By Mary Franks, MSN, APRN-FPA, FNP-C

Mental health has long been a stigmatized topic in conversations. In recent years, the COVID-19 pandemic only further exacerbated the mental health crisis, affecting not only the general public but also, and perhaps more severely, nurses. 

In the aftermath of the pandemic, the psychological well-being of many nurses has become compromised due to the overwhelming volume of patients and the increasing complexity of patient cases. Many nurses have left bedside practice or nursing altogether due to their poor mental well-being. The decision to leave nursing has been influenced by various factors, including burnout from high-stress work environments, understaffing, and perceived poor management.

The stigma surrounding mental health in nursing often discourages nurses from seeking help, as they fear judgment, professional repercussions, or being perceived as unable to handle the demands of their job. Because of this stigma, the nursing field has been historically considered “the survival of the fittest.” Depending on the specialty, some nurses have even felt rejected or discouraged in their capabilities due to seasoned staff having higher standards, especially for new graduate nurses. These high standards set an impossible bar to reach, furthering inducing anxiety and depression for many. 

Nurses also often have to maintain unrealistic workloads along with the mental, emotional, and moral burdens they experience while caring for their patients. Many nurses become accustomed to deprioritizing their mental health needs to be more supportive of their patients and their families first.

Jacqueline Howard of CNN News reviewed the elevated risk of healthcare workers and suicide. The data revealed that the annual suicide rate for registered nurses was 16 per 100,000 person-years, significantly higher than the rate of 12.6 for non-healthcare workers. This is a staggering statistic. And although many nurses and other healthcare professionals struggle with mental health, they often hesitate to report them to their state licensure and credentialing board, fearing it may jeopardize their ability to obtain or maintain licensure.

Supporting nurses is crucial not only for their well-being but also for the financial health of healthcare systems. Burnout remains a persistent challenge for healthcare professionals, leading to staff shortages, deteriorating work conditions, and, in extreme cases, suicide.

Therefore, the well-being of nurses directly impacts both the financial and operational success of an organization. A study from Becker's Healthcare reports turnover in nursing can cost $44,000 for one nurse and $3.6 to $6.1 million per year for hospitals. A nurse’s well-being impacts the patients’ as well, as staff with high anxiety or burnout may be struggling to care for patients emotionally and physically. Poor nurse mental health can increase absenteeism leading to further short-staffing situations in high-stress areas.

First and foremost, know that getting help is more than okay—it’s encouraged. Nurses should seek support to prevent burnout, as addressing mental and emotional strain early helps improve their well-being, enhance patient care, and promote a more sustainable career in health care. So how can we prevent nurse burnout?

While organizations have employee assistance programs (EAP) in place for these situations, many nurses and healthcare professionals do not seek this support due to lack of resources within the EAP. Nurses seeking EAP assistance may feel worried that these services are often sheltered within the administration area, which places concerns about privacy regarding mental health assistance with nurses. American Association of Critical-Care Nurses noted that nurses felt they should “be able to handle mental health,” which takes a more significant toll on furthering burnout.

While these concerns are quite valid, perhaps you can start small. Reach out to a trusted mentor or fellow nurse and share your experience.  You may even be surprised that they are feeling the same stress, and you can lean on one another for support. Also, begin setting boundaries to prioritize self-care. Even small steps can lead to big improvements in your well-being. 

For more information on how to prevent nurse burnout, take a look at our course Burnout: Impact on Nursing and Quality of Care. 

The process of identifying and addressing nurse well-being is multifaceted. Nurses should be able to identify their own needs, including physical activity, proper nutrition, and sleep prioritization, but also be able to identify the negative impacts of the role. This includes increased anxiety, possible substance use disorders, bullying in the workplace, or ethical dilemmas.   

At the system level, nurse leaders have direct observation of the nursing staff. Nurse leaders should therefore have an open-door communication policy so their staff can feel safe and comfortable communicating feelings of burnout. The nurse leader can serve as a role model exhibiting the skills needed to foster positive nurse mental health.

Organizations should also ensure breaks are taken away from the bedside. Many nurses find, despite a Joint Commission flag, they are eating their meals or taking their break at the bedside. The United States Department of Labor discusses that while coffee or lunch breaks are not required by federal law, mealtime breaks can be part of state laws. For example, Massachusetts workers have a right to at least a 30-minute meal break for each 6 hours worked in a calendar day. During their meal break, workers must be free of all duties and free to leave the workplace. Rest breaks such as this are proven to improve nurse well-being and reduce fatigue.

Organizations should also be encouraged to re-examine their current processes for EAP, as EAP resources and private locations can increase usage. Instituting these programs to help support nurses and other healthcare staff will create an environment filled with mindfulness and healthy habits. The Schwartz Center developed the Schwartz Rounds program to offer regularly scheduled time for healthcare providers, especially nurses, to openly discuss social and emotional concerns. While this program doesn’t specifically tackle nurse well-being, it does allow for nurses to share stories and know that they are not alone in today’s mental health crisis. Hearing from other nurses sharing similar struggles often opens the door for a nurse seeking mental health services.

Lastly, organizations should share resources to assess and cope with burnout. The overall well-being of nurses can be improved by establishing techniques and providing education on management of burnout, which in turn yields a more positive staffing environment. Nurses should be provided with the tools to recognize their own limitations with skills or patient loads, and having the support of the leadership to not surpass this. As skillsets get more advanced, confidence can dwindle, signaling emotional distress that, if not reversed, could have detrimental effects for a nurse’s physical, emotional, and psychological well-being as well as the ability to provide optimal patient care. 

Mental health in nursing and nurse well-being have a significant impact on nurses, patients, and organizations alike. Prioritizing nurse well-being in physical, emotional, and moral dimensions can cultivate a healthier lifestyle and, in the best case, will save many nurses from burnout or, in the worst case, suicide. 

*If you or someone you know is having a mental health crisis, you can dial or text 988 free of charge for mental health support. Further information on the 988 Suicide and Crisis Lifeline can be found at https://988lifeline.org/talk-to-someone-now/. You can also seek assistance by calling 911 in life threatening situations. 

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