While the rewards of a career in nursing are many, dealing with traumatic experiences and death often comes with the job. For the most part, the job demands nurses carry on working despite any challenges. There are few resources to support a nurse after a patient dies, and there’s little time on the clock to make use of any that do exist.
This culture is exhausting and sometimes debilitating, says Shannon McPeek, RN, BSN, a long-time NICU nurse and founder of Operation Happy Nurse (OHN). After experiencing her own bout of anxiety and obsessive-compulsive disorder from the stress of nursing, McPeek founded OHN as a free community to support the mental wellbeing of nurses coping with the profession’s challenges.
“I never really had to deal with death before, and then all of a sudden, I was expected to cope with the death of infants. It was extremely difficult, and no one was talking about it. There was limited mental health support, and I just began to spiral,” says McPeek.
Culture of burnout persists in nursing
McPeek’s realization that nurses need better mental health support came in 2018. The pandemic increased awareness of burnout among frontline workers, but it also exasperated the existing crisis. Today, says McPeek, there are more resources to support nurses’ mental health, but there is little change that’s occurred within healthcare systems. “In many ways, the culture has gotten worse since COVID,” she says.
In an American Nurses Foundation mental health and wellness survey of 7,400 respondents, positive emotions among nurses are on the decline while negative feelings of stress and anxiety remain consistently high.
Consider some of the following findings:
- 56% of nurses are experiencing burnout, including emotional exhaustion
- 64% say they feel “a great deal of stress because of their job
- 39% indicated they were likely to leave their current position in the next 6 months
- 66% of nurses said they are suffering mental anguish or toxic emotions and are either not seeking or not receiving mental health support
- 56% say there is stigma as a health care provider associated with receiving mental health care
Recognizing signs of fatigue, burnout and anxiety
It took time for McPeek to realize she needed more support to deal with the challenges that come with a NICU nursing job. Her work with Operation Happy Nurse is to create a free community for nurses to find a safe space to feel and provide much needed support and resources. Recognizing signs of mental health fatigue, burnout and anxiety in yourself and others is an important first step to addressing the mental health crisis in the nursing profession.
Here are some signs to watch for:
- Increased irritability and agitation
- Persistent fatigue that doesn’t improve with rest
- Avoiding social activities and feeling isolated
- Activities that once brought pleasure no longer do
- Headaches, stomach issues and other unexplained physical ailments
“During a particularly challenging period, I noticed I was getting more agitated and that people perceived me differently. I wasn’t as happy, and things that normally brought me joy didn’t anymore,” says McPeek.
If you notice these signs in a colleague, McPeek recommends approaching them with empathy and support. “Just saying you’ve noticed some changes and are here if you want to talk can make a significant difference,” she says.
Solutions for supporting nurses’ mental health
Increased awareness about mental health needs and healthcare burnout goes a long way toward helping individual nurses recognize signs of needing help. For some, this might just mean making time for self-care or talking to a friend. Others may find support from professional help or by joining a community of peers, like OHN.
The onus shouldn’t just be on individuals, though, says McPeek. Healthcare systems as a whole need to do more to support front-line workers. This includes adding employee mental health resources, having adequate staffing and allowing staff to take breaks throughout a shift.
McPeek recommends the following:
- Accessible mental health resources: Hospitals should provide easy access to mental health professionals who aren’t affiliated with the organization. This ensures nurses can seek help without stigma.
- Regular debriefing sessions: Healthcare systems should implement debriefing sessions focused on emotional well-being, not just clinical outcomes.
- Dedicated break nurses: Some states, like California, instituted break nurses who ensure that nurses can take uninterrupted breaks without compromising patient care. This is necessary in every patient setting.
To implement real change, McPeek says healthcare organizations need to do a better job of listening to staff’s needs and involve them in decision-making processes related to their well-being. Effective leaders regularly engage with bedside staff to understand their challenges and provide appropriate support. “In order to build trust, a lot of organizations need to start listening to their staff and what they need,” says McPeek.
Nurses’ mental health is crucial for maintaining a high standard of patient care. By recognizing the signs of fatigue, burnout and anxiety in themselves and others, nurses can take proactive steps towards better mental health. For real change, though, healthcare organizations must implement systemic changes to create more supportive environments.
Resources
- Operation Happy Nurse: An online community and nursing support resources
- Debriefing the Front Lines: Debriefing sessions outside of the hospital
- Don’t Clock Out: Mental health support for healthcare workers
- Therapy Aid Coalition: Free and low-cost therapy for first responders
