A Call for Balance: The Toll of Chronic Stress on Infection Preventionists

Dear Helpdesk: Inoculating Your Work Life with IP Wisdom

Dear Helpdesk,

I recently went to the doctor after months of avoiding it…my physician told me that what I'm experiencing is most likely due to chronic stress, and my body can no longer handle it. I made the appointment, afraid something was seriously wrong with me, and now I’m wondering how I allowed myself to get here. I’m 45 years old, having been told that I am on the path to a heart attack due to the stress my body was experiencing at work.

As infection preventionists (IPs), we take on so much, having lived through COVID-19, staffing shortages, and bad hospital finances. I cannot help but wonder how I allowed myself to go from “We are in this together” to “I will work 12-hour days, 7 days a week for months.” I take on my role and the workload of 2 other IPs because we don't have funding to hire more staff. How did this mentality become okay? And why did it take fear for my health to become aware of how I’ve been working for the last nearly 5 years?

How do we allow ourselves to work in these insane conditions and think it is okay and temporary?

Thanks,

Stressed and Struggling,

Dear Stressed and Struggling,

First, let me say how much I admire your courage in sharing this story. Many of us in infection prevention have walked a similar road—carrying far more than we should, driven by a sense of duty that leaves little space for our own well-being. You are not alone in this struggle.

Yet, I hear the weight of guilt in your words. You feel like you should have seen this coming, that somehow, you let yourself down by pushing too hard for too long. But please, let’s take a moment to release that guilt—you are not the problem. The problem is the unrealistic demands and unsustainable expectations that so many of us have assumed. Your being here, reflecting on how to heal and grow, is a sign of your strength.

How Did We Get Here?

(Image Created with Ideogram AI by Author)

Your story is one I’ve heard often from colleagues across the health care field, especially in infection prevention and public health. When the COVID-19 pandemic hit, we were united by a sense of purpose, determined to do whatever it took to protect patients and staff. Twelve-hour days and seven-day workweeks became the norm. And at the time, there was a sense of, “We’re in this together.” But somewhere along the way, this crisis-mode mentality became the new normal.

As health care workers, we often struggle to say no, especially when budgets shrink and staffing shortages worsen. Taking on the roles of two—or even three—IPs may have seemed necessary during the COVID-19 pandemic, but it’s not sustainable and can’t continue. Slowly, the boundary line between what we could do in an emergency and what we should do every day has eroded. We keep telling ourselves, “Just a little longer, just one more week, one more month,” until 5 years have slipped by.

What you are now experiencing —chronic stress that has taken a physical toll—is a wake-up call. But please, know that your body’s response to the chronic stress you’re experiencing is not a failure. It is simply a message, a signal to us all that it’s time to re-center ourselves and prioritize our own well-being.

How Do We Start to Heal?

There’s no easy fix for years of chronic stress, but small, intentional steps can guide you toward healing and help you reclaim your balance. Here’s where to begin:

1. Acknowledge the Stress and Its Impact

We’ve been through a lot over the past 5 years. Rather than blaming yourself, try to view this moment with compassion. Your stress was not caused by personal failure—it resulted from extraordinary circumstances and a health care system that demands far too much from too few. Just as you wouldn’t blame a colleague for feeling overwhelmed, you must offer yourself the same grace. You must acknowledge the stress you’ve endured with compassion. More often than not, chronic stress leads to a sense of disillusionment in our work. It drains us of the joy we once experienced in our work and causes us to forget why we entered this profession in the first place.

Reflect on what parts of your work bring you joy and what drains you. Identifying these areas will help you reconnect with what’s meaningful and address what’s unsustainable.

2. Rebuild Boundaries, One Step at a Time

Thinking about setting new boundaries can feel overwhelming, but healing starts here. Ask yourself, “What is one small boundary I can set today to protect my well-being?” Maybe it’s leaving work at a reasonable hour or deciding not to check emails after 6 PM. These small boundaries will become your protective armor, helping you to rebuild space for yourself.

It might help to revisit the collective mentality we developed during the pandemic: “We’re in this together.” You can’t carry everything alone, and you shouldn’t have to. Seek opportunities to delegate and offload responsibilities appropriately. You’re only one person, and you shouldn’t have to carry the weight of 5.

Take the time to reevaluate and reprioritize your work. Decide what you can reasonably expect of yourself and where you might need to ask for help. Adopting new boundaries often means saying no when you’ve previously said yes. It can be difficult at first, but setting appropriate boundaries is essential for becoming healthy in our relationship with work. For a deeper dive into setting boundaries in the workplace, see the earlier Dear Helpdesk, entitled Setting Boundaries in the Workplace.

3. Communicate Your Needs Clearly

Once you’ve identified where you need boundaries, it’s important to communicate them. Schedule a meeting to calmly explain how your current workload has impacted your health and well-being. This conversation is about not just saying no but setting sustainable limits to succeed in your role.

You might say, “I realize I’ve been taking on more than I can handle. It’s starting to take a toll on my physical health. Moving forward, I need to focus on my core responsibilities to do my job effectively without compromising my health.”

This conversation may feel uncomfortable, but remember: Boundaries are not about saying no to work—they are about saying “yes” to your well-being and the long-term success of your role as an IP. Boundaries do not exist if we do not communicate them and communicate them clearly.

4. Focus on What You Can Control

You cannot change hospital finances or fix staffing shortages overnight, which will impact your work. What you can control is how you respond to these stressors. You must become proficient at recognizing when you’re reaching your limit and responding to yourself with care. It’s okay to say, “I’ve done all I can do today,” and leave the rest for tomorrow.

If the workload still feels unmanageable, it may be time to have a conversation with leadership or HR about finding additional support. Documenting the workload and its impact on patient care, your health, and the health of your team can help make the case for long-term change.

5. Permit Yourself to Rest

Many IPs feel guilty for resting—after all, our work is essential! Rest, however, is not a reward for a job well done; it’s a necessity. Just as you can’t pour from an empty cup, you cannot care for others without first caring for yourself. We must recognize that we will always have work left to do in this field. We cannot do it all, and we certainly will never reach our goals when we’re burnt out and physically exhausted. Ensure you’re taking care of yourself first and allowing yourself to rest.

Consider what the rest looks like for you. Maybe it’s spending more time with loved ones, engaging in hobbies, or sitting quietly with a good book. Whatever rest means for you, allow yourself to embrace it fully.

Moving Forward with Compassion

It’s okay that it took a health scare for you to see the need for change. What matters now is how you move forward. You’ve already taken the first step by recognizing chronic stress's toll on your body. The next step is choosing how to protect yourself moving forward—not out of guilt, but compassion for yourself and a commitment to your well-being. You have given so much to your work, but now it’s time to give back to yourself. Start small, rebuild your boundaries, and trust that healing is possible. The work will still be there, but you will face it with new strength and clarity after permitting yourself to reprioritize yourself.

Finally, you must continue working closely with your physician to manage your health. Discuss your work stress with your doctor and discuss any necessary accommodations, such as time off, medical testing, or follow-up appointments. Partnering with your health care provider will ensure you have the support and medical documentation necessary for workplace accommodations.

Have compassion for yourself. You are not alone on this journey and are not the problem. You are a dedicated professional who is doing your best in a challenging environment. It’s time to take care of the person who has cared for so many others—yourself. It’s time we all did that.

With care,
Dear Helpdesk