Assistant Professor Lehigh University, United States
Introduction: Healthcare workers, especially those working in critical care or emergency settings, undergo immense stress in their jobs daily. Since the start of the COVID-19 pandemic in early 2020, burnout rates and perceived stress have been at an all-time high for healthcare workers. However, very little quantitative data exists pertaining to the health of healthcare workers during performance of their jobs. According to a study by Rutgers health, 64% of nurses are experiencing burnout, 51% screened for positive symptoms of PTSD, 51% reported dissatisfaction with their jobs, and 42% plan to leave their current jobs. This study aims to capture the vital signs of healthcare workers for an extended period, comparing their baseline vitals to their vitals during work. Using a Garmin Vivoactive 5 Health and Fitness Tracker, participant’s vital signs including heart rate (HR), blood oxygen saturation (SpO2), respiratory rate (RR), and heart rate variability (HRV), will be obtained. A questionnaire, which will be completed following the conclusion of the workday will collect data on sleep, sleep quality, exertion scores, case information, and case duration.
Materials and
Methods: A 20 year old Emergency Medical Technician (EMT) was given a Garmin Vivoactive 5 and told to wear it during a typical night shift. The provider fell asleep at approximately 0200 and was awoken in the middle of the night, at approximately 0430, by a pager and the provider responded to a real world 911 call. The fitness device tracked a number of vital signs both prior to the case, during the case, and after the case. Data collected from the Garmin Vivoactive 5 was manually transcribed from 30 minutes prior to the case, the hour the case occurred, and 30 minutes after the case. The vitals that were collected were heart rate, respirations, and stress score. Heart rate and respirations are collected continually and averaged out in 2 minute intervals. Stress score is a value that is prescribed to the wearer based on abrupt changes in heart rate variability and a “score” is provided on 3 minute intervals. Heart rate variability is the fluctuation between adjacent heart beats. The lower the heart rate variability, the lower the time between heart beats, and the higher the calculated stress score. Using the manually transcribed data, three sets of box and whisker plots were generated for the provider’s heart rate, stress score, and respirations.
Results, Conclusions, and Discussions: From a resting heart rate of approximately 57 BPM, the provider's heart rate doubled to 114 BPM upon being woken up. The provider’s respirations increased moderately by 2-4 breaths per minute at the same time, The provider’s stress score increased more than ten fold from 8 to a stress score of 91, indicating a significant decrease in heart rate variability. The provider’s respirations showed a slight, but meaningful increase during the caseload. Just a 2-4 breath per minute increase in respirations seems insignificant but is actually very meaningful as normal breathing for adults fluctuates between 12-20 breaths per minute, but appears insignificant when compared to the rest of the data and the generation of the box plot. Prior to the case, there is very low variability for all vital signs as these stay relatively consistent when sleeping. Additionally, 30 minutes after the caseload, not enough time elapsed for the vital signs to return to their normal resting values for heart rate, stress score, or respirations. The analysis of the box and whisker plots reveals significant physiological and psychological responses exhibited by the provider during the case. Both the heart rate and stress score experienced substantial increases, with the heart rate doubling from its resting rate and the stress score soaring more than tenfold. Notably, there were numerous outliers in both datasets, particularly above the provider's baseline values, indicating instances of elevated heart rate and intense stress.
Through two cases, there were significant increases in HR (heart rate), RR (respiration rate), and stress scores by 84%, 28%, and 268% respectively. This highlights the pressing need to transition from reactive to proactive measures in developing optimization wellness protocols. Future endeavors will focus on evaluating alterations in vital signs among pediatric nurses in critical care units within a high-volume primary medical center. By gathering both objective and subjective assessments, we aim to construct activity and fatigue scores that accurately depict schedule intensity, ultimately working towards the prevention of nurse burnout.
