75% of nurses are burned out. How their mental health crisis affects an “already fragile” healthcare industry

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Danielle Bowie is Vice President of Clinical Strategy and Transformation of Trusted Health, a career marketplace for healthcare professionals. Bowie has worked for health systems managing nurse workforces and as a practicing nurse for fifteen years. 

Even though it’s been nearly a decade since my last role as a nurse manager, I still have vivid memories from my experience. Missed care opportunities, patient emergencies, and constant understaffing meant that every day was a marathon of life-or-death decisions with little room to process any of it. There was no talk of burnout or the mental strain of the job. You were expected to shake off one challenge and move quickly to the next. You did what you had to do to keep people safe and healthy, even if it came at the expense of your own sanity. Even at the age of 24, I knew this lifestyle was unsustainable. And this was all before the pandemic stretched our nation’s nurses to their breaking point.     

Although I’ve moved away from the bedside, I’ve witnessed the toll that the pandemic has taken on our nation’s nurses over the last few years. First as the System Vice President of Nursing Workforce Development at Bon Secours Mercy Health, where I oversaw the execution of the health system’s strategic nursing workforce plan for 14,000 clinicians across more than 40 hospitals. And now as the Vice President of Clinical Strategy and Transformation at Trusted Health, where I work with health systems to help them build best practice nursing workforce strategies to achieve operational efficiencies that support a healthy work environment and the provision of high quality patient care.

Since COVID-19 began, nurses have watched patients die at unimaginable rates, often serving as a stand-in for patients’ family members who couldn’t access hospitals due to social distancing regulations. All through this grueling work, nurses faced further isolation at home as they socially distanced from family and friends in order to keep their loved ones safe. The burden this placed on my close colleagues and peers is indescribable.      

All the while, a steady stream of media coverage detailed the sacrifices that nurses were making and lauded them as heroes. My hope was that the media coverage around nurse mental health and the wider mental health impacts of COVID would catalyze a reckoning in healthcare. Sadly, new research from Trusted suggests the mental health headlines of the last few years have done little to create substantive change in the working lives of nurses.      

According to our third annual survey of frontline nurses, two-thirds believe that the healthcare industry’s stance on their mental health has not changed since the start of the pandemic. An overwhelming 95% of respondents said that their mental health was either to their companies, or that it was a priority, but that there were inadequate measures in place to support it.

Even though nurses are reporting disturbing levels of burnout (75%), compassion fatigue (66%), depression (64%), declines in their physical health (64%) and extreme feelings of trauma, extreme stress and/or post traumatic stress disorder (PTSD) (50%), they don’t feel comfortable seeking help at work for these issues. Sixty percent of respondents said they were either “very unlikely” or “somewhat unlikely” to share feelings of acute depression, suicidal thoughts, or mental health issues with their manager or another individual at their facility, even if it they felt it might impair their ability to do their jobs.

In fact, 40% of nurses don’t know what mental health benefits their current employer offers, and among those that do, more than half of nurses are dissatisfied with the level of support their current facility provides related to their mental health and well-being. Given all that, it’s unsurprising that 64% of nurses say they are less committed to the profession than they were pre-pandemic.

As one of the single largest professions in the U.S., the struggles that nurses are facing and the rate at which they are leaving the industry must serve as a wake-up call to all of us. A 2021 U.S. healthcare labor report from Mercer projects a shortage of 3.2 million healthcare workers within five years. Beyond this, nurse staffing shortages are associated with increased patient mortality and cost hospitals an estimated $24 billion in the first 18 months of the pandemic. Not only will our already fragile healthcare industry collapse without these nurses, but they are now the most extreme example of corporate policy failing to change in the wake of this historic moment when our collective mental health has been damaged, possibly forever.           

In order to address the nurse mental health crisis, health systems need to offer benefits that make nursing a more sustainable career choice. Respondents in our survey identified a wellness or fitness stipend (74%); access to a gym, yoga studio or group fitness classes (67%) and flexible scheduling (64%) as some of the top benefits that would support their mental health. Hospitals also need to do more to destigmatize mental health issues and to create a culture in which nurses feel comfortable being open and honest about the issues they are facing, particularly when those struggles are a direct result of the demands of the job. When mental health programs are marketed internally, they should be packaged with strong messaging around confidentiality and job and license security.      

While I’m heartened by the growing discussions around mental health and work, more decisive action is needed to transform workplaces into places that support mental health rather than detracting from it. Without a concerted effort to address mental health, especially for individuals in high stress jobs, employee attrition will continue to impact our nation’s ability to staff critical industries and the mass exodus of nurses will be just the beginning.