How Has Covid Affected Nursing?

Updated | Published

Have you noticed that ICU and ER nurses in your facility are leaving? Is it Covid related, or something else?

Specializes in Gastrointestinal Nursing. Has 29 years experience.

Are nurses leaving because of COVID?

How Has Covid Affected Nursing?

Nurses have a larger portion of burnout than other professions which can lead to patient care issues. Some of the prominent contributing factors for nurse burnout are: lack of supplies necessary to do their job, psychological effects of taking care of a larger number of critically ill patients, fear of infection, and basically, just being overwhelmed (Jose, Dhandapani, & Cyriac, 2020). Covid 19 has stretched our countries’ resources in ways that have caused many people psychological distress, especially for nurses. Burnout is described by Jose, Dhandapani, and Cyriac in their article as, “ a prolonged response to chronic emotional interpersonal stressors on the job” defined by emotional exhaustion, cynicism and not being effective on a personal level (Jose et al, 2020). 

Just last week I was in the ICU to assist with a procedure on a Covid patient. When I walked into the ICU room, my jaw dropped. The attending nurse saw my face and asked me if I had seen one before (COVID patient). I just shook my head and continued to try and absorb what I was seeing. She could tell how shocking it was for me. I can usually make sense of things I have seen as a nurse, but this time I couldn’t.  All this time, I had heard a lot of stories and definitions of the treatments for COVID patients. However, seeing it in person took it to a whole other level. This particular patient was a young, white unvaccinated male who was prone and ventilated. He had skin breakdown on all extremities and was on ECMO. There were more IVs than I had ever seen in one place along with a tube feeding. 

I asked the nurse to explain the ECMO (extracorporeal membrane oxygenation) machine to me and she explained that it was a method of oxygenating the patient's blood. It is similar to a bypass machine that is used in open-heart surgery, allowing the patient’s heart and lungs to rest.  This particular patient had been in the hospital for many weeks and at this point, the prognosis is poor. I’m sure that many of you reading this have experienced COVID up close along with the tragedy that can follow. That day, the nurse taking care of this young man was my hero, as are all of you out there.

While I was setting up all of the equipment, I asked the nurse a few questions, such as, “did she feel supported by the management.” I also told her that I knew several ICU nurses had left the hospital to do travel nursing, and did she know the reason why. She told me that she felt very supported by her immediate management, for which I was very glad to hear. She also told me that the nurses who had left to travel had done so basically for the money. A couple had left to do Hospice nursing as well. So the information that this nurse gave me was not what I expected to hear, especially after reading some of the research on how Covid has influenced nurses’ job satisfaction. 

It is important for our leaders to understand how this pandemic has changed the job description for many nurses.  In doing so, they can develop ways in which to support nurses (Thompson et al, 2021). By offering employee assistance programs, counseling, and other ways to help deal with the stress will decrease fatigue, below-average job performance, and higher patient errors (Thompson et al, 2021). 

I reached out to our Chief Nursing Executive, with a few questions regarding what she had seen as a trend among the nurses this past couple of years. Also, what her thoughts were on what the nurses are going through on an emotional and mental level. 

“I think that nurses are dealing with moral distress, burnout, fatigue from losing more patients than they ever have and working long hours and extra hours. I am glad you asked about this as I just talked on our leadership council last week about this and the plans that we have to roll out. ...High level: serenity room, badge access to utilize roof garden, process groups with Valley therapists for key areas - 4E, MICU and RT, a comprehensive list of all benefits such as NurseCAre, EAP, etc., Chaplin increasing rounds and holding monthly sessions”

Research has shown that the Covid pandemic has greatly affected the nursing profession. Hailey Mensik in her article, “Pandemic Keeps Exacerbating Burnout Among Nurses, Including Travelers”, tells us that not only has the nursing burnout not been addressed adequately, but many nurses are considering different work environments or continuing their education in order to open different career opportunities (2021). Hospitals are using sign-on bonuses to attract nurses, as well as using travel nurses to fill in the gaps (Mensik, 2021). 

We as nurses know that burnout is common in the medical field due to the demands of the job. The effects on nurses who take care of  Covid patients are much higher due to the higher rate of death among the patients (Gadiva, 2021). The usual contributing factors that affect job performance and job satisfaction are workloads, conditions, and workplace violence. The factors that are not often thought of are things like an EHR that is not streamlined (Gadiva, 2021). This can lead to errors that affect patient care and outcomes. The lack of PPE is something that also greatly influences how a nurse perceives their job. Not being able to protect themselves properly makes them question their career choice and live in fear of contracting the virus. 

There are multiple sides to how the pandemic has changed our healthcare system, and jobs in healthcare. Some of the changes have been for the better, and others have put a strain on everyone involved. From financial concerns to physical and emotional exhaustion, we have been through a trying time. As a result, many nurses have retired early, some went into a different line of work, and others are leaving for more lucrative jobs. How a nurse feels supported by their facility can greatly influence job perception and satisfaction level.

We all have had very different personal experiences during the COVID pandemic. Share some of those experiences so that we can be supportive of each other and stand together at this turning point in healthcare. 
References

Gadiva, M. (2021). EHRs, Covid-19, and Understaffing: Spotlighting Contributing Factors to Nurse Burnout. The American Journal of Managed Care

Jose, S., Dhandapani, M., & Cyriac, M. (2020). Burnout and Resilience among Frontline Nurses during Covid-19 Pandemic: A Cross Sectional Study in the Emergency Department of a Tertiary Care Center, North India. Indian Journal of Critical Care Medicine, 24(11), 1081-1088.

Mensik, H. (2021). Pandemic keeps Exacerbating Burnout Among Nurses, including Travelers. Healthcaredive.

Thompson - Munn, L., Liu, T., Swick, M., Rose, R., Broyhill, B., New, L., Gibbs, M. (2021). Well-Being and Resilience Among Health Care Workers During the Covid-19 Pandemic: A Cross-Sectional Study.  American Journal of Nursing, 121(8), 24-34. 

85 Articles   294 Posts

Share this post


Link to post
Share on other sites

8 Comment(s)

toomuchbaloney

Has 43 years experience.

Traumatic stress disorder is rarely diagnosed and poorly treated among the general population.  

4 hours ago, Brenda F. Johnson said:

“I think that nurses are dealing with moral distress, burnout, fatigue from losing more patients than they ever have and working long hours and extra hours. I am glad you asked about this as I just talked on our leadership council last week about this and the plans that we have to roll out. ...High level: serenity room, badge access to utilize roof garden, process groups with Valley therapists for key areas - 4E, MICU and RT, a comprehensive list of all benefits such as NurseCAre, EAP, etc., Chaplin increasing rounds and holding monthly sessions”

Well that explains not only why things won't be improving any time soon, but also exactly how they got this way.

It is really hard to understand why there is such a persistent disconnect around these issues. It's like looking at a broken dam and pretending to help by planting flowers at a park a mile down the road.

It is also precisely why I disagree with the use and application of the concept of burnout in the nursing profession.

Edited by JKL33

CKPM2RN, ASN, EMT-P

Specializes in Emergency. Has 4 years experience.

You want to help us? Hire more staff. Yes, I know RNs are hard to hire. How about all the ancillary staff that makes our days bearable? I want a high ratio of aids (CNA, NAC, Med tech, whatever...) in every unit. For a while now we haven't just been doing our jobs, we are doing their jobs because they don't exist in enough numbers on any floor. I believe my unit manager would hire a lot in a hot second, but that's not how hospitals work.

Oh, and who has time for this "serenity garden"?

Edited by CKPM2RN
Add sentence

bluescrubs, ADN, ASN, RN

Specializes in Corrections, Surgical. Has 1 years experience.

On 10/28/2021 at 12:21 PM, CKPM2RN said:

You want to help us? Hire more staff. Yes, I know RNs are hard to hire. How about all the ancillary staff that makes our days bearable? I want a high ratio of aids (CNA, NAC, Med tech, whatever...) in every unit. For a while now we haven't just been doing our jobs, we are doing their jobs because they don't exist in enough numbers on any floor. I believe my unit manager would hire a lot in a hot second, but that's not how hospitals work.

Oh, and who has time for this "serenity garden"?

I love that you said this. Are we supposed to be in the garden or taking care of patients? Its like when they have free food at a specific location but no one has time to leave the unit, wait in line and get it. Plus free food only goes so far. I want good CNA's and safe patient ratios to start. The unit I am working on has 2 massage chairs in the comfort room. Luckily most nights I am able to take a lunch break but the 2 chairs in the room is for the whole hospital so most of the time its being used by someone on the floor or from a different floor. It's a nice gesture but just that, a gesture. The rare times I get to use it someone is coming waiting to use it and I feel guilty using it for my whole lunch break. CNA's will make or break the job. When you have all your task plus the CNA's task it seems never ending. Recently the hospital extended the visiting times for family till 9pm. Worst thing they could have done. I have family coming to me at shift change and calling me, one lady asked me to microwave her popcorn while I was reviewing orders for the shift. I swear as soon as I come on the unit and they know I'm the nurse for the room they bombard me with questions. I don't want to sound uncompassionate but they need to make a decision. I can tell you every little thing even though you've been here all day seeing the patient and you know there is literally no changes or updates or I can take care of your loved ones, which one?

SmilingBluEyes

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis. Has 24 years experience.

Stop calling us "heroes". It's impossible to live  up to and we don't want to be heroes. We just want to be able to do our jobs safely and sufficiently.

NotMyProblem MSN, ASN, BSN, MSN, LPN, RN

Specializes in Med/Surg, LTACH, LTC, Home Health. Has 35 years experience.

As a former travel nurse, I was already on my way out of acute care when COVID hit...had one foot out the door. But the straw the broke the camel’s back was when I was assigned one of the ONLY-TWO COVID cases in that entire county, in addition to the ONLY-FOUR other infectious/isolation patients on that MED-SURG unit, plus the run-of-the-mill, frequent-flyer drug seeker.

That was my last shift in acute care and I haven’t regretted walking away from the big bucks AT ALL!!  I came to help and this was the thanks I got. As the infamous ‘they’ say, if you can’t value my presence, then appreciate my absence. 

PMFB-RN, BSN, RN

Specializes in burn ICU, SICU, ER, Traum Rapid Response. Has 16 years experience.

My hospital employs hundreds of nurses. 

    Last Wednesday I attended a meeting where our risk manager said that out of all our nurses, only one was being fired for failure to get vaccinated as directed while not having one of the authorized waivers.

    No names where mentioned but one of our nurses has been complaining on social media about being fired for refusal to get vaccinated. He is very much playing the myarter card.

   I know him, a few months ago he was removed from direct patient care for "retraining" because he's incompetent and dangerous.  In the mean time they have him manning the front door asking those who enter about COVID symptoms and handing our masks. Knowing how our system works it's pretty obvious a case to fire him for incompetence was being out together. 

    Now, instead of being the guy who got fired for being incompetent and resistant to training,  he gets to crow about being a victim and myarter for "freedum".

     The revolting part for me is how much sympathy he is getting on social media.

vintagegal, BSN, RN

Specializes in Geriatrics. Has 2 years experience.

Don’t hire travelers at a going rate of 75-150 an hour. When they don’t pull their weight and they make double or triple a normal going wage it causes bitterness.