More than a third of nurses have PTSD symptoms; a third of doctors are burned out. What are we doing about it?

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  • Peter G M Cox says:

    It is, of course, commendable that the problem of excessive levels of “burn out”, depression, mental health and suicide among front-line healthcare workers are being addressed by (some, I suspect rather limited) initiatives to help those affected – and that “recent international evidence indicates (the very obvious, common-sense conclusion) “that … (this) … affects the quality of care”.
    However, the initiatives outlined suggest that they are aimed at “alleviating the symptoms” rather than addressing the “disease” (and are diverting resources that might – in the absence of such “symptoms” – be used to improve patient care and safety): as Christine Devine’s quote in the article highlights – “if you don’t address operational and environmental factors … – nothing is going to change”; this is the “disease” – and it stems from a shortage of sufficient numbers of doctors, nurses and hospital beds (relative to the number of patients).
    In Canada it is not that there are insufficient funds spent on healthcare. It is that the system is dysfunctional: according to international studies, it has resulted in Canada employing fewer doctors, nurses, hospital beds and diagnostic machines (per capita) than most comparable economies – while we also have among the highest (if not the highest) ratios of administrators to healthcare professionals and hospital beds in the World and are among the very highest spenders (per capita) on pharmaceuticals.
    And, of course, this does have an effect on patient and caregiver well-being: extended wait times for a multitude of medical services often causes unnecessary stress and must, in some circumstances, have a deleterious effect on their condition (not to mention their satisfaction with the “service” they receive).
    Well-run businesses know that their success depends on satisfied customers and (to make this possible) engaged staff – particularly those on “the front-line”.
    Until those responsible for the direction and management of healthcare understand this need to address the “disease”, rather than treat the “symptoms” of it, the issues discussed in this article will continue to be perennial.
    (I have a sense of futility about submitting this comment. The observations are so obvious and have been made countless times in innumerable ways but still fall on deaf ears – among those in a position to act upon them!)

  • William Pryor says:

    Healthcare has many challenges for it’s workers and I don’t see a light at the end of this tunnel in the near future.
    This may become more challenging as the baby boomers ( a large portion of the workforce) start leaving the work sectors because there will be even more patients to care for.

  • Barry Rubin says:

    This was an outstanding summary of the impact of burnout on the health care system.

  • Emanuela Nardella says:

    As a Psychotherapist I made the decision to be in private practice a long time ago. After 30 years and at age 65, I continue to work learn and play in my job. I experience support, challenge and joy and bcontinue to provide others with the same.

    My heart goes out to our healers in the medical professions. The most useful tool I use is the model of the Victim Triangle. As healers and teachers we need to dig deep and broad into our role as Rescuers. We need to heal our own Victimized and wounded selves before embarking on the road to a helping profession.
    Yes indeed the medical system is broken. The larger societal field is broken. We need to acknowledge this and find our own pockets of support within the challenge.

    • Harry J Zeit MD says:

      Hi Emanuela Nardella –
      Thank you for sharing, from your wisdom and from your heart
      It will always be a challenge to work through the (Karpman) Triangle (I like to add the fourth position of negligent bystander to go with perpetrator, victim, and rescuer).
      As the situation in the workplace becomes more taxing, and “victimized and wounded selves” or rescuing parts become more triggered, there will naturally be more perpetrator activity as well. And I think that this is the unspoken part that the article is missing. It’s very easy – in some ways – to say that the system is breaking us and burning us out. But it’s difficult to discuss the natural consequence that the same forces that drive breakdown also drive perpetration, which is what we’re seeing markedly in the breakdown of the larger societal field.
      And the perpetration and negligent bystander stances lead to more animosity between patients and caregivers, and more toxic regulation, which just drives more extreme behavior within the Triangle. And when the organizations meant to protect and regulate are now traumatized and traumatizing, and locked into survival mode, where do we look for help?
      You are right, I think, that we deal with our own trauma first alongside finding pockets of support … and perhaps the best hope is that those pockets become the source of vision and activism that can exist outside the “doer-and-done-to-world” where more and more organizations, caregivers and patients live.

      • Emanuela Nardella says:

        Thank you Harry for expanding upon my comment. Absolutely the larger field with a macro lens defines us. How we relate, advocate, educate …within the larger field is part and parcel to our micro intra selves. Our intimacy blocks as the interpersonal angle is another impactful piece. Successful emotional/societal work is dependent upon raising awareness within all avenues.
        Using the Co-Empowerment/Challenger/Supporter dynamic as a structure to ease movement away from the Victim/Persecuter/Rescuer Mentality by deconstructing our blocked fixed neurotic gestalts. We observe where in our experience the blocks are and use the empowerment model to create awareness, mobilization, action and assimilation of the new learnings.This is called the gestalt cycle of experience. It lights up the road to healing for us all.

  • Julia Hanigsberg says:

    Holland Bloorview Kids Rehabilitation Hospital was the first Canadian hospital to adopt Schwartz Rounds for compassionate care. Sunnybrook HSC followed about a year later. While not a cure for the systemic/organizational issues that give rise to provider burnout, Schwartz Rounds do address cultural tendencies to stoicism or not wanting to admit the emotional toll of the work of care and draws a direct line from compassion for self to compassionate caregiving.

  • Chris Hayes says:

    We have two sessions on Joy in Work at the upcoming Quality Improvement and Patient Safety Forum and Health Quality Transformation held October 16-17 hosted by Health Quality Ontario

  • Chris F says:

    I appreciate the authors providing this piece that addresses the important issue of physician and nurse wellbeing but I have serious concerns about the claim in the title that, “More than a third of nurses have PTSD.”

    When this is reiterated in the piece, this claim changed to say more specifically that, “up to 40 percent of nurses suffering symptoms of post-traumatic stress disorder (PTSD).” There is a significant difference between having a PTSD and having symptoms of PTSD as the physician authors of this piece can surely appreciate. This distinction should have been made so as to not have the inaccurate title that is currently in place.

    This leads to the question of whether the claim is even accurate. When we look at the referencing of this claim, it is a link to a document from the Canadian Federation of Nursing Unions. In the document that is linked to, the claim is further referenced back to a document from the Manitoba Nurses Union (MNU).

    Though the link to this MNU publication is dead, this document can be located through an internet search. In this document, it is stated that, “The exposure to mentally exhausting and challenging work is not openly discussed or recognized publicly even though research claims now identify that 30 to 40% of nurses are suffering from PTSD.”

    At the end of this sentence they reference, “Laposa, J., and Alden, L. (2003). Posttraumatic stress disorder in the emergency room: exploration of a cognitive model. Behaviour Research and Therapy 41, 49-65.” The abstract for this study was located on PubMed ( It is notable that it is a small survey of 51 emergency room personnel. In the abstract they state that, “Twelve percent of participants met formal diagnostic criteria for PTSD, and 20% met PTSD symptom criteria.” I do not have the access to the full text to see whether anything closer to the 40% number is mentioned in some other context.

    While we certainly need to be concerned about physician and nurse wellbeing, I am disappointed to see a clickbait-style headline on a piece on this site that then goes on to make a claim from a labour union that does not seem to be backed up with research. I would respectfully suggest that the title be modified for accuracy and that the reference to the PTSD symptom claim be made to an appropriate source or that the claim be appropriately modified.

  • L says:

    Primarily it is doctors and nurses who suffer burnout but some hospitals are so understaffed it’s also unit/ward clerks who suffer burnout.

    • Nancy meens says:

      I too have been there. Now at this point in my career have taken a position teaching psws. What a wonderful way to exit my career in a couple of years. For those of you, with burn out, please take time off for yourselves. Because nobody in this industry really cares how tired and worn out we are.


Vlad Dragan


Christine Miskonoodinkwe Smith is a Saulteaux woman from Peguis First Nation. She is an emerging writer, graduated from the University of Toronto with a specialization in Aboriginal Studies in June 2011, and graduated with a Master in Education in Social Justice in June 2017. She has written for the Native Canadian, Anishinabek News, Windspeaker, FNH Magazine, New Tribe Magazine and the Piker Press.

Joshua Tepper


Joshua Tepper is a family physician and the President and Chief Executive Officer of North York General Hospital. He is also a member of the Healthy Debate editorial board.

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