Working in Emergency Conditions and COVID-19 Pandemic in Hospitals and Health Workforce Retentions

Dear Editor,

Human resources are one of the most critical determinants of a system’s efficiency and have a crucial role in healthcare systems relative to other factors. That is why it is unquestionably valuable among all hospital and service-provider resources. Without qualified and trained personnel, healthcare functions will be hindered (1).

Inadequacies and a decrease in the effectiveness and motivation of human resources will deteriorate the quality of patient care services. Identifying healthcare personnel’s needs is one of the most frequent challenges hospitals encounter. Therefore, human resource management should be an integral part of the planning for healthcare systems (2).

The COVID-19 epidemic has put a tremendous amount of strain on healthcare systems, resulting in a shortage of workers as well as an increase in exhaustion, fatigue, and trauma among healthcare professionals. These pandemic-related hardships have occurred in a setting of significant predetermined workforce shortages and an unequal distribution of skilled health workers. In addition, exhaustion, stress, and mental health issues (including a persistent risk of post-traumatic stress disorder) have always been a great concern for health managers and policymakers (3).

The administrative, clinical, and instructional duties expected from health professionals must be balanced with other responsibilities. The lack of an effective vaccine against this new virus, insufficient experience, and shortage of evidence-based information may have also fueled the panic (4).

In an emergency, healthcare facilities and hospitals must provide service to a large number of patients, and healthcare administrators and national legislators need to meticulously design and implement effective strategies accordingly. During emergencies and disasters like pandemics, the most critical aspect of planning is increasing the personnel’s motivation to attend to their jobs and deliver effective services.

These precautions can prevent issues such as increased working hours and workload of health staff. In addition, personnel is obliged to carry out their responsibilities effectively and precisely. Healthcare professionals are also exposed to the risk of infection, exhaustion, separation from family, and emotional stress and grief caused by the loss of patients and colleagues (5-7).

A systematic review conducted by Nafar et al. examined 26 studies from nine countries with different incomes (8). Twenty-four specific challenges faced by health professionals were identified, and the research team reviewed 27 major strategies and interventions utilized by policymakers to support and empower health workers (8).

The most common causes of the workforce abandoning their positions in critical situations are mental and psychological issues, health concerns, and the quality of relationships between the management and healthcare employees. However, the majority of actions for the sustainability of forces have focused on the managerial and financial sectors. Therefore, this imbalance can undermine policies implemented for retaining healthcare personnel.

The results of the mentioned study demonstrated that one of the most critical challenges of maintaining healthcare personnel is the inability of the managers to meet the emotional needs of personnel. Issues such as being away from the family, which leads to mental and emotional exhaustion, can put the personnel in moral dilemmas and can lead to absenteeism. Employment of sufficient health professionals, particularly volunteers, and planning flexible schedules for healthcare employees in crisis can effectively minimize this exhaustion and fatigue (8).

Maintaining the healthcare workforce throughout times of hardship is not a one-dimensional issue. Policymakers must recognize its complexity and make decisions accordingly. Officials and health policymakers should prioritize the implementation of measures based on evidence-based strategies, including a root-cause analysis of challenges and identification of solutions tailored to the requirements of countries, including the local culture, to have a better understanding of the issue.

It is recommended that a specialized operational and research working group should assist leading health system managers in facilitating the process of addressing these obstacles through field surveys and data extraction and analysis. If there is a balance between the difficulties and the solutions, it can be anticipated that the challenges of retaining the workforce during crises and natural catastrophes will be mitigated, and systems will be more resilient. In addition, the country’s disaster management can confront natural or man-made disasters by identifying the crisis-prone areas of the country and training the health personnel accordingly, conducting successive exercises, identifying the local challenges of the country and the region, and resolving these challenges with better preparation and methods employed in advance.

In light of the strategic value of maintaining human resources during crises and disasters, particularly in the context of the COVID-19 pandemic, it is suggested that a comprehensive survey be developed with the assistance of academics who are experts in the fields of human resources and disasters.

An analysis of the proposed recommendations for planning and policymaking will be conducted within the next six to twelve months. To enhance plans and procedures, administrators and legislators must examine the feedback.