The Problem | Healthcare
Workforce Stress And Burnout

Aworkers have been experiencing an epidemic of toxic stress and burnout, exacerbated in recent years by the COVID-19 pandemic and its aftermath. Nowhere have these effects been more pronounced than among the US healthcare workforce. Rates of burnout, depression, and anxiety among healthcare workers are at historically high levels and have not abated, but rather have continued to accelerate, in the aftermath of the pandemic. Many healthcare workers are choosing to leave their professions, creating additional stressors on health care facilities and systems that already were stretched frighteningly thin. 

Our Approach | Heal The Healers Now

To address this problem, “Heal the Healers Now,” an initiative to bring the stress-reducing Transcendental Meditation® (TM) technique to frontline US healthcare workers, was launched nationally in April 2020 by the Institute for Mental Health and Resilience of the David Lynch Foundation and the US TM organization.

More than 3,000 healthcare workers at more than 80 US hospitals and medical centers have participated in the program. Research on the TM technique and its benefits for healthcare workers has been conducted at leading medical institutions such as Brigham and Women’s Hospital (Harvard Medical School), Duke University Medical Center, University of Michigan Medical Center, and Weill Cornell Medical Center. Results from published research have shown consistent and significant improvements in healthcare worker burnout, depression, anxiety, insomnia, and mental wellbeing, with rapid onset of improvement within 2 weeks. Those who learn to meditate keep it up — compliance with TM practice has been uniformly high among participants, demonstrating feasibility of the program for busy healthcare workers.

“TM has given me a new way to start each day.
Even early on, I found myself able to be less reactive, more calm, and with greater reserves of patience
for dealing with whatever was happening.”
Attending Physician, Internal Medicine
Alignment with NIOSH’s Total Worker Health initiative The Heal the Healers Now initiative is aligned with the Total Worker Health initiative of the National Institute for Occupational Safety and Health (NIOSH), a division of the Center for Disease Control (CDC), which promotes institutional policies and strategies to support workers’ health and wellbeing. In addition to providing the TM program for individual healthcare worker wellbeing, Heal the Healers Now advocates with its hospital partners for institutional policies to facilitate the adoption and success of worker wellbeing interventions, including Transcendental Meditation. Such policies would include, wherever feasible, increased flexibility in employee work schedules to allow protected break time on the job for wellbeing interventions, including TM practice, as well as providing dedicated spaces for such practices. The goal is to foster and expand an on-the-job culture of staff wellness. For further information on NIOSH and the Total Worker Health initiative, visit https://www.cdc.gov/niosh/twh/programs/index.html.
Healthcare workers share how TM has helped them cope with crushing levels of stress, while researchers from leading medical institutions share evidence of TM’s benefits for burnout, depression, anxiety, and sleep. (4:04 minutes)

Partnerships

Inside I would be very jittery and very uneasy. But after starting TM, I can plant my feet on the ground and feel like I’m touching the floor. Having healthcare workers care for themselves through meditation is going to have a significant impact.
Mohammad Shams, MD, MBA,
Chief of Medicine, Harford HealthCare
Arizona
  • University of Arizona Medical Center, Tucson
  • Jewish Family & Children Services, Tucson
  • CODAC, Tucson
California
  • UCLA Health, Los Angeles
  • Mission Hospital, Mission Viejo
Connecticut
  • Stamford Health System, Stamford
FloridaMiami multi-site trial:
  • Encompass Hospital
  • Mercy Hospital
  • Baptist Hospital
Sarasota-Tampa multi-site trial:
  • Sarasota Memorial Hospital, Sarasota
  • Tampa General Hospital, Tampa
  • Moffitt Cancer Center, Tampa
  • Cleveland Clinic Indian River Hospital, Vero Beach
Georgia
  • Emory Healthcare, Atlanta
Illinois
  • Sinai Health System, Chicago
  • Advocate Illinois
  • Masonic Medical Center, Chicago
Maryland
  • MedStar Montgomery Medical Center, Olney
Massachusetts
  • Brigham and Women’s Hospital (Harvard), Boston
  • Southcoast Health System-St. Luke’s Hospital, New Bedford
Michigan
  • Ascension Health, Detroit
  • Helios Healthcare, Troy
  • University of Michigan Health System, Ann Arbor
New Jersey
  • CentraState Medical Center, Freehold
  • MetroDerm, Fort Lee
New York CityNorthwell Hospitals:
  • Lenox Health Greenwich Village
  • Lenox Hill Upper East Side
  • Long Island Jewish
  • Long Island Jewish-Forest Hills
  • Long Island Jewish-Valley Stream
  • Manhattan Eye Ear Throat Hospital
  • Northwell HQ
  • North Shore Hospital
  • Northern Westchester Hospital
  • Staten Island University Hospital
NYC Health + Hospitals
  • Central Office
  • Hospitals
  • Bellevue
  • Coney Island
  • Elmhurst
  • Harlem
  • Jacobi
  • Kings County
  • Lincoln
  • Metropolitan
  • North Central Bronx
  • Queens
  • Woodhull
  • Post Acutes
  • Carter
  • Coler
  • McKinney
  • Sea View
  • Gotham
  • East New York
  • Gouverneur
  • Morrisania
  • Sydenham
1199SEIU Healthcare Union
HQ sites — Manhattan, Brooklyn, and the Bronx:
  • St. John’s Riverside Hospital-ParkCare
  • St. Cabrini Nursing Home
  • Somers Rehabilitation & Nursing Center
  • Ryan Chelsea-Clinton Community Health Center
Memorial Sloan Kettering Cancer Center:
  • Manhattan
  • Westchester
New York County Medical Society:
  • NYU Langone Health
  • Weill-Cornell Medicine
North Carolina
  • Duke University Medical Center, Durham
Oregon
  • Kaiser Permanente, Portland

Transcenadental meditation, Stress, Burnout, and Resilience

P
eer-reviewed published studies have documented that TM practice ameliorates the symptoms of workplace burnout for healthcare workers and other populations, as well as produces the following effects:

  • Reduction in stress and anxiety
  • Reduced depression
  • Improvement in sleep disorders
  • Reduced post-traumatic stress disorder (PTSD)
  • Increased psychological and emotional resilience
  • Reduced substance abuse
Featured Research

Studies On
Healthcare Workers

Decreased Burnout, Sleep Difficulties, Anxiety, and Depression Symptoms in Emergency PersonnelJ Am Coll Emerg Physicians Open, 2021; Single group pretest-posttest

Thirty-one emergency clinicians (physicians, nurses, and physician-assistants) from two urban hospitals were recruited to participate in TM instruction and follow-up for 3 months in this single-arm study. TM participants demonstrated significant reductions in burnout (P < .05; Cohen's d = 0.43–0.45) and in symptoms of depression, anxiety, stress, and sleep disturbance (P < .001; Cohen's d = 0.70–0.87). 90.6% (n = 29/32) attended 6/8 TM training sessions and 80.6% self-reported meditating at least once a day on average.

Research Field Site: Brigham and Women’s Hospital, Boston, MA

Reference: Azizoddin DR, Kvaternik N, Beck M, et al. Heal the Healers: A pilot study evaluating the feasibility, acceptability, and exploratory efficacy of a Transcendental Meditation intervention for emergency clinicians during the coronavirus disease 2019 pandemic. J Am Coll Emerg Physicians Open, 2021;2(6):e12619

Reduced Anxiety Symptoms, Sleep Problems, and Burnout in Healthcare WorkersJAMA Network Open, 2022; RCT

Eighty healthcare workers from a southeast medical center were randomly assigned to either Transcendental Meditation (TM) or a usual care control group (with access to wellness resources). The TM group had significant reductions compared to controls in emotional exhaustion on the Maslach Burnout Inventory (MBI) (P = .006); sleep difficulties, with the Insomnia Severity Index (P = .05); and anxiety, using the Generalized Anxiety Disorder-7 scale (P = .01) over 3 months. Marginally significant differences between groups were found for depression symptoms, with the Patient Health Questionnaire-7 (P < .06) and MBI Depersonalization scale (P < .08). Thirty-eight participants (92.7%) in the TM group were compliant with their home practice (defined as meditating at least once a day).

Research Field Site: Duke University Medical Center and Mind Path, NC

Reference: Joshi SP, et al. Efficacy of Transcendental Meditation to reduce stress among healthcare workers: A randomized clinical trial. JAMA Network Open, 2022 Sept 19;5(9):e2231917. doi:10.1001/jamanetworkopen.2022.31917

Decreased Burnout and Depression Symptoms in Faculty PhysiciansJournal of Continuing Education in the Health Professions, 2023; RCT

Forty academic physicians at a Midwest medical school and affiliated VA hospital were randomly assigned to Transcendental Meditation or usual care control group with a 4-month intervention period. Assessment was conducted at baseline, 1 month, and 4 months. Significant improvements were found for the TM group compared to controls at 4 months in total burnout (p = .020), including the Maslach Burnout Inventory dimensions of emotional exhaustion (p = .042) and personal accomplishment (p = .018), and depression symptom (p = .016). Qualitative interviews supported these outcomes.

Research Site: University of Loyola Stritch Medical School, Chicago, IL

Reference: Loiselle M, Brown C, et al. Effect of Transcendental Meditation on physician burnout, depression, and insomnia: A randomized controlled study. Journal of Continuing Education in the Health Professions (JCEHP), 2023 Jan. 26; doi.org/10.1097/CEH.472

Improved Mental Well-Being in NursesJournal of Nursing Administration, in press; RCT

A randomized controlled trial with 104 clinical nurses over a 3-month period at 3 magnet hospitals in west central Florida showed significant improvements, with medium to large effect sizes, in TM subjects compared to controls in the following mental well-being measures: anxiety, burnout, PTSD symptoms, and flourishing. Compliance with home TM practice was high, with over 90% of TM subjects reporting meditating at least once daily on average.

Research Field Sites: Sarasota Memorial Hospital, Tampa General Hospital, Moffitt Cancer Center

Reference: Bonamer J, Kutash M, Hartranft S, Aquino-Russell C, & Johnson A. Transcendental Meditation improves clinical nurse-well being: a multi method randomized controlled trial. Journal of Nursing Administration (in press).

Improved Depression, Anxiety, Emotional Exhaustion, Insomnia and Mental Well-Being in Healthcare WorkersPLOS ONE, 2023; Controlled parallel population study

A controlled parallel population study of 130 healthcare workers at three Miami hospitals at the height of the Covid pandemic found highly significant improvements in the TM group relative to non-meditating controls in depression, anxiety, emotional exhaustion (a key component of burnout), insomnia, and mental well-being beginning as early as 2 weeks after starting TM and continuing throughout the 3-month study.

Research Field Sites: Baptist, Mercy, and Encompass Hospitals, Miami, FL

Reference: Nestor MS, Lawson A, Fischer D. Improving the mental health and well-being of healthcare providers using the Transcendental Meditation technique during the COVID-19 pandemic: A parallel population study. PLOS ONE, 2023;18(3):e0265046. https://doi.org/10.1371/journal.pone.0265046

Reduced Burnout, Depression and Anxiety Symptoms and Increased Mental Well-BeingOnline Journal of Issues in Nursing, 2023; Single group pretest-posttest

This single-arm study evaluated the feasibility and effectiveness of the Transcendental Meditation (TM) intervention in a sample of 32 healthcare clinicians who provided care to COVID-19 patients. At one-month and three-month posttest, statistically significant improvements were observed for the burnout scales of emotional exhaustion and personal accomplishment, depression and anxiety symptoms, and overall mental well-being, with large effect sizes on most scales. TM practice was found to be feasible in this population, with high levels of compliance in attendance at training sessions and TM home practice.

Research Field Site: University of Michigan Health, Ann Arbor, MI

Reference: Calarco M, Stratton K. The impact of Transcendental Meditation in reducing burnout and enhancing well-being in frontline healthcare clinicians during the COVID-19 pandemic. Online Journal of Issues in Nursing, 2023;28(3). doi:10.3912/OJIN.Vol28No03PPT55

Improved Compassion Fatigue and Resilience in NursesJournal for Nurses in Professional Development, 2019; single group pretest-posttest

A pilot study with 27 nurses found significant improvement over 4 months in compassion fatigue and resilience due to TM practice. Both subscales of compassion fatigue, secondary traumatic stress and burnout, were observed to decrease. Increased resilience was found to be correlated with reduced compassion fatigue.

Research Field Site: Sarasota Memorial Hospital, Sarasota, FL

Reference: Bonamer J, Aquino-Russell C. Self-care strategies for professional development: Transcendental Meditation reduces compassion fatigue and improves resilience for nurses. Journal for Nurses in Professional Development 2019; 35(2): 93–97.

Improved Burnout and Resilience in Medical StudentsIn review for publication; single group pretest-posttest

Thirty-nine students at Georgetown University School of Medicine were assessed at baseline, 1 month and 3 months after instruction in TM. Significant improvements, with medium to large effect sizes, were demonstrated at 3-month post-testing in the following measures: burnout, anxiety, depression, insomnia, resilience, and mental well-being. Overall adherence to home TM practice was high, with 85% of subjects meditating at least once daily on average. A dose-response effect was observed, with strength of effect significantly correlated with frequency of home TM practice (twice daily vs. once daily vs. less than once daily).

Research Field Site: Georgetown University School of Medicine, Washington, DC

Reference: James C, Heiman I, and Amri H. A Pilot Intervention to Reduce Burnout and Enhance Resilience through Transcendental Meditation among Georgetown University Medical Students. In review for publication.

Conferences

NEW SOLUTIONS-WASHINGTON, DC Symposium on Transcendental Meditation® as a Clinical Health Intervention
Solutions for Health Care Workers — Highlights
October 20, 2021 • Washington, DC

Researchers from Weill Cornell Medicine (Emergency Medicine Department), Brigham and Women’s Hospital (Harvard Medical School), Duke University Medical Center, and University of Miami School of Medicine shared encouraging research on ways that TM mitigates emotional exhaustion, depersonalization, insomnia, burnout, and other trauma symptoms among healthcare workers.

Healthcare Workplace
Advisory Board

Hakima Amri, PhD
Associate Professor of Biochemistry and Molecular and Cellular Biology at Georgetown University and co-founder and co-director of Georgetown’s Complementary and Alternative Medicine Graduate Program
Desiree Azizoddin, PsyD
Assistant Professor, Department of Family and Preventive Medicine at the University of Oklahoma College of Medicine
Alsan Bellard, Jr., MD, MBA
Chief Medical Officer, Community of Hope community health centers, Washington, DC
Jen Bonamer, PhD, RN, NPD-BC, AHN-BC
Nursing Professional Development – Research Specialist and Education, Professional Development & Research Department at Sarasota Memorial Health Care System
Margaret Calarco, PhD, RN, NEA-BC
Director for Clinical Innovation and Adjunct Clinical Instructor at University of Michigan Medical School
Bradley Collins, MD
Associate Professor of Medicine, Warren Alpert School of Medicine, Brown University; President, Rhode Island Chapter of the Society of Hospital Medicine
Gary Deutsch, MD
Program Director, Northwell Complex General Surgical Oncology Fellowship; Associate Professor of Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
Charles Elder, MD
Senior Investigator, Internal Medicine; Primary Care Internist; and Executive Director, Fellowship for Medical and Associate Professor of Physiology and Health at Maharishi International University.
Alex Kolevzon, MD
Professor of Psychiatry and Pediatrics, Icahn School of Medicine; Clinical Director, Seaver Autism Center; and Director, Child and Adolescent Psychiatry,Mount Sinai Health System
Patty Lee, MD
Senior Faculty, Medicine, Pulmonary, Critical Care and Sleep Medicine at Icahn School of Medicine at Mount Sinai Health System
Mark Nestor, MD, PhD
Director, Center for Clinical and Cosmetic Research, and Voluntary Professor, Department of Dermatology and Cutaneous Surgery, Department of Surgery, Division of Plastic and Reconstructive Surgery at the University of Miami Miller School of Medicine
Mandy O’Hara, MD
Child Abuse Pediatrician at Children’s Hospital at Montefiore and Associate Professor at Montefiore Einstein Department of Medicine
Peter Steel, MD
Vice Chair for Clinical Services and Associate Professor, Department of Emergency Medicine, Weill Cornell Medical College
“Nothing can erase the stress and anxiety in our lives, but meditation has enabled me to handle them better. It is important for my patients to know how much it has helped me. I recommend it to everyone.”
Erica Cargill Jones, MD
Clinical Associate Professor of Medicine;
Weill Cornell Medical College, New York, NY