Chris Caulfield RN, NP-C is the co-founder & CNO at IntelyCare, overseeing nursing, clinical compliance, education, quality, and innovation.
Nurses are consistently ranked as having one of the world's most stressful jobs. A health-risk survey found that 82% of nurses stated they are at a "significant level of risk for workplace stress." And that number was pre-pandemic.
Stress, unfortunately, is commonplace for the nursing profession. But amid the Covid-19 pandemic, the stress that nurses and other health care workers are dealing with is unprecedented.
In the wake of the current crisis, nurses are asked to shoulder many emotional and physical burdens, like processing patient deterioration and death in high numbers, working overtime clad in PPE, or worrying about caring for patients without proper PPE. They are living with the anxiety that they might pass on the virus, whether it's to a loved one or a stranger at the grocery store.
Not to mention that in today's health care crisis, nurses are also contending with the extra anxieties that the average person is dealing with during with, like grief over lost income, a lost sense of economic security, and the unusual challenges of social distancing, staying at home, and having family members who are working or schooling at home.
These stressors have manifested themselves as a "perfect storm" of stress for nurses around the world, and the results are sobering. According to one recent study surveying over 1,200 health care workers in China, nearly half of the health care respondents who treated Covid-19 patients now have anxiety and depression, and a third struggle with insomnia.
The physical and mental health consequences of this cannot be understated or ignored. Experts predict a large number of nurses and other front-line medical providers will likely struggle with post-traumatic stress disorder (PTSD) in the near future, in addition to depression, anxiety, insomnia and other issues.
As the pandemic continues, it can only be expected that nurses may burn out from the stress, get sick themselves or struggle to grapple with workplace trauma. If and when these nurses step away from work to get the care they need and deserve, will that care be readily available to them?
These are important questions that local and federal agencies, as well as individual health care organizations, must be prepared to answer as the rapidly evolving pandemic continues to unfold around us. If nurses' needs are not met, nurses will likely struggle on the job, take a leave of absence or potentially leave the field altogether, which could further exacerbate the U.S. nursing shortage.
Using Technology To Support Nursing Professionals
Supporting nurses in the time during the global pandemic requires a multitiered approach at both the individual and organizational levels.
On the individual level, I recommend nurses learn and utilize coping techniques to manage their stress, improve overall well-being and promote self-care. Common strategies, such as acknowledging feelings, exercising regularly, breathing deeply and practicing mindfulness or spiritual routines, are proven to be effective and affordable.
Of course, even the best self-care techniques are not always enough to restore a person's mental wellness. Technology has its role to play as well.
There has already been a recent increase in telemental health visits. It's promising that the mental health industry is gravitating toward digital mediums that support continued social distancing and increased access for areas with limited services. The increased adoption in telemental health is far from a magic solution, and leaders must be prepared to address valid concerns, such as barriers to access, finances and perceived value.
Telemental health offers several notable benefits for stressed nurses. In a work environment that could already potentially expose them to Covid-19, having access to telemental health services help eliminate an additional route. This delivery method fits in better with the extended shifts and hours that nurses are often pressed to work during this pandemic. Instead of struggling to get someone to cover their shift for a couple of hours so they can dash out for talk therapy — or sacrificing the needs for those of the other people they care for — telemental health is available 24/7.
Another upcoming technological intervention includes virtual reality. The possibilities in the virtual reality realm go far beyond gaming. A recent study showed that using virtual reality can help people stay connected and calm during the global pandemic. Using immersive virtual reality videos of a calming environment like the beach or a peaceful garden can help reduce anxiety, offer a space for reflection and provide a sense of community.
In Italy, software developed as the result of collaborative efforts between Stanford, Harvard and Yale universities is being used to support health care workers psychologically. Using the software and virtual reality headsets, the staff is transported to places that hold happy memories for them. They then discuss their memories with a clinician who assists them in applying those positive feelings to their present setting.
As we navigate the pandemic and post-pandemic reality, responsibility will fall to both individual nurses, as well as health care systems. Health care organizations need to promote resources that are easy-to-access and affordable for nurses. Otherwise, nurses will risk the continuation of PTSD, anxiety, depression, insomnia or other challenges that could threaten their lives and livelihood and the sustainability of the nursing profession as a whole.