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Military treatment facilities commonly reported “burnout and fatigue” among their medical personnel—both civilian and uniformed—due to the extra demands of the pandemic, an IG report has said.

Officials at 25 of the 30 facilities the IG examined “reported staff burnout and fatigue as a current challenge or future concern”—11 of them cited it as the most serious concern that might be encountered in the future—which has already caused what one described as a “cycle of burnout leading to a loss of staff, which then leads to the 9-to-12-month process of getting new employees.”


Meanwhile, officials at two-thirds of facilities reported difficulty with recruiting and hiring civilian medical staff to replace the losses “because, they stated, salaries are too low, especially for nurses . . . Multiple MTF officials also stated that the General Schedule grade levels for recently graduated nurses, established in accordance with Office of Personnel Management guidelines, were too low to enable the MTFs to compete for nurses in the hiring market.”

In terms of impact on the employees, officials told the auditors that “burned out and fatigued personnel were having emotional breakdowns on the job”; “that the MTF cannot maintain such a high stress level during this “new normal” without significant effects on mental health stability”; and that “ultimately civilian and military personnel will begin to leave and the staff’s demand for mental health care will go up, which the MTF had already begun experiencing “

Impacts on patient care included reduced health care services, more referrals of patients to outside health care providers, delays in care, reduced training of staff, and “increased risk to patient safety,” it said.

Recommendations included reducing “the physical impacts leading to fatigue and burnout” including by setting new limits on working hours; creating a group to address staffing challenges including hiring; and identifying staff and other resources that will be needed for “future long-term pandemic response and biological incidents.” It said that while DoD generally agreed, it considered the recommendations unresolved because the department did not describe specific steps it would take.

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