُ إِبْرَاهِيمَ، حَدَّثَنَا إِسْمَاعِيلُ ابْنُ عُلَيَّةَ، أَخْبَرَنَا ابْنُ جُرَيْجٍ، قَالَ أَخْبَرَنِي عَطَاءٌ، عَنْ صَفْوَانَ بْنِ يَعْلَى، عَنْ يَعْلَى بْنِ أُمَيَّةَ ـ رضى الله عنه ـ قَالَ غَزَوْتُ مَعَ النَّبِيِّ صلى الله عليه وسلم جَيْشَ الْعُسْرَةِ فَكَانَ مِنْ أَوْثَقِ أَعْمَالِي فِي نَفْسِي، فَكَانَ لِي أَجِيرٌ، فَقَاتَلَ إِنْسَانًا، فَعَضَّ أَحَدُهُمَا إِصْبَعَ صَاحِبِهِ، فَانْتَزَعَ إِصْبَعَهُ، فَأَنْدَرَ ثَنِيَّتَهُ فَسَقَطَتْ، فَانْطَلَقَ إِلَى النَّبِيِّ صلى الله عليه وسلم فَأَهْدَرَ ثَنِيَّتَهُ وَقَالَ ‏ "‏ أَفَيَدَعُ إِصْبَعَهُ فِي فِيكَ تَقْضَمُهَا ـ قَالَ أَحْسِبُهُ قَالَ ـ كَمَا يَقْضَمُ الْفَحْلُ ‏"‏‏.‏ قَالَ ابْنُ جُرَيْجٍ وَحَدَّثَنِي عَبْدُ اللَّهِ بْنُ أَبِي مُلَيْكَةَ، عَنْ جَدِّهِ، بِمِثْلِ هَذِهِ الصِّفَةِ أَنَّ رَجُلاً، عَضَّ يَدَ رَجُلٍ، فَأَنْدَرَ ثَنِيَّتَهُ، فَأَهْدَرَهَا أَبُو بَكْرٍ رضى الله عنه‏.‏

Narrated Ya`la bin Umaiya:I fought in Jaish-al-Usra (Ghazwa of Tabuk) along with the Prophet (ﷺ) and in my opinion that was the best of my deeds. Then I had an employee, who quarrel led with someone and one of the them bit and cut the other's finger and caused his own tooth to fall out. He then went to the Prophet (with a complaint) but the Prophet (ﷺ) canceled the suit and said to the complainant, "Did you expect him to let his finger in your mouth so that you might snap and cut it (as does a stallion camel)?" Narrated Ibn Juraij from `Abdullah bin Abu Mulaika from his grandfather a similar story: A man bit the hand of another man and caused his own tooth to fall out, but Abu Bakr judged that he had no right for compensation (for the broken tooth)

أَخْبَرَنَا أَحْمَدُ بْنُ سُلَيْمَانَ الرُّهَاوِيُّ، وَمُوسَى بْنُ عَبْدِ الرَّحْمَنِ، قَالاَ حَدَّثَنَا مُحَمَّدُ بْنُ بِشْرٍ، قَالَ حَدَّثَنَا سُفْيَانُ، عَنْ مُوسَى بْنِ عُقْبَةَ، عَنْ سَالِمِ بْنِ عَبْدِ اللَّهِ بْنِ عُمَرَ، عَنِ ابْنِ عُمَرَ، قَالَ كَانَتْ يَمِينٌ يَحْلِفُ عَلَيْهَا رَسُولُ اللَّهِ صلى الله عليه وسلم ‏ "‏ لاَ وَمُقَلِّبِ الْقُلُوبِ ‏"‏ ‏.‏

It was narrated that Ibn 'Umar said:"The oath by which the Messenger of Allah used to swear was: 'No, by the Controller of the hearts

أَخْبَرَنِي مُحَمَّدُ بْنُ يَحْيَى بْنِ عَبْدِ اللَّهِ، قَالَ حَدَّثَنَا مُحَمَّدُ بْنُ الصَّلْتِ أَبُو يَعْلَى، قَالَ حَدَّثَنَا عَبْدُ اللَّهِ بْنُ رَجَاءٍ، عَنْ عَبَّادِ بْنِ إِسْحَاقَ، عَنِ الزُّهْرِيِّ، عَنْ سَالِمٍ، عَنْ أَبِيهِ، قَالَ كَانَتْ يَمِينُ رَسُولِ اللَّهِ صلى الله عليه وسلم الَّتِي يَحْلِفُ بِهَا ‏ "‏ لاَ وَمُصَرِّفِ الْقُلُوبِ ‏"‏ ‏.‏

It was narrated from Salim that his father said:"The oath by which the Messenger of Allah used to swear was: 'No, by the Controller of the hearts

حَدَّثَنَا أَبُو بَكْرِ بْنُ أَبِي شَيْبَةَ، حَدَّثَنَا وَكِيعٌ، وَحُمَيْدُ بْنُ عَبْدِ الرَّحْمَنِ الرُّؤَاسِيُّ، عَنْ مُغِيرَةَ بْنِ زِيَادٍ، عَنْ عُبَادَةَ بْنِ نُسَىٍّ، عَنِ الأَسْوَدِ بْنِ ثَعْلَبَةَ، عَنْ عُبَادَةَ بْنِ الصَّامِتِ، قَالَ عَلَّمْتُ نَاسًا مِنْ أَهْلِ الصُّفَّةِ الْكِتَابَ وَالْقُرْآنَ فَأَهْدَى إِلَىَّ رَجُلٌ مِنْهُمْ قَوْسًا فَقُلْتُ لَيْسَتْ بِمَالٍ وَأَرْمِي عَنْهَا فِي سَبِيلِ اللَّهِ عَزَّ وَجَلَّ لآتِيَنَّ رَسُولَ اللَّهِ صلى الله عليه وسلم فَلأَسْأَلَنَّهُ فَأَتَيْتُهُ فَقُلْتُ يَا رَسُولَ اللَّهِ رَجُلٌ أَهْدَى إِلَىَّ قَوْسًا مِمَّنْ كُنْتُ أُعَلِّمُهُ الْكِتَابَ وَالْقُرْآنَ وَلَيْسَتْ بِمَالٍ وَأَرْمِي عَنْهَا فِي سَبِيلِ اللَّهِ ‏.‏ قَالَ ‏ "‏ إِنْ كُنْتَ تُحِبُّ أَنْ تُطَوَّقَ طَوْقًا مِنْ نَارٍ فَاقْبَلْهَا ‏"‏ ‏.‏

Narrated Ubaydah ibn as-Samit: I taught some persons of the people of Suffah writing and the Qur'an. A man of them presented to me a bow. I said: It cannot be reckoned property; may I shoot with it in Allah's path? I must come to the Apostle of of Allah (ﷺ) and ask him (about it). So I came to him and said : Messenger of Allah (ﷺ), one of those whom I have been teaching writing and the Qur'an has presented me a bow, and as it cannot be reckoned property, may I shoot with it in Allah's path? He said: If you want to have a necklace of fire on you, accept it

حَدَّثَنَا عَمْرُو بْنُ عُثْمَانَ، وَكَثِيرُ بْنُ عُبَيْدٍ، قَالاَ حَدَّثَنَا بَقِيَّةُ، حَدَّثَنِي بِشْرُ بْنُ عَبْدِ اللَّهِ بْنِ يَسَارٍ، قَالَ عَمْرٌو حَدَّثَنِي عُبَادَةُ بْنُ نُسَىٍّ، عَنْ جُنَادَةَ بْنِ أَبِي أُمَيَّةَ، عَنْ عُبَادَةَ بْنِ الصَّامِتِ، نَحْوَ هَذَا الْخَبَرِ - وَالأَوَّلُ أَتَمُّ - فَقُلْتُ مَا تَرَى فِيهَا يَا رَسُولَ اللَّهِ فَقَالَ ‏"‏ جَمْرَةٌ بَيْنَ كَتِفَيْكَ تَقَلَّدْتَهَا ‏"‏ ‏.‏ أَوْ ‏"‏ تَعَلَّقْتَهَا ‏"‏ ‏.‏

A similar tradition has also been transmitted by 'Ubadah b. al-Samit through a different chain of narrators, but the former tradition is more perfect. This version has:I said: What do you think about it, Messenger of Allah? He said: A live coal between your shoulders which you have put around your neck or hanged it

الخامس: المحترف: وهو محتاج إلى الكسب له أو لعياله، فليس له أن يستغرق الزمان في التعبد، بل يجتهد في الكسب مع دوام الذكر، فإذا حصل له ما يكفيه عاود الأوراد.

الثالثة الخوف من كثرة الحرج بسبب كثرة الأولاد والاحتراز من الحاجة إلى التعب في الكسب ودخول مداخل السوء وهذا أيضا غير منهي عنه فإن قلة الحرج معين على الدين نعم الكمال والفضل في التوكل والثقة بضمان الله حيث قال @QB@ وما من دابة في الأرض إلا على الله رزقها @QE@ ولا جرم فيه سقوط عن ذروة الكمال وترك الأفضل ولكن النظر إلى العواقب وحفظ المال وادخاره مع كونه مناقضا للتوكل لا نقول إنه منهي عنه

وخاصية التعبد الحب مع الخضوع والذل للمحبوب فمن أحب شيئا وخضع له فقد تعبد قلبه له بل التعبد آخر مراتب الحب ويقال له التتيم أيضا فان أول مراتبه العلاقة وسميت علاقة لتعلق الحب بالمحبوب قال الشاعر

قالوا لأنه أبعد الأشياء عن هواها وهو حقيقة التعبد

والأفضل في أيام عشر ذي الحجة الإكثار من التعبد لا سيما التكبير والتهليل والتحميد فهو أفضل من الجهاد غير المتعين

فعندهم أن العبادات شرعت أثمانا لما يناله العباد من الثواب والنعيم وأنها بمنزلة استيفاء أجرة الأجير

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Moral distress among acute mental health nurses: A systematic review.: Moral distress has been identified as an occupational hazard for clinicians caring for vulnerable populations. The aim of this systematic review was (i) to summarize the literature reporting on prevalence of, and factors related to, moral distress among nurses within acute mental health settings, and (ii) to examine the efficacy of interventions designed to address moral distress among nurses within this clinical setting. A comprehensive literature search was conducted in October 2022 utilizing

Can Schwartz Center Rounds support healthcare staff with emotional challenges at work, and how do they compare with other interventions aimed at providing similar support? A systematic review and scoping reviews.: Objectives: (i) To synthesise the evidence-base for Schwartz Center Rounds (Rounds) to assess any impact on healthcare staff and identify key features; (ii) to scope evidence for interventions with similar aims, and compare effectiveness and key features to Rounds. Design: Systematic review of Rounds literature; scoping reviews of comparator interventions (action learning sets; after action reviews; Balint groups; caregiver support programme; clinical supervision; critical incident stress debrie

Job satisfaction and burnout syndrome among intensive-care unit nurses: A systematic review and meta-analysis.: Introduction: The severe conditions often experienced in an intensive care unit, combined with poor working conditions, increase stress and therefore decrease job satisfaction. Sustained stress in the workplace leads to the development of burnout, a syndrome characterised by three dimensions: emotional exhaustion, depersonalisation and perceived lack of personal fulfilment. Objective: To analyse the relationship between burnout syndrome and job satisfaction among ICU personnel. Data sources: The

A preliminary comparison of the efficacy of online Acceptance and Commitment Therapy (ACT) and Cognitive Behavioural Therapy (CBT) stress management interventions for social and healthcare workers.

Social and healthcare workers have been shown to experience greater levels of illness, depression and burnout as a result of chronic workplace stress. The purpose of this study was to examine whether brief online ACT and CBT interventions could reduce the experience of stress and burnout in employees, while also improving mental health and psychological flexibility. A total of 42 individuals working within the social and healthcare professions were randomly assigned to either a 2-week online ACT or CBT intervention. Recruitment was undertaken internationally, although the majority of participants were based in Ireland at the time of their participation (79%). Participants' perceived stress, burnout, mental health and work-related psychological flexibility were assessed at baseline and post-treatment. Intent-to-treat analyses were conducted on all data. Outcomes indicated that both interv…

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Prevalence and Nature of Sexist and Racial/Ethnic Microaggressions Against Surgeons and Anesthesiologists.

Importance: Workplace mistreatment can manifest as microaggressions that cause chronic, severe distress. As physician burnout becomes a global crisis, quantitative research to delineate the impact of microaggressions is imperative. Objectives: To examine the prevalence and nature of sexist and racial/ethnic microaggressions against female and racial/ethnic-minority surgeons and anesthesiologists and assess the association with physician burnout. Design, setting, and participants: This cross-sectional survey evaluated microaggressions and physician burnout within a diverse cohort of surgeons and anesthesiologists in a large health maintenance organization. A total of 1643 eligible participants were sent a recruitment email on January 8, 2020, 1609 received the email, and 652 replied, for a response rate of 41%. The study survey remained open until February 20, 2020. A total of 588 individ…

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Mental health among clinicians: what do we know and what can we do?

Mental health and mental health disorders among clinicians remain a taboo, despite increasing evidence showing the direct impact on medical teams and patient care. This editorial is aimed at increasing awareness of mental issues amongst healthcare professionals, identifying perceived barriers to seeking help, and suggesting ways in which to seek help. Mental health disorders, including anxiety and depression, are prevalent from medical school, leading to increased burnout and suicide risks at later stages of a clinician's career. There is often a reluctance to seek help, particularly amongst the surgical specialties, caused by self-criticism, lack of convenient access and the potential negative impact on medical licensure. This editorial has been written in loving memory of our colleague, friend and board member Dr. Nikolaus Veit-Rubin, who sadly passed away at the beginning of the year.…

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COVID-19 and Moral Distress: A Pediatric Critical Care Survey.

Background: Moral distress adversely affects the delivery of high-quality patient care and places health care professionals at risk for burnout, moral injury, and the loss of professional integrity. Objectives: To investigate whether pediatric critical care professionals are experiencing moral distress during the COVID-19 pandemic and, if so, for what reasons. Methods: An exploratory survey of pediatric critical care professionals was conducted via the Pediatric Acute Lung Injury and Sepsis Investigators Network from April to May 2020. The survey was derived from a framework integrating contemporary literature on moral distress, moral resilience, and expert consensus. Integration of descriptive statistics for quantitative data and thematic analysis for qualitative data yielded mixed insights. Results: Overall, 85.8% of survey respondents reported moral distress. Nurses reported higher de…

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Adapting RISE: meeting the needs of healthcare workers during the COVID-19 pandemic.

The COVID-19 pandemic has placed extraordinary stresses on healthcare workers. Combined with disruptions to daily life outside of work, health care professionals experience a high prevalence of anxiety, depression, acute stress reaction, burnout, and PTSD. Top leaders at Johns Hopkins Medicine appreciated the mission-critical importance of maintaining the well-being and resilience of its essential workers. In March 2020 they asked the Johns Hopkins RISE (Resilience in Stressful Events) peer support program to help organize support for all staff. RISE made several adjustments, including adding virtual encounters to the usual in-person support, training additional peer responders, and rounding proactively on active units. Communication was broadened to reach less visible and lower wage workers. RISE collaborated actively with hospital epidemiology and infection control and began reporting …

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Moral Distress Among Interdisciplinary Critical Care Team Members at a Comprehensive Cancer Center.

Background: Moral distress (MD) has been linked to health care professional burnout, intent to leave, and decreased quality of care. Objectives: The aim of this study was to describe the perceptions of MD among critical care interdisciplinary team members and assess the association of MD with team member characteristics. Methods: A descriptive cross-sectional design was used with interdisciplinary team members in an intensive care unit setting at an NCI-designated Comprehensive Cancer Center in the southeastern United States. The Measure of Moral Distress for Healthcare Professionals was provided to registered nurses, oncology technicians, providers, respiratory therapists, and ancillary team members (social workers, pharmacists, dietitians). Results: A total of 67 team members completed the survey. Mean responses for 3 items were higher than 8 (halfway point of scale): "Follow family's …

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Predictors of caring ability and its dimensions among nurses in China: A cross-sectional study.

Background: Caring is an essential component of professional nursing practice, which directly affects the quality of patient care. Nurses' caring ability may not meet patients' demands for high-quality care. There are challenges in designing and implementing interventions to improve nurses' caring ability, especially in China. Understanding Chinese nurses' caring ability and related influential factors serves as the basis for effective interventions to improve their ability to care for patients. Aim: To describe the caring ability of nurses and its potential predictors in China. Methods: From January to February 2018, a cross-sectional survey was conducted among 2304 Registered Nurses working at different levels of hospitals across 29 provinces in China. The structured online survey included socio-demographic information, Caring Ability Inventory, Caring Efficacy Scale and Professional Q…

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Burnout and psychological distress amongst Australian healthcare workers during the COVID-19 pandemic.

Objective: To examine psychological distress in healthcare workers (HCWs) during the COVID-19 pandemic in April-May 2020. Methods: A cross-sectional survey examining demographic, employment and mental health characteristics of HCWs in a large metropolitan hospital in Australia. Results: HCWs showed significant symptoms of moderate-severe level depression (21%), anxiety (20%) and posttraumatic stress disorder (PTSD; 29%), associated with burnout, prior psychiatric history, profession and resilience. Conclusion: Despite low levels of COVID contact, moderate to high levels of psychological distress were reported. Continued monitoring and support for HCWs' mental well-being is warranted as the COVID-19 pandemic develops.

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Medical errors during training: how do residents cope?: a descriptive study.

Background: Physicians' self-perceived medical errors lead to substantial emotional distress, which has been termed the "second victim phenomenon." Medical errors during residency are associated with increased burnout and depression. It is important to know how residents cope with self-perceived medical errors and how they gain personal and emotional support in order to develop effective interventions. Objective: To assess the impact of self-perceived medical errors on residents' well-being, the range of coping strategies during training, and the extent of personal and institutional support. Methods: An online cross-sectional survey was administered via email in October 2018 to 286 residents across all specialties in a 548-bed single urban academic medical center. The survey covered three domains focusing on residents' most serious self-perceived medical error: (1) emotional response, (2…

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Moral distress in frontline healthcare workers in the initial epicenter of the COVID-19 pandemic in the United States: Relationship to PTSD symptoms, burnout, and psychosocial functioning.

Introduction: Little is known about the relationship between moral distress and mental health problems. We examined moral distress in 2579 frontline healthcare workers (FHCWs) caring for coronavirus disease 2019 (COVID-19) patients during the height of the spring 2020 pandemic surge in New York City. The goals of the study were to identify common dimensions of COVID-19 moral distress; and to examine the relationship between moral distress, and positive screen for COVID-19-related posttraumatic stress disorder (PTSD) symptoms, burnout, and work and interpersonal functional difficulties. Method: Data were collected in spring 2020, through an anonymous survey delivered to a purposively-selected sample of 6026 FHCWs at Mount Sinai Hospital; 2579 endorsed treating COVID-19 patients and provided complete survey responses. Physicians, house staff, nurses, physician assistants, social workers, c…

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Prevalence and Predictors of Moral Injury Symptoms in Health Care Professionals.

This study examined the prevalence and predictors of moral injury (MI) symptoms in 181 health care professionals (HPs; 71% physicians) recruited from Duke University Health Systems in Durham, NC. Participants completed an online questionnaire between November 13, 2019, and March 12, 2020. Sociodemographic, clinical, religious, depression/anxiety, and clinician burnout were examined as predictors of MI symptoms, assessed by the Moral Injury Symptoms Scale-Health Professional, in bivariate and stepwise multivariate analyses. The prevalence of MI symptoms causing at least moderate functional impairment was 23.9%. Younger age, shorter time in practice, committing medical errors, greater depressive or anxiety symptoms, greater clinician burnout, no religious affiliation, and lower religiosity correlated with MI symptoms in bivariate analyses. Independent predictors in multivariate analyses we…

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Grit in Surgeons.

Background: Women in surgery are often told that they are not "tough enough" to be surgeons. A Grit Score provides a validated measure of passion and perseverance, which are aspects of "toughness." Methods: Survey data were collected from residents and attendings in all surgical fields through multiple surgical societies. Grit and burnout were measured using validated measures. Results: Among surgeons, gender did not have an impact on Grit Score. Burnout had a statistically significant inverse relationship with Grit Score, and women were more likely to report burnout compared to men surgeons. Conclusions: Women in surgery have just as much grit as their male counterparts. Grit should not be a factor in women pursuing a career in surgery.

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Burnout and Depression in Portuguese Healthcare Workers during the COVID-19 Pandemic-The Mediating Role of Psychological Resilience.

During the COVID-19 pandemic, healthcare workers (HCW) have been exposed to multiple psychosocial stressors. Resilience might protect employees from the negative consequences of chronic stress. The aim of this study was to explore the mediating role of resilience in the relationship between depression and burnout (personal, work-related, and client-related). A cross-sectional study was performed using an online questionnaire distributed via social networks. A survey was conducted comprising standardized measures of resilience (Resilience Scale-25 items), depression (subscale of Depression Anxiety Stress Scales-21 items), and burnout (Copenhagen Burnout Inventory Scale-19 items). A total of 2008 subjects completed the survey, and a hierarchical regression model was estimated for each burnout dimension. The results revealed that depression had not only a directed effect on personal, work- …

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Morally Distressing Experiences, Moral Injury, and Burnout in Florida Healthcare Providers during the COVID-19 Pandemic.

Because healthcare providers may be experiencing moral injury (MI), we inquired about their healthcare morally distressing experiences (HMDEs), MI perpetrated by self (Self MI) or others (Others MI), and burnout during the COVID-19 pandemic. Participants were 265 healthcare providers in North Central Florida (81.9% female, Mage = 37.62) recruited via flyers and emailed brochures that completed online surveys monthly for four months. Logistic regression analyses investigated whether MI was associated with specific HMDEs, risk factors (demographic characteristics, prior mental/medical health adversity, COVID-19 protection concern, health worry, and work impact), protective factors (personal resilience and leadership support), and psychiatric symptomatology (depression, anxiety, and PTSD). Linear regression analyses explored how Self/Others MI, psychiatric symptomatology, and the risk/prote…

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Professional Stigma of Mental Health Issues: Physicians Are Both the Cause and Solution.

After a medical student prompted medical faculty to tell their stories of depression and related mental health issues, the author wrote this article with the aim of decreasing the stigma of mental illness and encouraging treatment, as needed, in the medical profession. The professional culture of the house of medicine not only mimics society in attributing stigma to people with mental health issues but may also contribute to high rates of suicide in the ranks of health care professionals by leading to a delay in seeking treatment. Acculturation accelerates in the first year of medical school such that medical students experience an increase in burnout and depressive symptoms from prematriculation levels. It follows that faculty have a responsibility to improve the learning environment. Survey data from medical faculty at the author's institution showed that depression decreased responden…

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Burnout and somatic symptoms among frontline healthcare professionals at the peak of the Italian COVID-19 pandemic.

Italy is among the most severely hit nations in terms of hospital patients' overload, and its healthcare workforce is struggling to cope with challenges that could threaten their own wellbeing. In this scenario, understanding the health-related consequences of COVID-19 outbreak on Italian frontline healthcare professionals is urgent. Our study provides a first account of the huge psycho-physical impact of COVID-19 outbreak for healthcare workers in Italy. Italian healthcare professionals reported relevant work-related psychological pressure, emotional burnout and somatic symptoms. This result requires attention as previous studies showed that emotional distress is associated with long-lasting effect on professionals' health, including risk of post-traumatic stress disorder.

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Walking Together in Exile: Medical Moral Injury and the Clinical Chaplain.

This article examines various sides of the recent discussion about establishing a medical category within the "moral injury" discourse. Essential differences between the nature and development of moral injury among physicians and combat veterans are acknowledged. Essential similarities are also explored. Case notes from a 3-year encounter between a clinical chaplain and a disoriented physician are offered as an illustration of how moral injury interventions with veteran populations can inform care for physicians experiencing burnout.

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Burnout in Pediatric Residents: Three Years of National Survey Data.

Background: We aimed to describe the national epidemiology of burnout in pediatric residents. Methods: We conducted surveys of residents at 34 programs in 2016, 43 programs in 2017, and 49 programs in 2018. Survey items included the Maslach Burnout Inventory, demographics, program characteristics, personal qualities, experiences, and satisfaction with support, work-life balance, and learning environment. Analyses included cross-sectional comparisons and cross-sectional and longitudinal regression. Results: More than 60% of eligible residents participated; burnout rates were >50% in all years and not consistently associated with any demographic or residency characteristics. Cross-sectional associations were significant between burnout and stress, sleepiness, quality of life, mindfulness, self-compassion, empathy, confidence in providing compassionate care (CCC), being on a high-acuity rot…

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Burnout Among United States Orthopaedic Surgery Residents.

Objective: There is growing interest in the problem of burnout among physicians. Here, we examine the factors associated with burnout in orthopedic surgical training. Design: An Internet-based anonymous survey assessing workload, work-life balance, education, and resident-specific factors such as marital status and postgraduate year was developed. The survey was distributed to United States orthopedic surgery residency directors in September 2018, and program directors were asked to forward the survey to their trainees. Multivariable analysis assessed correlations with burnout. Setting: All 161 Accreditation Council for Graduate Medical Education (ACGME)-accredited United States orthopedic surgery residency programs. Participants: Two hundred and three United States orthopedic surgery residents. Results: Thirty-eight percent of respondents reported symptoms of burnout. Even so, the vast …

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Mitigating the Psychological Impact of COVID-19 on Healthcare Workers: A Digital Learning Package.

The coronavirus pandemic (COVID-19) will undoubtedly have psychological impacts for healthcare workers, which could be sustained; frontline workers will be particularly at risk. Actions are needed to mitigate the impacts of COVID-19 on mental health by protecting and promoting the psychological wellbeing of healthcare workers during and after the outbreak. We developed and evaluated a digital learning package using Agile methodology within the first three weeks of UK outbreak. This e-package includes evidence-based guidance, support and signposting relating to psychological wellbeing for all UK healthcare employees. A three-step rapid development process included public involvement activities (PPIs) (STEP 1), content and technical development with iterative peer review (STEP 2), and delivery and evaluation (STEP 3). The package outlines the actions that team leaders can take to provide p…

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Mental and Physical Factors Influencing Wellbeing among South Korean Emergency Workers.

Emergency workers are frequently exposed to hazardous situations and such life patterns can influence their wellbeing. This study examined the relationships among South Korean emergency workers' precedents and consequences of positive emotion, engagement, relationship, meaning, and achievement (PERMA), a wellbeing concept, and offered solutions. A total of 597 emergency workers in Daegu, South Korea, participated in a survey. This study measured post-traumatic stress disorder syndrome, burnout, depression, PERMA, quality of life, life satisfaction, and sleep quality to test the relationships. Results demonstrated that post-traumatic stress disorder syndrome and burnout predicted distracting sleep behavior and sleep health. Depression was significantly related to PERMA. The better the emergency workers' PERMA was, the better their quality of life and life satisfaction were. PERMA signific…

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Academic Emergency Medicine Physicians' Anxiety Levels, Stressors, and Potential Stress Mitigation Measures During the Acceleration Phase of the COVID-19 Pandemic.

Objective: The objective was to assess anxiety and burnout levels, home life changes, and measures to relieve stress of U.S. academic emergency medicine (EM) physicians during the COVID-19 pandemic acceleration phase. Methods: We sent a cross-sectional e-mail survey to all EM physicians at seven academic emergency departments. The survey incorporated items from validated stress scales and assessed perceptions and key elements in the following domains: numbers of suspected COVID-19 patients, availability of diagnostic testing, levels of home and workplace anxiety, severity of work burnout, identification of stressors, changes in home behaviors, and measures to decrease provider anxiety. Results: A total of 426 (56.7%) EM physicians responded. On a scale of 1 to 7 (1 = not at all, 4 = somewhat, and 7 = extremely), the median (interquartile range) reported effect of the pandemic on both wor…

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Burnout and Posttraumatic Stress Disorder in the Coronavirus Disease 2019 (COVID-19) Pandemic: Intersection, Impact, and Interventions.

The coronavirus disease 2019 (COVID 2019) pandemic has presented myriad challenges to an underprepared health care system. Health care providers are facing unprecedented acute workplace stress compounded by a high baseline rate of physician burnout. This article discusses the relationship between acute stress disorder, posttraumatic stress disorder, and burnout through a literature review focusing on the mental health impact on health care providers after prior epidemics and natural disasters. We offer both a framework for understanding the mental health impact of the COVID-19 epidemic on physicians while proposing a systems based model to respond to these challenges.

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Problematic internet use and its correlates among resident doctors of a tertiary care hospital of North India: A cross-sectional study.

Background: Problematic Internet use/ Internet addiction (IA) has gained the attention of mental health professionals recently and studies have found that medical professionals are not immune to IA with prevalence rate ranging from 2.8 to 8%. Few studies from India have also reported high rates of IA among medical students. The term 'Problematic internet use' is being increasing used nowadays in place of IA as it signifies a better terminology than the word 'addiction' per se. However, there is lack of information among resident doctors. Aim: To evaluate the prevalence of problematic Internet use and its association with depressive symptoms, perceived stress, and health care outcomes among resident doctors working in a government funded tertiary care Institute. Materials & methods: An online e-mail survey was carried out among medical professionals (a total of 1721 doctors) in a tertiary…

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Sources of work stress in veterinary practice in the UK.

The veterinary profession recognises the importance of addressing work-related stress for veterinary surgeons' wellbeing. Identifying aspects of veterinarians' work that are sources of stress is a key step in implementing appropriate stress management interventions for the profession. However, little systematic research on the causes of stress in veterinary work has been carried out. A qualitative interview study was conducted with 18 veterinarians practising in the UK to explore aspects of their work that are stressful. Thematic analysis revealed principal stressors to be poor work-life balance, interaction with animal owners, specific aspects of euthanasia, dealing with poor animal welfare and staff management responsibilities. Injury risk, supervision arrangements for newly qualified veterinarians and lack of control over work were stressors for some. The practical implications of the…

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