Can Empathy protect Against Burnout? Accounts of Work-Related Distress during Compound Disasters in Puerto Rico

Abstract

Objective: To identify how healthcare workers experienced work related distress during compound disasters in Puerto Rico. Methods: Over three weeks, a research team composed of ten undergraduate students and three faculty visited eight healthcare sites in Puerto Rico. The team utilized rapid qualitative methods by conducting observations, informal interviews, and two focus groups. Data were documented in notes and analyzed via a shared RREAL table, where the team collaboratively organized, recategorized, and reviewed the findings. Results: Participants reported symptoms such as physical tiredness, emotional exhaustion and frustration. High levels of compassion were also present. Researchers apply the concepts of burnout and moral injury to understand how eroding conditions and prolonged disasters produce these emotional conflicts. Moral distress arose when professionals could not meet patients’ needs due to a lack of providers, limited resources, and a fragmented healthcare system. Additionally, health care workers experienced conflicts between their work and family roles. We argue that strong connections to their communities and patients foster resilience in healthcare workers and protect against the full range of burnout symptoms. However, these strong community connections can also give rise to moral injury. Conclusions: Burnout and moral injury coexist in healthcare professionals when they cannot provide the best patient care due to obstacles created by prolonged compound disasters and a broken healthcare system.