- COVID-19 has heightened positive perceptions of nursing, but has also highlighted gaps in inadequate compensation, occupational safety, and work-life balance.
- Nearly one in four people have researched information about healthcare careers since the pandemic began.
- Higher pay, better mental health care, and safer working conditions were the top solutions to increasing interest in nursing.
The COVID-19 pandemic has brought nursing into the national spotlight. While stories of individual sacrifice and resilience have elevated public perception of the profession, the pandemic has also highlighted the critical strains on the workforce. Reports of high nurse turnover because of burnout, physical exhaustion, experiences with workplace aggression, and constant nursing staff shortages reflect the reality that there has never been a more challenging time to be a nurse.
However, despite concerns that the pandemic might diminish interest in nursing careers, enrollment in bachelor's in nursing programs has increased by 5.6% since 2020. The focus on healthcare careers during COVID-19, along with the "Fauci effect," fueled by the popularity and visibility of the Chief Medical Advisor to the President, may have precipitated a spike in nursing school applicants.
To further explore how the pandemic has changed the public's perception of nursing, NurseJournal conducted a survey of 1,008 respondents about the impact of the pandemic on nursing as a career, concerns about mental health, compensation, and work-life balance. The findings shed light on challenges the nursing profession must overcome in the future to provide quality healthcare, address workforce supply and demand, and create a hospitable and safe work environment.
81% of People View Nursing as a Favorable Career Choice
An overlooked result of the COVID-19 pandemic has been a growing awareness of the nursing profession. Public perception has heightened in response to daily news accounts of nurses working long hours in unsafe conditions, and dealing with increased patient loads without adequate resources or support.
According to survey results, respondents hold an overwhelmingly positive view of nursing. Eighty-one percent of all respondents hold a favorable opinion of nursing. Despite the challenges nurses have experienced during the pandemic, these results suggest a growing interest in nursing as a career. They also reveal a greater understanding of the concerns that nurses face in the workplace.
Results across generations show less favorable perceptions by the youngest age groups. Generation Z, born between 1997 and 2012, is twice as likely as other generations to view nursing unfavorably. However, two-thirds of Generation Z respondents report an overall favorable view of the profession. Among Millennials, the generation between 25 and 40 years old, 79% hold a favorable view of nursing as a career choice. Older survey respondents, Generation X and Baby Boomers, express the highest favorable ratings.
These age differentials suggest that the nursing profession must address ways to attract a younger and more diverse nursing workforce that reflects the demographics of the U.S. population. The median age of RNs is 52, with over one-fifth planning to retire over the next five years. As the nursing workforce ages and leaves the field, the profession must train new nurses to fill these vacancies and meet increasing demand.
Majority View Nursing Profession More Positively Since Pandemic
When asked whether they viewed the nursing profession more or less favorably since the pandemic began, the majority polled said they held a more favorable opinion. Roughly one-third of respondents said their opinion was neither more nor less favorable, and only 17% said they held a less favorable opinion of the profession.
When examining changes in perceptions of nursing by demographic, some interesting trends emerged. Sixty percent of men report a more favorable perception of nursing compared to 47% of women. Nursing programs have long called for increasing efforts to recruit more male nurses. Despite the percentage of male nurses being at an all-time high, men are still significantly underrepresented at only 13% of the workforce.
Nurses More Admired but Concerns Rising Over Mental Health, Compensation, and Work-Life Balance
The pandemic has focused unprecedented attention on nurses in the workplace. Consequently, many Americans have formed opinions about what aspects of nursing they view more positively or negatively.
The survey asked respondents to consider whether they viewed certain aspects of nursing more or less favorably since the pandemic. The results indicate mixed perceptions of nursing, as both an admirable profession and one filled with daunting challenges.
Survey results show that the aspects most valued by respondents include respect and admiration for the nursing profession, nurses' ability to make a difference, professionalism in nursing, and nursing employment demand. Most respondents hold nurses in very high regard. More than 80% view respect, admiration, and the ability to make a difference much more positively since the pandemic began.
These changing perceptions reflect the growing awareness of the importance of the nursing profession in the U.S. healthcare system. As many states continue to cope with surging transmission rates, nurses have become indispensable.
At the same time as the public perception of nursing improves, the more negative aspects of the profession come to light. Over half of the survey respondents indicate a more negative view of work-life balance and workplace safety since the pandemic began. Nurses' mental health, job satisfaction, and compensation also rank among the most negatively perceived aspects of nursing.
Widely shared narratives about nurses throughout the pandemic fuel these negative perceptions. Countless news stories show nurses without access to PPE or masks, working in fear of infecting themselves or their families. Media accounts of nurses struggling to maintain composure dealing with critically ill and dying patients are common.
Analysts also discuss the pandemic's financial impact on nurses, such as rising childcare costs or the loss of income from unemployed family members. These factors, constantly in public view during COVID-19, contribute significantly to the negative evaluations of the nursing profession.
Opinions Mixed on the Overall Impact of COVID-19 on Nursing
While media portrayals of nurses may influence how the public views the profession, survey results reveal mixed perceptions about the impact of COVID-19 on nursing careers. Just over a third of all respondents believe the pandemic could bring increased nursing employment, compared to 43% who believe that the number of people pursuing a nursing career will decline.
Despite the perception that the pandemic might dissuade people from entering nursing careers, recent trends point to a strong interest in nursing education. According to the American Association of Colleges of Nursing (AACN), student enrollment in bachelor's, master's, and doctoral nursing programs increased in 2020.
AACN also reports that thousands of qualified applicants have been turned away from four-year nursing schools because of a shortage of nursing faculty, clinical sites, and other resource constraints. Considering the ongoing impact of the pandemic and the effect of turnover and retirement on nursing shortages, the profession must address ways to attract a new generation of nursing students and increase the capacity to train them.
Millennials and Generation Z Display Interest in Healthcare Post-Pandemic
The pandemic has impacted the working lives of Americans in significant ways. Because of the slow economic recovery, many workers who lost their jobs do not expect to be rehired. Facing uncertainty about their job security, many people have decided to change careers. According to the Pulse of the American Worker Survey released in 2021, one in five workers have changed to a new line of work over the past year, citing work-life balance, compensation, and the desire to try something new as their primary motivation.
Many of these job seekers may look for opportunities in healthcare, including nursing fields. The Bureau of Labor Statistics projects that healthcare occupations could add more jobs than any other field between 2020 and 2030, growing by 16%.
Since the onset of COVID-19, 23% of all respondents have researched healthcare careers. As more Americans consider career changes, they seek information about educational requirements, salary prospects, work environment, and responsibilities to help them make an informed choice about their future employment prospects. The percentage looking for healthcare information is highest among younger respondents.
Over one-third of Millennials surveyed and 28% of Generation Z indicated they have researched opportunities in healthcare. These younger demographic groups, who comprise the largest percentage of the American workforce, are more likely to change careers than older generations. Because they have invested less time in their current careers than the older workforce, they may be more likely to take advantage of a part-time or an online degree, more willing to relocate, and generally more open to risk-taking.
Because the nursing profession has received so much attention during the pandemic, it comes as no surprise that most respondents express an interest in nursing as a career. While Generation Z is less likely to pursue a nursing career, all other age groups indicate they would be more or as likely to consider the nursing profession. Generation X respondents indicate the strongest interest.
Men express a stronger interest in nursing careers across all age groups. Male respondents from Generation X show the highest level of interest at 73%, while those in Generation Z report the least interest at 47%. Generation Z and Millennial women indicate they are far less likely to enter nursing. Among Generation Z and Millennial females, only 39% state that they are more or as likely to consider a nursing career.
The nursing workforce, which remains predominantly female, anticipates shortages due to retirements and turnovers. In May of 2021, the management and consulting firm McKinsey & Company surveyed 400 frontline nurses and found that 22% considered leaving their current positions.
Why Are You Interested in a Career in Nursing?
"My mother is a nurse, and I would love to follow in her footsteps. She worked during the COVID-19 pandemic, and I admire her so much for her courage and determination." - Woman, 20
"Nursing is not just a profession; it is a responsibility and duty towards society because when there is a catastrophe or an epidemic in the world, nurses are the first to come forward and extend a helping hand to the people. That is why I consider this career to be the most humane and respected professions." - Man, 31
"The ability to help people, especially now, would be so rewarding in my mind. I do understand there is still a risk during the pandemic. However, I would want to be able to help should something like this ever arise again." - Man, 61
Why Are You Not Interested in a Career in Nursing?
"I've seen nurses make a real difference, and that aspect of the job is appealing. But it is sometimes appalling how citizens treat members of the healthcare industry, showing little respect for the risks that we are making." - Man, 58
"With COVID-19, I feel it is a much more unsafe and stressful profession than it used to be. I also would not feel comfortable dealing with people's injuries and trauma all day." - Woman, 32
"I work as a nursing assistant currently. I would like to be an RN, but I've not had the time for the schooling. The pay is much better, and job positions are generally better. However, not with COVID-19. Too much risk and stress." - Woman, 53
Increased Pay, Work-Life Balance, and Safety Are Critical to Increasing Interest in Nursing
The survey asked respondents what needs to improve to increase their interest in a nursing career. Their top choices, summarized in the graph below, mirror the same concerns cited among the most negative aspects of nursing — compensation, work-life balance, safety, and mental health care.
What Generation Z is More Likely to Value
Improved nurse mental health and wellness
Increased student loan forgiveness
Reduced educational costs
What Millennials are More Likely to Value
Improved nurse work-life balance
Safer working conditions
Increased nursing autonomy
The most frequently mentioned concern — the need to increase pay — has hampered nursing long before the onset of the pandemic. On average, most registered nurses make significantly more than the national average for all occupations. However, pay scales for all nursing roles differ by thousands of dollars, based on specialty, location, experience, and education. The pandemic has brought into focus just how hard nurses work, bolstering the argument that their pay does not align with their job responsibilities.
The need for safer work conditions, cited by 40% of the respondents, has come to light during COVID-19. Nurses have always worked in difficult conditions, and the rate of injury in the profession is significantly higher compared to other healthcare workers. Nurses are exposed to blood and bodily fluids, suffer injuries from lifting, and even risk assault from patients or their families.
The desire for work-life balance, mentioned by 44% of respondents, and improved mental health and wellness care, listed by 37%, have been long-standing issues for nurses. The need to address these concerns has become more pressing during COVID-19, as nurses found themselves overextended and exhausted, working long shifts with seriously ill and contagious patients.
Survey respondents also raise the issues of student loan forgiveness and reduced educational costs. While the struggle to attract well-trained nurses to the profession has existed before the onset of COVID-19, burnout and turnover during the pandemic has made the situation worse.
Nursing schools and lawmakers have begun to address these issues. They are working together to provide more financial aid for undergraduate training. Several initiatives focus on increasing funding to expand nursing school capacity, through grants for facilities and equipment, and graduate scholarships for nurse faculty training.
The federal government sponsors the Nursing Education Loan Repayment Program that allows RNs to pay off part of their student loan balance in exchange for two or more years of work in healthcare facilities experiencing critical shortages of nursing staff.
The Future of Nursing Post-Pandemic
Perceptions about nurses and nursing have changed since the onset of the pandemic, revealing pressing concerns about the current and future state of nursing as a career. The nursing profession's response to these issues focuses on several strategies. The following list, while not exhaustive, describes some of the primary areas to address:
Expansion and Changes to Nursing Education
A major obstacle to solving the nursing shortage is the limited capacity of nursing schools to enroll and graduate enough nurses to meet demand. Nursing educators have forged partnerships with donors and lawmakers to provide scholarship and loan forgiveness opportunities focused on underrepresented groups and preparing nursing faculty. Nursing schools are working with public and private organizations to fund new teaching facilities and upgrade resources.
Because so many clinical sites shut down during the pandemic, nursing schools have had to implement innovative solutions using online learning and other technological resources to help students meet clinical requirements. Remote learning and more flexible learning opportunities are now permanent features of many nursing programs.
Compensation and Benefits
The disparities in nursing salaries grew more apparent during the pandemic. While discussions on compensation have been primarily focused on frontline workers, these issues are not limited to nurses working in hospitals and the ICU. Wide pay differentials exist for nurses employed in physician offices, dental practices, nursing facilities, and home healthcare, among other settings.
Professional nursing associations and healthcare providers have just begun to negotiate remedies, including institutional salary reviews, benefits packages that include mental healthcare and counseling, flextime, and extended vacation days.
Nurse Burnout and Mental Health
The media images of overcrowded ERs staffed by exhausted nurses will be with us long after the pandemic has subsided. While the strain created by the pandemic highlighted the emotional toll taken on by frontline workers, the issue of nurse burnout has been present long before COVID-19 cases first overwhelmed hospitals.
To address burnout, employers must ensure proper staffing ratios, provide training to nursing leaders and supervisors, and create new programs to support mental health and wellness.
Expansion of Nursing Roles
While not explicitly addressed in this survey, an important lesson that emerged from the pandemic is how nurses can be more widely utilized. The pandemic has popularized the use of telehealth delivery and technology. It has also highlighted the need for RNs to acquire advanced practice specializations and certifications in areas like emergency and critical care.
Efforts to expand nursing roles and authority may attract younger generations who value greater professional autonomy and leadership roles in their work lives.
These survey findings shed light on the challenges and opportunities confronting the profession, as it moves forward to bolster the status of nursing as a career and offer the necessary leadership to strengthen the U.S. healthcare system.
Methodology and Limitations
To explore the influence of the COVID-19 pandemic on the nursing profession, NurseJournal conducted an online survey of 1,008 respondents on August 13, 2021. Survey respondents were selected to create a U.S. representative sample according to the U.S. Census Bureau estimates based upon age, gender, and ethnicity.
Although respondents were selected to create a U.S. representative sample, certain demographics may be underrepresented. A larger sample of respondents may yield more accurate insights into specific populations. No statistical testing was performed.
Limitations for online sampling include rapid-responder bias, selection bias, and technological access. Limitations for self-reporting include exaggeration, selective memory, and social desirability bias.
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