Pandemic Took Toll on NH Leaders; Some Are Leaving the Sector Due To Burnout, Exhaustion

November 9, 2022

November 9, 2022
Contact: Ellen Mullally

Even before the pandemic, post-acute and long-term care (PALTC) facility leaders were facing stress, burnout, and emotional exhaustion. Despite this, they rose to the challenges of managing the pandemic. However, an article in the November issue of JAMDA spotlights the high personal cost of these efforts.

In This Was My Crimean War, the authors observed that research about the impact of the pandemic on team members hasn’t focused specifically on or singled out leaders. So, they conducted Zoom-assisted interviews with 21 nursing home leaders—14 managers and 7 directors of care. They uncovered four major themes: responsibility to protect, overwhelming workloads, mental and emotional toll, and moving forward.

Specifically, the authors found that leaders employed extreme precautions to protect residents, staff, and their own families; and they experienced profound distress when COVID-19 infiltrated their facilities. At the same time, they often worked double shifts to cope with pandemic demands while maintaining their usual work. As a result, interviewees reported symptoms of anxiety, depression, and insomnia leading to ongoing exhaustion; and shifting staff focus from caring to custodial enforcement of isolation caused considerable distress, guilt, and grief.

Moving forward, study participants’ responses indicated a need for change. Not only did the pandemic spotlight gaps and issues that lead to inadequate quality of care and burnout, but some leaders suggested that their experiences with COVID signaled an unanticipated end to their careers.

The authors concluded, “This is an urgent call for systemic change to improve working conditions for leaders and quality of care and life for residents. Nursing home leaders are at increased risk of burnout, which must be addressed to mitigate attrition in the sector.”

This article was conducted by researchers at University of Alberta, Edmonton, Alberta, Canada.

Get more information on the findings above and more details about the study. To contact the researchers or JAMDA editor for an interview, please email





JAMDA is the official journal of AMDA – The Society for Post-Acute and Long-Term Care Medicine. JAMDA publishes peer-reviewed articles including original studies, reviews, clinical experience articles, case reports, and more, on all topics more important to post-acute and long-term care medicine. Visit for more information.

About AMDA – The Society for Post-Acute and Long-Term Care Medicine
AMDA – The Society for Post-Acute and Long-Term Care Medicine is the only medical specialty society representing the community of over 50,000 medical directors, physicians, nurse practitioners, physician assistants, and other practitioners working in the various post-acute and long-term care (PALTC) settings. Dedicated to defining and improving quality, we advance our mission through timely professional development, evidence-based clinical guidance, and tireless advocacy on behalf of members, patients, families, and staff. Visit for more information.