Health care industry needs to address nurses’ mental health

SSince the start of the Covid-19 pandemic, the dire state of nursing has given rise to countless headlines, studies and reflections, as has the epidemic of clinician mental health issues.

People like me who care about nursing hoped that this moment could actually be a catalyst for progress and a step towards implementing some of the reforms the profession needed long before SARS-CoV-2 changed. lives in the world. The pandemic has exposed — and exacerbated — fissures that already existed, from understaffing to unsustainable patient loads to workplace cultures that often downplay mental health.

My colleagues at Trusted Health and I were interested in seeing if the widespread conversations about mental health translated into programs, benefits, and institutional and cultural change for frontline nurses. We dig into this via the company’s annual survey conducted in May this year, which over 2,500 nurses responded to via an online questionnaire.


The results do not paint a pretty picture. Nurses’ mental health has not returned to pre-Covid levels, even as the most acute phase of the pandemic appears to be easing. On a scale of 1 (poor) to 10 (excellent), nurses rated their current mental health and well-being at an average of 5.8, compared to an average of 7.8 before Covid-19, a down 26%. They also reported a range of physical and mental health issues as a result of the pandemic, including burnout, compassion fatigue and depression.


The majority of nurses said they were unhappy with workplace support for their mental health. And perhaps most disturbingly, 1 in 10 nurses reported having had suicidal thoughts since the start of the pandemic, more than double the incidence of such thoughts among American adults.

Despite seemingly endless conversations in the public sphere on this issue, two-thirds of nurses said the health care industry’s position on nurses’ mental health had not changed since the start of the pandemic. Worse still, 95% said their mental health was not a priority for the healthcare industry or that it was a priority but that the measures in place to support it were insufficient.

My interpretation of these findings is that the majority of nurses view mental health conversations and campaigns as pure lip service and believe that the healthcare industry has made few substantive changes to make nursing a career path. more sustainable.

Seen in this light, it’s no wonder that nurses are unlikely to seek help at work for mental health issues that could interfere with their ability to do their job. Nearly 60% of survey respondents said it was ‘unlikely’ or ‘very unlikely’ to share feelings of acute depression, suicidal thoughts or mental health issues with their manager or anyone else institution, citing concerns about privacy (72%), job security (69%), and little or no effort to resolve the issue they are having (64%).

And – no surprise here – 64% of nurses said they were less engaged in the profession than they were before the pandemic, a 39% increase from the 2021 survey. This figure is particularly worrying when these answers come from nurses who are still in the profession. Even those who have stayed the course for more than two years from the horrors of patient care during a once-in-a-generation pandemic now have one foot out.

What I take away the most from the results is that the nurses do not feel supported or cared for by their establishments and their leaders. They don’t feel like the sacrifices they’ve made over the past few years have been honored by the kind of cultural shifts that would make nursing more compatible with their mental health and well-being. And yet, I take comfort in knowing that many of the short-term solutions are simple.

For nurses in acute distress, crisis helplines, individual counseling and therapy are still essential, but respondents to this year’s survey made it clear that the benefits that support their well-being long term are in the foreground. Flexible hours, wellness allowances and access to fitness facilities and/or classes top the list of offers ranked by respondents.

The desire for new and innovative scheduling options aligns with previous research from Trusted Health, which found that nearly three-quarters of nurses (71%) said their experiences as nurses would improve if they had more control over their schedules, and more than half (52%) said the way nurses are traditionally scheduled – three 12-hour shifts per week, with schedules set for four to six weeks at a time. forward – reduces their job satisfaction. Nurses are watching high-skilled workers in other industries access things like flexible hours and remote work and some nurses are being drawn to opportunities in other industries that recognize their value. To keep nurses at the bedside, hospitals and healthcare systems must find ways to provide them with the same opportunities.

They must also take decisive action to address the long and well-documented history of clinician mental health stigma. The fact that nurses experience extremely high levels of depression, trauma, stress and suicidal thoughts, and yet do not feel comfortable potentially disclosing these issues to their employers, is alarming, particularly when these struggles result directly from the demands of the job. .

More needs to be done to create a culture in which nurses feel safe to talk about their mental health and know that it will not negatively impact their jobs. When mental health programs are launched and promoted to nurses, they should be accompanied by strong messages about confidentiality and security of jobs and licenses.

Improving the relationship between nurses and their managers is another important step toward creating the kind of psychological safety net needed for nurses to come forward. The average nurse manager has between 85 and 90 direct reports, leaving little time for mentorship or relationship building. The impact of this is evident not only in nurses’ reluctance to talk about their mental health, but also in the fact that only 3% of nurses said in the Trusted 2022 survey that their relationship with their manager kept them engaged in nursing care.

Given the outsized importance this relationship plays in nurse satisfaction and retention, it needs a massive overhaul. Hospitals and health systems need to better train their nurse managers, find ways to free them from the boredom of tasks such as staffing and scheduling, and help prepare them to lead from a place transformation rather than transaction. This includes encouraging and facilitating substantive discussions about nurses’ career aspirations, well-being and contribution to the wider profession, rather than just pay, hours and day-to-day tasks. .

The pandemic has caused a sea change in conversations about mental health and the workplace. More and more Americans are realizing not only that they are unwilling to sacrifice their mental health for the sake of their work, but that their employers should take a more active role in helping to support it.

Based on the sacrifices nurses have made over the past two and a half years, they deserve this kind of support. And the stakes couldn’t be higher for them to get it.

Danielle Bowie is a registered nurse, nursing workforce expert, and vice president of clinical strategy and transformation at Trusted Health, a career marketplace for healthcare professionals.

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