Emotional Health of Nurses Appears Continues to be Severely Impacted by the COVID-19 Pandemic, Survey Says

Findings from a United States–based survey published by the American Nurses Foundation indicated that 1 in 3 nurses do not feel emotionally healthy.¹

Specifically, 34% of nurses shared that they do not consider themselves to be emotionally healthy as a consequence of the COVID-19 pandemic. Furthermore, 42% of nurses said they have experienced trauma related to COVID-19 and 50% of nurses shared that they have considered leaving their position. Young nurses, in particular, noted that they feel a stigma continues to exist around seeking mental health support.

Notably, the findings also showed that healthy diet and accurate COVID-19 information was associated with emotional health.

“A robust nursing workforce is essential to our nation’s health and therefore, nurses’ well-being and mental health must be a top priority,” said Kate Judge, American Nurse Foundation Executive Director, in a press release.² “The data collected from this survey overwhelmingly demonstrate the need to provide consistent and comprehensive support for our nation’s nurses.”

This most recent survey represents the fourth installment of “Pulse on the Nation’s Survey Series on Mental Health and Wellness.” Between August 20, 2021, and September 2, 2021, a total of 9,572 nurses responded to the survey, either completely or partially, with a ± 1.0% margin of error and a 99% confidence level. Among those who responded, 88% completed all the mental health-related questions.

Among participants, 77% identified as White, 10% identified as Black or African American, 5% identified as Hispanic or Latino, and 4% identified as Asian. Participants included nurses in all fields of care. Thirty-six percent of nurses self-reported as 55 or older.

Of the nurses who shared that they did not feel emotionally healthy, 52% worked in intensive or critical care, 46% worked in emergency departments, 44% worked in medical-surgical units, 40% worked in acute care, and 36% were nurse managers. Fifty-one percent were between the ages of 25 and 34, 47% were under the age of 25, 42% were between the ages of 35 to 44, 35% were between 45 to 54%, and 21% were older than 55%.

Notably, younger nurses were more likely to share that they felt emotionally unhealthy, with almost half of nurses under the age of 25 identifying as emotionally unhealthy, compared to only a quarter of nurses 55 or older.

Regarding trauma, 42% of responders indicated that they experienced an event that was extremely stressful, disturbing, or traumatic. In terms of race and ethnicity, a significant response came from Latino and Hispanic respondents, of whom 49% shared that they had experienced a traumatic event. The departments in which nurses were most affected by trauma were intensive or critical care and the emergency department.

As of August 2021, 21% of nurses stated that they intended to leave and 21% were considering leaving their position. Of note, 31% of respondents under the age of 35 shared an intent to leave their position. Across all age groups and departments, the key drivers behind a desire to leave included mental health, staffing, and organizational issues. Twenty-five percent of nurses intending to leave shared that they wanted to leave because they felt they could no longer provide consistent quality care and 13% cited retirement.

Another significant takeaway from the survey is that self-reported nurse burnout has increased by 350% since the first ANA COVID-response survey in June-July 2020.

In terms of solutions, 71% of participants shared that spending time with friends and family helped them to strengthen their well-being. Other activities associated with strengthened well-being included a healthy diet, receiving accurate COVID-19 information, a religious community, expressions of gratitude, and regular exercise.

Additionally, the survey highlighted a potential stigma with seeking mental health support. The data showed that over a third of nurses met stigma while seeking mental health support, 17% of which reported that the stigma came from themselves, 10% from family, and 8% with colleagues.

Reports of stigma differed by race, 75% of Black or African American participants did not experience stigma, compared with 63% White participants, 58% Hispanic or Latino respondents, and 53% of Asian respondents.

Similarly, a higher percentage of nurse educators and academia respondents did not report experiencing medical surgical departments. Age also contributed to variation, with a higher percentage of nurses reporting stigma from themselves and their family in the “under 25” age bracket.

“The COVID-19 pandemic is not over yet and its impact will persist for a long time. Its challenges have left the nursing profession in a particularly vulnerable state, exacerbating nurse staffing shortages, and negatively impacting nurses’ quality of life,” said Judge. “Nurses are playing a pivotal role in efforts to end this pandemic, so we must ensure nurses are physically and psychologically safe and healthy to function optimally in caring first for themselves, their families, patients, and communities.

References

1. American Nurses Foundation. Pulse of the nation’s nurses survey series: mental health and wellness. October 13, 2021. Available from: https://www.nursingworld.org/~4aa484/globalassets/docs/ancc/magnet/mh3-written-report-final.pdf. Accessed November 1, 2021.
2. American Nurses Foundation. NEW SURVEY DATA: Thousands of nurses are still stressed, frustrated, and overwhelmed almost 2 years into the pandemic. October 26, 2021. Available from: https://www.nursingworld.org/news/news-releases/2021/new-survey-data-thousands-of-nurses-are-still-stressed-frustrated-and-overwhelmed-almost-2-years-into-the-pandemic/. Accessed November 1, 2021.