Many of America’s nurses are angry—and they have every right to be
Loressa Cole is CEO of the ANA Enterprise, comprised of the American Nurses Association, the American Nurses Credentialing Center and the American Nurses Foundation. Ernest Grant is president of the ANA, which represents the interests of the nation’s 4.3 million registered nurses.
March 11 began year three of the COVID-19 pandemic as declared by the World Health Organization. This global crisis has taken its toll in suffering, economic distress and over 6 million lives lost.
As the vanguard of the pandemic response, nurses continue to face unrelenting and long-standing challenges. Healthcare leaders in every setting must sustain solutions to support and retain their nursing workforce. The delivery of quality and equitable patient care today and post-pandemic depends on leaders’ actions now.
The American Nurses Foundation has released a new survey of nearly 12,000 nurses detailing the impact of COVID-19. The top-line conclusion: Nurses are struggling from the strain and stress of the pandemic. They are exhausted, overworked and feel undervalued. These words come from at least half of nurses surveyed about their pandemic experiences. More than 1 in 3 nurses in the foundation’s survey chose the word “angry”. Given all that nurses have experienced and lost, they have every right to feel that way. WHO estimates that from January 2020 to May 2021, 115,000 healthcare workers died from COVID-19. When we don’t protect nurses, we dishonor the legacy of nurses who have died, and those who are still responding to COVID-19.
Nurses at all levels feel let down. According to a new study, 75% of hospital-based chief nursing executives and 64% of those based in health systems say they are “stressed” and “dissatisfied.” While leading during the pandemic, the top three challenges were staffing, burnout and turnover. Nurse leaders have demonstrated unwavering loyalty to nurses and a steadfast commitment to providing high-quality patient care. They have successfully led interprofessional teams through one of the most difficult times in nursing’s history, but they are not immune to the deep-seated impact of COVID-19 and must have support systems from their organizations to sustain nursing excellence.
Before the pandemic, nurses’ working conditions were already high-risk and unsustainable due to injuries on the job, exposure to infectious diseases, staffing concerns and many other stressors. One of the most disturbing issues for nurses is an increase in workplace violence, particularly in intensive-care units and emergency departments. This is all compounded by the sad reality that younger nurses, the future of our nursing workforces, are experiencing more of the negative impacts of the pandemic. Among nurses under age 25, 69% say they have been suffering from burnout, which is substantially more than those older than 25 (49%). Additionally, nurses under 25 (47%) and nurses 25-34 (46%) consider themselves not or not at all emotionally healthy compared with nurses over age 55 (19%).
Leaders must do everything within their power to retain nurses. Limiting the challenges solely to the “supply” or “shortage” of nurses is a narrow
vantage. This isn’t just a “numbers” issue. Nurses are quitting their jobs because of unchecked work environment challenges.
It’s time to enforce “zero tolerance” workplace violence policies and remove barriers that discourage nurses from reporting all forms of abuse. Bolster training opportunities at entry and on an ongoing basis so nurses can address the increasing complexities of patient care. Build systemic structures that foster diverse, inclusive and respectful work environments. Provide competitive compensation packages that reflect nurses’ experience and knowledge. Promote nurses to leadership roles so they are decision-makers for staffing and patient safety issues. Nurses need autonomy and growth opportunities. There are more pathways for nurses to explore entrepreneurship than ever before. These opportunities are increasing as nurses seek opportunities beyond the bedside.
If hospital and health system leaders want to have their organizations thrive in a post-pandemic era, they must heed the lessons learned. We must recommit to supporting a reinvestment in our community’s public health infrastructure and nursing workforce. The nation’s public health infrastructure is critical to responding to pandemics and natural disasters but has been shortchanged for decades. A meaningful step is to support efforts to attract more nurses representing all genders and races to address critical health disparities and inequities.
These extraordinary times call for transformational action. We can do better for the professionals ranked by Gallup polling as the most honest and ethical for 20 years straight by demonstrating through action the value of nursing care and addressing the underlying issues of work culture and environment. Let’s improve things now and for the future of the nursing profession. There’s too much at stake. ■
“This isn’t just a ‘numbers’ issue. Nurses are quitting their jobs because of unchecked work environment challenges.”