Nurses did not “sign up for this.” Yet, here we are.
And so, the current challenge to tackle is: how does the field of nursing survive a pandemic? And how does healthcare keep its nurses in the careers they dreamed of, long before March 2020 happened?
With the deadliest pandemic in the history of the United States1, nurses have had to reinvent themselves, reinvigorate their love for healthcare and find ways to recharge like never before.
Nurses are being bombarded daily not only with their own anxiety and stressors, but with instructions and pressure to practice self-care. Codes for therapy services are being handed out like candy. Beloved brands and stores are providing “front-line hero” discounts. But what is actually working, what is just a band-aid? And what can nurses do to help ease the emotional turmoil of taking care of the human race during these trying times?
One solution that is both evidence-based, and rooted in what nurses often already do, is peer support.
So just what is peer support? Peer support encompasses what many nurses already naturally do…airing our frustrations in the break room during lunchtime, asking advice from the seasoned charge nurse and giggling together over an experience that no one but another nurse could possibly understand.
The difference is that peer support takes on a more organized and structured approach than the organic ways nurses often help each other. This strategy can help to heal the psychological wounds, anxiety and moral dilemmas that many of us are experiencing daily during this pandemic. Examples include support groups, mentoring, one-on-one sessions, and online forums.
Recent studies have investigated the role and effectiveness of peer support with encouraging results. One looked at the well-established peer support programs at two medical centers, and the lessons learned from those experiences. “One-on-one or group peer support can effectively offset the increased stress and other challenging experiences of nurses during the COVID-19 pandemic and other challenging events”2.
In a practical sense, managers and human resources departments can keep an eye out for staff that has certain characteristics and behaviors, such as:
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High emotional intelligence
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Natural helpers on their team
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Are great at maintaining trust and respect within their peer group
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Have been in a clinical role for at least 18 months
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Are highly effective at communicating
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Show an empathic presence
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Viewed as non-judgemental by their peers3
Once these natural tendencies are identified, these staff members can be recruited to help support distressed colleagues in a more formal way4. These teammates can then be trained and deployed to serve as individual peer supporters, run group meetings, or round on varying units. High-risk areas, in relation to covid, should receive more attention and assistance.
Another study5 evaluated formal peer support groups that were offered at a designated covid-only hospital. Groups were led by psychiatrists and psychiatry residents and were attended virtually by hospital staff, including nurses. In comparison to the previous study, this group used trained mental health providers to help staff members through these difficult times. The group members were assisted through group processes like feeling ventilation, peer support, the moral challenges of taking care of covid patients, and the trauma associated with it. Those with more extensive struggles, or those who needed more time. were given additional interventions such as individual sessions.
The researchers did not use formal methods to calibrate improvement in mood or coping, as the participants were practicing nurses and not research subjects. However, their determination was that it was a useful tool to offer in support of emotional and mental health issues surrounding covid.
If you aren’t in a place where your facility can institute a formal peer support program right at the moment, remember that peer support can happen organically, anywhere and at any time. If you notice that a coworker seems like they are struggling, they are acting differently at work, or they tell you that they are having a hard time, evaluate your comfort level by providing some informal peer support.
The American Association of Nurse Anesthesiology has some great tips on how to get started providing peer support to others6.
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Make sure that you are in a healthy place to provide support for someone else. Set boundaries and check in with yourself consistently.
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Express care, concern, and express appreciation for anything the person shares
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Reflect back on their experience and summarize for them
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Validate their feelings and express how it can be normal
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Explore with them what coping mechanisms have worked in the past
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Ask about current support systems
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Share reliable resources, such as an Employee Assistance Program
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Listen more than you talk
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If you feel like suicide or self-harm is a risk, ask directly if they are thinking about suicide and take appropriate action if the answer is “yes”
Nursing today brings about struggles unlike our profession has ever seen. According to Becker’s Hospital Review, 66% of nurses are currently considering leaving the profession7. These are staggering statistics. Often the fight against this exodus feels hopeless, but we all must do our part to try and keep ourselves mentally healthy. Peer support not only offers one way to help our colleagues but also provides one way we can fight back against Covid-19 and its effects on nursing. Consider that a win-win.
References
1COVID-19 Is Officially the Worst Pandemic in US History, Surpassing the Death Toll From the 1918 Spanish Flu
2,3,4At the Heart of the Pandemic: Nursing Peer Support
5Support groups and individual mental health care via video conferencing for frontline clinicians during the COVID-19 pandemic
6American Association of Nurse Anesthesiology. (2020). Peer Support - Giving and Receiving
766% of nurses say pandemic has made them consider leaving profession
