Nidhi Tewari Transcript: May 22, 2025

Rachel Jones/NPF (00:00):

For the next session of the covering workplace mental health training, we’ll get an exclusive briefing about the mental health and wellbeing of frontline workers. Sure. This is a topic that many of us thought a great deal about during the pandemic and certainly afterwards words. Nidhi Tewari is a practicing licensed clinical social worker with over 13 years of experience working with high performing leaders who cope with trauma, anxiety, stress, and burnout in their workplaces. And she’s also authoring a book with Penguin Random House titled Working Well, how to Build a Happier, healthier Workplace Through the Science of Attunement. And that’s scheduled for an April, 2026 release. So we’ll certainly look forward to that. So please, let’s welcome Nidhi and her presentation.

Nidhi Tewari/LCSW (01:00):

Thank you. I really appreciate it. It’s a pleasure to be here. It is such a joy to get the opportunity to speak at the National Press Foundation to all of you fellows. Now, I know I’m going to cover quite a bit of material over these 30 minutes, so I welcome you to take pictures, screenshots of slides that resonate with you, nuggets that are dropped in these 30 minutes that you might want to take back and report on. And all I ask is that at the end of this presentation, you’ll see a little QR code to connect with me on LinkedIn, just post it on LinkedIn, tag me. I’d love to see what resonated. And that way I just get a sense of what landed and what really stood out to you in this talk. Now we just hit the five-year anniversary of COVID-19 pandemic, and I think many of us can remember that day in March, 2020 when we got the news that an unknown disease was ravaging through the world.

(01:57):

We heard about millions of people dying. And for me, I had really high hopes actually going into 2020. It was the start of a new decade and I was entering private practice for the first time after working for a hospital system and then for community mental health agencies as an outpatient clinician. But I never imagined that in March, 2020, I would be thrust backed into being a front liner once again. These are the images of March, 2020 ERs filled with thousands of individuals sick with COVID. 19, no treatment, no vaccination, no idea about how to be able to increase the survival rate as people contracted this illness. I think many of us remember those stories that were so uplifting, hearing the tunes of togetherness from the people in Italy who were singing for the healthcare workers as they exited their shifts, or even the individuals in the apartment complexes in New York City that applauded every time that the healthcare workers came off of their shifts at 7:00 PM But the devastation of COVID-19 was something that hit the frontliners particularly hard, that included not only healthcare workers, but EMTs, police officers, grocery store workers became frontliners as well.

(03:17):

And so we reflect back on March, 2020 as a really devastating time for people on the front line, especially for mental healthcare workers like myself. Our caseloads had never been higher and the acuity of the people coming to see us was beyond anything I’d ever seen before, but I never imagined that I would also be simultaneously going through the same trauma that my clients were going through. That has never happened before, and I hope it never happens again. So we reflect on this time as being horrifically traumatic for front liners, but the time that we often forget was difficult for frontliners as well. It was 2022, the return to normal. That was a particularly challenging time for frontliners because here we were as a society ready to move on as quickly as possible from everything relating to the pandemic. And it made sense. We’d spent two years quarantined and isolated from our families and our loved ones, and we were desperate to get out there to eat out at restaurants and go to bars again, to be able to go to concerts, conferences, to be able to spend time in the physical vicinity of the people that we loved.

(04:33):

But unfortunately, for the frontliners, return to normal was anything. But these are the images of the return to normal for frontliners in the pandemic. While society moved on from this trauma and did anything that we could to forget it, frontliners carried the burden. They carried the wounds, the invisible wounds from having to care for millions of people across the globe.

(05:00):

The pandemic may have ended, although we know COVID-19 still exists, but the pandemic itself ended in 2022. But that was the beginning of what I have coined to be the great repression. This is when society decided to forget about all of the turmoil that we had experienced. Even worse, some people claimed that this was all a hoax, that it wasn’t as bad as we had imagined, that maybe the frontliners actually didn’t have to care for these thousands of people witnessing people dying on a regular basis. And so here they were being gaslit for their experiences, society completely for forgot them. In one moment they were lauded and in the next they were totally forgotten. And so the great repression began, and we are still in the great repression today. I can’t tell you how many organizations I spoke to, fortune 500 companies, professional organizations that when I mentioned the pandemic, my talk, they asked me to edit it out.

(06:00):

They said things like, haven’t we moved on yet? I think people are kind of done talking about the pandemic. They let’s just leave that out. And so I myself found myself editing my own talks to be able to appease those who had hired me to speak to their organizations about wellbeing. And unfortunately, this did a great disservice to the frontliners. Now, this is an interview that had been conducted in 2025, so just in March by Connecticut NPR. And this is an interview that talks to and speaks to the experience of frontliners five years later. So let’s listen in

Speaker 3 (06:44):

For us. It feels back to business a lot of the times with just some new protocols and things in place to support this, but I can definitely see how it feels so distant of a memory at this point.

Speaker 4 (06:58):

And what about for you and your colleagues? I know you just mentioned it feels just like yesterday, but now we’re business as usual today. Are some of the memories still fresh or do they feel far away consistently?

Speaker 3 (07:12):

I think it’s a mix. There’s definitely things that feel so far away like having to go outside and triage people outside and attend and all these care spaces we constructed to separate and have areas just for the COVID suspected patients and the non COVID suspected patients. That feels so long ago. But I think carrying the memories of what has happened and the patients that we treated and just talking about that connectedness and the little moments of humanity. There’s one that I will never forget, and we got all the very public support from everyone as talked about with the people making masks and dropping off food and the signs, and that was so appreciated. But I think one that will stick with me forever is I was caring for a particularly young patient, very, very critically ill, and I remember bringing him up to the critical care unit and he was coughing and he kept saying, I’m so sorry. I’m so sorry, because he was worried about me and exposing me, and I was worried about him because he was so critically ill and in that moment, he couldn’t even think about himself. He was worried about me, and that connectedness is something I never really experienced before and that will carry with me forever. For sure.

Nidhi Tewari/LCSW (08:27):

That was Audrey who was a frontliner through the pandemic. She was the director of operations at Hartford Hospital Center, and she was somebody who was right there in the ER having to care for individuals that were critically sick with COVID-19. And you can hear the emotion in the way that she even speaks about this, that it’s a memory that she will never forget that she will carry with her forever. This is what is continuing to happen and was so interesting as I was preparing this presentation was that we actually haven’t gotten back to normal as a society either. We pretend like we’re operating as normal, but the research shows something very different. 72% of mental healthcare workers reported increased client severity since the pandemic, and this was a statistic taken in 2024, so this is now two years post pandemic. So clearly return to normal hasn’t even happened for us as a society.

(09:22):

It’s something that we still grapple with, but yet nobody ever speaks about. Now, the mental healthcare workers, we talk a lot about the ones that I’ve already mentioned, EMTs, police officers, nurses, doctors. We talk about even the grocery store workers, but the mental healthcare workers were the forgotten frontliners because when people were left alone with their thoughts for 24 hours a day when they were holed up with family members for 24 hours a day, brought to the brink who was there? It was us, the mental healthcare workers, the number of suicidal clients that I met with during that time was astronomical compared to other points in my 13 year career. And so the acuity was intense, and yet we never were really spoken about in terms of the toll that it took on us. Even if we weren’t in the er, we still were facing similar types of tragedy in our own work.

(10:19):

Now, one of the other things that I noticed when it came to articles written about front liners health was that burnout was the primary topic, right? I’m sure you all can remember the headlines. It was healthcare workers are more burned out than ever. They’re taking on more shifts, more hours, not enough support, and all of that is very much true, but burnout stole the spotlight from moral injury, and that is the true crisis that happened for healthcare workers is that they were put in positions and had to make decisions that they never wanted to make in their entire career. Really tough moral decisions that went against their value systems. So moral injury, which is when someone engages in, fails to prevent or witnesses acts that conflict with their values and belief systems. When that happened, that led to immense PTSD and trauma for frontliners, many of whom are still carrying those wounds today.

(11:18):

These are the images of moral injury situations where frontliners could not allow family members to come in to say goodbye to their loved ones. And so instead, people were literally on their death beds, FaceTiming with their loved ones because of quarantine procedures. It was what needed to happen at that time. But imagine being the healthcare provider that had to TA family, no, you cannot be with your grandparent, your mother, your sister, your best friend, whoever it was who was dying of COVID-19, because that was just what needed to happen. That’s something that’s in conflict with their moral code. Oops, where am I at? What happened? Oh, I’m pressing the wrong button. Sorry. Here we go. Another situation was completely slammed ERs. Now we all know that healthcare workers take what’s called a Hippocratic oath where you are sworn to help protect and serve and be able to help to remedy any illness for any person, regardless of the reason, regardless of their socioeconomic status.

(12:22):

Whatever factors played into it, it doesn’t matter. You’re supposed to be able to provide care. Yet through the pandemic, many healthcare workers had to make decisions about who received care and who did not receive care. You can imagine the level of moral injury that comes from that. People who were aging in elderly unfortunately did not get the resources that they deserved because resources were so limited during that time. It was a question of where do we have a ventilator available to put somebody on, and what is the percentage chance that this person will be able to survive having an intubation or having a ventilator hooked up to them? That is moral injury. That’s part of what led to PTSD anxiety and depression that we’re still seeing three years now after the pandemic. In fact, according to a 2023 study done by Syracuse University, 55.3% of healthcare workers reported experiencing PTSD like symptoms.

(13:19):

That includes symptoms like sleep disturbance, so having difficulties, being able to fall asleep, being able to stay asleep, having nightmares, flashbacks, hypervigilance, feeling like you’re on edge all the time, waiting for the next tragedy to strike. All of these were symptoms that people are still continuing to experience, yet it is fallen out of the news cycle. It’s not something that we talk about any longer. Unfortunately, what happened was many businesses, particularly hospital systems that are run often by people who are not front liners made the decision that we need to just move on. If society’s moving on, then we as a business, as a hospital system, we will also move on. We’re not going to speak about what you all just endured. And so the expectation is pull yourself up by the bootstraps, get back to work, do what you need to do. But it’s not so easy.

(14:14):

I think we all know that trauma isn’t something that we can just get over, and if it was, I’d be out of a job because trauma is what I specialize in, right? It’s not so easy as, let me just think my way through it and let me just process through it on my own. Trauma requires intervention. It requires support. And the reason why trauma isn’t something that we can just move through so quickly is because trauma changes the brain. It changes our brain chemistry, it changes the wiring of our brain. And one of the ways that this affected frontliners was that they had such hypervigilance. So three parts of the brain are typically impacted by trauma. One is the amygdala, which is our alarm system. So think of it like a car alarm where if somebody’s breaking into your car, you want that alarm to be going off.

(15:02):

But unfortunately, what happens is somebody brushing up on the car after you develop PTSD sets off that car alarm again, right? So threats that are non-existent trigger you. Things that look like sound like or feel like a past experience will evoke that same fight, flight, freeze fawn response, and that’s what a lot of healthcare workers experienced. Then you have the hippocampus, which is the memory center of the brain that’s diminished. So if you look at these MRI scans here, the healthy brain on the left has such little activation compared to the PTs D brain on the right, and that’s because we have these centers of the brain that are simultaneously overactive, overactive and underactive. So that memory storage, that ability to store short-term memories is diminished. And so is that ability to rationally think through a situation. So the prefrontal cortex, which is the part of the brain that’s in charge of decision-making, it’s in charge of appropriate responses, inappropriate responses, being able to rationally think something through that also got diminished. Yes.

Julia Carpenter/Independent  (16:09):

Just have a quick question about these two brain scans. Is this taken during a moment of rest or during a moment of concentration? Just so I understand if what we’re seeing is why the PTSD brain scan looks so different?

Nidhi Tewari/LCSW (16:28):

That’s a good question. Typically, MRIs are done at rest. So these are people who are laying down, going through a machine, and they weren’t asked to think about anything in particular. This is just their baseline. Their baseline is overactivated, and that’s what a lot of frontliners experienced too. They were constantly operating at this really high level. So no wonder they had difficulties with focus memory challenges. For those of us who enter this field, it’s not for the faint of heart. Many of us enter into the medical fields and become frontliners because it’s very mission vision aligned with us. We want to help people, and that lends itself, unfortunately really well to falling into the trap of fawning or people pleasing. So a part of why so many frontliners burnt out during the pandemic and post pandemic is because we couldn’t say no. The need to help more and more people was what was driving us, what continued to give us some sort of dopamine or pleasure during a time where we were very dopamine deficient, right?

(17:26):

Not a whole lot of good was happening during that time. And same thing with the hypervigilance and hypo arousal. So that feeling of being on edge, that was looking out for that next threat that was pretty consistent with frontliners, but so was hypo arousal or the feeling of being depressed, shut down, dissociated, disconnected, and unfortunately for a lot of frontliners that looked like substance use, it looked like going home and doing anything possible to numb out what they were feeling. One of the biggest internal that I as a therapist saw with my clients who were frontliners is that they had a hard time holding this dialectic, this dichotomy between their passion and love for their job, and then this feeling of moral injury and burnout. And they’re like, how can these two things coexist? I love going into work. I love helping people, but yet I feel miserable and I’m not getting the same fulfillment that I normally would get, and I had to help them to be able to process through this internal conflict that arose post pandemic and teach them that, no, these two truths can exist.

(18:34):

You can love your job and simultaneously be burnt out and experience moral injury. They are not mutually exclusive concept. So something that a lot of people didn’t realize and still don’t realize is that healthcare workers and frontliners are often unable to seek help. Now, of course, there’s the stigma and taboo aspect, but it goes beyond that. Medical boards actually ask questions relating to your mental health diagnoses and any treatment that you’d received. So what I found happening during the pandemic and now many years afterwards, is that people are seeking therapists that are out of state that don’t take insurance because they don’t want the paper trail. They don’t want it to get back to the board that they have A-P-T-S-D diagnosis, that they have an anxiety disorder, that they have major depressive disorder because they could run the risk of losing their license and being deemed incompetent.

(19:33):

That’s wild when you think about this is still happening in 2025. Now, I’m happy to say that starting in 20 23, 23 states have now passed legislation that prevents this from happening, but that’s less than 50% of the United States. So this is still very much a contributor towards why people are leaving the frontline industries. Now, this very much ties into this exodus that we’re seeing. A 2024 Mercer report predicts a national healthcare worker shortage of a hundred thousand healthcare workers by 2028. That’s massive. That’s a massive deficit, and if you look here, we’re just not keeping up. So here’s the demand. You can see here in this black line and down here is the supply of physicians and clinicians to serve those populations. What’s really unfortunate is that the populations that are going to most suffer from this are rural populations where they already have limited access to really good healthcare. And then on top of that, it is so expensive, as we know for many communities, prohibitively expensive to even go and get a degree in nursing or to go to medical school. So those rural communities, by 2037, I mean, look at this. This is less than 120 K, very limited growth, yet pretty significant growth in terms of demand, and that’s not even considering the fact that we have an aging population that has more chronic illnesses and needs more a higher level of care than ever before.

(21:11):

I have to talk a little bit about the mental healthcare angle, right? Because like I said, we were kind of forgotten in all of this, 93% of mental healthcare workers have experienced burnout. These are once again post pandemic statistics, and 48% of mental healthcare workers have considered other employment options, 93%. I was even flabbergasted seeing that. I was like, oh my gosh, that’s almost all of us have gone through this, and I’ve gone through two bouts of burnout myself, so maybe it shouldn’t be so surprising, but I was kind of taken it back to see that. So we are also going to experience an exodus of mental healthcare workers, and we already know that there’s a broken system when it comes to mental health care in this country, and that’s only going to be exacerbated over the next couple of years. Okay, so we’ve talked about trauma. We’ve talked about mental health being contributing factors, but now I think it’s really important to also underscore the systemic issues that exist that are causing frontline workers to not only struggle with their mental health, but leave this industry altogether, which by the way, is a really hard decision for any one of us to make because we so love what we do. We love helping people, but we got bills to pay. We have our own mental health and wellbeing to attend to, and work culture is a major contributor towards why people are leaving as well.

(22:34):

Believe it or not, one in five Gen Z healthcare workers may leave the industry. That’s from 2024 as well. When you consider the fact that the Gen Z workforce is 28 between the ages of 18 to 28, that is astounding that already by the age on the upper limit limit of 28, gen Z workers are already feeling burnt out in the healthcare industry. That’s not boating well for future generations to want to join this industry and want to be able to help people through healthcare. And the major reasons cited are these workplace culture challenges. 83% of Gen Z frontline employees report burnout. That’s also tremendous. Out of 27 industries, healthcare ranked last for employee satisfaction with pay and with work culture. And the work culture includes micromanagement. So in my time working for the hospital system, I don’t know if you all know this, but there are so many regulations that you have to be able to meet in order to even practice as a clinician.

(23:41):

There’s insurance regulations, which is the joint commission regulations that you have to hit. There’s treatment team meetings. There’s shift change, there’s client notes, there’s billing. There’s so many things that contribute beyond even just sessions, client care that you’re providing to people, and that micromanagement means that your boss is constantly on you asking, Hey, have you submitted this claim? Hey, have you submitted this note? Hey, have you done this? Have you done that? So there’s a lot of eyes always on you. A lot of younger generations don’t love the fact that healthcare is very much ingrained in this hierarchical system of ranking. You got the CEOs, you’ve got the directors, many of whom have never set foot on a hospital floor, they’ve never worked in a frontline type of role, and then you’ve got doctors that are the highest ranking of the clinicians. Then you’ve got nurse practitioners and you’ve got nurses, and you’ve got CNAs.

(24:35):

I mean, it just is like this massive ladder, and people don’t see any hope for advancement within that industry. It’s like, well, okay, I’m never going to be able to make it to a director level role. So what’s the point? That hierarchical structure, a lot of younger generations look at democratization of power as a major sell for an organization, and healthcare is way behind in that regard. There’s a lack of leadership support. So as I mentioned, leaders just wanted to drop everything and move on. If you talk about burnout, the response that I had gotten when I worked in the healthcare industry and in the hospital system was, this is what you signed up for. It’s a very unempathetic stance to take. And so when you have no supports in place, when you have continually increasing workloads, a lack of hiring because people are leaving this industry at record rates, why would you stay aside from needing a paycheck? Right?

(25:37):

I think one of the biggest takeaways from the pandemic that is so sad is that what was once considered abnormal has now completely become normalized. So the shortages are now just you have to do more with less the increased patients. That’s just an expectation. Now, too bad we just have to adapt, right? You’re not agile enough if you can’t adapt to this. Many of you’re probably wondering, this is a graph that shows grocery the prices of groceries, and I’m sure you’re wondering, what does that have to do with healthcare? I’m going to tell you why. Let’s look at this. This is 2020 to 2025. Not much has changed. In fact, the prices have continued to go up right across the board. Very few dips have happened along the way, all across the board here. And the point is that the circumstances that drove up the cost of groceries no longer exists, yet the prices still remain high.

(26:36):

Why? Because when you charged previously 20 19, 2 50 for a of eggs, but then through the pandemic, and now through 2025, you can charge $12 for a carton of eggs. What’s the incentive from a standpoint to ever go back down to two 50? Right? You’ve lost your $10 margin. There are nine 50 margin. The same thing holds true for the healthcare industry. The factors that caused stress during the pandemic are no longer there yet the stress levels and the demands have still remained. I bet if I did a graph for this for healthcare workers, it would look very similar trending upwards in terms of what those stress levels have looked like. And it’s because the same demands from the pandemic may not exist, still are the same shortages. Nothing has changed systemically within the healthcare industry to remedy this. So I’ll end with this because I want to leave some time for q and a.

(27:35):

This is a quote that really stood out to me from Southern Italy’s medical workers. They said, we became heroes, but they’ve already forgotten us. How many years have we spent not talking about frontliners, right? How many times have we forgotten the sacrifice that they made so that millions of people could recover from COVID? 19? How many times have we forgotten the mental health impact that is still affecting them to this day? Yet they cannot speak about it for fear of censure, for fear of being reprimanded, for fear, of losing the way that they make a living. I hope that today some of the articles that you’ll write, don’t forget these front liners and speak to the moral injury, speak to the trauma, speak to the systemic issues, the work culture challenges that continue to plague them every day. Thank you so much. Here’s that QR code I was telling you about. Feel free to connect with me on LinkedIn. I also have a book coming out in 2026. As Rachel so kindly mentioned, it’s titled Working Well, how to Build a Happier, healthier Workplace Through the Science of Attunement. And it’s all about how to be able to fix these work culture challenges that I spoke about today. How can we reduce burnout? How can we create trauma-informed dynamics within the workplace that are supportive and provide people the longevity that they seek in their careers? I look forward to answering your questions.

Rachel Jones/NPF (29:02):

Once again, a speaker has reminded me of how much I miss being a reporter because incredibly dynamic presentation. But the one thing I wanted us, I don’t know how many of the rest of you have heard that term, the great repression when it comes to this. Stunning to me. I mean, if I were a journalist, I would try to find somebody who maybe was a frontline worker, who then got a federal government job, and now they’re going through the same nightmare. But the coping mechanism mechanisms that we’ve had to use to get through these past five years, repression has been a huge part of it. That’s right. Thank

Nidhi Tewari/LCSW (29:51):

You.

Speaker 6 (29:52):

I have two questions. They’re very different, but they’re quick, so don’t

Nidhi Tewari/LCSW (29:55):

Worry. Yep, yep. I’m here.

Alyssa Goldberg/USA Today (29:56):

My first question, so I, I’m quite familiar with the term moral injury, and a friend of mine, she did her thesis on burnout and moral injury in healthcare when we were in grad school together. She is a certified nurse midwife who was working in delivery rooms during COVID, working with mothers who were delivering their babies alone and working just in insane hours. And she ended up leaving her job and is working as a reproductive care coordinator at a university now. But she talked a lot about how much she absolutely loved her job and how it’s really painful for her to no longer be doing that work, but the burnout was so severe. I think maybe she’s like 35, and she was like, it was just so severe that I can’t go back to work. And I’m just wondering, do you see people that are leaving the industry and planning to come back or people who have already come back? What is the answer to burnout once it’s already happened? I know there’s so much on the prevention side that we should be talking about, but the reality that from the stats you’re showing is that a lot of people have already experienced it. So how do we come back from that?

Nidhi Tewari/LCSW (31:02):

That’s a great question. Yeah. So I mean, of course, like I mentioned the systemic piece, I feel like people are not coming back to the healthcare industry because the same problems exist. It’s like putting a bandaid on a wound, a gaping wound. It’s only going to do but so much until you address the inequities that exist within the healthcare field. But once you’ve already experienced burnout, I think a couple of things have to happen. I can speak from personal experience as well as somebody who’s done a lot of this work and with corporations. One is that you need time and space away, and it’s not like a two week vacation. That’s not how this goes. For me. After I burnt out, my best friend passed away from brain cancer when I was in 2018, right before the pandemic actually hit. And that was my first experience with burnout.

(31:47):

And I thought, oh, I’ll just take two weeks off to recuperate and I’ll be right back at it. I became so physically ill. I nearly was hospitalized because my body was keeping the score of all of the stress. And so I think that there needs to be enough time and space away from those stressors to fully not only psychologically recuperate, but to physiologically recuperate. And for me, it required a lot of therapy. Actually, I went through a full year of EMDR therapy to be able to address the nervous system dysregulation that happened as a result of, I mean, burnout is a trauma in and of itself, isn’t it? So I think that that is a key component of this is one, if we’re so privileged to be able to take some time off to do so, but even if you are still having to work a different job to be able to take care of your mental health by seeking out the support that was denied to you before, and learning the ways to be able to regulate your nervous system, because something I do see a lot with people that exit the healthcare field is when they go into a position that’s much less intense, they feel bored, they feel like something is off, they’re like, I’m just not enjoying this.

(32:58):

And it’s like, well, is it that you’re not enjoying it? Or is it that your nervous system is used to crisis mode all the time? And anything that is below a crisis feels like something is off? And that is often what ends up happening is that is actually the latter that, oh, shoot, my nervous system was dysregulated. Does that make sense? Does that answer your question?

Alyssa Goldberg/USA Today (33:19):

It does. Yeah. Thank you, and thanks for sharing your personal experience as well. My other quick question was also what we’ve talked about is people don’t want to hear about this anymore, which is part of the issue. But with that, as journalists, part of when we’re pitching stories to our editors, whether we’re staff or we’re freelance, is whether or not people are going to read the story.

Nidhi Tewari/LCSW (33:36):

Sure.

Alyssa Goldberg/USA Today (33:37):

So how do we report on this in a way that actually gets people to read it when we’re in a climate where people don’t want to talk about COVID anymore?

Nidhi Tewari/LCSW (33:44):

Totally. Yeah, absolutely. I think you could I share the COVID impact with you all for context? I think moral injury is still happening every single day with healthcare workers and with frontliners. So I think if you can speak about that concept and the systemic challenges that exist, those are all, I think, important stories to be covering, maybe even separated from the pandemic, because the pandemic just simply exposed things that were already problematic within the healthcare industry. It exacerbated it, and it shined a spotlight on it. But those problems have existed for a really long time, and they’ve only gotten worse. So speaking about the healthcare shortages, for example, it’s a pretty alarming number to think about, oh wow, shoot. There may come a time where accessing a physician is going to become really challenging, or, oh, wow, there may be so many people that are experiencing moral injury that they not only have to leave the field, they’re never going to come back. And here’s the long-term impact that that has on us as a society. Those might be angles that are a little bit separated and dissociated from the pandemic that are still very pertinent and salient today.

Thank you so much.

Nidhi Tewari/LCSW (34:53):

Yeah, you’re welcome. Shortages, you might also be able to localize. Yes,

Rachel Jones/NPF (34:58):

Katie. And then let’s get down to Julia.

Katie Brandt/Chicago Health Magazine

Hi, I am Katie Brandt from Chicago Health Magazine. This was excellent. Thank you. Thank you. Mine are more two comments about what I’ve noticed in my reporting that I’d love to hear your take on.

Nidhi Tewari/LCSW (35:13):

Sure.

Katie Brandt/Chicago Health Magazine (35:13):

So one is a lot of speaking about burnout and staffing shortages. A lot of people won’t go on the record. They’re like, absolutely, this is happening. I feel it every day. The moral injury as well with related to insurance too, but they won’t go on the record because of, I think the commercialization of healthcare as well, because a few, well, a decade ago it was less, there was less of this, but as more hospitals get bought up by big places, PR teams get stronger, people won’t talk or they’ll talk, but anonymously, you’re off the record. So I want your take on that. And then also on misinformation, because I think a lot of what happened during the pandemic was a politicization of everything related to COVID. And so then how does that play a role in healthcare workers?

Nidhi Tewari/LCSW (36:08):

So I’ll take the first, I’ll answer both, but let’s start with the challenges, getting people on the record. I think you’re going to continue, this is not the answer you probably want from me, but I think you’re going to continue to experience that because there’s a lack of psychological safety within their workplaces. So not only is it that you have PR firms that are really, they’re very much micromanaging how people describe their workplace, but on top of that, a lot of people fear retaliation from their own bosses when it comes to speaking out about the systemic challenges. So if you go on the record and you say, well, I don’t feel like I have any leadership support, and I feel like I’m drowning all the time, that’s not going to go over so well with your boss and your supervisor. So unfortunately, I think once again, we’re looking at a foundational problem here that has to be resolved before people are going to feel safe showing up and expressing to you with their name on the record. I’m happy to speak about it because I’ve left the industry, right? It’s like, whatever, I’m an entrepreneur. It doesn’t matter to me. But I think while somebody is still in that role, that will continue to be a challenge simply because the lack of psychological safety is there. And then I believe the second question was, could you repeat that? I’m so sorry.

Katie Brandt/Chicago Health Magazine(37:21):

Misinformation.

Nidhi Tewari/LCSW (37:21):

Misinformation,

Katie Brandt/Chicago Health Magazine(37:22):

Just the role that played

Nidhi Tewari/LCSW (37:24):

Significant role, right? Part of that gaslighting that we talked about that contributed towards people’s burnout, PTSD, all of that was because of misinformation. People saying that this was a manufactured disease that, oh, people are making up these numbers. There aren’t millions of people dying. We’re the death record. It was just like it was this intensity of people wanting to disprove this trauma that had just happened, this collective trauma. And so sadly, that is a reality of the pandemic, and I think that that continues to be the case, even in reporting outside of that. So in the current state of affairs that we live in, there’s a lot of disinformation when it comes to health topics in general. A lot of really pseudoscience that’s being put out there. And I think as reporters being able to differentiate and really fact check what’s being said in interviews is going to be critical. Because yeah, there’s a lot of people out there that are like, oh, they have no credentials. They have no clinical experience yet. They purport themselves to be experts in this field. And it’s like, well, I don’t know if you’re the best resource for me for this article, then yeah, you want to target the people that are going to hold their integrity and fidelity to what research and evidence-based says. Thank you. Yeah, you’re welcome. Thank you, Julia.

Julia Carpenter/Independent (38:46):

Hi, I am Julia. I’m a freelance reporter. I was really struck by the grocery prices graph that you put up. I write a lot about financial and business news. Certain industries have seen their earning power stagnate, and on the whole, we’re seeing just paychecks go less, what am I trying to say? Paychecks aren’t going as far as they used to have. We seen this with frontline workers and mental healthcare workers? And do we know if there are certain segments of healthcare worker pay that have been impacted

Nidhi Tewari/LCSW (39:25):

Across the board? I would say physicians are maybe the only subgroup of frontline workers where their pay has been consistently high. However, nurses, and I can absolutely speak to the mental healthcare worker element of this. We are criminally underpaid. I mean, it’s like, it’s awful. It’s awful. So for example, if you see job postings for mental healthcare jobs within agencies, $50,000 a year, $60,000 a year, and I’m talking about, this is not in rural America. This is in the city center of many places in the United States. When I look at, I am in Richmond, Virginia, and when I look at the cost of living to purchase a house in Richmond, Virginia, average house prices is 500,000 or so, a $50,000 a year salary. You’re scraping by. So the mental healthcare pay has not kept up with the cost of living. It’s not kept up with inflation, and we’re actually the most underpaid of the higher, more highly educated medical fields.

(40:34):

So to become a therapist, you have to have an undergraduate degree, a graduate degree, then you have to do two years postgraduate degree of gaining experience. Then you have to take a licensing exam, and then every two years you have CEUs that you have to pay for out of pocket and trainings. So it’s expensive, and we’re not getting paid hardly anything at all. The same is actually true for the nursing industry too. They’re also significantly underpaid compared to their physician counterparts. And so that’s also a contributing factor, of course, for why people are leaving the field if you can’t sustain a living. And then on top of that, you’re carrying your work home because that’s just the nature of the work that you do. Once again, what’s the sell of the industry? It’s like you’re losing on all ends of the equation.

(41:22):

You want to say something? Okay. Hi, one more question.

Candace Y.A. Montague/Independent

Okay. Hi, I’m Candace Montague. I’m a freelance writer as well. And my question is centers around race and healthcare workers, because we’ve known, at least I’ve known for quite some time, that people of color who are in the medical industry get treated terribly. Absolutely right. I mean, there are patients who flat out say, I don’t want a black doctor to touch me. And that’s been happening for many, many decades, years, centuries, whatever. But I feel like the pandemic, while it exposed the shortcomings of the healthcare industry as far as how patients come in already sick and then getting COVID, it didn’t really talk much more. I don’t remember seeing a lot of coverage about how the healthcare workers of color were affected by this pandemic as well as far as the burnout. So what are your suggestions on how I can report on the intersection between racism, burnout, and moral injury? Is there any research or people who have been studying this that could give me some more insight on that?

Nidhi Tewari/LCSW (42:32):

Sure. Yeah, I think that’s a fabulous question, and I think that it’s an important one because yes, it was not something that was reported on. I think ultimately the pandemic, unfortunately, people were in a desperate situation, and so I think a lot of people ended up seeking care from whoever was available, and I don’t think that they had the luxury, unfortunately of being demanding. I don’t want to see X, Y, Z person. That being said, that does not mean that there was not racism during the pandemic. I just think it was a desperate time. Right. So can I get back to you with some research on this? Because I want to give you some statistics. I want to give you something that’s meaningful to put in an article about this. Email you my question right now. Okay, that would be great. Please do. Because I want to give you an educated answer. And to be a hundred percent honest with you, and this is maybe a blind spot for myself, I did not look up that intersectionality, and I think it’s one that is so important to reflect on. So if that’s okay with you, I’d love to do that. Yeah, yeah, of course.

Rachel Jones/NPF (43:33):

Well, I am especially excited because I think we found our keynote speaker for next year. Aw, thank you. Talk to your publisher and get ’em to send us some free books. Yes. Thank you so much, Minnie, for an incredibly dynamic presentation, and I’m sure the journalists will want to be in touch with you.

Nidhi Tewari/LCSW (43:53):

I really appreciate it. Thank you for having me. Thank you all.