Critical-care nurses were physically and mentally fried before the pandemic struck

A new analysis found that a majority of critical-care nurses scored themselves low on physical and mental health status even before the pandemic began.

Survey results conducted by researchers at Ohio State University College of Nursing found 61% of more than 700 critical care nurses rated their physical health a score of five or lower out of a possible 10, while 51% reported their mental health with a score of five or lower The data were collected from Aug. 31, 2018, through Aug. 11, 2019.

Nearly two-thirds of nurses reported to have made medical errors in the past five years. The study found nurses who reported having poorer physical and mental health were 31% to 62% more likely to have made medical errors compared with those who reported being in better health with a score of six or higher. The findings were published Saturday in the American Journal of Critical Care.

The results suggest that healthcare providers need to prioritize the health and wellbeing of nurses to avoid issues of employee burnout and improve patient care quality concerns associated with preventable medical errors.

Lead study author Bernadette Melnyk, chief wellness officer and dean of the College of Nursing at Ohio State, said the findings highlighted the importance for hospitals to make sure nurses are aware of the workplace wellness resources the organization provides.

The proportion of nurses who reported having better physical health increased when they had higher perceptions of available workplace wellness support. More than 55% who reported better physical health said they had “very much support” from their employer while 67% of nurses who rated themselves as being in better mental health also said they had “much support.”

“If nurses believe they work for an institution that is supportive of their wellbeing they actually have better health outcomes,” Melnyk said.

Overall, the study’s findings point to a number of concerns around the wellbeing of the country’s nursing workforce that experts have warned have only gotten worse during the pandemic.

A study published last September in the journal General Hospital Psychiatry that surveyed more than 650 clinicians at a New York City medical center in April 2020 found 57% screened positively for acute stress but that 64% of nurses and advanced practice providers screened positive compared to 40% of physicians.

The Ohio State study found nearly 40% of critical care nurses reported some degree of depressive symptoms and more than 50% reported having anxiety symptoms. But only about one-third reported having a high professional quality of life, while 61% said they had made medical errors in the past five years.

“With all of the extra pressures critical care nurses have faced during the pandemic, we have what I’m calling a mental health pandemic among our clinicians inside of the COVID-19 pandemic,” Melnyk said.

Melnyk said short-term actions hospitals could take to help nurses include promoting wellness programs that provides counseling for clinicians. Last summer, Ohio State launched a wellness support line made up of nursing students that nurses could call as a means of dealing with their stress.

But longer term Melnyk said hospitals will need to make broader reforms. She felt one action that could make a huge difference was if hospitals eliminated the traditional 12-hour work shift, which often times can turn into 13- to 14-hour workdays.

“Nurses like working the 12-hour shifts because then they work three [days] then they get four [days] off,” Melnyk said. “But it leads to burnout.”

She said health systems need to have staffing levels are adequate to ensure the ratio between nurses and patients does not get too high.

Despite the physical, emotional and psychological toll on nurses since the beginning of the pandemic, images of clinicians on the frontline of the crisis over the past year has seemingly inspired more individuals to want to enter the medical field.

Enrollment in baccalaureate nursing school programs increased 5.6% to 251,145 students in 2020, according to data from the American Association of Colleges of Nursing.

Gerard Brogan, director of nursing practice for the California Nurses Association/National Nurses United, said such increases were encouraging, but he was worried healthcare would continue to practice what he felt has been a pattern of disregard for the safety and welfare of nurses. Brogan cites the ongoing struggles nurses face in procuring adequate supplies of personal protective equipment. A survey released last June by the American Nurses Association found only half of nurses reported they had sufficient supplies of PPE while 68% reported working with inadequate staffing levels.

“There’s a real split between (hospital) administration and clinicians,” Brogan said. “I’ve never seen this level of disaffection between clinicians and their employers.”