Home Health Care 3 strategies for preventing a mental health crisis amongst nurses

3 strategies for preventing a mental health crisis amongst nurses


Since Covid-19 first appeared, the eyes of the world have been on healthcare workers like never before. Initially, this was because of the selfless service of nurses and physicians who rushed to the frontlines in hot spots like New York, and then later because of the outcry over the lack of facility preparedness, PPE, and other essential supplies. In recent weeks, a chorus of voices has emerged from the frontline, sounding the alarm over the emotional well-being of clinicians who have had to ration care, watch their colleagues fall ill, and comfort scores of dying patients. In mid-May, the UN echoed this finding, warning of a global mental health crisis that could impact healthcare workers especially hard.

What makes these calls to action particularly disturbing is that the issue of burnout has plagued healthcare workers, and nurses in particular, long before the pandemic. It has been written about extensively in the media and peer-reviewed journals, with some studies estimating that up to 63 percent of nurses exhibit symptoms such as job-induced stress, anxiety, and depression. And while there have been a series of efforts to address this issue in the past, the Covid-19 has highlighted just how far we have to go. We must start with the way we design and operate our institutions – from education to staffing – to effectively support nurses at a systemic level.

After working at the bedside, in academia, as a nursing executive, and now in the healthcare technology world, I’ve had a chance to witness this problem from many angles. My perspective is that many of the existing solutions put the burden on nurses to manage their own mental health and well-being, rather than getting at the root of the problem. In order to address these issues and mitigate the growing number of Covid-19-related mental health issues across the country, we need to focus on more meaningful, substantive changes.

The first step starts with our education system and changing the way that we prepare nurses for the profession. Newly licensed RNs often find that their schooling hasn’t prepared them for the realities of being a nurse, such that one-third ultimately leave their first post within two years. We can address this issue by integrating skills-building around wellness and stress management into both undergraduate and graduate curriculums. Entering the profession with a solid foundation, nurses could then expand and refine these skills, with tailored content around mental health and well-being offered through mandatory Continuing Education Units (CEUs) and professional boards.

Once nurses are in a role, they need to be better supported by their facilities, with processes and structures that promote their mental health and well-being. Today, this is largely addressed through employee wellness programs, which are in place at nearly 90 percent of hospitals, though overall participation remains low. Why? Because they are often a bandaid over larger systemic issues that need to be addressed.

One such issue — and perhaps the most important — is the lack of an effective staffing system. No amount of gym discounts, yoga sessions, or healthy snacks can compensate if nurses are working excessively long hours, have unsustainable patient assignments, or aren’t able to take a break during the day. Evidence also suggests the industry-standard 12-hour shift also leads to burnout and patient safety issues.

Lastly, for those nurses who do need emotional or mental support, we need to institute specialized programs that are tailored to their needs. Providing patient care comes with a unique set of stressors that requires more than a one-size-fits-all approach. While Employee Assistance Programs provide basic counseling that is sufficient for some needs, nurses who are working in high-stress units like the ICU or ED often require more comprehensive support. We should be offering nurses an ecosystem of options that includes access to crisis support, cognitive-behavioral skills building, and mindfulness techniques. Such programs for physicians have also recently sprung up in response to the pandemic. This peer-to-peer relationship has been shown to be effective in getting people to open up and catalyze healing in other high-stress jobs like the military, law enforcement and fire fighting.

I believe that the Covid-19 crisis has highlighted not only how indispensable nurses are, but also the ways in which the healthcare system is failing them. I also believe that we have a choice to make about the legacy of this pandemic. We can add what will no doubt be the long-lasting effects of the crisis to the issues of burnout and mental health that were already afflicting our nursing workforce, or we can use this as a catalyst to come together to find sustainable solutions to support them. I certainly hope that it’s the latter.

Photo: gpointstudio, Getty Images








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