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Understanding the final toll of the COVID-19 pandemic on frontline nursing will take time, but a new survey suggests that the crisis has had a heavy impact on nurses.

Nursing is a “profession in crisis,” according to the 2021 Frontline Nurse Mental Health & Well-being Survey by Trusted Health, a company that applies digital technology to staffing needs such as travel nursing. The online study, conducted in March 2021, gathered responses from more than 1,000 nurses, 80 percent of whom said they provided direct care to COVID patients. Trusted Health conducted a similar study in 2020.

“I do think our profession’s at a blockbuster moment,” Dan Weberg, PhD, RN, Head of Clinical Innovation at Trusted Health said in an interview.

The crisis is reflected in two ways. First, nurses are reporting big declines in their mental health. Second, and more alarming, nurses, especially those who are younger, are feeling less committed to the profession.

Declines in Mental Health

“We did a similar study a year ago right in the peak of COVID and we found similar things. Nurses did not feel supported then, and it just exacerbated through COVID. They don’t feel their mental health and wellness is supported now.”

—Dan Weberg, PhD, RN, Trusted Health

For the second year in a row, the study found, nurses reported steep declines in their mental health as a result of the COVID-19 pandemic. On a scale of 1-10, nurses rated their current mental health and well-being an average of 5.7, compared to an average of 7.9 prior to the COVID-19 crisis, representing a decline of 28 percent.

What’s more, nurses aren’t particularly pleased with the lack of support from their facilities. On a scale of 1-10, nurses rated their current facility an average of 4.6 in terms of the support it has provided related to their mental health and well-being, a slight decline from 2020’s rating of 4.8.

“We did a similar study a year ago right in the peak of COVID and we found similar things,” Weberg says. “Nurses did not feel supported then, and it just exacerbated through COVID. They don’t feel their mental health and wellness is supported now.”

Mental health and wellness support need to be integrated into professional practice, Weberg says. Those methods could include ways to be mindful, de-stress, and obtain counseling. “We can embed some of these wellness and mental health support tools within the shift,” he says.

Waning Commitment

Acute care, emergency, critical care, and pediatric nurses were the most likely to report that their commitment had decreased.

Of note, nearly half (46 percent) of surveyed nurses said they were less committed to nursing due to the COVID pandemic, compared with 54 percent who say they are equally or more committed. Notably, nurses between the ages of 20 and 29 and 30 to 39 were 24 percent and 15 percent more likely to report that their commitment to nursing had decreased, respectively. Nurses who work in acute care, emergency, critical care, and pediatrics were the most likely to report that their commitment had decreased, the report says.

Of those respondents who said they were less committed to nursing, nearly 1 in 4 are actively looking for a job outside nursing or planning to retire, the report notes.

Implementing New Staff Retention Strategies

To address retention issues, the survey offers various recommendations:

  • Focus on culture over messaging. Culture changes could include strategies to address bullying and incivility, education and coping mechanisms for compassion fatigue and moral injury, and comprehensive support for nurses who are experiencing acute mental health issues, the report recommends.
  • Rethink nurse staffing. Millennial and Gen Z nurses want more flexibility around their careers and the ability to try different things.
  • Create new opportunities. For instance, hospitals need to identify opportunities in less acute settings or away from the bedside for those who want it.

Demanding a Difference

“The newer generation of nurses coming in is demanding a different experience than their predecessor, so I think that will create a shift,” Weberg says. “I think consumers are demanding a different healthcare experience, which is creating new opportunities for nurses to come in. And I think that the nurse leaders are seeing that they need to shift their thinking towards supporting the workforce a little bit differently than they have in the past.”

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