Addressing the Crisis in Healthcare:
Enhancing Hospital and Health System Worker Well-being and Retention

Healthcare services have never been in greater demand. But at the same time, the healthcare system has never been under so much strain. Significant shortages are looming in the hospital and health system workforces and facilities:

  • The Association of American Medical Colleges predicts a shortage of between 54,100 and 139,000 physicians by 2033.1
  • About 100,000 registered nurses have left the workforce since 2021, and another 610,388 reported an intent to leave by 2027.2
  • Between 2005 and spring 2024, nearly 200 U.S. hospitals have closed or reduced services.3

The changes to the healthcare workforce and the dramatic increase in demand for healthcare during the COVID-19 pandemic illuminated the pressures on healthcare workers. Staff working in all aspects of care experience high stress levels, overwork, and burnout. That has prompted calls for great emphasis on worker well-being across the healthcare field.

Managing worker satisfaction and well-being will be a crucial element in maintaining an adequate healthcare workforce in the coming years.

Challenges in the Healthcare Workplace Environment

Hospital and healthcare system leaders are positioned to dramatically improve worker well-being by adopting responsive workplace wellness programs that address the unique mental health challenges faced by healthcare workers.

High Stress Levels

Healthcare professionals often work in high-pressure environments with life-and-death situations that have significant emotional effects. Workers witness patient suffering, which they may or may not have the capacity to treat. They are expected to be clear-headed and engage in complex decision-making under stress.

The pressures of providing care are an expected part of the job, but without proper emotional support and work-life balance, constant strain can lead to mental and emotional exhaustion.

A 2022 survey of healthcare workers conducted by found that job-related emotional effects were common among respondents:4

  • 34% reported depression symptoms
  • 57% reported anxiety
  • 89% reported stress-related sleep disturbances in the previous year
  • 93% reported experiencing burnout at some point in the 30 days

High Stakes Environment

The high stakes of their work influence stress levels in healthcare workers. Workers make quick, effective decisions in an environment where mistakes can have serious consequences. Healthcare workers report that concerns about patient death and fear of making errors, especially in the case of critically ill patients, contribute to an overall patina of stress that overlays patient care. 5

 Long and Irregular Hours

Many hospital staff work long shifts, overnight hours, or spend long hours on call. Long hours and variable schedules can disrupt sleep patterns, eating habits, and personal time. The cumulative effects of irregular and taxing schedules can contribute to physical and mental health issues.

A 2023 survey of nurses found that longer shifts were associated with higher psychological demands, more frequent burnout, greater coffee consumption, and a higher number of daily smoked cigarettes than among nurses working shorter shifts.6

A 2024 study of nurses showed that consistently working night shifts is associated with increases in mental health symptoms such as depression, anxiety, and stress.7

 Physical Demands

Healthcare work is physically demanding, as well as being emotionally and intellectually taxing. Workers often must be on their feet for long hours. In addition, many healthcare jobs include duties such as lifting patients, moving medical equipment, and performing repetitive tasks, which can lead to physical strain and injuries.

Workplace injuries are very common in healthcare settings. OSHA reports that in 2019, U.S. hospitals recorded 221,400 work-related injuries and illnesses. That comes to a rate of 5.5 work-related injuries and illnesses for every 100 full-time employees, almost twice the rate of illness and injury for private industry as a whole.8

Even among workers who don’t sustain workplace injuries, the physical demands are significant. In 2020, almost 70% of surveyed workers reported physical exhaustion due to their workload. Being tired in the workplace can increase the risk of future injuries.9

Exposure to Illness and Trauma

Daily exposure to diseases, infections, and traumatic situations can take a toll on health workers’ physical and psychological well-being. Repeated exposure to traumatic events, such as treating patients with severe illnesses or injuries and witnessing patient deaths, can lead to an increased risk of post-traumatic stress disorder (PTSD). A 2010 study at the University of Colorado Hospital found that 18% of nurses met the diagnostic criteria for PTSD.10

PTSD in healthcare workers has increased in recent years. A 2021 study found that PTSD rates among ICU staff were 3.3 to 24% before the COVID-19 pandemic. The prevalence rose to 16–73.3% after the pandemic.11

Workers who have exposure to communicable diseases carry an additional mental burden. Many are concerned that they can bring illness home with them and either become sick themselves or expose loved ones to illness. Evidence of this mental stressor was illuminated during the COVID-19 pandemic. At the time, 76% of healthcare workers with children reported that they were worried about exposing their children. Almost half reported fears about exposing their spouse or partner, and 47% of workers were worried that they would expose their older adult family member(s).12

Compassion Fatigue

Healthcare workers often need to provide emotional support to patients and their families. The emotional labor involved can lead to compassion fatigue, where individuals feel emotionally drained and unable to empathize or feel compassion for others or themselves. People with compassion fatigue may experience symptoms such as anxiety, depression, somatization, hostility, and negative self-esteem. Compassion fatigue is a risk factor for burnout.13


The combination of high stress, long hours, and emotional demands of healthcare work can lead to burnout. Workers experiencing burnout struggle with emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment.

A 2023 survey found that 47.3% of responding physicians reported burnout. Over 25% of respondents also expressed an intent to leave their jobs, with 24.3% of physicians saying they planned to quit in the next two years.14

Burnout can affect job performance, and it can also lead workers to leave the profession altogether. This places a financial strain on healthcare organizations. Researchers estimate that burnout-related turnover costs $4.6 billion every year. 15

Work-Life Balance Challenges

The intensity and time commitment of healthcare work can create challenges in maintaining a work-life balance. Workers who focus on the job to the exclusion of other activities and relationships typically experience marital and family discord, which can increase stress and unhappiness. In addition, people with poor work-life balance report poor mental and physical health, suffer from health ailments, and have low health parameters.16

Solving the Healthcare Workforce Wellness Crisis

In 2022, the federal government issued The U.S. Surgeon General’s Advisory on Building a Thriving Health Workforce. The publication detailed proactive steps healthcare organizations and facilities can take to improve the health and well-being of healthcare workers. Suggestions include:17

  • Build an organizational commitment to the health and safety of health workers
  • Review and revise policies to ensure health workers are not deterred from seeking appropriate care
  • Increase access to high-quality, confidential mental health and substance abuse services
  • Invest in health prevention.

Many of the most significant wellness concerns facing healthcare workers are manageable when individuals have easy access to support. Hospitals and healthcare organizations can meet wellness needs by adopting health promotion programs and offering workplace wellness services that focus on the specific concerns of healthcare workers.

Employers can begin by incorporating the CDC’s recommendations for comprehensive workplace health promotion programs. The five key elements are:

  • Health education
  • Supportive social and physical environments
  • Enterprise-wide focus on health and well-being
  • Access to related services such as employee assistance programs (EAPs)
  • Physical and mental health screenings with appropriate follow-up care

The impacts of workplace wellness programs extend beyond the direct effects on individuals. Employers who adopt comprehensive workplace wellness initiatives see benefits in lowered cost of care of employees. According to the CDC, the ROI of workplace wellness programs ranges between $1.20 and $4.60 for every dollar invested.18

    Ramp Health Workplace Wellness Services

    Ramp Health provides comprehensive wellness services for workplaces. We offer a combination of in-person and virtual offerings. Through this “High-tech, high-touch” approach, our professionals can help workers regain control of their mental health and well-being.

    Wellness Coaching

    Our wellness coaching programs are designed to support workers as they address both physical and mental health goals. Our certified wellness coaches can work with employees on issues including:

    • Stress management
    • Work-life balance
    • Tobacco cessation
    • Life satisfaction

    Wellness coaching can be virtual or in-person. All sessions are entirely confidential and tailored to each participant’s unique circumstances.

     Mental Health Services

    Ramp Health gives employees access to Mental Health First Aid (MHFA) certified healthcare professionals and licensed behavioral health counselors.

    Counselors are trained to assist clients with a broad range of issues, including stress, anxiety, depression, substance abuse, sleep issues, and work-life balance.

    Participants can schedule counseling appointments either onsite, via video or phone call.

    Available services include:

    • Evidence-based, solution-focused psychotherapy
    • Psychosocial assessments and treatment plans
    • Screenings for suicide, depression, and anxiety
    • Psychological testing and assessments
    • Specialist referral and monitoring
    • Crisis intervention facilitation

    Workplace Safety

    Establishing and reinforcing safety protocols can improve patient care and reduce the risk of workplace injuries that negatively affect staffing levels.

    Ramp Health partners with Soter Analytics, combining AI safety assessments with personalized coaching. Our Injury Prevention Coaches utilize the data from smart technology to perform assessments of worker movement patterns. Injury Prevention Coaches use that data to deliver tailor-made interventions that improve worker safety.

    Digital Platform

    Ramp Health’s digital health platform is designed to give organizations the tools to improve the well-being of their populations. The best-in-class app is perfect for busy healthcare professionals who can access it as needed.

    The platform puts all wellness tools participants need right at their fingertips.


    Ramp’s digital content encourages positive changes to enhance physical well-being. Lifestyle interventions include strategies for stress mitigation, nutrition, and exercise, as well as advice for chronic condition management and disease management.


    Financial concerns can lead to a lot of stress. Ramp’s digital platform seeks to empower participants to better manage their finances. The platform presents ideas for smart shopping and finding a financial advisor.

    Mental Health:

    Our platform’s mental health tools focus on building healthier relationships and social interactions for improved well-being. We offer guidance and support for both personal and professional relationships.

    Personal Growth:

    Promoting personal and professional growth can improve worker satisfaction. Our digital platform includes activities around growth, such as ways to find and pursue a passion, learn something new, or improve human capacity in the workplace.

    Employees have all the wellness tools they need at their fingertips. In addition, clients get the real-time data they need to ensure their workplace programs are successful.

    To learn more about Ramp Health’s comprehensive workplace wellness services, contact us

    About Ramp Health

    As a comprehensive healthcare solution provider since 2002, Ramp Health is dedicated to improving the health and well-being of individuals and communities. Our range of services and nationwide network allows us to effectively meet the needs of a diverse customer base, from individuals to government organizations. We focus on high-quality care and measurable outcomes to give organizations the best ROI and VOI. We have an unwavering commitment to providing exceptional services, and we are dedicated to helping our customers achieve better health and well-being.


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    2. American Hospital Association. “Study projects nursing shortage crisis will continue without concerted action.
    3. Cecil G. Sheps Center for Health Services Research. “Rural Hospital Closures.” [Accessed June 20, 2024]
    4. Nigam JA, Barker RM, Cunningham TR, Swanson NG, Chosewood LC. Vital Signs: Health Worker–Perceived Working Conditions and Symptoms of Poor Mental Health — Quality of Worklife Survey, United States, 2018–2022. MMWR Morb Mortal Wkly Rep 2023;72:1197–1205. DOI:
    5. Rink, L. C., Oyesanya, T. O., Adair, K. C., Humphreys, J. C., Silva, S. G., & Sexton, J. B. (2023). Stressors Among Healthcare Workers: A Summative Content Analysis. Global qualitative nursing research, 10, 23333936231161127.
    6. Fond, G., Lucas, G., & Boyer, L. (2023). Health-promoting work schedules among nurses and nurse assistants in France: results from nationwide AMADEUS survey. BMC nursing, 22(1), 255.
    7. Ugwu, L.E., Idemudia, E.S. & Onyedibe, MC.C. Decoding the impact of night/day shiftwork on well-being among healthcare workers. Sci Rep 14, 10246 (2024).
    8. Occupational Health and Safety Administration: “Worker Safety in Hospitals.”
    9. Mental Health America: “The Mental Health of Healthcare Workers in COVID-19.”
    10. Mealer, M., Burnham, E. L., Goode, C. J., Rothbaum, B., & Moss, M. (2009). The prevalence and impact of post-traumatic stress disorder and burnout syndrome in nurses. Depression and anxiety, 26(12), 1118–1126.
    11. Deltour, V., Poujol, A. L., & Laurent, A. (2023). Post-traumatic stress disorder among ICU healthcare professionals before and after the Covid-19 health crisis: a narrative review. Annals of Intensive Care, 13(1), 66.
    12. Mental Health America: “The Mental Health of Healthcare Workers in COVID-19.”
    13. Yeşil, A., Polat, Ş. Investigation of psychological factors related to compassion fatigue, burnout, and compassion satisfaction among nurses. BMC Nurs 22, 12 (2023).
    14. Rotenstein, L.S., Brown, R., Sinsky, C. et al. The Association of Work Overload with Burnout and Intent to Leave the Job Across the Healthcare Workforce During COVID-19. J GEN INTERN MED 38, 1920–1927 (2023).
    15. Khullar D. Burnout, Professionalism, and the Quality of US Health Care. JAMA Health Forum. 2023;4(3):e230024. doi:10.1001/jamahealthforum.2023.0024
    16. Borowiec, A. A., & Drygas, W. (2022). Work-Life Balance and Mental and Physical Health among Warsaw Specialists, Managers and Entrepreneurs. International journal of environmental research and public health, 20(1), 492.
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    18. Centers for Disease Control and Prevention. “Workplace Health Model.