New Focus on Nurses’ Mental Health, Well-being
Discover wellness resources and self-care tips for nurses
Has the continuing COVID-19 pandemic left you and your nursing colleagues exhausted, stressed, frustrated or in need of emotional support? If so, you’re not alone. Nursing leaders continue to search for ways to support nurses’ mental health and well-being while ensuring the country has sufficient numbers of skilled nurses to care for patients.
“We are definitely seeing a high incidence of depression and anxiety, and suicidal ideation,” said Candace Burton, PhD, RN, AFN-BC, AGN-BC, FNAP, associate professor of the Sue & Bill Gross School of Nursing at the University of California Irvine. “And 50 percent of nurses are considering leaving their jobs.”
Bryan Sisk, DNP, senior vice president and chief nursing executive at Memorial Hermann Health System in Houston, added, “COVID has been an incredible challenge for so many and our nurses and the nursing profession have truly been tested during this time. We recognize that our nurses – and so many others – have experienced terrible loss, frustration and pain.”
Tasha Holland-Kornegay, PhD, LCMHC, a mental health therapist and author in North Carolina, reported that even though COVID-19 cases are down in 2022, health professionals still “struggle with the tragedy, stress, uncertainty and fear from those days, and they still go in and help COVID patients today. There are going to be long-term effects.”
“We knew from the first days of the pandemic that nurses would face extraordinary challenges,” said Kate Judge, executive director of the American Nurses Foundation. “We also knew that they would rise to those challenges, but it would come at a cost.”
That cost has been nurses’ well-being and mental health.
The Well-being Initiative for nurses
The American Nurses Foundation’s COVID-19 Impact Assessment Survey – The Second Year, conducted in January 2022, found 60 percent of nurses working in hospitals felt burned out, and seventy-five percent indicated feeling stressed, frustrated, and exhausted. Nurses reported a top reason for intending to leave their jobs was an inability to consistently deliver quality care.
“We did not know how long it would go on or the struggles nurses and other healthcare providers would face in getting the public and patients to get vaccinated, masked-up, and to stay safe,” Judge said.
The stress is often caused from burnout, both physically and mentally. While physical burnout is more easily observed, mental burnout is not visible and worsens if it is not addressed. Some signs of burnout include avoiding the workplace- more call outs, arriving late, and leaving early; increased negativity; callousness; withdrawing; and resisting change. To recover from the strain, nurses can enact self-care strategies such as meditation, ensuring adequate amount of sleep, and getting outdoors. Read How to Prevent Nurse Burnout for more prevention tips.
As a consequence of the growing reports of burnout, the American Nurses Foundation joined with several nursing organizations, including the American Nurses Association (ANA), the American Association of Critical-Care Nurses (AACN), and the Emergency Nurses Association (ENA), to “develop and provide ways for nurses to get direct support for their mental well-being recovery,” Judge explained. “Our commitment was to offer free, evidence-based resources and interventions to all nurses.”
Their joint project, dubbed the Well-being Initiative, offers resources for nurses dealing with stress or mental health issues. Created by nurses for nurses, these free resources include:
- The Moodfit mobile app to support wellness goals
- A guide to better sleep
- The Happy App and phone support line
- An online self-assessment tool
- Articles, podcasts, videos and factsheets on wellness topics
- Virtual support for nurse mental health
Recognition of the problem
“As we rebuild from the pandemic, we must transform the workplace and the culture to eliminate the harm being caused to nurses and to give them the support to do the extraordinary and very difficult work they do each and every day,” said Judge.
In addition to ensuring adequate staffing and support, nurse leaders can help nurses recognize when they need might need some extra help, and encourage them to ask.
“I am passionate about getting the message out to our nurses that ‘It is okay to not be okay,’” said Sisk. He encourages nurses to reach out to team members and leaders in those moments when they need someone to help them and to watch out for one another.
Mental health symptoms differ for each person, he added, but if “they start noticing a lack of concentration, the feeling of not wanting to go to work or they are getting agitated more easily, they could be experiencing stress, anxiety or depression.”
Sisk added that nursing leaders must do better to “allow our nurses the opportunity to speak up about how they are feeling and how we can help them with their mental health.”
Nurses recognize what they are feeling, Burton said, and some are seeking out mental health care. But owning those feelings, and recognizing the trauma they have endured, can be difficult for nurses to accept.
Taking action to support nurses’ mental health
Memorial Hermann Health System has developed interventions, such as quiet rooms that nurses can utilize to rest when they need to step away for a minute or something called “Code Lilac,” where nurses can call on a team member to come give them a break and allow them time to regain their center.
“It’s all about establishing that culture of family and camaraderie that allows people to communicate and to be vulnerable with each other,” Sisk said.
Holland-Kornegay urged nurses to take time to recharge, to relax, and to have fun. For those with post-traumatic stress disorder symptoms, clinicians need to seek out a mental health professional. Nurses must take care of themselves to take care of patients. She urged nurses to “take their wellness as seriously as they take their patients’.”
The American Nurses Foundation found through its surveys and focus groups that nurses “need support, but there are barriers preventing them for accessing that support,” Judge said. Those barriers include a lack of time, distrust of employer assistance programs, fear of regulatory or employment repercussions or feelings that they need to handle it themselves.
“We are encouraged to know that more nurses are reporting they’ve sought professional mental health support and feel they can talk to their peers more freely than before the pandemic, but there is still a long way to go,” Judge said.
Burton encourages nurses to practice self-compassion, recognizing that they are hurting and have been hurt after experiencing so much loss and death. They may have to practice saying “no” to working extra shifts or hours, and saying “yes” to activities that make them feel better, whether that is taking a run, playing with children or lying down in a dark, quiet room.
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