Zombie burnout is haunting healthcare. Workers keep showing up

Forget the groaning, shuffling zombies roaming the streets this Halloween. There's a different kind of zombie haunting U.S. healthcare, and these ones are much harder to spot. They're wearing scrubs, clocking in for their shifts and caring for patients, even when they're running on fumes.

That's the picture painted by BambooHR's 2026 Healthcare Workforce Report, which suggests the industry may be experiencing what it calls "zombie burnout." Its survey found that 65% of healthcare workers experience some form of compassion fatigue, burnout, moral distress or secondary traumatic stress.

Yet fewer appear to be walking away. Voluntary turnover accounted for 56% of healthcare departures this year, down from 61% in 2023, according to data from more than 15,000 healthcare organizations on BambooHR's platform.

For Nicole Csiszar, senior director of HR services at BambooHR in California, that's what makes the zombie comparison so fitting.

"I think the association with the zombie is because you're burnt out, but you still walk amongst the living," Csiszar said. "So you picture these poor healthcare workers that really don't have the option to not show up for their patients and all the things that have to continue to go on. While the burnout is so real, they have to show up anyways, and they continue to do it over and over."

Why burned-out workers stay put

Burnout might seem like a reason to start looking for the exit, but leaving doesn't necessarily promise relief. For healthcare workers already stretched thin, the prospect of starting over somewhere else can bring its own uncertainty.

Csiszar said her perspective comes partly from conversations with nurses she knows, who face a difficult question when weighing whether to leave.

"There's also stress in leaving," Csiszar said. "You weigh out the options. Will it be better somewhere else, or is it just a different name on the side of the hospital or building that you're working for?"

Csiszar said burnout is rising in other industries too. The pressures aren't the same as in healthcare, she said, but fears about the job market and AI are leaving some workers reluctant to move on.

"I think burnout is rising in other areas because of fear," Csiszar said. "If I leave, will I be able to find a job? Will AI take my job? Some of that fear creates paralysis of wanting to make a change. And so they just accept the burnout as something they need to live with, which is a shame."

Burnout is also fueling career doubt outside healthcare. A global Kickresume survey conducted this summer found that 87% of office workers open to leaving for a trade said stress or burnout had made them question their careers.

Fewer hands, same workload

The pressure on healthcare workers isn't easing as staffing growth slows. Healthcare hiring has fallen to 4.3% this year, while net workforce growth, which measures hires minus terminations, has dropped to 0.61 percentage points from 3.4 at the start of 2023, BambooHR found. Federal projections also show a tight labor supply, with the Health Resources and Services Administration estimating an 8% national shortage of registered nurses in 2028.

At the same time, one in three healthcare terminations is now involuntary. Csiszar said she believes employers are weighing performance issues alongside budget constraints when making cuts, even as the industry continues to face heavy workloads.

"When people are burnt out, they can't perform at their best," she said, adding that rising costs are also forcing employers to make difficult decisions.

For the workers who remain, those departures can mean taking on responsibilities that haven't gone away. Administrative work is one example, Csiszar said, with tasks often falling to other staff or being absorbed by healthcare workers already stretched thin.

"There is so much admin that comes along in the healthcare industry," she said. "And so other people are left to take on that burden, or even some of the healthcare workers have had to absorb it."

"If you're not growing at the same rate as the workload, then those who remain are left to carry that burden," she added.

The administrative burden has long been recognized as a contributor to health worker burnout. The U.S. Surgeon General's 2022 advisory on the issue listed reducing administrative burdens among its core recommendations.

Pay is another pressure point. BambooHR's survey found that compensation that doesn't match the demands of a role is the second-greatest cause of healthcare worker distress, behind understaffing. But Csiszar cautioned against treating higher pay as the answer when the underlying workload remains unchanged.

"If you're burnt out, paying me more won't take away my burnout," she said. "I'll just get paid more for doing too much work. Instead of paying more, pay another person and take off that work burden."

What HR can do about it

Tackling burnout starts with understanding what workers are experiencing, rather than relying on retention figures alone. Csiszar suggested looking at engagement levels, leaves of absence and absenteeism to get a better sense of how people are coping.

"Even if they're still employed, how often and how well are they showing up for work when they do?" she said.

But measuring the problem is only the first step. Csiszar said HR should involve workers in finding ways to ease the pressure, including looking more closely at their day-to-day responsibilities and identifying where processes could be simplified.

"I would say go to the workers and ask for what their solutions are," she said. "Where do they see that they could feel some relief? And also do some process mapping. What are these people doing in their day-to-day, and what could we take off of their plates?"

That's particularly important when workload is the underlying problem. An Aflac report covered by HRD America found that heavy workload is the top driver of workplace stress, warning that no benefits program can make up for unsustainable demands.

Csiszar said employers should look for efficiencies that ease the workload, rather than simply redistributing it among the remaining staff.

"The solve is a tough one because it does come down to budgetary constraints," she said. "But what other efficiencies can you bring? Are they introducing AI or other things that could help alleviate some of the workload?"

Korn Ferry research covered by HRD America similarly found that AI works best when it takes repetitive, low-value work off people's plates.

For Csiszar, there's also a longer-term concern. She said she believes burnout will have lasting effects on workers' mental and physical health, particularly as people continue to accept it.

"Burnout is real, and I don't think we quite know the effects that will linger as a result of it," she said.