A Conversation with Dr. Aditi Nerurkar, Leading Stress and Resilience Expert

Dr. Aditi Nerurkar, MD, MPH

Dr. Aditi Nerurkar is a Harvard physician, Forbes contributor, and an NBC News medical commentator. Her expertise is in the science of stress, resilience, and burnout. She offers insights in optimizing mental health, wellbeing, and productivity during the Covid-19 pandemic and beyond.

Dr. Nerurkar is on faculty at Harvard Medical School in the Division of Global Health & Social Medicine and serves as the Co-Director of the Harvard Clinical Clerkship in Community Engagement. Prior, she worked in global public health in Geneva, Switzerland with a World Health Organization collaborating center.

NHPCO had the opportunity to sit down with Dr. Nerurkar and ask her a few questions about leading high-quality programs in the healthcare sector, and her lessons learned over the years. NHPCO questions are italicized for clarity.

How will we know when the pandemic is over? Will we know when we have reached the “new normal?”

We are officially in the post-pandemic era from the policy perspective. On May 5, the World Health Organization (WHO) declared the end of the global health emergency but still said that COVID continues to be a global health threat. We are at present entering the new normal. That doesn’t mean that people won’t continue to get COVID or to be hospitalized and potentially die from the infection, it simply means we don’t have the policy guardrails, funding, and coordination we once did when it was considered a global health emergency. There are many downstream implications of this, many of which we cannot understand or begin to perceive now.

Why should hospice and palliative care teams enhance their focus on burnout and mental health? Where should they begin?

Every industry should be focused on mental health at this time because we are seeing unprecedented levels of mental health issues among employees across sectors. We’ve endured a major global event with broad ramifications on mental health, stress, and burnout. Particularly for those in the healthcare sector, this is especially marked. Prior to the pandemic, we were already noticing a rise in burnout among healthcare staff.

However, the pandemic exponentially accelerated this rise. We now have an epidemic of burnout among healthcare workers. We need to heal the healers

There are so many ways to begin to focus on protecting healthcare workers mental health and burnout. The first is to remove the burden of responsibility off the individual healthcare workers. This is a system-wide issue that needs systemic solutions. Broader institutional approaches to protect burnout must be instated. The American Medical Association has a wide array of resources and data on how to do this within an institution.

At the same time, we can support our healthcare workers by normalizing and validating this experience for them. Data shows that 60-72% of healthcare workers have at least one feature of burnout. We must do more to aid in burnout recovery for these individuals, who are now the majority.

You note that the pandemic has created an “occupational health crisis.” What does that mean?

We refer to the pandemic as a public health crisis, which it has been. But it’s also been an occupational health crisis and a mental health crisis. Mental health has been the shadow pandemic. We’ve seen an unprecedented rise in stress and burnout during the pandemic as well as a rise in stress-related conditions like anxiety, depression, and insomnia. The focus on recovery should include both individual and institutional factors. We must help individual healthcare workers recover from their burnout, but we also must focus on systemic solutions to help create more sustainable working conditions and an environment that supports the mental health needs of the individual workers. When an organization’s culture and an employee’s experience can align, that’s when mental health is optimized.

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If you’re interested in learning more from Dr. Nerurkar, she was a keynote speaker at the NHPCO 2023 Virtual Interdisciplinary Conference. Her session recording, The Reentry Phenomenon: A Blueprint to Navigate the New Normal, is now available in the conference portal for attendees. If you are not yet registered for the conference, register now and access the recording along with an extensive on-demand content library offering 22+ hours of CE/CME-eligible education.

NHPCO members can also find more resources on the end of the PHE through the NHPCO Regulatory and Policy Alerts webpage, under Updates and Alerts and titled “Final CMS Guidance for the Expiration of the COVID-19 Public Health Emergency (5/2/23).”