Stress, burnout and compassionate fatigue are conditions now synonymous with nurses at the forefront of the COVID-19 pandemic. Nearly 75% of nurses in Pennsylvania say they feel more tired, overwhelmed and anxious then than they did last spring.
But let’s be clear. COVID did not create these conditions. Long before the pandemic, many of America’s 4 million nurses had physical and mental health problems linked to their jobs while the institutions that employed them neglected or did not realize these problems.
Nurses and their patients have paid a price for this negligence. And it’s time for heads of hospitals and health systems to start making sure they’re healthy and healthy and can be a foundation of care in any environment.
In a recent study, nurses who claimed to have poorer physical and mental health were 31% and 62%, respectively, more likely to make medical mistakes compared to peers in better health. Two years before COVID, the majority of nurses relied on physical and mental health.
We are sitting on a committee of the National Academy of Medicine that was recently released “The future of nursing 2020-2030: charting a path to achieving health equity”, which examined the nurse’s well-being status. Here’s what we learned:
There is a “planned culture” in nursing in which young or new nurses ordinarily encounter intimidation, intimidation, hostility, and impetus from other staff nurses, supervisors, and managers.
About 1 in 4 nurses experience violence at the hands of patients or their family members. These incidents are often underestimated for lack of reporting policies in the workplace and for fear of revenge.
Racism, discrimination and dehumanizing attitudes on the part of employers, educators, leaders, colleagues and patients are ubiquitous. Black nurses have long been reported to have encountered racism at work and at school. But there has been an increase in Asian nurses reporting verbal and physical attacks amid COVID-19; and LGBTQ nurses have reported discrimination and harassment.
All of this contributes to emotional fatigue and a low sense of personal fulfillment at work that leads to poor patient outcomes, higher costs and more nurses leaving the profession.
Hospitals, nursing homes, schools and other organizations that employ nurses have a vital role to play in shaping the conditions that promote well-being. This means prioritizing supervision and improving the well-being of nurses, removing health impediments, and being responsible.
It starts with the leaders of suite C who must take a deliberate and unalterable position of zero tolerance. They should develop and implement evidence-based policies and programs that promote civilization and ensure that the governing body of the hospital is informed and establishes a clear direction for implementation, supervision, and monitoring for compliance.
As a member of the C-suite team, the head nurse sets the culture and tone for other nursing leaders. The CNE is responsible for informing members of the management team about welfare challenges and pushing hard for adequate pay and benefits, ensuring that nurses are not overworked, and promoting safety and civilization in the work.
Suite C leaders should also ensure that nurses are not afraid of revenge when they identify a deficiency in the system. Nurses, for example, should feel free to report a disability or mental illness to their employer or ask for accommodation to do their job. But many institutions make it difficult.
The foundation for nurse well-being begins even before they begin the practice. Educators should pass on to nursing students the tools and skills needed to protect their physical and mental health throughout their careers. The promotion of well-being should be disseminated throughout the curriculum in meaningful ways. Some institutions, including the University of Pennsylvania, have hired a head of welfare.
When nurses work for institutions that support their well-being, they are more engaged in care, make fewer medical mistakes, and their patients perform better.
But little will change until leaders make it a priority. They need to keep their ears on the ground and find a way to stay connected with the front-line staff through things like rounding out suite C.
The NAM report predicts that nurses will more fully update their role in addressing the social, economic, and environmental factors influencing health. If we want nurses to succeed in this role, the institutions where they learn and work give them the support and protection they need to thrive. This support and protection begins with the leadership of those institutions that need not only to listen, but to hear what their teams have to say.