Nurses Are Feeling 'Utterly Broken' and Exhausted: Is Help Available?

In late December 2020, I learned that a nurse colleague had perished from COVID-19. Although she was working out of state at the time, this was a bright, enthusiastic young woman I had mentored, and the news of her sudden death stunned me. I lacked words to describe what I was feeling, but my energy level plummeted and my spirits became disheartened. How many more might succumb, I wondered? One year later, I found words in print to describe what I had been feeling.

Nursing Times reported findings from a group of nurses in the United Kingdom regarding the cost to their mental health and well-being related to working through the pandemic. When questioned, one nurse described herself as feeling "utterly broken." Others expressed feeling "exhausted, low and under-appreciated." Two thirds of the nurses surveyed believed their mental health had deteriorated since the peak of the pandemic plus continuing into fall, as cited by the same source.

Unfortunately, these findings regarding the well-being of nurses are not new. Even before the pandemic, suicide statistics among nurses were higher than those of the general population, demonstrating that stressors on America's heroes often prove too much to bear.

Of the 1200 UK nurses who responded to the Nursing Times survey, 44% described their mental health and well-being as "bad" or "very bad." In addition, 84% felt more stressed than before the pandemic.

Are US Nurses Also Feeling Utterly Broken?

The American Nurses Foundation surveyed 9572 nurses working in critical care units (via a series of pandemic-related polls). Their findings proved distressing. Kate Judge, executive director for the American Nurses Foundation, was surprised by the variety of roles (eg, educators, managers, school nurses) in which nurses displayed elevated levels of stress, to the point of risk for PTSD, according to the same source.

More than half of the nurses surveyed said they were "not emotionally healthy," 75% described themselves as "stressed," and 10% expressed feeling "worthless." More troubling, 39% of the nurses reported feeling numb.

Additional Challenges in Nursing in a Pandemic

A pandemic has stressed caregivers beyond their limits, even though they might not be articulating angst, as I found. Jessica Gold, MD, assistant professor of psychiatry at Washington University, explains that during COVID-19, for medical professionals, the "calm surface appearance is the only armor they have left." Underneath, these same providers may be "barely keeping it together."

In addition, processing feelings takes time, as it did for me after losing a colleague. Nurses may feel exhausted and anxious, but they may not have time to work through issues. We may be depressed but not recognize the symptoms as readily as we would with a patient. We could be paddling like ducks under the surface but calm in demeanor.

Unfortunately, we may also believe this to be status quo. According to the Robert Wood Johnson Foundation Interdisciplinary Nursing Quality Research Initiative, nurses experience depression at twice the rate of the general population. Depression affects 9% of the public but 18% of nurses, as determined by the same source. Consequently, nurses could believe that their ongoing feelings are normal.

Is Help Available for Our Embattled Heroes?

Healthcare institutions have recognized that mental health should be addressed, but national response has been sporadic.

The establishment of the role of CWO, or chief wellness officer, was created by senior leaders as a "strategy to address burnout, mental health, and compassion fatigue." Although this role is not a panacea for nursing issues, it is a start.

In addition, research has demonstrated that investing in wellness is profitable, with hospitals realizing a $3-$6 return for every dollar spent on employee well-being.

But until CWOs become mainstream or nurses have the time to pursue support, readers should evaluate whether they or colleagues are at risk for a crisis. Nurses should understand that stress may be affecting them more than they recognize. They should also learn to identify symptoms of distress, whether physical (recurrent illness, fatigue, insomnia), or mental (feeling anxious, numb, or fearful). Nurses would do well to avoid media coverage that relates to the pandemic and instead focus on a menu of self-care activities that are enjoyable (pets, walking, music, reading a book).

Nurses: If You're Feeling Overwhelmed, Seek Assistance

If you know someone (yourself or a colleague) at immediate risk for self-harm, access the National Suicide Prevention Lifeline at 1-800-273-8255.

For less immediate assistance, the SAMHSA National Helpline at 1-800-662-HELP (4357) offers 24/7, 365-day-a-year referral. Information and is available in both English and Spanish.

Mental Health America is another source that offers free, online discussion for mental health concerns and support for family and friends.

In summary, nurses need to support one another and recognize that mental anguish may be a common denominator among pandemic providers. For, as the World Health Organization puts it, "There is no health without mental health."

How healthy are you feeling? Would you share?

Follow Medscape on Facebook, Twitter, Instagram, and YouTube

About Diane M. Goodman

Diane M. Goodman, BSN, MSN-C, APRN, is a semi-retired nurse practitioner who works from home contributing to COVID-19 task force teams and dismantling vaccine disinformation, as well as publishing in various nursing venues. During decades at the bedside, Diane worked in both private practice and critical care, carrying up to five nursing certifications simultaneously. Yet she is not all about nursing. She is equally passionate about her dogs and watching movies, enjoying both during time away from professional activities. Her tiny chihuahuas are contest winners, proving that both Momma and the dogs are busy, productive girls!

Comments

Commenting is limited to medical professionals. To comment please Log-in.

Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.