Pandemic-Related Effects on Nurses and Nursing: What Lies Ahead?

Nurses are the backbone of the healthcare system. If too many nurses leave or too few students decide to pursue a career in nursing, the consequences could be catastrophic, according to researchers in Florida who surveyed nurses and nursing students nationwide between May and June of 2021. Approximately 37% of respondents reported being burned out, stressed, and/or overworked.

During the early days of the pandemic in 2020, the Florida Atlantic University (FAU) Christine E. Lynn College of Nursing teamed up with Cross Country Healthcare Inc, both in Boca Raton, Florida, to offer monthly webinars providing information and self-care tips to address compassion fatigue. They decided to conduct a joint survey because of trends they observed among the webinar attendees. 

The 571 respondents were between 18 and 74 years old, with 42% aged 39 to 54. Survey participants were practicing nurses and nursing students in the United States employed in various specialties at hospitals and healthcare facilities. Participants were a cross-section of nurses, including oncology nurses, who had provided care to patients with COVID-19.

“We did not break out oncology as a separate practice, but the answers applied across the board. Many oncology nurses were pulled to COVID units to cover those areas when the demands were high,” explained Henry “Hank” Drummond, PhD, RN, senior vice president and chief clinical officer at Cross Country Healthcare.

Changing Perceptions on Nursing as a Career

Only 32% of nurses are very/completely satisfied with their occupation, compared to 52% prior to the pandemic. Survey results showed that 66% of nurses considered leaving the profession at some point, signaling potential long-term impacts on the healthcare system post pandemic. Twenty-nine percent reported the nursing shortage and inadequate staffing levels as top contributors to their low satisfaction.

Millennial nurses, who are the future of the nursing workforce, said the pandemic has contributed to feelings of dissatisfaction in several aspects of their careers, and many report they are considering leaving the profession.

Christopher R. Friese, RN, PhD, a professor of nursing and health management and policy at the University of Michigan in Ann Arbor, said the data reported are worrisome but not at all surprising.

“The joint survey revealed that nurses, in many cases, are overextended due to the demands associated with the COVID-19 pandemic,” explained Safiya George, PhD, professor and dean at FAU Christine E. Lynn College of Nursing.

“They are seeking relief and solutions. Nearly 40% say they are burned out, stressed, and overworked,” she added.

Identifying the Burdens

Participants’ responses highlight how much the pandemic-related increased workloads have physically drained nurses. “As a previous oncology nurse myself, I recognize that compassion fatigue and burnout is also prevalent among oncology nurses and palliative care nurses due to the great emotional effort it takes to care for patients with cancer and patients with serious illness and comorbidities, especially during end of life,” commented Dr George.

Oncology nurses have been impacted adversely by the pandemic. “Early on, we saw patients who stayed away from care or screening due to fear of COVID-19. This led to the patients being even sicker when returning to the hospital,” explained Steven Morris, executive director, oncology clinical services at Siteman Cancer Center in St Louis, Missouri. This made the workload that much more demanding.

Constant change in supply availability, policy/process changes, and staffing shortages have taken a toll. During a recent meeting of oncology nurses at the Siteman Cancer Center, the nurses described the current situation as “defeated acceptance,” referring to a feeling of working in an environment that is in constant flux and uncertainty.

“Our nurses have always been at high risk for compassion fatigue. All of the situations brought on by the pandemic have compounded that risk. Nurses feel drained, exhausted and stressed,” Mr Morris added. 

Oncology nurses have traditionally been a tough group; however, the ongoing and lingering effects of COVID are starting to wear down on their spirits and mental well-being. “As a specialized unit, we were unable to rely on the traditional float pool and travel nurses. We had to find resources from within. Shifting staff and cross-training within the cancer service line became the norm,” explained Angela Hornsby, MBA, BSN, RN, the manager of outpatient infusion at Georgia Cancer Center at Augusta University in Augusta, Georgia.