Supporting Nurses’ Mental Health: An Open Letter to Nurse Leaders During COVID-19
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The past 19 months have not been the gentlest or most enjoyable for healthcare personnel, especially nurses. We are all burned out. We are discouraged. We are angry, and many of us are becoming resentful of those who have yet to receive their COVID-19 vaccines for their own health and the health of others.
A lot of our colleagues have opted out of nursing to pursue different paths to make a living without the stress and anxieties that we are now experiencing in nursing due to caring for multiple gravely ill patients.
Many have turned the remaining passion they have left toward other paths where they will not have to think of embracing the continuing nursing shortage or working longer hours across many days without breaks in what feels like an underappreciated working environment, where we are being asked to do more with less.
The stress level is visible and the anxiety is palpable. The frustration is written all over the faces of once cheerful, committed caregivers and can no longer be swept under the rug.
How Nurse Leaders Support Nurses' Mental Health
As nurse leaders, we are expected to do even more to support our teams. We are to be present physically, morally, emotionally, and sometimes spiritually for our team. We are continually striving to be the unique angels we are to create a supportive environment for nurses.
In ensuring a supportive workplace, we are creating an atmosphere that allows nurses to safely unburden their hearts. My office has become a haven where nurses are welcome to share their grief, concerns, and frustrations.
"Nursing is an act, and most nurses are empaths and deeply committed to caring for others, even to the point of exhaustion and defeat. According to J. Maben and J. Bridges (2020), the pandemic has led nurses to experience the highest level of stress that have ever been recorded compared to other professions."
Many leaders have embraced an open-door policy where humor and gratitude can be shared, and staff can come in to vent, cry, and be embraced safely and encouraged.
Acknowledgments continue to be expressed for the continuing efforts and commitment of our staff caring for patients and residents. We celebrate every win and recognize every staff member's effort in the care they provide and for showing up to work every shift.
In addition to individual and team appreciation, it is amazing the love that is still pouring in from the community. Our community continues to give back to caregivers in hospital settings.
The appreciation for healthcare providers, especially nurses, has been enhanced by the experiences we are having with the pandemic. There have been food and snacks delivered to different departments by different organizations, religious groups, vendors, individuals, and even hospital administration.
The Toll of COVID-19 on Nurses' Mental Health
The pandemic has led to new protocols and more changes to the delivery of care, as well as an increased frequency in changes to certain policies, all of which must be implemented. This has led to an increase in the level of anxiety among nurses and pronounced underlying depression.
Nursing is an act, and most nurses are empaths and deeply committed to caring for others, even to the point of exhaustion and defeat. According to J. Maben and J. Bridges (2020), the pandemic has led nurses to experience the highest level of stress that have ever been recorded compared to other professions.
As nurses, we often feel like we could and should be doing more, even when we are already giving our all. We continue to embrace the ongoing changes that are constantly being implemented for safety. Most nursing leaders understand this concept, since we are empaths ourselves.
The hospital where I work has made it possible to openly talk about COVID-19. Staff members are able to talk about their fears and the unknown, the effect that COVID-19 is having on their families, and the effect on the hospital system. Leadership ensures that nurses are compensated for their time at work and when they are out sick due to COVID-19.
Working longer days has resulted in nurse burnout and has been a major issue since the pandemic started. We have put different measures in place to hire more nurses with different incentives for retention.
The goal is to ensure that there is flexibility in scheduling and staff are able to take days off work for their mental health and routine wellness checks. We are continually hiring nurses who have a passion for improving the health and lives of others despite the situation that we find ourselves in.
Nurses need time to care for themselves, and we need to make sure they are taking intermittent breaks for food, drinks, and rest periods. Sleep hygiene also needs to be discussed to ensure nurses are getting adequate rest at home before returning for their next shifts.
Facing the Unknown as a Nurse Leader
Being a nurse leader, especially during the pandemic, comes with its own share of challenges.
One of the greatest challenges that I believe all nurse leaders are having currently is staffing. We are doing all we can to ensure that we have adequate staffing on the unit daily to alleviate the level of stress that nurses have to endure each day. We leaders make ourselves available to help in whatever capacity is needed on the unit and provide physical support.
"I encourage up-and-coming nurse leaders to be open-minded and approach each nurse they encounter in a holistic manner. A lot has happened during the past 19 months that will forever change our delivery of care, our relationships with each other, and how we approach different situations."
Another challenge is being there for staff who are grieving the loss of loved ones during this pandemic and are not able to be physically present with their families to grieve together.
I have team members in this situation who cannot travel outside the country to see family due to the pandemic. Many have not seen their aging parents for almost two years now due to the restrictions that have been enforced over the past 19 months.
But I encourage up-and-coming nurse leaders to be open-minded and approach each nurse they encounter in a holistic manner. A lot has happened during the past 19 months that will forever change our delivery of care, our relationships with each other, and how we approach different situations.
Self-care for nurses is an essential aspect of humanity. Taking time for self-care should not be seen as a selfish act. It is an important means of decompressing, reflecting, re-energizing, and restrategizing to refuel our empty tanks in order to have more to give to others.
I encourage my nurses to take turns taking time off work to attend to their health and family needs. It can be helpful to give staff a gentle nudge to remind them to schedule their routine preventative screenings, time alone with friends, or even gardening.
Our staffing coordinators put a lot of effort into flexing nurses' schedules in order to accommodate vacations or holidays.
Nurse leaders should be willing to put in the effort to develop compassionate teams that will support each other on the unit and look after each other's well-being. We also need to recognize our own strengths and weaknesses and be willing to make changes. While we are striving to be strong for others, we should also look after ourselves.
Margaret Apara, DNP, APRN, NP-C
Margaret Apara, DNP, APRN, NP-C, is a certified family nurse practitioner (FNP) and currently the nursing director at Northside Gwinnett Extended Care Center in Atlanta. She earned a master of science in nursing - FNP degree from Walden University and a doctor of nursing practice from Chamberlain College, where she graduated with honors.
In addition to the primary care setting, Apara has worked in medical-surgical, trauma, home care, geriatric care, and nursing home settings. She is an active member of several professional organizations, including the American Association of Nurse Practitioners, American Nurses Association, and Sigma Theta Tau International Honor Society of Nursing.
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