Burnout of the nursing profession following the COVID-19 pandemic is continually highlighted throughout research studies. According to the Royal College of Nursing (RCN), the number of sick days taken by nurses in England are up almost a fifth on pre-pandemic levels, with a survey completed six months into the global pandemic identifying that 76% of 42,000 nurses reported a significant increase in their stress levels, with 52% concerned about their mental health and wellbeing. It is reasonable therefore to suggest, that the rise of mental health concerns amongst the nursing workforce can in part be attributed to the COVID-19 pandemic.
The unprecedented demand on healthcare services throughout the pandemic is undisputed, demand which was met by an already depleted nursing workforce. The nature of nursing roles changed in the blink of an eye, as new processes and trust policies were continually introduced with each government response to infection rates, death tolls, and as ongoing research and evidence in relation to the virus became clear. Alongside an increase in patient volume and acuity, came new protocols to be learnt overnight, an increase in rapid patient deterioration and end of life procedures, adaptations to clinical roles, isolation restrictions, an increase in the use of virtual technology, and a new workforce model which saw nurses redeployed from their regular speciality to meet the growing needs of the acute nursing workforce.
‘The Emergency Department consultant and appointed COVID-19 lead sat the whole team down one day and told us to buckle up, because in our entire careers we wouldn’t see anything else like this pandemic, we would be stretched to our limits, and we needed to look after each other first and foremost. The fear that took over the whole team was palpable. People had questions she couldn’t answer then, and I don’t doubt people have questions she still can’t answer now.’ – Emergency Department Nurse.
Fears in relation to the pandemic may have hit the nursing workforce harder than most, as working frontline meant an increased risk of exposure to infection and isolation from family and friends. This particular concern was only exacerbated when equipment and PPE shortages became paramount, leaving nurses dangerously ill-equipped to care for their patients, and creating a culture of betrayal from their management and the government, producing a clear disconnect between the nursing workforce and those who are in position to support them.
Plummeting staff morale and job satisfaction can be seen through the number of nurses who are continually making the decision to leave the profession. According to another survey completed by the RCN, over half of nursing staff are considering or actively planning to quit their job following the “toll of the pandemic’, with burnout and high stress environments the most commonly reported reason. A direct correlation can be seen between nurse staffing levels and patient care quality and outcomes, including morbidity and mortality rates, as higher nurse to patient ratios create unsafe caring environments and place unprecedented pressure on an individual nurses role and workload. A concern pre-pandemic which has undoubtedly been exacerbated, with many hospitals relying on agency nurses to fill the void,
who command much higher rates of pay, leading to feelings of dissatisfaction amongst permanent members of staff who feel they are not being fully compensated for their roles.
As an emergency department nurse who worked throughout the pandemic, I can personally testify to the overall effects which have been discussed. Whilst short term benefits of working frontline such as free meals and ‘clap for carers’ boosted moods temporarily, the long term effects of working the pandemic are not being effectively managed. Aside from the obvious need to fully staff work forces and provide fair pay, the importance of effective management, regular team meetings, debriefs following stressful shifts and incidences at work, cultivation of a positive work environment and support seeking behaviors should be of high priority.
In order to maintain an effective nursing workforce following the effects of the pandemic, retain experienced staff and therefore improve patient outcomes, it is necessary to recognise and respond to the mental health concerns of those who work in such high stress environments. Maintaining an environment where nursing professionals feel they have the opportunity to discuss their needs starts from within, normalising discussions around mental health at work, with leaders in health taking responsibility of the wellbeing of staff in order to encourage staff resilience and retention, increase job satisfaction and motivation, and ensuring the welfare of those who look after our society is being effectively maintained.
The pandemic has both exacerbated underlying issues within the nursing workforce, and has created new issues, and while many of the nurses who remain in practice may be waiting for a time when their roles will ‘go back to normal’, this may never be the case. Alongside the pandemic has come new ways of working that are more than likely here to stay, and in order to ensure nurses have the ability to work with these new role requirements and challenges, training, workforce recruitment, and wellbeing practices must be prioritised and maintained.
Royal College of Nursing.