Healthcare's first responders are often hailed as "heroes." This classification could be contributing to higher burnout rates, according to a recent study.
The research, published in the Journal of Employment Counseling on Aug. 10, examined the impact of "meta-dehumanization" on 211 first responders: those working in fire service, emergency medical services, law enforcement, emergency departments (nurses, physicians), 911/dispatch and the National Guard. Nearly half of the participants identified as EMS workers.
Meta-dehumanization occurs when someone is aware of their own dehumanization by others, inside and/or outside of their circles. The symptoms present similarly to self-dehumanization, the study's authors note: emotional distress, negative self-perception, depression and anxiety.
First responders are continuously exposed to trauma, increasing their susceptibility to burnout, according to the study's authors. The situation was made worse by the pandemic, political and civil unrest, economic uncertainty and a thinning workforce. Despite their challenging work environments, first responders are trained to appear in control, knowledgeable and unafraid. Their stoicism can make them appear subhuman in the public eye, and they tend to be classified in extremes: for example, police officers are more likely to be viewed as villains, while emergency department clinicians are seen as heroes.
First responders also can experience this dehumanization from their own organizations, something Michael Ivy, MD, deputy chief medical officer of Yale New Haven (Conn.) Health, explained in a June interview with Becker's.
"Nobody becomes a physician because they hope to feel like a cog in a factory," Dr. Ivy said. "However, between meeting the demands of payers for referrals, denials of payment and increased documentation requirements in order to assure proper reimbursement and risk adjustment, as well as an increasing number of production metrics, it can be difficult not to feel like a cog."
Participants in the study were asked to rate their levels of agreement with statements indicating levels of meta-dehumanization and organizational meta-dehumanization; for example, "I feel that others see me as responsive and warm, as capable of emotion," or "My organization treats me as if I am a robot." They also gauged burnout levels with questions like, "I feel trapped in my job as a helper," and, "I have beliefs that sustain me."
They found that first responders do experience meta-dehumanization, and the extent significantly predicts burnout. Emergency department workers reported the highest levels of organizational meta-dehumanization, and the second-highest burnout levels behind law enforcement.
The study's authors suggest that — in addition to promoting respectful and supportive leadership and improving workforce retention — "fostering a cultural shift that encourages de-emphasizing superhero or robot stereotypes, destigmatizing mental health concerns and mental health help-seeking, developing more robust Employee Assistance Program services, and/or providing financial assistance to first responders who wish to seek mental healthcare could contribute to workforce wellness."