This article will provide you with details about MENTAL HEALTH SUPPORT FOR NURSES
Mental health challenges have been an age long issue of concern that is not exclusive to the general population but also seen in nurses and other healthcare providers. However, the increasing incidence of mental health crisis amidst the healthcare workforce in recent days has been alarming.
A study showed that there is a high-rise in suicidal tendency amongst nurses than the public, with female nurses (24%) at more risk; which is majorly due to mental health struggles, easy access to lethal substances or doses such as opioids, benzodiazepines and many other stressors. Comparatively, another findings revealed that nurses are about four times more likely to commit suicide than workers in non-healthcare sector, this trend is also seen in doctors and other healthcare professionals.
Higher rates of anxiety, depression, PTSD and other mental health problems amongst nurses are linked to various factors such as burnout, stressful work environment, traumatic experiences, poor work conditions, low pay and so on, which is further aggravated by the COVID-19 pandemic. A study conducted on healthcare professionals in China in the wake of the pandemic showed that about 50% reported at least mild depression; 14% of physicians and around 16% of nurses reported moderate or severe depressive symptoms and about 34% reported insomnia. Furthermore, other stressors outside work such as domestic violence, loss of loved ones, financial crisis can equally negatively impact the mental wellbeing of nurses to a great extent.
Sadly, the majority of nurses might not seek help due to fear of stigmatization, fear of judgment, inadequate access to care, license and legal issues.
The mental health crisis on the rise in nursing workforce is due to the following factors:
Demanding Work Environment
The increasing incidence of mental health challenges and it’s burden are triggered by stressful events nurses face like high patient-nurse ratio due to nursing shortage, extra shifts, psychological demands, exposure to patient’s traumatic experiences and dealing with it’s pain alongside the patients relatives, in addition, the issue of PPE shortages which creates fear because they are not being safeguarded from getting infected. The impact of all these events are often interwoven and produce a ripple effect amidst nursing professionals.
Studies have shown that nurses that work 12-hour shifts or longer report that they experience increased stress due to being constantly overworked thus affecting their physical as well as mental health; it has also been revealed that nurses who work in demanding units like ICU, critical care, emergency and so on are more affected.
Other reports showed that around 44 percent of nurses mentioned that burnout coupled with a high-stress environment is the reason they desired to leave the role.
Additionally, other findings show that nurses who worked above 40 hours in a week reported factors like stressful work environments, inadequate staffing, and so on as contributing to the reason they want to leave.
They also mentioned that leaving is a decision to protect their well-being, be in a saner work environment that offers them satisfaction.
A great deal of emotional and psychological strain are placed on nurses and it takes resilience to stay sane and in control, but for how long? If rapid measures are not taken to protect the nursing workforce even the strong can get pulled in.
COVID-19 Pandemic Crisis
Recent findings revealed that the COVID-19 pandemic is one of the major reasons nurses are leaving the bedside, in addition, a new research in china elucidate that a significant proportion of healthcare workers treating patients exposed to COVID-19 have symptoms of depression, anxiety, and insomnia which is because the COVID-19 pandemic has aggravated the mental health issues amongst nurses
When the COVID-19 pandemic hits, lots of healthcare workers including nurses were willing to do all it takes to help the world return to normalcy and nurture them to health, however, the repeated cycle of different waves of the pandemic depicted that they might be in for it for a very long time.
With more lives getting lost daily, having to deal with the trauma of seeing repeated patients’ deaths, witnessing colleagues and family members give up their last breath, the question for nurses is whose is next? and for how long should they await their impending doom?
The disheartening situation of the pandemic crisis is one of the major stressors placing high emotional strain on nurses, of a major concern is also the burden of whether they will infect their family members due to large exposure to a number of infected cases.
The mental health challenge amongst nurses is no longer individual but systemic and if a blind eye is turned to can soon become another global pandemic and this time amongst the healthcare workforce.
Poor Workplace Environment
A sensitive work environment would have contributed greatly to providing the necessary support nurses need as they battle with emotional trauma from their practice; however, reverse is the case as they have to deal with workplace cultures that are unsupportive of their personal well-being.
Certain experiences within the workforce like bullying, assault from patients or coworkers, aggressive patients or relatives, poor relationships with team members, superiors or administrators and others have proven to further aggravate the situation thereby potentiating the mental health crisis amongst Nurses.
The following are the major mental health concerns Nurses face that need to be addressed rapidly;
- Post-traumatic stress disorder (PTSD)
- Sleep disorders
- Stress Disorders
- Major depressive episode
- Generalized anxiety disorder,
- Substance abuse,
The impact of the mental health crisis within the nursing workforce is costly, “study analysis determined that depression was the leading predictor of self-reported medical errors. In addition to worsening nurse population health outcomes, the mental health crisis also has created costly job turnover rates and increased risks to patient care and safety.”
The effects of mental health challenges are burdensome; it has a huge influence on the quality of care provided to the patients, can negatively affect the outcome of patient care and can lead to an increased mortality rate within the hospital. Moreover, it can result in huge turnover of nurses from the workforce which places a high demand on the healthcare organizations for recruitment and retention of staff. While the impact on nurses is vast, some of it can be job dissatisfaction, reduced productivity and quality of life and even in extreme cases, loss of life.
Rapid systemic interventions can reduce the number of cases of healthcare workers including nurses with mental health problems and also protect their lives from the negative impact of mental health disorders. There’s a need to intensify the mental health preventive and promotive actions to address the mental health concerns amidst nurses. Support when offered at the right time can foster resilience and help them develop emotional agility.
These are some of the ways mental health challenges can be addressed not only for nurses but other healthcare professionals;
Mental Health screening
Mental health screening should be carried out on nurses especially those at high risk for prompt identification of abnormalities and to provide rapid and adequate mental health care to them.
These should be routine and ongoing, addressing the various aspects of an individual’s well-being for effectiveness.
Self-Care measures are effective towards promoting physical and emotional well-being, these are some activities that can be beneficial to nurses:
- Regular exercise for about 30 minutes daily
- Adequate rest and sleep (at least 8 hours)
- Healthy eating including fruits and vegetables instead of fast food and junks
- Quitting smoking and limiting alcohol intake.
- Practicing stress relieving or relaxation techniques such as mindfulness, gratitude (keeping a journal), meditation, reading a book, listening to music.
- Spending time with family and friends.
- Taking a break whenever needed or avoiding duty overload
- Taking a break from social media.
- Asking for professional help when necessary.
Positive Workplace Culture
Promoting good workplace practices can be done by creating an environment that fosters effective communication, discourage bullying and take stringent actions against assaults and aggressiveness towards staff.
Furthermore, intentionality in safeguarding physical health of workers e.g providing adequate PPE can also positively impact the mental well-being of workers.
Having a strong circle of support has proven to be of tremendous benefits to nurses in promoting their mental wellness especially in times of crisis. Spending time with family members and friends can help nurses ease off their stress and feelings of overwhelm. It is essential that nurses speak up about their struggles, share their feelings and concerns with people so that they can find their footings and effectively manage their situation.
Mental Health Interventions
Healthcare organizations can provide expertise services to their staff to help them get professional help in meeting their mental health needs. The following services have proven to tremendously help nurses manage their mental health and likewise reduce the incidence of mental health crises amidst healthcare professionals; cognitive-behavioral interventions, muscle relaxation, biofeedback, therapeutic supportive modalities, psychological counseling guided imagery, and transcendental meditation.
Other coping support that can be of help includes: workshops for training emotional intelligence, individual counseling, teaching and promoting mindfulness, building resilience in staff.
Nurses can maximize the following resources to promote their mental wellness.
- Nurses can call their local emergency number for help.
- For example the National Suicide Prevention Lifeline in the US that provides free and confidential emotional support to people in suicidal crisis or emotional distress.
Virtual Resources to support Nurses. For example,
The Well-being Initiative gives nurses access to digital mental health and wellness-related sources, tools, and support to build resilience free of charge.
The Royal College of Nursing Counseling services for nurses
Emotional and practical support service by the Nursing and Midwifery Council UK
NHS Mood Zone where you can avail various mental health support services.
The evidence-based Healer Education Assessment and Referral (HEAR) program launched by the University of California, San Diego, which provides screenings and referrals to mental health services, has successfully identified and provided care to healthcare workers struggling with suicidal thoughts, substance use disorder, and other mental health conditions.
MINDBODYSTRONG program, which provides a workbook-based, seven-session cognitive behavior therapy program for nurses and other clinicians.
ANA Enterprise’s Healthy Nurse, Healthy Nation™ initiative to promote personal wellness amongst nurses by improving their health in six areas namely: mental health, physical activity, nutrition, rest, quality of life, and safety.
The National Academy of Medicine’s (NAM) Action Collaborative on Clinician WellBeing and Resilience to promote clinician well-being for positive patient care outcome
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Written By: Mayowa Racheal Popoola
RN, Content writer.