Intensive care nurses are experiencing burnout at an alarming rate

Key points

  • A new study comes from American Journal of Intensive Care It is the latest research showing that nurses feel extremely tired due to the pandemic.
  • In the study, 53.2% of participants reported symptoms of anxiety, 39.5% reported symptoms of depression, and 42.2% reported feelings of stress.
  • Many nurses hope that their healthcare system can provide support in responding to the effects of the pandemic.

Since April 2020, Walden University Master of Nursing student Sabena Dorman RN has been working as a traveling nurse in five hospitals in New York City, mainly in the COVID-19 Intensive Care Unit (ICU). The traveling nurse usually spends a day adjusting to a new location, but the pandemic means she has no choice but to go all out.

In the heyday of New York, Dorman often received at least four patients at a time, instead of the usual one or two patients, and worked 12 to 13 hours at a time. Often there is no time to go to the bathroom, let alone lunch. After six months of overtime, Doman felt exhausted and anxious before each shift.

“I find myself worrying about which patient may die of COVID-19 every day, which is very difficult,” Dorman said. “The coronavirus patient is the most critical patient I have ever cared for. I have been a nurse for 16 years.”

Dorman is one of many nurses who work tirelessly with other medical staff in a devastating and uncertain pandemic. They made unimaginable sacrifices, from working overtime to contracting COVID-19. From the beginning, mental and physical losses have permeated the nurse’s life. Now, more than a year has passed, and the result is obvious: the nurses are exhausted.

Nurse exhausted

A recent study comes from American Journal of Intensive Care (AJCC) proves the universality of these feelings. Researchers surveyed 771 members of the American Association of Intensive Care Nurses to determine the impact of various physical and mental health and workplace support.

Mental health problems are common among intensive care nurses, with 53.2% of participants reporting anxiety symptoms, 39.5% reporting depressive symptoms, and 42.2% reporting feelings of stress.

Before the pandemic, burnout was already a major problem for nurses. In a study in February 2021, 31.5% of nurses who left in 2017 reported that they left because of burnout. Factors that contributed to this decision include working more than 40 hours a week, stressful working conditions and understaffing-the pandemic has exacerbated all aspects.

Even with fewer COVID-19 cases in the United States, intensive care nurses are still in a difficult situation. “Those of us who work in the intensive care unit still see the most seriously ill patients in history. Unfortunately, we will not have so many success stories to tout, because the virus and its sequelae have defeated us in many cases. ,” said Annie Dablo Woods, the chief nurse of DNP, RN, Wolters Kluwer, Health Learning, Research & Practice, and the daily weekend intensive care nurse of the large Philadelphia area health care system.

“Learning that many of our patients will never go home again to be reunited with their families, and that our faces will be the last time they see them, which makes us feel difficult and sad,” she said. Looking back on the mental loss she continued to experience during the pandemic, Dabrow Woods deeply felt the fear of her and many nurses, especially when faced with so much uncertainty.

“Fear that we will be infected and take them home to our family; fear that we will not have sufficient personal protective equipment, resources or well-trained employees, and fear that we will not be able to take adequate measures to save the lives of those in need. However. , No matter what we have to care about. We are full of COVID-19 and said we will not be intimidated, it is difficult and scary like that,” said Dablo Woods. “Caring is part of us as nurses.”

Further evidence of nurse burnout

This Midland Association The results of the survey echoed previous studies that focused on the well-being of health care workers throughout the pandemic. A study in February 2021 found that 22.8% of healthcare workers in the United States may have PTSD.

A December 2020 study of 1,119 healthcare workers examined the mental health loss caused by the pandemic between June and September 2020. Among all medical staff, 93% of participants expressed a sense of stress.

Nurses are more likely than other healthcare workers to report feeling too tired (67% to 63%) and think they do not have enough emotional support (45% to 39%). Among the 245 nurses surveyed, 40.82% of nurses work directly with COVID-19 patients, and another 48.57% of nurses are at risk of contact.

Brooke was a registered nurse in the operating room of the Level 1 Trauma Center and became pregnant when the pandemic began. “Stress and fear have undoubtedly played a big role in my mental health, especially when there are many unknowns at the beginning of the pandemic,” Brooke said, choosing to identify it only by her own name.

“I am very anxious because I am not only worried about my health, but also about the health of my unborn child. Thankfully, I work in a hospital and did a good job of taking care of me during my pregnancy,” Brooke said.

After giving birth in June 2020-as the virus spreads more widely-Brooke’s fear and stress levels begin to decline. However, physically, she was exhausted-partly because of having a new baby. Work is still the main source of her fatigue, especially when many nurses leave. ”

The remaining staff are responsible for filling these vacancies,” Brooke said. “Our operation volume is very busy now, so some staff have to perform more than twelve hours of surgery, which may cause physical and mental fatigue, especially continuous work. Days. ”

participant Midland Association The subjects were 92.2% women and 83.4% non-Hispanic whites. However, medical staff of people of color contracted more COVID-19 than their white counterparts.

An October 2020 review by the U.S. Centers for Disease Control and Prevention (CDC) found that between March 1 and May 31, 2020, black hospital personnel accounted for 52% of inpatients, while non-Hispanic white hospital personnel This ratio is 27.4%.

According to a September 2020 report by National Nurses United, 24.1% of American nurses are of color. However, of the 213 registered nurses who died of COVID-19 before September 16, 2020, 58.2% were people of color—a number that is clearly out of proportion.

For example, Philippine nurses accounted for only 4% of registered nurses, but before then accounted for 31.5% of deaths. In contrast, 75.9% of registered nurses were white, but accounted for 39.4% of deaths.

Sabena Doman, registered nurse

I find myself worrying about which patient may die of COVID-19 every day, which is very difficult.

— Sabena Dorman, registered nurse

Alvin Cantero, DNP, FNP, graduate of Walden University’s Doctor of Nursing Practice and Master of Nursing Programs, CEO of Houston Urgent Care and Walk-in Clinic Alvin Clinica Familiar, worked as a doctor during the epidemic, for example in his The motherland of Cuba is infected with dengue fever and cholera.

“Although nothing can compare to the new coronavirus pandemic, my previous experience has helped me mentally and physically prepare for the current pandemic,” he said.

Throughout the pandemic, Cantero sees 65 to 80 patients daily during 12 to 16 hour shifts (including weekends). He feels physically strong, but mentally suffers. He said: “People’s poor perception of the risks of this pandemic has cost many lives that could have been saved, and it’s exhausting.” Cantero attributed excessive working hours, increased workload, and frustration to medical staff. Burnout and post-traumatic stress disorder.

As a pediatric COVID-19 ICU nurse in Idaho explained, “Night shift is difficult for my body. Obviously, it affects my sleep, which can easily affect mood, metabolism, and immunity. ”

These factors will not only harm workers, but also cause potentially dangerous situations. “In the worst case, exhausted providers may be more likely to make mistakes, which can have a negative impact on patients,” Cantero said.This Midland Association Studies have found that nurses who report poor physical or mental health are more likely to make medical errors.

Dabrow Woods agrees: “Nurses must realize that if we don’t care about ourselves first, we can’t care about others.”

How to help nurses

For nurses who work long shifts and increase patients, it is not feasible to take measures to prevent burnout. Although nurses may start to have some time to take care of themselves, as in the case of non-medical workers, they may face obstacles such as cost and access. The mood of the nurses is clear: they need help.

Brooke said: “I think nurses who are and have been caring for COVID-19 patients should be examined and provide a free plan so they can talk about what they are doing.”

Dabrow Woods expects employers to provide consultations with experts trained in disaster, burnout and post-traumatic stress. “If employees feel valued, have sufficient resources, receive appropriate training, and feel physically and emotionally safe in the work environment, then the patient’s treatment outcomes will be optimized,” said Dabrow Woods. “The healthcare system needs to cultivate resilience by investing in the well-being of its employees. It is more important now than ever.”

Nurses hope that therapy is one of many measures taken to support them and their hard work. “The treatment plan is great. I’m very happy that mental health is becoming more and more mainstream, but in the final analysis, nurses need a place to live and food on the table, so the salary increase actually keeps up with the cost of living will be appreciated,” Aida The Dutch nurse said that she is a talent advocate for Incredible Health and requested to remain anonymous.

Anne Dabrow Woods, DNP, registered nurse

We are full of COVID-19 and say that we will not be intimidated as hard and terribly as that.

— Anne Dabrow Woods, DNP, RN

He said that as the case progressed slowly, Cantero hoped that the workers could extend their rest periods to “spend more time with their families and get proper rest after everything they have experienced in the past year or so,” he said.Like Cantero, more than two-thirds of participants Midland Association The research report stated that their working day exceeds 12 hours.

As for how ordinary people express their support, Brooke suggests asking nurses how they behave or feel to show that you care about their health.

The medical system needs to quickly resolve the collective burnout that nurses are experiencing. “Not keeping pace with the times will force nurses to go elsewhere, retire early, or leave their bedside or career altogether,” Dorman said. “However, not all facilities are the same, so there is no one-size-fits-all answer.”

Brooke agrees with this view: “I think this epidemic has changed healthcare and medical workers forever. I have seen and heard that some nurses left the healthcare industry completely and chose other careers because they were too exhausted. I I think we will continue to see a shortage of nurses in all specialties for some time.”

What this means to you

During the pandemic, nurses paid a lot to help others, but often at their own expense. “To my nurses and practitioner colleagues, you are heroes. However, heroes sometimes need help,” Cantero said. “Remember to seek help or support at any time, eat well, exercise, get adequate rest, and focus on positive thoughts when possible.”

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