Authors

  1. Moffa, Christine PhD, RN, APRN, PMHNP-BC

Abstract

System-level changes must address issues such as staffing and burnout.

 

Article Content

When planning our May issue, we often choose covers celebrating nurses for Nurses Day or highlight a critical care photo to show the important work nurses do. Last year's May cover was a bright collage of nurse portraits painted to honor nurses for their work on the front lines of the COVID-19 pandemic. This year, I can't help but notice the difference in our cover, which shows a lone nurse caring for a patient in a dark ICU room. While this image wasn't intentionally chosen as a somber contrast to last year, its tone seems to reflect what nurses are experiencing today.

  
Figure. Christine Mo... - Click to enlarge in new windowFigure. Christine Moffa

This year marks the 40th anniversary of Nurses Day. Critics of the celebration cite the shallow attempts to honor nurses through ice cream parties and cheap giveaways like key chains and stress balls-I've gotten them all-and the waste of money, which could otherwise be used for important things, like adequate staffing. In May 1982, AJN editor Mary Mallison used the phrase "somewhat embarrassing" to describe the first "national nurse's day." Perhaps she already envisioned the trivial expressions and gifts to come. Instead, she suggested nurses celebrate the day with declarations of the work they do in detailed, straightforward language, so the public could get a clear idea of the essential work of nursing.

 

This is the third Nurses Day celebrated since the start of the pandemic and nurses' work has gotten more recognition than ever. But is that recognition enough?

 

Saying "Happy Nurses Day" this year seems like an oxymoron, as nurses are probably the unhappiest they've ever been, and it shows. The staffing crisis we've been warned about for years is now a reality, as nurses have had to work in conditions so unbearable, they see no choice but to leave their current job or the profession altogether. The lead story in this month's In the News focuses on staffing and how the crisis has only been exacerbated by the COVID-19 pandemic, "which transformed a long-simmering nursing shortage into a full-blown crisis."

 

The ECRI Institute's Top 10 Patient Safety Concerns 2022 report cited the number one concern this year as staffing shortages, stating that prior to 2021, "there was a persistent shortage of clinical and nonclinical staff across the continuum," but that the problem has "continued to increase throughout the pandemic." And the high-profile court case of RaDonda Vaught, a former nurse recently convicted of negligent homicide for a fatal drug error in 2017, again brings systemic issues such as staffing to light, with the American Nurses Association commenting: "The nursing profession is already extremely short-staffed, strained and facing immense pressure-an unfortunate multi-year trend that was further exacerbated by the effects of the pandemic. This ruling will have a long-lasting negative impact on the profession."

 

May is also Mental Health Awareness Month. Multiple studies have reported that nurses are experiencing higher levels of anxiety, depression, posttraumatic stress disorder, and suicidal ideation. A study of the prevalence of suicidal ideation among U.S. nurses in the November 2021 AJN found that 5.5% of survey respondents (403 of 7,378 nurses) reported feelings of suicidal ideation, and these data were collected three years prior to the COVID-19 pandemic. We must remember that while we honor nurses on Nurses Day, we must also address the issues contributing to nurse burnout and stress, as well as their solutions.

 

In this issue, AJN Reports addresses the current state of mental health stigma. And in Cultivating Quality, the authors describe one medical center's burnout prevention project of offering serenity lounges with massage chairs on 10 hospital units. As if in response to the recent pushback from some nurses who find the advice for self-care and resilience amid the current crisis to ring hollow, the authors emphasize, "No one should expect that interventions such as those described here can completely prevent burnout. What's needed is a comprehensive, systems-level wellness initiative that includes appropriate staffing levels; a sufficient budget; and organizational policies that promote health care providers' well-being." And the authors of this month's Viewpoint also discuss nurse burnout, saying that it's time to address it not only at the individual level, but also systemically: "It's time to refocus our burnout research not just on awareness that the problem exists, but rather on solutions." The time to act and truly honor nurses is now. Hopefully it's not too little too late.