THE GREAT RESIGNATION AMONG HEALTHCARE WORKERS DURING THE COVID-19 PANDEMIC: CAUSES AND STRATEGIC SOLUTIONS

Öz

Healthcare workers, as one of the most critical resources of healthcare systems, have been at the forefront during the pandemic, facing challenges such as excessive workload, burnout, lack of work-life balance, and perceived insufficient institutional support. These factors have reduced job satisfaction among healthcare workers, leading them to reconsider their career decisions and bringing the phenomenon of the “Great Resignation” to the forefront in the healthcare sector. The increased workload and risky working conditions during the pandemic have made workforce losses in the healthcare sector more pronounced compared to other sectors. This study aims to examine, from a conceptual perspective, the factors leading healthcare workers to resign due to the challenging working conditions created by the COVID-19 pandemic. In this context, the study seeks to evaluate in detail fundamental factors affecting healthcare workers’ decisions to leave and to develop strategic recommendations aimed at preserving the workforce in the healthcare sector.

Anahtar Kelimeler

• Büyük İstifa
• COVID-19
• Pandemi
• Sağlık Çalışanı

COVID-19 PANDEMİSİ SÜRECİNDE SAĞLIK ÇALIŞANLARINDA BÜYÜK İSTİFA SORUNU: NEDENLER VE ÇÖZÜM ÖNERİLERİ

Öz

Sağlık sistemlerinin en önemli kaynaklarından biri olan sağlık çalışanları, COVID-19 pandemisi süresince ön saflarda yer alarak aşırı iş yükü, tükenmişlik, iş-yaşam dengesi eksiklikleri ve algılanan kurumsal destek yetersizliği gibi zorluklarla mücadele etmişlerdir. Bu faktörler, sağlık çalışanlarının iş doyumunu azaltarak kariyer kararlarını yeniden değerlendirmelerine yol açmış ve sağlık sektöründe “Büyük İstifa” olgusunu gündeme getirmiştir. Pandemiyle birlikte artan iş yükü ve riskli çalışma koşulları, sağlık sektöründeki iş gücü kayıplarını diğer sektörlere kıyasla daha belirgin hale getirmiştir. Bu çalışmanın amacı sağlık sisteminin en önemli kaynaklarından biri olan sağlık çalışanlarının, COVID-19 pandemisinin yarattığı zorlu çalışma koşulları nedeniyle istifa etmelerine yol açan faktörleri kavramsal açıdan incelemektir. Bu kapsamda, sağlık sektöründe yaşanabilecek olası personel eksikliklerinin önüne geçebilmek için iş yükü, tükenmişlik, şiddet gibi sağlık çalışanlarının işten ayrılma kararlarını etkileyen temel unsurların kavramsal açıdan ele alınarak ayrıntılı olarak değerlendirilmesi ve iş gücünü korumaya yönelik stratejik öneriler geliştirilmesi hedeflenmektedir.

Anahtar Kelimeler

• Büyük İstifa
• COVID-19
• Pandemi
• Sağlık Çalışanı

Kaynakça

1. Abbasi, J. (2022). Pushed to their limits, 1 in 5 physicians intends to leave practice. JAMA, 327(15), 1435-1437. American Association of Critical-Care Nurses (AACN) (2021). Hear us out campaign reports nurses’ COVID-19 reality. https://www.aacn.org/newsroom/hear-us-out-campaign-reports-nurses-covid-19-reality adresinden 8 Ekim 2024 tarihinde alınmıştır.
2. American Hospital Assosication (AHA) (2021). Strengthening the health care workforce. https://www.aha.org/system/files/media/file/2021/11/strengthening-the-health-care-workforce-II.pdf adresinden 8 Ekim 2024 tarihinde alınmıştır.
3. Arafa, A., Shehata, A., Youssef, M. & Senosy, S. (2022). Violence against healthcare workers during the COVID-19 pandemic: A cross-sectional study from Egypt. Archives of Environmental & Occupational Health, 77(8), 621-627.
4. Astorga-Pinto, S., Hewlett, E. & Philip Haywood, P. (2023). Protecting mental health. In OECD Health Policy Studies, Ready for the Next Crisis? Investing in Health System Resilience (s.236-265). OECD Publishing, Paris. https://doi.org/10.1787/1e53cf80-en.
5. Bellanti, F., Lo Buglio, A., Capuano, E., Dobrakowski, M., Kasperczyk, A., Kasperczyk, S., ...& Vendemiale, G. (2021). Factors related to nurses’ burnout during the first wave of Coronavirus Disease-19 in a university hospital in Italy. International Journal of Environmental Research and Public Health, 18(10), 5051.
6. Byon, H. D., Sagherian, K., Kim, Y., Lipscomb, J., Crandall, M. & Steege, L. (2022). Nurses’ experience with type II workplace violence and underreporting during the COVID-19 pandemic. Workplace Health & Safety, 70(9), 412-420.
7. Canadian Federation of Nurses Unions (CFNU) (2022). Canadian Federation of Nurses Unions Member Survey Summary Report, January 2022.
8. Choi, S. H. & Lee, H. (2017). Workplace violence against nurses in Korea and its impact on professional quality of life and turnover intention. Journal of Nursing Management, 25(7), 508-518.

9. Cook I. (2021), Who is driving the great resignation? https://hbr.org/2021/09/who-is- driving-the-great- resignation adresinden 8 Ekim 2024 tarihinde alınmıştır.
10. Çalışma ve Sosyal Güvenlik Bakanlığı (2022). Kamuda 3600 Devrimi. https://www.csgb.gov.tr/haberler/kamuda-3600 devrimi/#:~:text=%C3%87al%C4%B1%C5%9Fma%20ve%20Sosyal%20G%C3%BCvenlik%20Bakanl%C4%B1%C4%9F%C4%B1%2C%20hayata%20ge%C3%A7ecek%20olan%203600%20Ek,niteli%C4%9Finde%20bir%20%C3%A7al%C4%B1%C5%9Fmaya%20imza%20att%C4%B1 adresinden 10 Kasım 2024 tarihinde alınmıştır.
11. Daneshvar, E., Otterbach, S., Alameddine, M., Safikhani, H. & Sousa- Poza, A. (2022). Sources of anxiety among health care workers in Tehran during the COVID-19 pandemic. Health Policy and Planning, 37(3), 310–321.
12. De los Santos, J. A. A. & Labrague, L. J. (2021). The impact of fear of COVID-19 on job stress, and turnover intentions of frontline nurses in the community: A cross-sectional study in the Philippines. Traumatology, 27(1), 52.
13. Duan, X., Ni, X., Shi, L., Zhang, L., Ye, Y., Mu, H., ... & Wang, Y. (2019). The impact of workplace violence on job satisfaction, job burnout, and turnover intention: The mediating role of social support. Health and quality of life outcomes, 17, 1-10.
14. Dutta, A., Sharma, A., Torres-Castro, R., Pachori, H. & Mishra, S. (2021). Mental health outcomes among health-care workers dealing with COVID-19/severe acute respiratory syndrome coronavirus 2 pandemic: A systematic review and meta-analysis. Indian Journal of Psychiatry, 63(4), 335-347.
15. Ergur, G. A., Nuhoğlu, Ş., Çobanoğlu, C., Çetin, N., Bostan, P. & Ergur, A. (2021). Adanmışlıktan tükenmişliğe, tükenmişlikten vazgeçişe: COVID-19 pandemisi’nde istifa eden/emekli olan hekimlerin çığlığı. İstanbul University Journal of Sociology, 41(1), 73-102.
16. EUROGIP (2022). Focus on the recognition of Covid-19 as an occupational injury in nine European countries - Eurogip-173/E - 6/2022, ISBN 979-10-97358-51-8.
17. European Federation of Nurses (2024). Violence Against Nurses in the EU – EFN at NVKVV Congress. Fernandez, R., Sikhosana, N., Green, H., Halcomb, E. J., Middleton, R., Alananzeh, I., ... & Moxham, L. (2021). Anxiety and depression among healthcare workers during
18. Frogner, B. K. & Dill, J. S. (2022). Tracking turnover among health care workers during the COVID-19 pandemic: A cross-sectional study. JAMA Health Forum, 3(4), e220371-e220371.
19. Galanis, P., Vraka, I., Fragkou, D., Bilali, A. & Kaitelidou, D. (2021). Nurses’ burnout and associated risk factors during the COVID‐19 pandemic: A systematic review and meta‐analysis. Journal of Advanced Nursing, 77(8), 3286-3302.
20. Gan, Y., Li, L., Jiang, H., Lu, K., Yan, S., Cao, S., ... & Lu, Z. (2018). Prevalence and risk factors associated with workplace violence against general practitioners in Hubei, China. American Journal of Public Health, 108(9), 1223-1226.
21. García-Hedrera, F. J., Gil-Almagro, F., Carmona-Monge, F. J., Peñacoba-Puente, C., Catalá-Mesón, P. & Velasco-Furlong, L. (2021). Intensive care unit professionals during the COVID-19 pandemic in Spain: Social and work-related variables, COVID-19 symptoms, worries, and generalized anxiety levels. Acute and Critical Care, 36(3), 232.
22. García-Zamora, S., Pulido, L., Miranda-Arboleda, A. F., García, D. E., Perez, G., Priotti, M., ... & Baranchuk, A. (2022). Aggression, micro-aggression, and abuse against health care providers during the COVID-19 pandemic. A Latin American survey. Current Problems in Cardiology, 47(10), 101296.
23. General Medical Council (2021). National training survey 2021. https://www.gmc-uk.org/-/media/documents/national-training-survey-results-2021---summary-report_pdf-87050829.pdf adresinden 15 Kasım 2024 tarihinde alınmıştır.
24. Ghareeb, N. S., El-Shafei, D. A. & Eladl, A. M. (2021). Workplace violence among healthcare workers during COVID-19 pandemic in a Jordanian governmental hospital: The tip of the iceberg. Environmental Science and Pollution Research, 28(43), 61441-61449.
25. Gooch, K. (2021). 18% of healthcare workers have quit jobs during pandemic: Morning Consult. https://www.beckershospitalreview.com/workforce/18-of-healthcare-workers-have-quit-jobs-during- adresinden 5 Kasım 2024 tarihinde alınmıştır.
26. Güvenç, D. (2021). COVID-19 pandemisi sonrası: Çalışmanın sorgulanması ve büyük istifa sorunsalı. Uluslararası Sosyal Bilimlerde Yenilikçi Yaklaşımlar Dergisi, 5(4), 248-255.
27. Hamidi, M. S., Bohman, B., Sandborg, C., Smith-Coggins, R., De Vries, P., Albert, M. S., ... & Trockel, M. T. (2018). Estimating institutional physician turnover attributable to self-reported burnout and associated financial burden: A case study. BMC Health Services Research, 18, 1-8.
28. Heponiemi, T., Kouvonen, A., Virtanen, M., Vänskä, J. & Elovainio, M. (2014). The prospective effects of workplace violence on physicians’ job satisfaction and turnover intentions: The buffering effect of job control. BMC Health Services Research, 14, 1-8.
29. Holmes, J. (2022). The NHS nursing workforce–Have the floodgates opened? https://www.kingsfund.org.uk/insight-and-analysis/blogs/nhs-nursing-workforce adresinden 15 Kasım 2024 tarihinde alınmıştır.
30. International Committee of the Red Cross (ICRC) (2021). Pakistan: New law to prevent violence against health-care workers, facilities and patients in Khyber Pakhtunkhwa”, https://www.icrc.org/en/document/new-law-prevent-violence-health-care adresinden 15 Ekim 2024 tarihinde alınmıştır.
31. International Council of Nurses (ICN) (2021). The global nursing shortage and nurse retention. International Council of Nurses Policy Brief.
32. Irshad, M., Khattak, S. A., Hassan, M. M., Majeed, M. & Bashir, S. (2021). How perceived threat of Covid-19 causes turnover intention among Pakistani nurses: A moderation and mediation analysis. International Journal of Mental Health Nursing, 30(1), 350-350.
33. Jiskrova, G. K. (2022). Impact of COVID-19 pandemic on the workforce: From psychological distress to the great resignation. Journal of Epidemiology & Community Health, 76(6), 525-526.
34. Kaldy, J. (2021). What’s behind the great resignation? Blame burnout. https://infrontworkforce.com/featured-brief-whats-behind-the-great-resignation-blame-burnout adresinden 25 Ekim 2024 tarihinde alınmıştır.
35. Karl M. (2022). Part I: The impact of the great resignation on the health care industry. https://staffready.com/article/great-resignation-1-impact-healthcare adresinden 4 Ekim 2024 tarihinde alınmıştır.
36. Kelly J. (2022). New survey shows that up to 47% of U.S. healthcare workers plan to leave their positions by 2025. https://www.forbes.com/sites/jackkelly/2022/04/19/new-survey-shows-that-up-to-47-of-us-healthcare-workers-plan-to-leave-their-positions-by-2025/ adresinden 4 Ekim 2024 tarihinde alınmıştır.
37. Kuhlmann, E., Brînzac, M. G., Czabanowska, K., Falkenbach, M., Ungureanu, M. I., Valiotis, G., ... & Martin-Moreno, J. M. (2023). Violence against healthcare workers is a political problem and a public health issue: A call to action. European Journal of Public Health, 33(1), 4-5.
38. Kupietzky, J. (2022). The great resignation hits healthcare: Actions to take. https://www.newsweek.com/great-resignation-hits- healthcare-actions-take-1761064 adresinden 3 Ekim 2024 tarihinde alınmıştır.
39. Kuzior, A., Kettler, K. & Rąb, Ł. (2022). Great resignation—ethical, cultural, relational, and personal dimensions of generation Y and Z employees’ engagement. Sustainability, 14(11), 6764.
40. Lafortune, G. & Levy, N. (2023). Supporting health workforce recovery and resilience. In OECD Health Policy Studies, Ready for the Next Crisis? Investing in Health System Resilience (s.295-326). OECD Publishing, Paris. https://doi.org/10.1787/1e53cf80-en.
41. Lancet (2020). Protecting Chinese doctors. Lancet, Editorial, 395(10218), 90.
42. Linzer, M., Griffiths, E. P. & Feldman, M. D. (2022). Responding to the great resignation: detoxify and rebuild the culture. Journal of General Internal Medicine, 37(16), 4276-4277.
43. Lorenz-Dant, K. (2020) Germany and the COVID-19 long-term care situation. LTCcovid, International Long Term Care Policy Network, CPEC-LSE, 26 May 2020.
44. Martin, N. (2023). Record numbers of NHS doctors are resigning. One senior consultant tells us why she had to leave. https://news.sky.com/story/record-numbers-of-nhs-doctors-are-resigning-one-senior-consultant-tells-us-why-she-had-to-leave-12815928 adresinden 8 Ekim 2024 tarihinde alınmıştır.
45. Maslach, C. & Leiter, M. P. (2016). Understanding the burnout experience: Recent research and its implications for psychiatry. World Psychiatry, 15(2), 103-111.
46. Medical Group Management Association, MGMA (2021). Measuring the toll COVID-19 took on the physician workforce. https://www.mgma.com/mgma-stats/measuring-the-toll-covid-19-took-on-the-physician-workforce adresinden 28 Ekim 2024 tarihinde alınmıştır.
47. Medscape (2024). Medscape Physician Burnout & Depression Report 2024.
48. Monteiro, W. F., Lima, K. J. V., Ferreira, D. S., Andrade, L. L. C. D. & Ramos, F. R. S. (2023). Existing workloads among managers and healthcare workers during the COVID-19 pandemic: Meanings in the Amazon context. Plos one, 18(10), e0292541.
49. Moon, Y. K., O’Brien, K. E. & Mann, K. J. (2023). The role of extraversion in the great resignation: A burnout-quitting process during the pandemic. Personality and Individual Differences, 205, 112074.
50. Nasrul, R. N., Zainal, V. R. & Hakim, A. (2023). Workload, work stress, and employee performance: A literature review. Dinasti International Journal of Education Management and Social Science, 4(3), 415-422.
51. Neely-Barnes, S., Hirschi, M., Taylor, L., Delavega, E., Malone, C., Shelley, S. A., ... & Harris, M. (2023). The great resignation and its impact in behavioral health and social services. Human Service Organizations: Management, Leadership & Governance, 48(2), 150-163.
52. OECD (2021). State of Health in the EU France Country Health Profile 2021.
53. Oğan, H. (2020). Pandemi ortamında sağlıkta şiddet. Covid-19 Pandemisi Altınca Ay Değerlendirme Raporu içinde (s. 355-368).
54. Parker, K. & Horowitz, J. M. (2022). Majority of workers who quit a job in 2021 cite low pay, no opportunities for advancement, feeling disrespected. Pew Research Center. https://www.pewresearch.org/short-reads/2022/03/09/majority-of-workers- adresinden 8 Kasım 2024 tarihinde alınmıştır.
55. Poon, Y. S. R., Lin, Y. P., Griffiths, P., Yong, K. K., Seah, B. & Liaw, S. Y. (2022). A global overview of healthcare workers’ turnover intention amid COVID-19 pandemic: A systematic review with future directions. Human Resources For Health, 20(1), 70.
56. Popowitz, E., Bellemare, T. & Tieche, M. (2022). Addressing the healthcare staffing shortage: An exploration of why the industry is losing thousands of workers, and how that’s putting the health of healthcare at risk. A Definitive Healthcare report, Definitive Healthcare.
57. Razu, S. R., Yasmin, T., Arif, T. B., Islam, M. S., Islam, S. M. S., Gesesew, H. A. & Ward, P. (2021). Challenges faced by healthcare professionals during the COVID-19 pandemic: A qualitative inquiry from Bangladesh. Frontiers in public health, 9, 647315.
58. Reißmann, S., Wirth, T., Beringer, V., Groneberg, D. A., Nienhaus, A., Harth, V. & Mache, S. (2023). “I think we still do too little”: Measures to prevent violence and aggression in German emergency departments–a qualitative study. BMC health services research, 23(1), 97.
59. Roche, M., Diers, D., Duffield, C. & Catling‐Paull, C. (2010). Violence toward nurses, the work environment, and patient outcomes. Journal of Nursing Scholarship, 42(1), 13-22.
60. Rodríguez-Bolaños, R., Cartujano-Barrera, F., Cartujano, B., Flores, Y.N., Cupertino, A.P. & Gallegos-Carrillo, K. (2020). The urgent need to address violence against health workers during the COVID-19 pandemic. Medical Care, 58(7):663. Doı: 10.1097/Mlr.0000000000001365
61. Said, R. & El-Shafei, D., 2020. Occupational stress, job satisfaction, and intent to leave: nurses working on front lines during COVID-19 pandemic in Zagazig City, Egypt. Environmental Science and Pollution Research, 28(7), 8791-8801.
62. Sairany, H. (2023). Managing burnout: The era of the great resignation. https://www.pharmacytimes.com/view/managing-burnout-the-era-of-the-great-resignation adresinden 3 Ekim 2024 tarihinde alınmıştır.
63. SASAM Enstitüsü (Sağlık-Sen Stratejik Araştırmalar Merkezi Enstitüsü) (2021). COVID-19 ile mücadelede sağlık çalışanları araştırması-2,. Sağlık-Sen Yayınları – 53, Ankara.
64. Shah, M. K., Gandrakota, N., Cimiotti, J. P., Ghose, N., Moore, M. & Ali, M. K. (2021). Prevalence of and factors associated with nurse burnout in the US. JAMA Network Open, 4(2), e2036469-e2036469.
65. Sheather, J. & Slattery, D. (2021). The great resignation-How do we support and retain staff already stretched to their limit? BMJ, n2533.
66. Shoja, E., Aghamohammadi, V., Bazyar, H., Moghaddam, H. R., Nasiri, K., Dashti, M., ... & Asgari, A. (2020). Covid-19 effects on the workload of Iranian healthcare workers. BMC Public Health, 20, 1-7.
67. Sinsky, C. A., Brown, R. L., Stillman, M. J. & Linzer, M. (2021). COVID-related stress and work intentions in a sample of US health care workers. Mayo Clinic Proceedings: Innovations, Quality & Outcomes, 5(6), 1165-1173.
68. Sinsky, C., Dyrbye, L., West, C., Satele, D., Tutty, M. & Shanafelt, T. (2017). Professional satisfaction and career plans of U.S. physicians. Mayo Clinic Proceedings, 92(11), 1625-1635.
69. Smith, C. (2020). The structural vulnerability of healthcare workers during COVID-19: Observations on the social context of risk and the equitable distribution of resources. Social Science and Medicine, 258: 1-4.
70. Sosyo Politik Saha Araştırma Merkezi (2020). Dı̇yarbakır’da Görev Yapan Sağlık Personellerı̇nin Pandemı̇ Sürecı̇nden Etkı̇lenı̇mlerı̇ ve Önerı̇lerı̇ Saha Çalışma Raporu, Ağustos 2020.
71. Superstaff (2024). Everything you need to know about “the great resignation”. https://www.superstaff.com/wp-content/uploads/2022/03/The_Great_Resignation.pdf adresinden 12 Kasım 2024 tarihinde alınmıştır.
72. Tan, C. (2021). More healthcare workers in S’pore quit amid growing fatigue as COVID-19 drags on. https://www.straitstimes.com/singapore/politics/more-healthcare-workers-in-spore-resigning-amid-growing-fatigue-as-covid-19-drags adresinden 10 Kasım 2024 tarihinde alınmıştır.
73. TTB (2020). Hekimlerin istifası yasaklandı mı? https://www.ttb.org.tr/haber_goster.php?Guid=4c71e674-1d0f-11eb-9f63-b7e1409e57db adresinden 2 Ekim 2024 tarihinde alınmıştır.
74. Türkiye Psikiyatri Derneği (2020). Türkiye Psikiyatri Derneği sağlık çalışanlarına destek hattı açıldı. https://psikiyatri.org.tr/2174/turkiye-psikiyatri-dernegi-saglik-calisanlarina-destek-hatti-acildi adresinden 15 Kasım 2024 tarihinde alınmıştır.
75. URL-1. U.S. Bureau of Labor Statistics (2024). Job openings and labor turnover, Table 4. Quits levels and rates by industry and region, seasonally adjusted https://www.bls.gov/news.release/jolts.toc.htm adresinden 5 Ekim 2024 tarihinde alınmıştır.
76. URL-2. https://www.bbc.com/turkce/haberler-dunya-54603919 adresinden 8 Ekim 2024 tarihinde alınmıştır. URL-3. https://medimagazin.com.tr/koronavirus/saglik-bakani-acikladi-2-bin-412-doktor-istifa-etti-522-doktor-ozel-hastanelere-gecti-94232 adresinden 8 Ekim 2024 tarihinde alınmıştır.
77. URL-4. https://t24.com.tr/haber/turk-tabipleri-birligi-18-ayda-8-binin-uzerinde-hekim-istifa-etti,982793 adresinden 15 Ekim 2024 tarihinde alınmıştır.
78. URL-5. https://www.theguardian.com/society/2021/may/03/nhs-faces-exodus-doctors-covid-pandemic-survey adresinden 10 Ekim 2024 tarihinde alınmıştır.
79. URL-6. https://news.ontario.ca/en/release/1005369/ontario-continuing-to-support-and-grow-its-nursing-workforce adresinden 8 Kasım 2024 tarihinde alınmıştır.
80. URL-7. https://www.cbc.ca/news/canada/montreal/quebec-recruit-foreign-nurses-1.6353552 adresinden 8 Kasım 2024 tarihinde alınmıştır.
81. URL-8. https://medicine.nus.edu.sg/nursing/2022/05/keep-calm-and-carry-on-virtual-reality-helps-medical-and-nursing-students-manage-agitated-patients-with-empathy/ adresinden 15 Kasım 2024 tarihinde alınmıştır.
82. URL-8. https://www.saglik.gov.tr/TR-64688/32-bin-personel-alimina-iliskin-yapilan-aciklama.html adresinden 8 Kasım 2024 tarihinde alınmıştır.
83. Wankhede, P., Wanjari, M., Late, S. & Rodge, H. (2021). Challenges faced by healthcare professionals during the COVID-19 Pandemic: A review. Journal of Pharmaceutical Research International, 33(53B): 89-92.
84. WHO (2021). The impact of COVID-19 on health and care workers: A closer look at deaths. Health Workforce Department–Working Paper 1, September 2021, WHO/HWF/WorkingPaper/2021.1, Geneva.
85. WHO (2024). Preventing violence against health workers. https://www.who.int/activities/preventing-violence-against-health-workers/1000 adresinden 6 Ekim 2024 tarihinde alınmıştır.
86. WHO & ILO (2003). Workplace violence in the health sector country case studies research instruments. Joint Programme on Workplace Violence in the Health Sector. who-quit-a-job-in-2021-cite-low-pay-no-opportunities-for-advancement- feeling-disrespected adresinden 6 Ekim 2024 tarihinde alınmıştır.
87. Williams, G. A., Scarpetti, G., Bezzina, A., Vincenti, K., Grech, K., Kowalska-Bobko, I., ... & Maier, C. B. (2020). How are countries supporting their health workers during COVID-19? Eurohealth, 26(2), 58-62.
88. Williams, G. A., Scarpetti, G., Langins, M., Callies, I., Fourcade, A., van Ginneken, E. & Maier, C. B. (2022). Human resources for health during COVID-19: Supporting and protecting health workers. Eurohealth, 28(1), 24-28.
89. Yang Y., Wang P., Kelifa M.O., Wang, B., Liu, M., Lu, L., & Wang, W. (2021) How workplace violence correlates turnover intention among Chinese health care workers in COVID-19 context: The mediating role of perceived social support and mental health. Journal of Nursing Management 30, 1407–1414.
90. Yılmaz, S. ve Işık E. (2021). Sağlık çalışanları açısından pandemiyle mücadele: 11 Mart 2020 - 11 Mart 2021. Sağlık-Sen Yayınları–52, Semih Ofset, Ankara.
91. Zamanzadeh, V., Valizadeh, L., Khajehgoodari, M. & Bagheriyeh, F. (2021). Nurses’ experiences during the COVID-19 pandemic in Iran: A qualitative study. BMC Nursing, 20, 1-9.
92. Zapata, T., Azzopardi Muscat, N., Falkenbach, M. & Wismar, M. (2023). From great attrition to great attraction: Countering the great resignation of health and care workers. Eurohealth, 29(1), 6-10.