Differences in Crowding and Stress Experienced by Emergency Medicine Physicians Prior to and During the COVID-19 Pandemic

Burnout in Emergency Medicine physicians has become an increasingly apparent problem in the United States. This psychological syndrome is a result of emotional exhaustion, detachment, and an overwhelming sense of ineffectiveness (Maslach & Leiter, 2016). Work demands within the emergency department are likely to produce chronic exposure to stressors. However, the onset of the COVID-19 pandemic likely contributed to amplifying workplace stressors, suggesting that the rate at which burnout developed was elevated. In the present study, data were collected from Emergency Medicine physicians at Greenville Memorial Hospital in Greenville, South Carolina prior to the start of and during the COVID-19 pandemic. Physicians provided saliva samplesfor salivary cortisol analysis and completed a short assessment of fatigue and shift demands. These data were collected at the beginning and end of each shift, for a total of 116 shifts. Analyses will be done to test whether the average number of stressors reported by physicians, National Emergency Department Overcrowding Scores (NEDOC) scores, and salivary cortisol levels increased in data collected after the start of the pandemic, in comparison to before, for the end-of-shift measures. In order to provide support for these claims, this thesis will begin with an overview of research that has previously been examined on the topic. Firstly, the significance of burnout in healthcare professionals will be described and discussed. The focus will then shift to emergency medicine, highlighting the primary stressors that are faced by healthcare personnel within the emergency department. The consequences of stressors, such as well-being or burnout, on emergency medicine physicians, including the use of salivary cortisol as an objective measure of stress, will be examined. Next, how the COVID-19 pandemic has exacerbated burnout within these settings will be discussed. The introduction will conclude with a presentation of the overview of the study and reveal the hypotheses that are intended to test