The news report seemed hardly new, and I suspect it is not all that surprising. “Nursing is in crisis, fueled by burnout (and) exhaustion,” reports New York Times health and science reporter Andrew Jacobs and correspondent Isadora Kosofsky. “An alphabet soup of respiratory illnesses has been spreading misery across the United States, once again pushing hospital staff to the brink,” they write.
“In 2023, recruiting and retaining good nurses could be the most critical area of focus in determining a hospital’s success,” adds Stacey Kusterbeck in a post on Nurse.com. “About half of nurses are reporting burnout, and turnover rates are at 20% to 30%, found a recent study,” she notes.
If we are determined by “resolution” to do anything during the dawning of this new year, resolving this issue must certainly be one of them.
Dr. Yves Duroseau is chair of emergency medicine and co-chair of disaster planning services at Lenox Hill Hospital in New York. “The biggest lesson COVID-19 taught hospitals is how thin they can be stretched — and that includes morale,” he explains to Time magazine. “We saw widespread burnout of staff trying to go above and beyond, every single day. That’s not sustainable — it’s too overwhelming.”
I have often written about this unfolding health care crisis since the pandemic first hit. In an ABC News analysis that I reported on that ran in April 2022, Dr. Richard E. Besser, president and chief executive of the Robert Wood Johnson Foundation in Princeton, New Jersey, and previously the chief health and medical editor at ABC News, wrote: “We enter crises ill-equipped to handle them and we exit crises by quickly forgetting our promises to learn from past mistakes … Two years into this (COVID) scourge, not enough has been done to prevent the next pandemic from playing out like this one or address how — pandemic or not — every day is needlessly a health emergency for far too many people.” As a result, he suggests that many nurses are experiencing mental health challenges. “According to a study of nearly 2,500 nurses surveyed from May through July 2020, during the early months of the pandemic, about 27% of nurses at New York City hospitals reported anxiety, and 17% reported depression.”
In an article in June 2020, I wrote: “If you and I were to apply a medical diagnosis to the nation’s hospitals and health care systems, according to current news reports, the ultimate costs as well as chances for full recovery would seem far from clear. And this holds true for both patients and practitioners.”
As The New York Times reports, staffing shortages and current conditions have “left many frontline workers feeling unappreciated and, at times, abused.”
You can take that “abused” comment literally. “In a recent survey conducted by National Nurses United, almost half of nurses who responded said they’d experienced workplace violence, mainly initiated by patients,” says the Time magazine report. “The situation is so serious that some hospitals have created de-escalation teams to calm aggressive patients … The emergency department is particularly prone to violent outbursts. In one AAMC study, nearly half of ER physicians said they’ve been assaulted, and 70% of ER nurses report being hit or kicked while at work.”
“A report from NSI Nursing Solutions, which surveyed over 3,000 U.S. hospitals in January 2022, the average hospital turnover rate is 25% annually, and even higher for nurses at 27%,” says Time reporter Elizabeth Millard. “At the same time, demand is increasing — the American Nurses Association estimates more nursing jobs will be available in 2022 than any other profession in the country. All of that means that as hospitals need to do more when it comes to emergency preparedness, they’re often accomplishing it with a smaller workforce.”
“It’s a vicious cycle: All of the turnover leaves hospitals understaffed and further exacerbates the burnout of the remaining staff,” writes Kusterbeck.
“In 2023, hospitals will be more mindful of the importance of keeping a capable nursing workforce,” believes registered nurse Lusine Poghosyan, a professor of nursing at Columbia University School of Nursing. “Leaders are searching for solutions to promote the well-being of nurses.”
As The New York Times points out, the act of caring for seriously ill patients needing round-the-clock attention during the pandemic has added “layers of commitment” for dedicated nursing staff. “The tale of how the pandemic has decimated hospital staff counts and dented patient care tells only half the story,” Jacobs and Kosofsky report. “For every bedside nurse who has left the field or transferred to a less stressful job at an insurance company or a school clinic, there are stalwarts … (who) have endured and in some cases thrived … fortified by the long, painful months of forced separation that rendered staff members the only link between patient and family.”
Some practitioners view nursing as a combination of creative art and science, says the Times. Others emphasize the importance of spirituality and human tenderness.
Like intensive care unit nurse Mariana Marquez, who sings hymns to those intubated in her care. She admits having grown more confident in the healing power of holding a patient’s hand. “Praying with the patient absolutely relieves a lot of sadness and pain for me,” said Marquez. She has been a nurse for two decades, yet she can still recall patient names from her first year on the job. “I will never forget them because they became a part of me.”
“At its core, if you love your job and that’s why you became a nurse, as long as you take care of yourself and you have good people around you, you’re going to come back to nursing,” says Gena Oppenheim, an ICU nurse in Santa Monica, California. “That’s how I look at it.”
It should also be pointed out that contract negotiations involving numerous hospitals in New York were at an impasse with no resolution as of this article’s deadline. It is hoped a strike will be averted.