Duty to Reduce Uncontrollable Stress in Healthcare Workers. Help Is on the Way

Objectives: To advise policy makers, law and administrative practitioners of the new science of physical injury to the brain of healthcare workers (HCWs) due to uncontrollable but not controllable occupational stress. Leaders have the potential and the means to affect the controllability of occupational stress on HCWs. Many resources and guides to do so are in the public domain. Without leadership interventions, the occupational stress remains uncontrollable. OSHA requires employers to provide a workplace free from recognized hazards likely to cause death or serious physical harm. New medical/neurologic findings now raise moral and legal duties for employers to protect healthcare workers from such hazards as uncontrollable occupational stress. Methods: Literature focused upon recent studies that outline severe neurological and medical impact from uncontrollable stress is supported by functional MRI studies and SPECT Scans. We reviewed existing policies, causes of uncontrollable stress on HCWs that exist in the current healthcare delivery environment and known interventions that healthcare leadership can perform to reduce uncontrollable stress by its volume reduction and especially allowing more HCW decisional latitude and participation to influence its reduction. We propose legal theories to incorporate these new findings, as seen in international practices. This process described was undertaken by an interprofessional collaboration of physicians, attorneys and healthcare economists resulting in conclusions and recommendations. Results: Current HCW work environments are characterized by uncontrollable stress manifested by little ability to escape from or influence mitigation of that stress. Leaders of healthcare work environments are in the prime position to reduce the factors that create uncontrollable stress conditions, thereby enabling HCWs psychological safety for feedback, opportunity to influence their work environment, express ideas for improvement, as well as allowing more options for choice in fulfilling their duties. HCW’s uncontrollable stress conditions in their work environment replicate conditions of brain injury and medical sequelae. Burnout is prevalent, well known to be a significant problem in healthcare and is foreseeable. Findings now approach, and likely meet, criteria for the legal standard of a recognized hazard. There are existing methods of recognition and detectability where the impact of HCWs’ uncontrollable stress meets the severity threshold, and there is feasibility of and existing guidance for