Stress, burnout, turnover, and retirement have contributed to obstacles in the student-to-nursing workforce pipeline. Nursing students and other healthcare professionals have experienced anxiety during the COVID-19 pandemic, research shows.1This affected both nursing and medical students as well as nurses working in any healthcare settings.

Students found their education altered by the nation’s shutdown in the spring of 2020 and the continued strategies of remote learning and social distancing to reduce the spread of the virus.

Nursing students’ and medical students’ education was disrupted by the pandemic because of the emotional toll of worrying about their own health and their families’ health, says Allison Yu, MD candidate, Class of 2022 at the University of California, Davis School of Medicine in Sacramento.

Yu studied the relationship between resilience and news monitoring with COVID-19 distress in students of health professions. She found that health science schools need to address the immense student stress with their curriculum disruptions during the pandemic.1

“We found that students were most concerned about their own family members and how things would change with school exams and societal responses to COVID,” Yu says. “We didn’t ask what they were looking for in societal responses, but we inferred discrepancy between [steps] the public was willing to take to adapt to the pandemic and how transmissible this virus was.”

Yu and colleagues found that people who showed more resilience were better equipped to handle COVID-19 stress. They also noted that students who checked the news more than once a day were more likely to experience stress.

“It’s interesting, because for a lot of health professionals, in general, knowledge is comforting and something they have control over,” Yu explains. “But we’re finding that maybe checking the news is not always the best way to go.”

Hire Seasoned Nurses

It is important for reproductive health organizations to introduce seasoned nurses to the reproductive health field, says Anna Brown, BSN, RN, education program director with Nurses for Sexual & Reproductive Health (NSRH) in St. Paul, MN.

“One of our programs in training and abortion care is to take experienced nurses and train them on site,” Brown says. “We bring education around any sexual and reproductive healthcare conversation.”

The focus is to find nurses who are not already in the field, but who either want to work in sexual and reproductive health nursing or are open to expanding their nursing experience, she adds.

For instance, a medical-surgical nurse could be trained as a sexual assault examiner nurse. Or, ICU nurses could be trained to work in an abortion clinic or to work with patients at risk of HIV infection and in need of pre-exposure prophylaxis.

Other contributors to nursing shortages are turnover and nurses leaving the profession.

“At the root of this is burnout,” Brown says. “There’s not a conversation happening to prevent burnout — nurses leaving the profession within a couple of years.”

Psychological Burden Is High

Nursing burnout has worsened during the pandemic, new research shows.2-4

Answering a survey through the summer of 2020, healthcare workers reported high rates of anxiety, depression, burnout, and work overload.4

Burnout affected 49% of healthcare workers, while 43% reported work overload. Also, 61% of workers reported fear of exposure or transmission of COVID-19.2

Canadian researchers found nurses and other healthcare workers’ psychological burden was high and rising as the pandemic persisted, and they needed ongoing support.4

One solution is to create a situation where nurses feel supported and can think about staying long-term. “In addition to focusing on providing a community and safe place for nurses, we need to address issues that come up in their workplace,” Brown says. “You may be the only nurse providing that reproductive healthcare in that clinic or setting.”

Current nursing burnout and stress was compounded by a pandemic that caused some family planning clinics to limit in-person visits and have nurses and other staff learn — literally overnight — how to help patients through telemedicine.

Frustrations Taken Out on Nurses

Nurses and other healthcare workers also dealt with the political and social frustration brought about by COVID-19.

“There was instability, lashing out, more yelling and name-calling, and refusal to wear masks,” says Crissy Hunter, DNP, RN, CHSE, CNE, clinical nursing faculty and course coordinator for the nursing education track at Southern New Hampshire University in Manchester. “Some community members took it out on the profession of nursing. In some states, when people were anti-masks and thinking it was a conspiracy, they were taking it out on nurses because nurses were in the frontlines.”

The closing of clinics — at least to in-person visits — also affected nurses’ mental health and stress. “Hospitals and healthcare institutions went on lockdown,” Hunter adds. “You couldn’t have visitors, and I think a lot of it was taken out on nurses as a whole because we make up the largest sector of workers.” This nationwide issue happened in every healthcare setting, she says.

For new nurses — those who graduated in late 2019 or early 2020 — the pandemic made their onboarding particularly challenging.

“COVID has shown us we can do so much from home, except practicing nursing,” Hunter says. “I know, firsthand, people in the nursing profession who have quit their jobs over COVID and burnout.”

Nursing schools also can help prevent nursing burnout through better preparing students for the emotional and social rigors of the profession.

“There are a lot of factors that lead into nurse burnout,” says Julie A. Manz, PhD, RN, associate professor and assistant dean of the undergraduate program at the Omaha campus of Creighton University. “I think it’s incumbent on all of us — academia and practice partners — to build resilience within our students and our employees. We have intentionally built in resilience, mental self-care, and reflective practice into our curriculum.”

Some of the college’s faculty conduct research on self-care and reflective practice, Manz says. They looked at these questions:

  • How do you take time out?
  • How do you recognize signs of stress?
  • What are overwhelming feelings of burnout?
  • What techniques can you employ to manage those feelings?

“We have to give individuals interested in nursing the skills they need to manage the stressors they face and the dynamic environment they work in,” Manz says.

REFERENCES

  1. Yu A, Wilkes M, Iosif A-M, et al. Exploring the relationship between resilience and news monitoring with COVID distress in health profession students. Acad Psychiatry 2021;1-9.
  2. Prasad K, McLoughlin C, Stillman M, et al. Prevalence and correlates of stress and burnout among U.S. healthcare workers during the COVID-19 pandemic: A national cross-sectional survey study. EClinicalMedicine 2021;35:100879.
  3. Kreitzer MJ. Voices of nurses during the COVID-19 pandemic: A call to action. Creat Nurs 2021;27:88-93.
  4. Maunder RG, Heeney ND, Kiss A, et al. Psychological impact of the COVID-19 pandemic on hospital workers over time: Relationship to occupational role, living with children and elders, and modifiable factors. Gen Hosp Psychiatry 2021;71:88-94.