Mental Health Concerns in Nurses
While many people relate burnout as a concern for nurses, there are other mental health conditions to look out for. These other conditions include compassion fatigue and PTSD. Though each of these conditions can be interrelated, they each have distinct characteristics.
Burnout
Burnout in nurses can manifest as emotional exhaustion, cynicism toward work, and a reduced sense of accomplishment. Symptoms may also include emotional detachment, decreased motivation, and absenteeism. Many factors can contribute to burnout, including heavy workloads, lack of control, and staffing shortages.
Compassion Fatigue
Compassion fatigue can develop as a result of secondary traumatic stress. This may occur when a nurse experiences emotional depletion from exposure to situations at work, such as patient suffering. Symptoms can include feeling emotionally drained, difficulty detaching from work, and feelings of helplessness. Factors that can contribute to compassion fatigue include moral distress and witnessing trauma.
PTSD
PTSD develops after a critical event that is considered to be traumatic by the nurse. This can be witnessing traumatic events or near-death experiences. Symptoms include flashbacks, nightmares, hypervigilance, and avoidance behaviors. Factors or situations that contribute to PTSD in nurses may be experiences such as witnessing patient death or other traumatic events.
Prevalence in Nursing
Areas like emergency departments, intensive care units, and oncology expose nurses to a higher frequency of trauma and death. This increased exposure significantly raises the risk of burnout characterized by emotional distress, hopelessness, and decreased job satisfaction.
The COVID-19 pandemic has exacerbated this concern. Pre-pandemic studies indicated 31.5% of nurses leaving their jobs due to burnout, primarily affecting nurses aged 45 and above. However, post-pandemic research shows a much higher burnout rate.
Around one-third of nurses develop symptoms of PTSD. Nurses diagnosed with PTSD often report exposure to traumatic events like patient deaths, trauma-related injuries, and caring for critically ill patients.
Causes of Poor Nurse Well-Being
There are several reasons why a nurse may have a poorly impacted mental health. Some reasons can be due to the work environment itself, such as:
- High nurse-to-patient ratios
- Elevated patient care acuity levels
- Short staffing
- Long work hours
- Mandatory overtime or extra shifts
- Not enough time for breaks
Other reasons may be due to other situations, including:
- Witnessing suffering
- Moral distress or ethical dilemmas
- Repeated exposure to death and trauma
- Individual situations at home
While not directly work-related, individual circumstances at home, such as financial strain, childcare difficulties, or personal health problems, can contribute to overall stress and exacerbate the mental health challenges faced by nurses.
The Impact of Nursing Well-Being
The impact of a nurse's mental health goes beyond the nurses themselves and reaches out to the environment around them. When nurses neglect their own well-being, they become vulnerable to burnout, compassion fatigue, and PTSD. This not only impacts the nurse but also may have repercussions on patient safety.
Emotional exhaustion and reduced empathy can lead to decreased quality of care and patient outcomes. Nurses experiencing mental health concerns may struggle to communicate effectively, respond promptly to patient needs, and provide compassionate care.
Nurses who are fatigued or distressed are more prone to making errors. Mistakes can include medication errors, communication errors, and other risks to patient safety.
A nurse who is burned out or experiencing compassion fatigue may have less emotional energy to connect with patients, leading to impersonal interactions and decreased patient satisfaction.
Strategies to Improve Nursing Well-being
During the COVID-19 pandemic, the suffering of nurses did not go unnoticed. The American Association of Critical Care Nurses (AACN) partnered with several nursing organizations and launched The Well-Being Initiative.
The Well-being Initiative
The Well-Being Initiative by the AACN targets the nurses' mental and emotional stresses by providing free resources to help.
These resources guide nurses and other healthcare workers through practical activities like:
- Maintaining a healthy diet
- Engaging in regular exercise
- Practicing mindfulness and gratitude
- Spending time in nature
The Well-Being Initiative shows case studies conducted by the initiative. After just 14 days of working in an ICU setting, over 50% of nurses reported feeling overwhelmed, anxious, and irritable. These nurses also experienced:
- Difficulty sleeping
- Relationship problems
- Poor appetite or overeating
- Increased alcohol use
Mental Health Initiative for Health Workers
Also recognizing the widespread mental health crisis in nursing, the National Institute for Occupational Safety and Health (NIOSH) has launched a program called the Mental Health Initiative for Health Workers. Funded by Congress in 2021, this initiative aims to:
- Raise national awareness about the mental health challenges faced by healthcare workers.
- Develop educational resources to promote mental well-being.
- Create tools to identify burnout and other mental health complications.
The NIOSH initiative emphasizes comprehensive mental health support for all healthcare workers, including doctors, nurses, and public health professionals.
Prioritizing Your Well-being as a Nurse
As a nurse, it is essential to prioritize your own health, including mental health, when caring for others. Recognizing signs and symptoms of burnout and compassion fatigue early can help prevent complications.
Take time for self-care strategies, including healthy habits like eating well, exercising, and practicing meditation. Set boundaries at work and schedule time for yourself and loved ones in your life. If you are struggling, take time to talk to someone and seek professional therapy.
Prioritizing mental health is for personal well-being and will help sustain a long and fulfilling nursing career. Support systems and resources are available to assist nurses in navigating these challenges.
Online courses are available to equip nurses with essential skills for managing stress, preventing burnout, and enhancing resilience. CEUFast offers "Mental Health for Nurses," which covers topics such as stress management techniques, self-care practices, and recognizing early signs of mental health issues.
References:
American Association of Critical-Care Nurses (AACN). (2020). Well-Being Initiative. American Association of Critical-Care Nurses. https://www.aacn.org/nursing-excellence/well-being-initiative
Cunningham, T. R. (2021). Mental Health Initiative for Health Workers (HW). National Institute for Occupational Safety and Health. https://www.cdc.gov/niosh/media/pdfs/mentalhealthinitiativeforhealthworkers_508.pdf?CDC_AAref_Val=https://www.cdc.gov/niosh/bsc/pdfs/MentalHealthInitiativeForHealthWorkers_508.pdf
Shah, M. K., Gandrakota, N., Cimiotti, J. P., Ghose, N., Moore, M., & Ali, M. K. (2021). Prevalence of and factors associated with nurse burnout in the US. JAMA Network Open, 4(2). https://doi.org/10.1001/jamanetworkopen.2020.36469
About the Author:
Breann Kakacek, BSN, RN, has been a registered nurse since 2015 and a CNA prior to that for two years while going through the nursing program. Most of her nursing years included working in the medical ICU, cardiovascular ICU, and the OR as a circulating nurse. She has always had a passion for writing and enjoys using her nursing knowledge to create unique online content. You can learn more about her writing career and services at ghostnursewriter.com
Breann is an independent contributor to CEUfast's Nursing Blog Program. Please note that the views, thoughts, and opinions expressed in this blog post are solely of the independent contributor and do not necessarily represent those of CEUfast. This blog post is not medical advice. Always consult with your personal healthcare provider for any health-related questions or concerns.
If you want to learn more about CEUfasts Nursing Blog Program or would like to submit a blog post for consideration, please visit https://ceufast.com/blog/submissions.
