As we begin navigating this endemic state, it won’t surprise you to read that in the wake of COVID-19, nurses are burned out. Many nurses (along with other frontline healthcare workers) are dealing with post traumatic stress disorder (PTSD) from the COVID-19 pandemic.
According to the APA, 96% of nurses reported having one or more symptoms of PTSD. So while the general statement that ‘nurses are burned out’ isn’t surprising, learning that nearly every nurse is experiencing at least one symptom of PTSD is alarming, and begs the question: What are we doing about it?
The simple answer, unfortunately, is probably not enough. We have a moral imperative to take care of all of our caregivers, which includes providing necessary services for PTSD, burnout and any number of other mental and physical responses they may be experiencing after taking care of patients during a global pandemic. Hospitals, healthcare systems – anyone who employs nurses – should have programs in place to address these needs, not just in response to the pandemic, but moving into the future in a proactive manner. It is absolutely critical that we do so; anything less than that feels like not enough.
While addressing burnout and PTSD are critical first steps, it’s imperative to think more broadly about how we’re supporting our nurses, which starts with giving them the power to control their own journey and career.
An environment of progress
We owe it to all of our front-line workers to ensure they’re at their best when it comes to providing first-rate patient care. But before we address specific conditions like PTSD, let’s address the environment in which they are working. Is it one of progress?
For a nurse to have a fulfilling career, it’s important to address their “why.” Most nurses feel a drive to help and serve patients. Simply put, patient care is a calling. But what motivates each individual nurse can be quite different. For some, it might be finding a better work-life balance. For others, it might be finding an employer known for prioritizing their clinicians’ mental health and wellbeing. For others, it might be career progress and access to professional development opportunities.
The common denominator here is that the nurse controls the journey. If we give a nurse ownership of their career, choices and determining what’s important on an individual level, we’re creating an environment in which nurses will thrive, rather than one where they are just trying their best to survive. This is the first step to progress.
PTSD and collective burnout among caregivers
For healthcare workers, in particular, PTSD can be even more challenging because they’re experiencing it in the context of a care delivery setting. Clinicians still have to deliver care – and there are patients and family memebers relying on them to deliver care – even though they may be experiencing PTSD or trauma.
As a former executive healthcare leader at Texas Health Resources, I was called into the facility during its Ebola response. When the first reports of COVID began streaming over social media, television and the internet, I remember feeling PTSD myself. It was all so real again.
Reflecting on our collective experience over the last few years, I think there are actionable steps we can and should take to address and even avoid PTSD and burnout:
- Consider including mental health breaks as part of the expectations for healthcare professionals. We have long asserted that in order for someone to “take a break” they must be at their breaking point – that somehow exhaustion is a badge of honor vs. something to be avoided and prevented. What if we looked for opportunities to set “standards of care” for our clinicians’ mental health and wellbeing, just as we do for patient care.
- Support services for our patients and family members during times of stress and loss are deemed to be an important resource in all hospitals and health systems. Making similar services more readily accessible for clinicians could become part of a total care package for clinicians rather than a total compensation package.
- Explore requirements or expectations for wellness check-ins. Insurance incentives for programs that promote healthy eating, weight and other habits like smoking cessation or fitness reimbursements exist today. Perhaps it’s time to recognize and reward those who commit to mental health wellness in the same way.
- While it’s absolutely critical that we care for clinicians who are experiencing PTSD, it’s almost as important that we reward and recognize the commitment to prevention and for the healthy maintenance of our lifestyle. In most cases, we don’t give the same amount of rigor to mental health and wellness that we give to physical health and wellness.
Industry examples
I think it’s time we work together to create personalized mental health and self-care standards, supported by accessible coaching and education in healthcare. Here’s a sampling of what we do at Nomad Health (of which we’re incredibly proud!)
We have a team of clinical navigators who are committed to supporting, coaching, encouraging and educating all clinicians before, during and after assignments. The services we provide are customized to clinicians and can include guidance on managing difficult situations/relationships on the unit, processing difficult patient events or outcomes, learning/education for competency exams for clinicians that may experience test-taking anxiety or just need a refresher.
We also support 24-7 counseling services. In our employee handbook, there is specific language about sick days that clearly includes mental health days. We prioritize mental health and wellbeing and encourage our industry peers to do the same.
Moving forward
Caring for our caregivers is a big task, and though we still have a way to go, advocating for reform at the federal level to support programs and initiatives that would drastically improve overall mental health and job satisfaction for nurses should be an action we consider.
This is particularly important as today’s healthcare environment still feels quite volatile and every budget line item must be examined and prioritized. As hospitals and health systems continue to navigate higher costs and lower margins, tight budgets can often mean additional support and care services are minimized. One of the biggest challenges ahead is the need to evaluate the cost of not taking action to support mental health and wellness. While investing in mental health and care services for clinicians will cost money up front, that cost would decrease significantly moving forward as the mental health of the workforce improves, as compared to costs associated with nurse burnout and turnover.
Ultimately, giving nurses more control of their own journey coupled with support for that journey along the way, will contribute to nurses being happier, healthier, living more balanced and fulfilling lives, ready to deliver the very best patient care. Our nurses – and our patients – are counting on us to do so.
Valerie Gale
Valerie Gale is vice president of clinical excellence at Nomad Health.
