COVID-19 pandemic and Nursing Burnout

The national healthcare issue that has affected many facilities worldwide in this time is the nursing shortage. According to the Journal on Nursing Education, “Beyond the obvious and most discussed risks of prematurely ending social distancing restrictions, such as a second and third wave of infections, more illness and deaths, and more long-term damage to the economy, an equally important risk to public health has not received the media attention it deserves: an acute and perhaps dramatic escalation of the national nursing shortage” (Spurlock, 2020). Nurses play a vital and centralized role in the healthcare system. The same article projects that the national nursing shortage will remain in effect well into the year 2030. The COVID-19 pandemic hit the healthcare system with a devastating blow. Hospitals were not prepared for the impact it would have on nursing personnel as well as supply. Working in a high acuity Emergency Department during this time in a considered “hot zone” was difficult and proved that the nursing shortage was real, and the surge of patients was overwhelming.

The healthcare organization that I am employed saw the ugly face of this pandemic up close and personal. Staffing ratios were inadequate at most times and the already minimal critical care beds remained occupied with patients who had contracted the virus. We brought in travelers to help and offered extra shift bonuses for staff to stay over or come in extra just to be able to keep up with the surge. However, inevitably the more staff were there the more staff got sick and were out of work. In order to keep up with he amount of tests that were being done, the hospital followed suit with many of the other healthcare organizations throughout the country and opened drive-thru testing centers for those whose symptoms did not pose an immediate emergency. This lessened the surge and workload on the already overworked staff in the Emergency Department. However, along with the rest of the country ideas to deal with this pandemic were being thought of on a reactive basis instead of a proactive approach.

The nursing shortage became even more prevalent after subsequent waves of the pandemic and nurses and hospital personnel were provided inadequate personal protective equipment resulting in higher numbers of nurses testing positive for the virus. According to the Center for Infectious Disease Research and Policy, “COVID-19–related shortages of personal protective equipment and drugs continue to plague the US healthcare system, but now in the third US pandemic wave, nursing and other staffing shortages are sweeping the country” (McLernon, 2020). To deal with these nursing shortages some states have begun to allow asymptomatic nurses who are positive for COVID-19 to take care of COVID patients. Though the healthcare facility I am employed has not implemented this practice and I hope they do not, it is safe to say that these are trying times and whatever the response for the further nursing shortage is it will most likely not be ideal for this worsening healthcare issue and the increase in burnout and mental health concerns for this profession will be seen for years to come.

References:

Spurlock, D. (2020). The nursing shortage and the future of nursing education is in our hands.

Journal of Nursing Education, 59(6), 303-304. doi:http://dx.doi.org.ezp.waldenulibrary.org/10.3928/01484834-20200520-01

Lianna Matt McLernon | News Writer | CIDRAP News | Nov 30, 2. (2020, November 30). COVID-related nursing shortages hit hospitals nationwide. Retrieved December 02, 2020, from https://www.cidrap.umn.edu/news-perspective/2020/11/covid-related-nursing-shortages-hit-hospitals-nationwide

response

Excellent information in your post. I think a lot of us have experienced the struggles of trying to maintain some sense of normalcy at work during the COVID pandemic. As you mentioned, trying to go about our daily work routine while constantly worrying about the lack of hospital supplies only fuels the already elevated stress levels many of us have. A recent survey from healthcare improvement company Premier Inc. found the item most in demand among hospitals surveyed are exam gloves (King, 2020). My hospital is unfortunately, no exception to this issue. We have had to resort to using dietary grade gloves in place of medical gloves for a lengthy amount of time this year.

Another area of increased demand that many hospital lack the supplies to accommodate are PPE supplies. In behavioral health, we do not use PPE very often but this year has been the exception. As we have had our fair share of positive patient cases, the need to keep these supplies stocked has been a point of emphasis. Sadly, we have had to resort to reusing unsoiled supplies in order to get by. In protests covered by the news media, healthcare workers compared themselves to firefighters putting out fires without water and soldiers going into combat with cardboard body armor (Cohen, Rodgers, 2020).

Cohen, J., Rodgers, Y. (2020). Contributing factors to personal protective equipment shortages during the COVID-19 pandemic. Preventive Medicine, 141:106263. doi:10.1016/j.ypmed.2020.106263

King, R. (2020). Fierce Healthcare. Gloves in demand for hospitals facing shortages due to COVID-19: Premier. Retrieved from https://www.fiercehealthcare.com/hospitals/gloves-demand-for-hospitals-facing-shortages-due-to-covid-19-premier

Discussion: Review of Current Healthcare Issues
If you were to ask 10 people what they believe to be the most significant issue facing healthcare today, you might get 10 different answers. Escalating costs? Regulation? Technology disruption?

These and many other topics are worthy of discussion. Not surprisingly, much has been said in the research, within the profession, and in the news about these topics. Whether they are issues of finance, quality, workload, or outcomes, there is no shortage of changes to be addressed.

In this Discussion, you examine a national healthcare issue and consider how that issue may impact your work setting. You also analyze how your organization has responded to this issue.

To Prepare:

Review the Resources and select one current national healthcare issue/stressor to focus on.
Reflect on the current national healthcare issue/stressor you selected and think about how this issue/stressor may be addressed in your work setting.
By Day 3 of Week 1
Post a description of the national healthcare issue/stressor you selected for analysis, and explain how the healthcare issue/stressor may impact your work setting. Then, describe how your health system work setting has responded to the healthcare issue/stressor, including a description of what changes may have been implemented. Be specific and provide examples.

Healthcare facilities face many challenges and issues; one of the biggest issues seen today is a nationwide nursing shortage. Nurses are the forefront of healthcare and a critical to patient care. They make up the biggest portion of the health profession. Some statistics found from StatPearls (Haddad, 2020): There are approximately 3.9 million nurses in the United States (US) and in 2020 it was estimated that 1 million additional nurses would be needed. In the US, More RN jobs will be available in 2022 than any other profession. To avoid a further shortage, 11 million additional nurses are needed.

Nursing shortage has been a topic for many years, but it appears to be an increasingly progressive issue. There are many potential reasons why the shortage is worsening such as, aging population, aging work force, nursing burnout, negative work environment, and poor staff ratios (Haddad, 2020). One of the biggest, current reasons today is COVID-19 causing stress and fatigue on nurses in and outside the healthcare setting. With the increased demand in many hospitals due to COVID-19, staffing ratios are increasing and nurses are burning out wanting to look elsewhere for work. Many nurses are feeling there was a lack of pandemic preparedness, which ultimately resulted in anxiety and fear among the workplace (Nyashanu et al., 2020).I work at a small, community hospital on the med/surg/telemetry floor where we have 99 inpatient beds. Our hospital has not been immune to the nursing shortage. We struggle most days to safely staff our floors. Often, nurses are working overtime each week to help fill the void. We have faced the issue of nurses feeling burnt out and have left the facility working in a non-hospital setting. Our hospital has implemented some changes over the last year to help with the staff shortage. These changes are listed:

• Have become affiliated with local colleges to improve student nursing clinical experience. The American Association of Colleges of Nursing (AACN, 2020) recommends that nursing schools form partnerships and seek support from healthcare facilities to expand their student capacity in order to properly train new RN’s.

• Nurses are precepting nursing students along with clinical leader.

• Bonuses offered to employees who recruit nurses who stay employed for a certain amount of time.

• Housing and a relocation stipend is offered to those who relocate to the area and remain employed.

• Longer new graduate orientation period for new nurses with improved educational materials and resources through the nurse educator.

Healthcare facilities need to be creative in finding ways to meet the needs of nurses, especially their current employees, not just potential new ones. Becoming a leader in your workplace you can encourage coworkers and give ideas to administration on how to retain employees.

References

AACN. (2020, September). News & Information. American Association of Colleges of Nursing: The Voice of Academic Nursing. https://www.aacnnursing.org/News-Information/Fact-Sheets/Nursing-Shortage.

Haddad, L. (2020, November 16). Nursing Shortage. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK493175/.

Nyashanu, M., Pfende, F., & Ekpenyong, M. (2020, July 17). Exploring the challenges faced by frontline workers in health and social care amid the COVID-19 pandemic: experiences of frontline workers in the English Midlands region, UK. Taylor & Francis . https://www.tandfonline.com/doi/full/10.1080/13561820.2020.1792425.

By Day 6 of Week 1
Respond to at least two of your colleagues on two different days who chose a different national healthcare issue/stressor than you selected. Explain how their chosen national healthcare issue/stressor may also impact your work setting and what (if anything) is being done to address the national healthcare issue/stressor.

I enjoyed reading your post. The nursing shortage is a pertinent problem affecting our healthcare system today. Over the years, the nursing shortage continues to progress. Notably, the nursing shortage almost doubled from 40,000 in 2010 to approximately 80,000 in 2020 due to nurses leaving the profession (AACN, 2020). Nurses’ continual downward turn affects the quality of patient care and increases nurse burnout, which further impacts the shortage. I feel the nursing shortage and burnout go hand and hand. Another significant issue affecting the deficit is work overload and high staff turnover.

Staff burnout has serious negative consequences on healthcare costs for organizations and their employees due to the physical and psychological tolls, which increases employees’ absenteeism (Mudallal et al., 2017). The nursing shortage/burnout will steadily increase, especially during the COVID-19 pandemic. Real solutions to the nursing shortage’s ever-growing concerns must take priority because the health of this nation depends on it.

References

AACN. (2020). Nursing shortage. American Association of Colleges of Nursing. https://www.aacnnursing.org/news-information/fact-sheets/nursing-shortage

Mudallal, R., Othman, W. M., & Al Hassen, N. F. (2017). Nurses’ burnout: The influence of leader empowering behaviors, work conditions, and demographic traits. National Center for Biotechnology, U.S. National Library of Medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5798741/

NURS_6053_Module01_Week01_Discussion_Rubric

Grid View
List View
Excellent Good Fair Poor
Main Posting
45 (45%) – 50 (50%)
Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.

Supported by at least three current, credible sources.

Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

40 (40%) – 44 (44%)
Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.

At least 75% of post has exceptional depth and breadth.

Supported by at least three credible sources.

Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

35 (35%) – 39 (39%)
Responds to some of the discussion question(s).

One or two criteria are not addressed or are superficially addressed.

Is somewhat lacking reflection and critical analysis and synthesis.

Somewhat represents knowledge gained from the course readings for the module.

Post is cited with two credible sources.

Written somewhat concisely; may contain more than two spelling or grammatical errors.

Contains some APA formatting errors.

0 (0%) – 34 (34%)
Does not respond to the discussion question(s) adequately.

Lacks depth or superficially addresses criteria.

Lacks reflection and critical analysis and synthesis.

Does not represent knowledge gained from the course readings for the module.

Contains only one or no credible sources.

Not written clearly or concisely.

Contains more than two spelling or grammatical errors.

Does not adhere to current APA manual writing rules and style.

Main Post: Timeliness
10 (10%) – 10 (10%)
Posts main post by day 3.
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
Does not post by day 3.
First Response
17 (17%) – 18 (18%)
Response exhibits synthesis, critical thinking, and application to practice settings.

Responds fully to questions posed by faculty.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Communication is professional and respectful to colleagues.

Responses to faculty questions are fully answered, if posed.

Response is effectively written in standard, edited English.

15 (15%) – 16 (16%)
Response exhibits critical thinking and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.

13 (13%) – 14 (14%)
Response is on topic and may have some depth.

Responses posted in the discussion may lack effective professional communication.

Responses to faculty questions are somewhat answered, if posed.

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

0 (0%) – 12 (12%)
Response may not be on topic and lacks depth.

Responses posted in the discussion lack effective professional communication.

Responses to faculty questions are missing.

No credible sources are cited.

Second Response
16 (16%) – 17 (17%)
Response exhibits synthesis, critical thinking, and application to practice settings.

Responds fully to questions posed by faculty.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Communication is professional and respectful to colleagues.

Responses to faculty questions are fully answered, if posed.

Response is effectively written in standard, edited English.

14 (14%) – 15 (15%)
Response exhibits critical thinking and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.

12 (12%) – 13 (13%)
Response is on topic and may have some depth.

Responses posted in the discussion may lack effective professional communication.

Responses to faculty questions are somewhat answered, if posed.

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

0 (0%) – 11 (11%)
Response may not be on topic and lacks depth.

Responses posted in the discussion lack effective professional communication.

Responses to faculty questions are missing.

No credible sources are cited.

Participation
5 (5%) – 5 (5%)
Meets requirements for participation by posting on three different days.
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
Does not meet requirements for participation by posting on 3 different days.
Total Points: 100
Name: NURS_6053_Module01_Week01_Discussion_Rubric
sample essay 3

The COVID-19 pandemic has earned the badge of being the top stressor in the healthcare field. The uncertainty on how much longer the virus is a threat to the well-being of the people, heightens our anxiety and fear. Nursing shortages, minimal personal protective equipment, burnout, and mental strain are a few issues that accompany this virus.

Shortage of nursing has been an issue, even before the pandemic. People are sicker at a rate faster than they can be cared for. Nurses are looking to be recruited across the United States. I have seen a lot of nurses take contracts through different agencies to work with COVID-19 patients. They mostly do this due to the higher rate of pay. The full-time employment nurses are not receiving enough pay to compensate for what they are risking when working on a unit or floor with patients affected with the virus.

The facility I work for has tried their best to keep up with the ever-changing rules and standards that come with handling coronavirus. The biggest thing was implementing tele-health for the psychiatrists to see the psychiatric inpatients we care for. We were also practicing safe distancing inside the nurses’ station and break rooms. Our patients must wear a mask, while employees wear masks and face shields. This is regardless of having a positive or negative COVID-19 swab. Healthcare agencies and facilities are learning as they go. It has become a mental strain to keep employees and patients safe.

Jacobs, Barbara, MSN, NEA-BC, RN-BC, CCRN-K, McGovern, Julie, MA, SPHR, Heinmiller, Jamie, et al. (2018). Engaging Employees in Well-Being: Moving from the Triple Aim to the Quadruple Aim. Nursing Administration Quarterly, 42, 231-245. https://doi.org/10.1097/NAQ.0000000000000303

Ricketts, T. C., & Fraher, E. P. (2013). Reconfiguring health workforce policy so that education, training, and actual delivery of care are closely connected. Health Affairs, 32(11), 1874-80. Retrieved from https://ezp.waldenulibrary.org/login?qurl=https%3A%2F%2Fwww.proquest.com%2Fdocview%2F1458313016%3Faccountid%3D14872

response

Healthcare strain is real, and it affects nurses and care providers worldwide (Worringer, et. al., 2020). Covid-19 has brought this strain to the forefront of problems, especially here in the United States. I know in the ICU where I previously worked, people were already pushed to their limit prior to Covid-19, with our annual flu season keeping our hospitals well over 100% capacity for months on end. When the Covid-19 patients began rolling in, the burnout pushed many of my former coworkers to the brink and they began to find new jobs. The stress of ICU work paired with long hours and what many termed not enough pay, were too much to handle.

I understand where people are coming from, especially with young families and wanting to be safe and have energy for them. In my view, this has been an evolving topic for several years. I got into nursing to help people, and then into critical care because I wanted the challenge and autonomy that it offered. I knew going in that the hours would be long, and it would be difficult treating people who were truly on their last breath. For me, my family was more important, and having time with them paired with going back to school to open more doors in my career was something that appealed to me. I don’t know that I have a solution for a nursing burnout, and I don’t believe that more pay will mitigate this factor. There is no amount of money that will bring more energy and time to someone searching for higher quality of life (Sköldunger, Sandman, & Backman, 2020).

References

Anders Sköldunger, Per-Olof Sandman, & Annica Backman. (2020). Exploring person-centred care in relation to resource utilization, resident quality of life and staff job strain – findings from the SWENIS study. BMC Geriatrics, 20(1), 1–9. https://doi-org.ezp.waldenulibrary.org/10.1186/s12877-020-01855-7

Worringer, B., Genrich, M., Müller, A., Junne, F., Contributors Of The Seegen Consortium, & Angerer, P. (2020). How Do Hospital Medical and Nursing Managers Perceive Work-Related Strain on Their Employees? International Journal of Environmental Research and Public Health, 17(13). https://doi-org.ezp.waldenulibrary.org/10.3390/ijerph17134660

sample post 4

Main Discussion Post Wk1:

National Healthcare Issue/Stressor

A national healthcare issue/stressor affecting healthcare systems across America for many years is the nursing shortage issue. The current nursing shortage has three parts; the aging population, and the limited supply of new nurses, and the aging workforce. Baby boomers play a critical role in the aging population. Right now, baby boomers are becoming close to retirement age; this means one out of every five people will be over the age of 65 (Haddad & Toney-Butler, 2020).

How healthcare issue/stressor may impact your work setting

With the shortage of nursing and the longer life expectancy of the aging population is growing at a faster rate than new nursing begin their career (Leung et al., 2020). As people age, their healthcare needs increase, creating more inpatient stays for the floor nurse to manage. With more patients needing medical attention, it will cause the crowded local emergency rooms, causing more nurses to work out of nurse to patient ratio at all levels of care. This, in turn, creates stressful work environments and staff burnout—ultimately, fewer nurses due to the staff turnover rate.

Describe how your health system work setting has responded to the healthcare issue/stressor

Currently, many local hospitals are now offering nurses a sign-on bonus to work at their facility. The bonuses are given over a year. My workplace has been using traveling nurses to help with the nursing shortage. My workplace needs to offer more incentives to all nurses. Nurses also need a better strategy to address staff and patient issues to management. Many times nurses voice concern and never hear back from management. I recently read an article where nurses left their job after being there for five years due to the managers’ lack of pay more attention to their nursing staff’s job satisfaction and the safety of their nurses (Marzieh Adel-Mehraban, & Azam Moladoost, 2020). With the COVID pandemic, the nursing shortage has become an even greater issue.

References

Haddad LM & Toney-Butler TJ. (2020, November 16). Nursing Shortage. StatPearls. Retrieved December 2, 2020, from https://www.ncbi.nlm.nih.gov/books/NBK493175/

Leung, P. P. L., Wu, C. H., Kwong, C. K., & Ching, W. K. (2020). Nursing shortage in the public healthcare system: an exploratory study of Hong Kong. Enterprise

Marzieh Adel-Mehraban, & Azam Moladoost. (2020). Nursing Staff Shortage: How About Retention Rate? Preventive Care in Nursing and Midwifery Journal, 9(1), 40–48.

response

It sounds like you were experiencing hospital shortages before Covid-19 hit, and then it was truly exacerbated with the additional need for beds? The shortage experienced in the United States is seen globally, and the biggest threat is beginning to take effect in specialty areas where extensive training is needed for patient care (Glasper, 2017). The specialty areas are labor intensive and expensive for hospitals to get nurses up to speed. You mentioned adding incentives for nurses to come work, do the incentives come with contracts for nurses so they must stay for a period of time? I feel that the hospitals need to have some assurance that the staff will stick around to make sure they get their money work.

Despite the shortage of nurses and hospital beds here in the United States, many other countries have seen significant decline in resources since the pandemic began (McMahon, Peters, Ivers, & Freeman, 2020). We are extremely fortunate to live here where our problems truly are first world problems. The issues we as a country and healthcare community have would never exist in other countries because often people go completely without treatment for critical diseases. I don’t anticipate the nursing shortage improving in the near future, but hopefully there will be improvements toward work environment and possibly pay to help improve the nurse’s attitude and decrease burnout.

References

Glasper, E. A. (2017). Does a Shortage of Specially Trained Nurses Pose a Threat to the Provision of Optimum Care for Sick Children in Hospital? Comprehensive Child & Adolescent Nursing, 40(1), 1–5. https://doi-org.ezp.waldenulibrary.org/10.1080/24694193.2017.1289740

McMahon, D. E., Peters, G. A., Ivers, L. C., & Freeman, E. E. (2020). Global resource shortages during COVID-19: Bad news for low-income countries. PLoS Neglected Tropical Diseases, 14(7), 1–3. https://doi-org.ezp.waldenulibrary.org/10.1371/journal.pntd.0008412

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