Do you have any idea which professional group is concurrently required to save your butt, clean your butt and give you a kick in the butt when necessary? You may have been thinking about someone else, but in fact this job description most closely resembles that of your basic bedside nurse. Nurses have a longstanding history of being considered one of the most trusted professionals, and this reputation isn’t undeserved. This career path is often motivated by a strong desire to help others, and its natural history almost always induces a powerful calling to advocate for patients’ needs over and above insurance company or various medical groups’ interests.
Nurses are at the forefront of public health education, are leaders in patient-centered care and are often actively present for patients and families in their most vulnerable moments. While the nurse’s career path easily provides the opportunity to fulfill a noble summon as well as manifest some of the most important human virtues, it is not without trials and tribulations.
As a professional group, nurses have always been subject to some degree of burnout: long hours, poor work-life balance, ineffective organizational leadership and stress are only some of the factors that have contributed to the collective fatigue and disassociation of nurses. Unfortunately, as a result of the ongoing pandemic, nurses have been subjected to significantly greater amounts of occupational burnout than ever before.
The COVID-19 pandemic has affected every layer of our society, and it has unleashed one of its most insidious assaults on our collective mental health. According to the World Health Organization, the global prevalence of depression and anxiety increased by 25 percent after the first year of the pandemic. As frontline healthcare workers, nurses have incurred disproportionate amounts of these negative psychological outcomes. Increased workloads and longer hours, fear of illness and of infecting family, deployment to other unfamiliar units of the hospital, not to mention the anguish associated with witnessing the effects of COVID-19 on sick and dying patients, are factors that have left nurses emotionally exhausted, depressed, anxious and sometimes traumatized.
It is important for healthcare organizations not only to evaluate and monitor, but also implement policies to alleviate professional burnout among nurses. According to the U.S. Surgeon General’s 2022 Advisory addressing healthcare worker burnout, nurses who are emotionally exhausted, depressed and anxious may in turn influence adverse patient outcomes. For example, medication errors and other dangerous safety incidents, lower quality and delayed care, increased hospital readmissions and increased hospital-acquired infections are all more likely as occupational burnout increases.
A meta-analysis and systematic review conducted by Garcia et al. found a greater than 60 percent association between burnout and patient safety. Occupational burnout in nurses also negatively affects organizations, which incur increased costs associated with replacing staff as well as the negative effects of increased risk of malpractice and poor patient satisfaction scores. Finally, it is important to know that our “healthcare heroes” are likely to suffer long-term consequences from the stressful working conditions associated with the pandemic. According to the Surgeon General’s advisory, healthcare workers are more likely to experience social isolation and substance abuse, relationship difficulties, heart disease, insomnia, diabetes, anxiety and depression as a result of burnout.
Organizations must implement practices and policies based on evidence generated by research to decrease burnout in nurses. Setting minimum staffing standards (adequate nurse-patient ratios) is a measure which research has shown will increase job satisfaction, improve patient safety and health outcomes, and increase employee retention. Healthcare organizations need to emphasize to their employees that they are valued; one way this could be accomplished is by encouraging nurses to utilize sick leave and family leave to help them renew their mental health and help them care for family members and themselves.
Ensuring access to confidential mental health services is important, but it would be truly commendable if healthcare organizations had mental health workers and spiritual counselors who regularly rounded throughout units and departments, inquiring as to the well-being of nurses and offering interventions to help them cope with stress, depression and workplace fatigue.
Formerly frontline heroes, but now more like an uncomfortable relic of a time we are hoping to forget, are the nurses who served our society in some of our most stressful and uncertain times throughout the COVID-19 pandemic. It is not enough to acknowledge nurses’ roles in this crisis; we need to appreciate that their professional burnout has far-reaching implications for patients, organizations and communities. Contact your state’s U. S. senators and urge them to support S.1567, the Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act, which would mandate safe nurse to patient ratios in hospitals, as well as mandate employers to post their nurse patient ratios.
Garner attention to this important issue by reaching out to your local representatives and telling them that nurse burnout is a critical issue with ominous consequences for our healthcare system. In caring for our caretakers, perhaps we can finally come full circle and pave the way for true healing to occur after a global pandemic.
Anna-Maria Alvares is a registered nurse and currently a master of science in nursing student at UConn who will graduate in May 2023 as a family nurse practitioner.