Day after day, nurses operate in high-stress environments that involve exposure to infectious diseases, severely injured or terminally ill patients, long working hours, and ergonomic issues.
Post the COVID-19 pandemic, the impact these conditions had on the healthcare industry became even more apparent, with calls to put in place measures to protect their health and well-being coming in loud and clear.
Studying nursing at a university or via an accelerated nursing program online may help set expectations on the physical demands nursing requires – but the mental demands vary greatly from person to person.
The National Institute of Mental Health estimated that in 2021 there were 57.8 million adults in the United States who suffered from any mental illness (a mental, behavioral or emotional disorder that can vary in impact ranging from mild, moderate to severe) which represents approximately 23% of the population.
There were an additional 14.1 million adults who suffered from Serious Mental Illness (a mental, behavioral, or emotional disorder resulting in serious functional impairment, which substantially limits one) which represents another 5.5% of all US adults.
And in both instances, the prevalence was higher among females.
The stigma surrounding females and mental health
The Women’s Health Research Institute notes that women are more prone to feel stigmatized for seeking help for a mental health issue. They may not seek treatment due to ‘internalized or self-stigma’ that results from their self-image being formed based on how others view them.
Women are often perceived as being more ‘emotional’, ‘dramatic’, and even ‘attention-seeking’, and so these legitimate symptoms of mental illness can often go ignored or untreated.
For nurses and other healthcare workers in particular, it is vital they receive adequate support to help manage their mental health. Failure to do so can seriously affect their professionalism, efficiency in delivering care to patients, and overall quality of life at work and home.
Because of this, nurses should have access to psychological first aid during times of crisis, mental health support programs, and a strong workplace emphasis on self-care or mindfulness to help manage or overcome mental health challenges.
Major Mental Health Issues in Nursing
Although there is a multitude of mental health issues nurses may face, stress and burnout are two significant outcomes of prolonged, unchecked, and unsupported mental health.
i). Stress in nursing
Nursing is an honorable profession that requires care, compassion, empathy, stamina, and resilience. It also exposes its workers to a significantly greater level of stress than your ‘average’ profession, including managing emotional situations with patients and their families, exposure to severe illness and death, and continuous pressure to perform which, when dealing with human health, becomes a more critical issue.
COVID-19 exacerbated many of these stressors while adding on an increased workload, longer days due to short-staffing, and anxiety dealing with an unknown situation, with many workplaces having not yet recovered from these changes.
Frontiers in Public Health reported approximately 48% of nurses surveyed had experienced occupational stress. The most stressful factors relating to their work were reported as dealing with death and dying, uncertainty around treatment, and conflict with a physician.
The report also found that nurses with children were 46% more anxious than nurses without children, and rotating day vs night shifts increased the respondents' risk of occupational stress by 2.8 times when compared to those working fixed day or fixed night shifts.
ii). Burnout in Nursing
Working for extended periods of time in highly stressful environments can also put nurses at risk of burnout. Burnout can be characterized by feelings of exhaustion, increased mental distance from one's job, negative connotations towards one's job, and/or reduced efficiency while working.
In a study on the effects of burnout in nursing, it found 54% of nurses surveyed reported experiencing burnout, with 28% experiencing high levels of burnout. For nurses surveyed a year later, it was also found their emotional exhaustion scores increased by 10% and cynicism increased by 19%,
The study also found that burnout contributes to nursing workforce turnover and that working day shifts (rather than night) and a higher exposure to death contributed to increased burnout.
Overly demanding physical work, unpredictable hours, and a lack of control over one’s environment can also contribute to burnout.
Those suffering from burnout are more likely to experience dissatisfaction with their work, provide sub-par care to patients, and even double their chances of medical error which contributes to a 17% increased chance of being named in a malpractice suit.
Breaking the Stigma
With stress and burnout persisting as a concerning problem for almost half of nurses, the stigma surrounding women and mental health must be broken. For many, this must begin at a workplace level.
Fostering an environment that recognizes, supports, and promotes mental well-being is the first step towards changing individuals' mindsets toward their own mental health.
Putting one’s own mental health as a priority without fear of judgment and with the support of workplace colleagues and managers will help build a culture where nurses will feel safe and can more effectively manage their stress or burnout.
A workplace that provides access to mental health resources such as psychological first aid, access to mental health support programs, and approachable managers who regularly check in with their subordinates can also help to recognize the early signs of mental health challenges, stress or burnout and assists in putting preventative measures in place before they become more serious issues that have a greater impact on one’s mental well-being.
Shifting the dial to better prepare our nurses and other healthcare workers is of benefit not just to the individuals who tirelessly work every day to ensure patients receive the proper care they need, but for the patients themselves, family and friends of nurses, and the broader population as a whole.
Encouraging people to continue to enter the industry and become qualified nurses is vital for a working society and to ensure the masses continue to have access to the proper health care they require.