As nurses contended with the increased strain of treating COVID-19, many said that institutional resources such as strong relationships with supportive coworkers or adequate training with personal protective equipment (PPE) played a key role in reducing their stress and anxiety.
The findings, based on a poll of nearly 2,500 nurses working at New York University Langone Health System (NYULH), outline the role organizations can play to support nurses during a public health crisis.
“Our study demonstrates that institutional resources—such as supportive staff relationships, professional development, providing temporary housing and access to personal protective equipment—were associated with lower levels of anxiety and depression among nurses,” Christine Kovner, a professor of geriatric nursing at NYU Rory Meyers College of Nursing and the study’s lead author, said in a statement.
“Hospitals can play a role in building and sustaining resiliency in their workforces by understanding the triggers that contribute to stress, depression and anxiety, and by developing resources to minimize these factors, particularly during crises,” she said.
About 27% of the nurses who replied to the survey reported feeling anxiety “nearly every day” and 16.5% indicated similarly for depression. Higher frequency of caring for COVID-19 patients was associated with greater stress, while ongoing issues with COVID-19 were tied to greater anxiety.
Foremost among the researchers’ findings was an association between high-quality nurse-physician work relationships and better mental wellbeing scores. Similarly, 75% of nurses pointed to coworker support as beneficial to their mental wellbeing during the pandemic.
Further, nurses also reported that having access to adequate PPE, stays in temporary housing to avoid infecting others or adequate support from the health system were all tied to better mental wellbeing. Conversely, reports of organizational constraints were tied to greater anxiety.
The researchers noted that institutional resources focused on professional development “were particularly important” in supporting nurses’ mental wellbeing, as receipt of PPE use training was among the most frequently cited (54%) factors in nurses’ ability to continue providing COVID-19 care. On the other hand, relatively few nurses said that their formal nursing education was beneficial to their ability to continue caring for these patients.
“Given the health care challenges posed by the emergence of this highly, infectious agent, this nursing education issue merits further attention,” the researchers wrote.
Speaking broadly, the researchers urged hospitals to keep these and similar institutional resources in mind to reinforce their workforce’s mental wellbeing prior to and during the world’s next public health emergency.
But in terms of the practical steps a hospital can take, Kovner told Fierce Healthcare that there are “no quick solutions” to building up a team’s resilience and suggested that the process begin as early as recruitment.
“An organization could assess potential employees for their level of resilience so that rather than having to train people in resilience they could hire people with resilience skills,” she said. “A long-term solution is to provide resiliency training as part of a professional development program. … In the short term, providing alternative housing and easily available mental health services are helpful in dealing with a disaster.”
Kovner and colleagues distributed their survey to 7,219 nurses employed at four NYULH hospitals between May 27, 2020 and July 11, 2020, of whom 2,495 responded. The results were recently published in Nursing Outlook.
Nurses and other healthcare workers have consistently put out the call for greater organizational support and resources over the course of the pandemic.
In November, for instance, members of National Nurses United held a virtual press conference calling for health systems to better protect the nursing workforce with adequate PPE. The organization has also backed recent demonstrations against hospital management focused on safe working conditions.