Working in the ER During the Height of COVID-19

Working in the ER During the Height of COVID-19

While the worst of the COVID-19 pandemic seems to be behind us, the spread of the Delta variant indicates that it’s not completely over yet. During the height of the pandemic, nurses worked on the frontlines all over the country, and some are just now sharing their experiences working in the ER during the height of COVID-19.

Rastisha Smikle, RN, works in an ER at a hospital in central Florida. Having worked as a nurse for more than 10 years, she answered our questions about what it was like in the ER during COVID-19.

As a nurse in the ER in Florida, what has it been like working there during COVID-19? How has it changed over the last year or so? 

It was very challenging to work during the pandemic. In the ER, we are a patient’s first point of contact, and because of that, our staff is considered at a higher risk of being exposed to the virus. Although safety and infection control elements have always taken priority in our roles, the unknown factors of the virus’ transmission, ever-changing symptomatology, and treatment contributed to our challenges because of all the unknowns.

Patients were more fearful than ever; they often came in anxiety-ridden wanting testing because of recent exposures, which added additional challenges because the critical emergencies also relied on our care.

In some ways, things have gotten better. As we have learned more about the virus and therapeutic treatments, patients are being cared for more efficiently so that they can recover at home. Unfortunately, hospitals nationwide are busier than ever right now. The volume that we are seeing is higher now than we saw during the pandemic. It’s tough to say what that is.

Did your duties change during COVID-19?

My duties didn’t change per se, but the way we cared for patients did.

Before the pandemic, PPE like N-95 masks were not permanently a part of my uniform. Now, I wear an N-95 and face shield with every patient encounter. Because of the wide range of symptoms, we have to be extra diligent in caring for patients just in case they have the virus and aren’t aware of it yet. In addition, minimizing my exposure time with known Covid-19 patients is also an element that I have had to implement in my care. For the safety of myself and the other patients, swift patient care must be implemented with these patients when appropriate.

Employing the use of hospital phones has been a way that I try to fill in the gap. Throughout this time, I have learned how fearful patients are after they get the diagnosis. With these talks, I can extend some reassurance, listen to their concerns, and figure out thoughtful and effective ways to help them with the emotional challenges that often accompany the diagnosis and isolation.

Was it scary to work there in the beginning of the pandemic? Why? 

There was a level of fear when it came to the unknowns. I had worries about getting the virus. But primarily because of my level of exposure in the ER, I was mainly concerned about others being around me. I isolated myself from family and friends, and my life was work and home.

There were times when we would care for patients with no known symptoms and later, we’d find out that they were positive for Covid-19. I would have mounting thoughts of whether I wore the correct PPE or if I was exposed in those moments.

We also had staff members contract the virus, which was scary. Thankfully, most of them recovered well, but seeing how careful other staff members were and finding out that they still contracted the virus was nerve-wracking. Every minor allergy symptom or cough would cause concern and anxiety about whether I was next. To combat those fears, I had to reshape my focus. Instead of being hyper-focused on getting sick, I began to fix my focus on doing my job well and providing the optimal patient care that I was used to. With this newfound focus, my anxieties slowly began to dissipate.

How do you keep yourself from bringing the stress of the job home? What do you do to relieve your stress?

Sometimes it can be challenging, especially after losing a patient. My go-to stress reliever is prayer. I have a solid spiritual foundation, and thankfully the organization I work for also provides spiritual support, if needed. As nurses, we are fortunate enough to work three shifts per week. I try not to take my days off for granted; I use that time to refuel. Therapy, exercise, and self-care activities have been essential to my mental well-being.

What are the biggest challenges of your job—especially during COVID-19?

One of the biggest challenges of my job is knowing that I have to be on my A-game at all times because the safety of myself and others depends on it. The unknowns that came along with COVID-19 made it challenging to do and be our best. For example, we didn’t always know the best course of action when treating some patients because everyone would respond so differently, which posed one of the biggest challenges. Thankfully, as time went on, we learned more about the virus, the treatment options that worked for others, and we eventually adapted very well.

What have been your greatest rewards during this time?

My greatest rewards have been seeing how the nursing and healthcare community banded together during the most challenging times. The support from our community members was also very inspiring. We often came into work with goodies from companies that wanted to encourage and thank us for our continued work.

Future of Nursing 2020-2030: Examining Scope of Practice

Future of Nursing 2020-2030: Examining Scope of Practice

The Future of Nursing 2020–2030 Charting a Path to Achieve Health Equity report, issued by the National Academy of Medicine Committee on the Future of Nursing 2020-2030, is addressing topics that will impact the nursing industry in the coming years. Sponsored by the Robert Wood Johnson Foundation, the report examined issues and topics foremost on the minds of those in the industry and brought forward recommendations to help guide important changes including scope of practice regulations, health and well-being of nurses, and better payment models.

Minority Nurse spoke with Regina Cunningham  PhD, RN, NEA-BC, FAAN, CEO of the Hospital of the University of Pennsylvania, professor of nursing at the University of Pennsylvania School of Nursing, and a member of the Committee on the Future of Nursing 2020–2030, about the report’s findings on regulations surrounding the scope of practice for advanced practice registered nurses (APRNs) and lifting barriers to expand the contributions of nursing.

Changing State Regulations

Currently, 27 states restrict the autonomous practice of nurse practitioners, despite the nurses having the education and training to practice in such a manner. With advocates working to remove these remaining restrictions, Cunningham says the progress is happening, but slow. “Each state has regulations that govern advanced practice registered nurse scope of practice,” she says. “When we say APRN, there are really four groups of nurses we are talking about. Most commonly it is nurse practitioners, but also includes certified nurse midwives, certified registered nurse anesthetists, and clinical nurse specialists.” The report also looks at the institutional barriers for other nurses, including registered nurses (RNs) and licensed practical nurses (LPNs), to allow them to practice to the top of their education and training.

The restrictions have been loosening ever so slowly. “There has been considerable progress in this area, I will says that,” says Cunningham, “but it has taken a couple of decades. There are 27 states that don’t allow APRNs in those states to do things they are educationally prepared to do. Examples include prescribing medicine, diagnosing a patient, and providing treatment independent of a physician. Even when it is allowed, there are administrative burdens. It’s not a very nimble system.”

Increasing Access to High-quality Care

The Future of Nursing report did a lot of research on the elements and regulations that limit access to care in general and to the high-quality care offered by APRNs, says Cunningham. And while opponents say that non-physician providers are less likely to provide high-quality care because they don’t have the same training or clinical experience, Cunningham disagrees saying the data doesn’t show that quality of patient care is reduced. “Arguments are made against scope of practice being relaxed really are not keeping the patient at the center of the discussion and it should be at the center of the discussion,” she says. “APRNs bring specific skills and knowledge. In states with restrictions, patients have less access to primary care.”

What autonomous practice does, she says, is significantly increase access to care, especially in rural and underserved communities where physician care may be scarce or difficult to access. APRNs aren’t looking to practice brain surgery, says Cunningham. What they will do, and are trained to do, is provide high-quality primary care services.

At various times, changes to these rules have proven to be especially effective. Interestingly, Cunningham says the COVID-19 pandemic inspired eight states to suspend scope of practice restrictions as a key strategy to manage the pandemic care in the interests of the public and when the health of the nation was at risk. The strategy worked so well, some of those states have moved to make those changes permanent, she says. In 2016 APRNs also saw expanded practice regulations when the Comprehensive Addiction and Recovery Act allowed nurse practitioners to prescribe buprenorphine, a drug used to manage addiction, says Cunningham. The bill increased access to care in rural areas and helped keep patients with substance use disorder safe. When federal authority supersedes state regulations (such as this instance), says Cunningham, that should be looked at more closely as it gives evidence of how loosening regulations can protect public health.

Reducing Administrative Burden

Granting nurses autonomy also helps organizations stay nimble, says Cunningham. It allows them to move nurses where they are needed during times of crisis like COVID, without the extensive forms and processes typically required. COVID, says Cunningham, showed how being able to move nurses to different areas to treat patients or to cover for nurses who were called to a different area, was essential to patient health.

And while the immediate outcomes look positive, Cunningham says the data that emerges from the pandemic will tell a more complete story. “Reductions in mortality especially will be the kind of outcomes data that will be compelling to make this permanent,” she says. “The current recommendation is that all changes that were adopted in response to COVID should be made permanent by 2022. That’s a strong recommendation coming out of the report, but there’s good data to show this is a strong direction.”

Improving Care Access Through the Workforce

And the sheer number of working APRNs would offer a significant boost to primary care efforts where they are especially needed such as in rural or low-income areas. “For counties that are deficient in the number of primary care providers, meeting the needs of the population is important,” says Cunningham. “It creates more equitable communities.”

To remain focused on the patient, the report’s findings show many ways APRNs are trained and educated to improve patient outcomes. “We should be focused on the health of the nation,” says Cunningham. “The current situation is antiquated given the health concerns of the nation. It is not focused on the patient. We need to ask, ‘How do we improve the health of the nation?'”

The report finds removing restrictions also has other benefits. “The clinical piece of this,” says Cunningham, “is that it would be extremely empowering for nurses to do all the things they are prepared to do.”

Careers for Nurses Who Like Working in the Community

Careers for Nurses Who Like Working in the Community

Hospitals remain the top employers for nurses, but they are certainly not the only places where nurses can find a fulfilling career. Some may find that their true passion is in helping others outside the confines of an inpatient setting. And luckily, that is possible. There is a great need nowadays for compassionate and skilled nurses who can serve people in the community setting. Listed here are just a few examples of specialty areas in community health that nurses may want to consider.

Hospice and Palliative Care Nursing

Hospice nurses provide comfort-focused care to patients who have a life expectancy of six months or less. Palliative care, though sometimes used interchangeably with hospice, is slightly different in that patients do not necessarily have to be in the terminal phase of their disease process. Palliative care nurses care for seriously ill individuals who are dealing with discomfort as a result of chronic diseases or treatments used to manage these diseases. Regardless of the technical differences between them, both hospice and palliative care nurses specialize in symptom management. Rather than focusing on curing patients, hospice and palliative care nurses promoting comfort, which may involve managing chronic pain, respiratory distress, or nausea, among other things. While some hospice and palliative patients are cared for in hospitals, many also receive care in their homes.

Infusion Nursing

If you are skilled with IVs, then you might consider working as an infusion nurse. Infusion nurses start and maintain various kinds of intravenous lines. Not only do they administer medications, but they also provide monitoring for their patients to make sure that treatments are effective and are not causing any adverse effects. Those who have had a lot of experience with IVs in the hospital setting might find this type of nursing appealing. Many companies, including home health agencies and pharmacies, are hiring skilled nurses who can provide infusions to patients in the community.

Wound Care Nursing

Wound care nursing is a specialty area for nurses who have a passion for helping patients afflicted with wounds, some of whom have chronic and debilitating injuries that put them at high risk for infections. Among the people who require the services of wound care nurses include bedbound patients, diabetics, patients with chronic circulation problems, and patients who have had accidents or surgeries. If you are interested in this kind of nursing, you may also want to consider getting some type of certification in wound care nursing. Your expertise will be valued by many organizations and you may see patients in their homes as a traveling consultant for durable medical equipment companies and healthcare agencies that specialize in wound treatment.

Worker’s Compensation Nursing

Getting injured at work can affect one’s life in many ways. Depending on its severity, workplace-related injuries may affect more than just one’s physical health. Losing the ability to work can also cause mental and financial strain. As a worker’s compensation nurse, you will have the opportunity to help these individuals get their life back on track. You will have the role of a case manager who will ensure that your patients get the high-quality treatment necessary to restore them to their highest level of function.

Nurse Educators

When you think of an educator, you may picture someone who is in a classroom, lecturing and scribbling notes on a chalkboard. While nurses do teach in academic settings, there are also nurse educators who work in the community. These are nurses who may work for pharmaceutical or medical equipment companies that are selling highly technical products. The job of nurse educators, in these cases, is to assist other health care providers in understanding how these products work so that they can be safely utilized in clinical settings.

Public Health Nursing

Public health nurses wear many hats. They may go out and educate communities about preventing the spread of certain types of diseases. They may go into clinics to provide vaccinations. Other times, public health nurses may visit people in their homes to ensure that they are living under humane and sanitary conditions. In some cases, they may also function as medical case managers for underserved individuals in the community. Whatever they do, the main role of public health nurses is to safeguard and promote the health and well-being of the communities they serve.

One of the beauties of the nursing profession is the sheer diversity of available opportunities. Inpatient settings, like hospitals, are just one of the many places where nurses can share their talents and make a difference. Nurses have a lot of freedom in shaping the course of their careers and if you are looking for a change of pace, now could be your chance to do so. Who knows, you just might find your calling as a community health nurse.

Do I Have What It Takes to Be a Nurse Practitioner?

Do I Have What It Takes to Be a Nurse Practitioner?

What is a nurse practitioner (NP) and how is it different from your role as a nurse? According to the American Association of Nurse Practitioners, an NP is a master’s or doctorate-prepared nurse with the knowledge and clinical competence to practice as a clinician in acute or primary care settings. Becoming an NP is highly rewarding and requires effort, time, money, and managing more licenses and certifications.

So you are comfortable with your role as a bedside nurse, but you feel like you want or need something different. You can hold various nursing positions with a bachelor’s of science in nursing (BSN) if you aren’t interested in pursuing additional education. But, if you want more of a challenge, more responsibility, more independence, and higher education, then becoming a nurse practitioner may be the right pathway for you. Read on to see what it takes to become a successful nurse practitioner.

 

5 Necessities to Becoming a Successful Nurse Practitioner

 

1. Registered Nurse Licensure

The first step to becoming a successful NP is to become a successful registered nurse (RN). If you aren’t an RN already, there are options for second-degree BSN programs available. If you are an associate-prepared registered nurse, RN to MSN programs are available for you to earn your MSN and your BSN. If you are a bachelor-prepared RN, there are numerous NP programs online and in-person all over the country. 

2. Know Your Specialty

Unlike physician assistant programs, nurse practitioners must decide on what specialty they would like to study before applying to their program. Most nurses will utilize their bedside experience to help decipher which focus they would like to pursue. Although this is not necessarily a requirement of an NP program, it is challenging to acquire advanced knowledge and skills in a field without that specific experience. NPs can decide later on a subspecialty if they choose to go down that path. NP specialties include:

  • Adult-Gerontology Acute or Primary Care
  • Family Acute or Primary Care
  • Neonatal Acute Care
  • Pediatric Acute or Primary Care
  • Psychiatric/Mental Health
  • Women’s Health Acute or Primary Care
3. Consider Interests as Subspecialties

NPs can decide later on a subspecialty if they wish to focus on an even more niche area of care. Not all NPs subspecialize, but if a nurse has experience or interest in a subspecialty and they would like to practice as an advanced practice provider in that field, they can do so after graduation. Additionally, NPs can get post-graduate certifications to further their subspecialty education. Subspecialties include, but are not limited to:

  • Allergy/Immunology
  • Cardiovascular
  • Critical Care
  • Dermatology
  • Emergency
  • Endocrinology
  • Gastroenterology
  • Hematology/Oncology
  • Infectious Disease
  • Neurology
  • Occupational Health
  • Orthopedics
  • Pulmonology
  • Sports Medicine
  • Urology

A nurse practitioner can even choose to switch their speciality if considering a career move. 

4. Independent Practice

NPs have varying levels of independence depending on their state of practice. In some states, overseeing physicians need to approve all decisions made by an NP. This style of collaboration is suitable for new graduates, but it can become tedious for more experienced NPs. In other states, NPs have what’s called Full Practice Authority (FPA) to order and prescribe as they see fit; this type of autonomy is excellent for more experienced NPs. However, it is still essential to know when to consult additional providers due to patient complexity. Regardless of their scope, NPs need to be effective autonomous providers with an increased level of accountability. It is crucial that an NP doesn’t rely solely on their overseeing physician to correct any potential mistakes made. 

5. Clinical Decision-Making

NPs have a more in-depth scope of clinical decision-making than their RN counterparts. Not only do NPs need the knowledge base to make clinical decisions, but they also need the confidence to make those decisions. The increased responsibilities include, but are not limited to:

  • Managing acute, chronic, and preventative care
  • Counseling, planning/implementing treatment plans and palliative care
  • Understanding and utilizing appropriate diagnostic and screening protocols
  • Distinguishing between normal and abnormal findings
  • Prescribing medications within the state’s scope of practice
  • Delivering patient-centered, culturally competent care and empathetic relationships with parents and caregivers

As you can see, there is a significant difference in the role of a nurse and a nurse practitioner. Deciding whether or not you have what it takes to leap into a more autonomous medical role isn’t a decision to take lightly. It is important to remember that to be a successful nurse practitioner, you must be a successful nurse first. There is more required to being a good nurse or NP than simply having the foundational knowledge. Nurses must have the personal qualities and characteristics that are necessary for creating a career as a competent nurse practitioner. 

Preventing Nurse Burnout, Beginning with Hospital Leadership

Preventing Nurse Burnout, Beginning with Hospital Leadership

Nurses—especially in the last year during the pandemic—have been experiencing burnout. Often, articles focus on what they can do to make themselves feel better. But what can their workplaces do?

Anne Dabrow Woods, DNP, RN, CRNP, ANP-BC, AGACNP-BC, FAAN, Chief Nurse of Wolters Kluwer, Health Learning, Research & Practice, a Critical Care Nurse Practitioner at Penn Medicine Chester County Hospital, and a Clinical Adjunct Faculty member at Drexel University. She’s also authored and presented on many clinical and professional topics including a recently published eBook, COVID-19: Transforming the Nursing Workforce in the New Paradigm of Care.

She took time to answer our questions about what hospital leadership can do to prevent nurse burnout.

From a hospital leadership standpoint, what are some of the steps they can take to help prevent nurses from burning out?

Health care systems need to recognize that their most valuable commodity is their workforce. For years, health care systems have focused on patient well-being, but now many of those institutions are beginning to see the importance of focusing on workforce well-being too. Hospitals need to provide a safe environment for their workers, recognizing when they’re exhausted, burnt out and/or experiencing moral distress on the job. Safe environments should include the assurance of personal as well as patient safety and having adequate personal protective equipment, clinical decision support resources, and adequate staff to appropriately care for patients.

Staffing needs must be based on clinical acuity and severity of illness, not just on the number of patients. And having an agile workforce that can work in a variety of units as well as be shifted to other units when and where they are needed the most, is also a new essential, thanks to COVID. What we want, and need, are multispecialty nurses who can work across multiple units, not just single-specialty nurses working only with one patient population. Cross-training and upskilling staff to care for patients in a variety of units with a variety of care needs brings flexibility and efficacy to the workforce so managers will not need to overwork staff and can provide necessary time off.

Health care systems need to recognize when a member of their workforce is experiencing burnout and moral distress by having leadership and those trained in recognizing emotional distress available and on the unit to assess for it. Social workers and mental health workers are excellent resources to utilize for this kind of assessment. Taking the time to debrief and discuss what went right and what could have gone better in emergencies is a great opportunity to decompress after stressful situations. Many hospitals have instituted a moment of silence after a death where everyone in the room stops to acknowledge the life that was just lost.

Employee assistance programs (EAP) are good, but only if they can be easily accessed by those who need them. Too often EAP programs are difficult to find on the health care system website, and once they are found, the paperwork and or searching for an available care provider is incredibly challenging. EAP programs need to be made readily accessible and usable.

What should they do first?

 The most important first step is to recognize that there is a problem with burnout. If staff are quitting, retiring early, or are becoming less engaged, there is a real problem. Be present! The leaders within the organization must be up on the units to experience what is going on firsthand. You need to find out if staff able to take breaks and leave the unit to have a meal. Are they able to sit down or are they constantly moving and up on their feet? Are they working as a team or as individuals? Health care is a team activity. It takes an interdisciplinary approach to provide the highest quality care and facilitate the best outcomes. If patient outcomes are not where they need to be, the first place to look is at your caregivers to see if they are exhausted, burned out, or experiencing moral distress.

 What action steps should leaders recommend that nurses take? How can they get this information to them?

The question should not be what steps leaders should recommend to nurses to combat burnout, but how can health care organizations facilitate workforce well-being and prevent burnout? It is the obligation of leaders to assess the situation, make a plan, implement it, and then evaluate if the plan and interventions are working.

Start meeting with the staff, watch and listen to what they have to say, and start implementing these 10 steps:

  1. Assess if the staff are burned out or experiencing moral distress.
  2. Make employee assistance programs easy to access and utilize.
  3. Adequately staff the patient care units with the right staff for the right patient populations.
  4. Cross-train the workforce so they are more agile and can go when and where they are needed.
  5. Provide adequate support systems, unit coordinators, unlicensed assistive personnel, and transporters.
  6. Make sure the workforce takes their breaks and mealtimes.
  7. Offer healthy food. Get a cart and take healthy options to the unit if the staff is too busy to get to the cafeteria at mealtime.
  8. Give the staff time to debrief and collect themselves after a challenging situation.
  9. Decrease documentation burden and make sure nurses have input on what is added to required documentation in the electronic health record.
  10. Offer continuing professional development activities and career ladders to meet the staff’s professional needs.

Remember, nurses have family and financial concerns; offer care alternatives and financial counseling if and when it’s needed.

If nurses are already experiencing burnout, what should hospital leaders do? How can they help? And how can they let nurses know that their jobs aren’t in jeopardy if they need to take time off for their mental health because of burnout?  

Take the time to see, hear, and experience what nurses are experiencing. You can’t do that from an office, so get up on the patient care units and look around. If the workforce doesn’t feel valued by the organization, they will leave, and there will be fewer caregivers left to care for the patients. Develop a “care without judgement model,” meaning that to whomever is in need of care—a patient, a nurse, or another employee—care will be delivered, without judgment. No one’s job should be at risk if they need to take time to step away and focus on self-care. You cannot be a good clinician unless you care for yourself first. Again, make it easy to access employee assistance and mental and physical health resources.

What should hospital leaders absolutely *not do when trying to prevent their nurses from burning out? What are the biggest mistakes they can make?

The biggest mistake health care leaders make is not recognizing that the health care workers are the most important commodity within their organization. Patient outcomes are optimized only if the staff feels valued, have adequate resources, are properly trained, and feel safe in their work environment—both physically and emotionally. Everyone on the health care team needs time to be able to take a moment to step away and recharge.

During COVID-19, what have been the biggest challenges that nurses are facing in terms of burnout? Is there anything that hospital leadership can do to help?

The biggest challenges have been fear and uncertainty. Fear that we initially didn’t know enough about the COVID-19 virus, and we might bring it home to our families or become infected ourselves, and fear that the death we experienced day after day wouldn’t stop. And uncertainty that we wouldn’t be strong enough to keep delivering care to our patients as we fought this seemingly unending pandemic. Yet we did. We looked fear and uncertainty in the face and said—”we will not be daunted!” That’s who we are—we are nurses, and our passion is to care for those in need.

Health care systems need to invest in workforce well-being, retaining the talent they have and recruiting new nurses to take the place of those who have left the profession. Care begins with those in our family. In health care, the workforce is our extended family.

Anything else?

The vaccine is a game-changer for nurses. The more shots in arms, the lower the number of patients we will see fighting for their lives because of COVID-19. Let’s trust in the science and use the evidence to educate people about COVID-19 and how to prevent it.

And finally, nurses need to invest in their own well-being so they can invest in caring for others.

Nurses Leaving the Profession: What Hospital Administrators Must Do to Keep Their Staff Post-Pandemic

Nurses Leaving the Profession: What Hospital Administrators Must Do to Keep Their Staff Post-Pandemic

The COVID-19 pandemic is undoubtedly one of the most trying and difficult things that many of us have had to endure in our lives. Nearly everything we care about was disrupted from child care to going to work to visiting friends and family. Many became socially isolated, even more are dealing with stress and anxiety from the virus. To some degree, all of our economy was impacted, with many businesses still struggling to reopen and many employees cautious about their options moving forward.

With all of the crazy things that COVID brought into the lives of everyday people, it can be hard to realize the even more significant toll it has had on health care providers, particularly nurses. Nurses have been on the front lines of the pandemic since the beginning and most have been put into situations that nobody outside of the profession can imagine. Understandably many are dealing with burnout and ready to leave nursing altogether.

One recent report from Business Insider stated: “Many nurses on the front lines of the pandemic are burned out and mentally and emotionally tired. A significant portion of nurses in a Trusted Health survey said they were considering a new career. Of those who said they felt less committed to nursing, 25% were looking for a new job or planning to retire.”

This high rate of burnout and apathy are concerning and ultimately beg the question: What are hospital administrators to do?

Put Trauma Care Front and Center

Our nurses have seen a lot this past year. Many have been put into positions where hospitals were at capacity and whole units had been converted to treating COVID patients, yet it still wasn’t enough. Supplies became limited and many watched as an uncountable number of patients died without the comfort of family from a disease most people knew nothing about and couldn’t do much to treat.

That kind of trauma is typically reserved for horrific places such as war zones.

Yet our nurses showed up day after day to care for the sick. Some gave up going home to their families for months to protect them from the virus. Others faced prejudice for “risking the lives of others” by going to the grocery store after a shift. Sooner or later, it is all enough to break a person.

One survey conducted by the International Council of Nurses laid out the serious mental and physical health impacts that the pandemic is having on nursing professionals. Perhaps the single best thing that hospitals can do to support their nurses is to provide on-site, free mental health support and treatment. This type of initiative could give nurses an outlet and help them work through some of the difficulties they have faced in the past year.

Assist with In-Hospital Moves

Unfortunately, regardless of the support and treatment options that become available, many nurses have still seen too much and will leave. Though COVID-19 has pushed many strong-willed nurses past the breaking point, a significant number were there already. Even before COVID, there were plenty of legitimate reasons that good nurses left the bedside for other opportunities.

In these instances, it may be possible for hospitals to help keep quality people on staff just in a different position. For example, perhaps a nurse would be willing to stay but in a more administrative role. Moving into something such as medical billing and coding could allow them to continue to serve the community they care about but shield them from the traumas the stress brought on by the pandemic.

Hospital administrators can also help nurses who don’t want to be at the bedside any longer move up into more specialized nursing roles. Some nurses may be willing to stay on staff with the promise that they won’t have to interact with COVID patients and can, instead, focus on specific diseases like GERD and provide the medication and treatment help with them.

Focus on Work-Life Balance

For those nurses who do stay, we can hope that mental health counseling and treatment will be available when needed. We can also hope that there will be a renewed focus on work-life balance from hospital administrative staff.

During the pandemic, many nurses were encouraged, if not forced, to work longer shifts or to pick up extra days. Unfortunately, once again, this behavior wasn’t exactly uncommon before the pandemic. It just became more apparent. Being overworked and underappreciated in this manner can lead to extremely high rates of burnout and ultimately more turnover, a less productive workforce, and a negative culture that permeates the entire workspace.

There are about a thousand studies out there that explain the incredible benefits of a strong work-life balance. These positives can range from significant improvements in personal mental and physical health to increases in workplace productivity, retention, and satisfaction. Though there is an undeniable need to fill a shortage of nurses, treatment of the folks already working should be paramount.

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The bottom line here is that our nurses have worked hard to do what they can to protect our nation during a global pandemic. Now, they need help. Changes that hospital administrators can make to help curb the number of nurses leaving are not necessarily small and easy ones, but they are critical to the long-term care of some of the most important caregivers.

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