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Burnout: Why Nurses Need More Mental Health Days

November 15, 2021 · 6 Min Read

Reviewed by Gina Fox, RN; Shaleea Venney; Jenna Liphart Rhoads

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Burnout: Why Nurses Need More Mental Health Days
YakobchukOlena | Getty Images

Once they start their shift, nurses are immediately confronted with stress and pressures from administration, the loss of a patient, or safety risks. These pressures put a strain on nurses' mental health. Calling nurses "healthcare heroes" or providing pizza parties in place of raises just isn't enough.

Prioritizing your mental health by taking mental health days from work has become front-page news. For example, gymnast Simone Biles and tennis pro Naomi Osaka both withdrew from competition to tend to their mental health. Nurses also need to focus on their mental health and challenge their employers to offer enough mental health days.

"Most nurses are empaths and patient advocates; the first one in the room, the one holding the patient's hand during those critical moments," says Shaleea Venney, a nurse and relationship/life coach. "Sometimes, it's hard to balance it all and can be overwhelming."

The most significant benefit of mental health days is they give nurses permission to put themselves first and drop the idea that they have to be a hero.

This article explores why nurses need more mental health days and how COVID-19, burnout, and the lack of mental health resources impact patient care. Additionally, it explores ways workplaces can prioritize nurses' mental health and how nurses can cope during the pandemic.

COVID-19, Burnout, and a Lack of Mental Health Resources

The current experience of working as a nurse during COVID-19 reveals the need for more mental health days for nurses, point-blank. Stress is clear in bedside nursing and extends to nurses working in outpatient facilities and from home as well.

"It's like a never-ending cycle, never feeling like you're doing enough while simultaneously feeling like there's nothing you can do," Venney says.

Nurses during Covid-19 experience the following reality:

  • They're overworked.
  • The nurse-to-patient ratio is pushed to the limit.
  • Nurses are pushed to the max physically, mentally, and psychologically.
  • Nurses lack breaks and often work through meals.
  • Nurses are dealing with patients and family members processing grief.
  • Facilities are overfilled.

Gina Fox, a registered nurse, sees nurses stretched to the breaking point, especially ones working closely with COVID-19 patients on short-staffed floors.

"The bedside nurses who have to wear PPE for extended periods of time feel isolated and unable to truly breathe," Fox says.

Burnout Directly Impacts Patient Safety

One of the most dangerous impacts of nurse burnout resulting from being overworked is patient safety. Nurses who suffer from burnout can:

  • Become disengaged with their patients
  • Make poor decisions
  • Make mistakes

Patient care suffers in a time of desperate need. Over time, stress from management, strained staffing, and lack of breaks can make mistakes easier.

Jenna Liphart Rhoads, Ph.D., a nurse educator, points out when she was feeling burnt out, she often felt callous or hardened toward her patients.

"This is never intentional because a nurse does not want to hurt anyone or be distracted," Fox says, "but the greater the stress and burnout, the more likely it can happen."

In times of trauma, like living through a pandemic, the brain distances you to protect you during high stress. When a nurse experiences this, they are often unable to be fully mentally present during patient care, which can often lead to mistakes.

"Nurses who have burnout typically 'turn off' their emotions in order to deal with getting through the workday," Rhoads says. "This impacts patient care because patients can perceive that burned-out nurses are not as emotionally invested or available."

A key way to address burnout, prevent dissociation during work, and increase patient care is to prioritize the mental well-being of nurses through increased access to mental health days. Nurses can relax and practice self-care for nurses before returning to work recharged.

Burnout Spills Over Into Other Areas of Nurses' Lives

Burnout spills over into other areas of nurses' lives, impacting far more than just patient care. Bringing stress home from work impacts the entire family, including pets. Nurses can become edgy, short-tempered, or even depressed, which can affect their loved ones.

"Although we leave work and try to walk away completely at the end of the day, it doesn't always leave," Fox says.

Venney shares this sentiment, describing working as a nurse as never-ending. Nurses take off their uniforms after their shift, but the work comes home with them. The stress of working through desperate times, as the COVID-19 pandemic has brought forth, stays with a nurse long after they've clocked out.

"[Burnout] can carry into our marriages, how we are raising our children, our interactions with others, and also in how we sleep, eat, take care of ourselves and so many other ways," Fox explains.

Nurses Become Irritable or Resentful of Their Jobs

Many nurses join the nursing workforce out of passion and a drive to care for others. Nurses repeatedly voice gratitude for their profession, feeling it is far more than a job but a calling.

But burnout can taint even the most passion-driven career.

Burnout impacts nurses' job satisfaction, and with the current nursing shortage, retaining staff is all the more crucial. When a nurses' workplace doesn't prioritize mental health, nurses can feel unappreciated and disposable, as if their voices aren't being heard.

"It's nice to have work/life balance," Venney says. "Not having that makes you feel like you have to choose between your job and your own needs."

Mental health days are one way to ensure nurses take time off to avoid burnout and manage unprecedented stress levels. Also, having mental health nursing benefits and resources provided by employers validates their stress, gives nurses permission to rest, and shows nurses that their mental well-being is a priority.

People tend to stay loyal to their employers when they feel seen as full humans with families, priorities, and needs outside of work. Feeling this way undoubtedly leads to higher retention rates.

Working as a Nurse Who Feels Burnt Out Is Incredibly Isolating

Five Distinct Stages of Burnout

1. Honeymoon stage 2. Balancing act 3. Chronic symptoms 4. Crisis stage 5. Enmeshment

At the point of enmeshment, burnout symptoms are so embedded in a person's life that they may not even fully realize it. If nurses are seen as heroes, sacrificing themselves everyday for others, it's even harder to realize when you've been sacrificing too much for too long.

Nurses may also hide that they are experiencing burnout. They might feel they have no choice but to keep working despite burnout, which can lead to isolation.

"Most of us try not ever to let our patients see or deal with our stress because we know they come first," Venney says. "But it can be hard to be comforting and strong for our patients when we are struggling with burnout."

At this point, nurses do not feel their struggles are taken seriously. In a pandemic that's brought on massive amounts of hospitalizations and deaths, nurses feel their struggles are often seen as a secondary concern.

The narrative even before the pandemic is that nurses are heroes or the "strong ones." But this narrative can strip nurses' humanity.

"We push ourselves to be everything for everyone else, often at the detriment of our own peace," Venney says.

Taking PTO Is Not the Same As Mental Health Days

Taking personal time off (PTO) is not the same as having designated mental health days. For nurses, taking PTO is even more difficult during the pandemic because of short staffing or increased callouts.

Nurses have options of taking time off if they have the PTO days or can work from home. But, Venney points out, sick days aren't enough.

"Mental health days directly address the unseen pain and illnesses related to mental distress," she says.

On top of this, because of the pandemic, it's even harder to ask for a day off. Nurses feel guilty asking for a day off, knowing the extreme needs of their colleagues and patients. They often have to take days off weeks in advance, with the potential of a denied PTO request.

Nurses are emotionally and mentally exhausted and need a day designated for their mental health and self-care.

"You'd think we'd take [mental health] more seriously in the healthcare field, but it often goes overlooked," says Venney.

How Workplaces Can Prioritize Nurses' Mental Health

We hear it all the time: Nurses are burnt out. In fact, nurses are burnt out on hearing about how burnt out they are. Change needs to happen.

Workplaces need to make key changes to make nurses' mental health a priority. They must validate nurses' struggles and encourage nurses to care for themselves. This will not only raise retention rates but improve patient care and address the nursing shortage head-on.

By working collaboratively with stakeholders like executives, administration, management, human resources, and other nurses, hospitals can develop strategies to improve work/life balance and mental health.

Some strategies include:

Allow employees to have at least one paid mental health day a month (not just PTO). Encourage staff to take these mental health days. Incorporate self-care into the daily schedule. Increase staffing to safe nurse-to-patient ratios.
Mandate minimum, upwardly adjustable staffing levels. Require hospitals to have nurse-driven staffing committees. Offer access to mental health support, like a therapist or counselor within the company.

Legislation is also in the works to maintain safe staffing ratios as well. For example, former New York Governor Andrew Cuomo signed legislation establishing clinical staffing committees to create specific guidelines on safe nurse-to-patient ratios. You can also advocate and get involved in supporting legislation that prioritizes nurses' mental well-being.

Mental health support for nurses should include adequate time off and personal days without guilt or backlash. Nurse leaders can support mental health for their stressed and grieving staff, so they feel appreciated and valued too.

There is power in numbers. Nurses need to continue gathering together and demand more mental health days from their employers. Joining workplace and local nursing committees or nursing unions and signing petitions are great strategies to advocate for nurses and their mental health.

How Nurses Can Cope During the Pandemic

It's not easy to cope with burnout on a regular day; it's even harder to cope during a pandemic. It's important first to acknowledge you are suffering from burnout, then you can address it.

Some tips for nurses coping during the pandemic include getting better sleep as a nurse. The National Sleep Foundation advises between 7-9 hours of sleep a night. Other coping tips include:

Taking advantage of community resources Not being afraid to seek counseling or therapy Attending a religious service, reading, and/or journaling Seeking out safe people in your life who can help you
Getting a pet Forming a support group to share stories and issues with other nurses and healthcare workers Practicing healthy boundaries and learning to say "no"

It is important not to lose sight of your personal life and hobbies. Managing stress is a great coping mechanism. Ways to manage stress include:

Deep breathing Meditation Mindfulness
Yoga Self-care

Meet Our Contributors

Gina Fox has been a registered nurse for 13 years in Ohio and has worked in telemetry, intensive care, and emergency units. She is currently a care coordinator and runs a ministry. Fox lives with her husband and furbabies, Rascal and Bandit.


Shaleea Venney is a licensed nurse and master-certified relationship/life coach. She is a bestselling author, internationally known speaker, and host of the successful podcast "Girl, Which Way?!" Through her work, the married mother of two is helping to change the narrative on how we define healthy relationships.


Jenna Liphart Rhoads is a nurse educator and freelance author/editor. She earned a BSN from Saint Francis Medical Center College of Nursing, a master's in nursing education from Northern Illinois University, and a Ph.D. in education with a concentration in nursing education from Capella University. Her clinical background includes surgical-trauma critical care and interventional radiology procedures, and she has taught in BSN, RN-to-BSN, and graduate nursing programs. She currently resides in Wisconsin with her husband and two children.

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