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nurse sitting on floor, looking depleted
A self-sacrificial ethos has long been the hallmark of workplace culture in the nursing profession—muscling through the workday’s lows and highs without a moment of respite, an introspective pause. The end goal to touch as many patients as possible, physically and figuratively, making space for their feelings, their emotions, their pain, and siphoning out just enough energy to clock out and make the commute home. Only to wake up and do it all over again.
And then a centennial pandemic happened. Nurses were already in the red, with 82 percent of them saying they were at a significant level of risk for illness due to workplace stress well before COVID—and the recent Omicron strain—bared down on the world. On top of nurses' declining mental health, they now have to contend with bed, ICU, and staffing shortages, left wondering if there’s even a glimmer at the end of an ever-protracting tunnel.
“Burnout is hard right now, and not just because my team members are nurses—it’s because they are human beings and have lives outside of work,” says Sara Williams, manager of postpartum, pediatrics, and lactation for Maple Grove Hospital. “I’ve been a nurse for 20 years and have never experienced this kind of crisis in my career. Our hospitals are full for a variety of reasons, not just for COVID, and when you’re working with burnout, that’s scary.”
Jessica Rush, assistant nurse manager at North Memorial Health Hospital, says the facility just expanded its COVID unit to make room for more beds. “I hear a lot of my team members in passing saying things like, ‘I don’t know if I have it in me again,’ or ‘I don’t know if I can get through this,’” she says. “They are incredibly emotional and yeah, they’re tired. The job market is hard and we are down staff. It’s not easy to find new hires that will just jump on the COVID floor.”
On Friday, the Minnesota Hospital Association issued a statement—more like a public plea—for all Minnesotans to avoid emergency room visits for non-emergency care. COVID-19 tests at emergency rooms, for instance, have strained health systems to the breaking point. “We have run out of words to describe what we are undergoing—a crisis does not even come close. Hospitals are literally full … ICUs are full, emergency departments are full, medical-surgical units are full, hallways are full, and surgeries are being canceled.” The state’s positive test rate hit a new record Tuesday of 19.1 percent, according to the Minnesota Department of Health. And our very own high priest of pandemics, Michael Osterholm, said these next few weeks could be “the equivalent of a viral blizzard.”
A Self-Care Mandate
While most of the general population is experiencing COVID news fatigue, becoming numb to the numbers, our local healthcare population is suffering from exhaustion that’s deep in the bones, at odds with reconciling a job they love while being pushed to near-impossible limits. To ease some of the burden nurses face on a daily basis, some healthcare systems—like Regions Hospital—have employed wellness and self-care practices, seeking out workers and their needs versus leaving it on the nurses to go in search of support in the midst of an already over-scheduled day.
“We have a massage therapist go to different departments and give 15-minute chair massages,” says Brooke Campbell, a wellness program manager for Regions Hospital. “This way, it’s much more convenient for colleagues to step away from their work for a well-deserved break.” She adds that chair massage cushions have been set up in break rooms to promote mini self-care breaks. Regions also has a Center for Employee Resilience, a respite from the ground floor, which offers resilience training, mindfulness classes, and “house calls” for one-to-one resilience coaching. Many of the services are available virtually, so employees can access them when they’re not on the clock.
“We’re also creating a peer support program as a result of listening to our colleagues tell us that having support from each other is the most helpful for their resilience,” Campbell says. “Our programs at Regions, specifically, are all about letting everyone know that self-care is never a selfish act; it’s a professional necessity.”
Under the American Nurses Association’s Code of Ethics, the fifth provision states that the moral respect that nurses extend to all human beings extends to oneself as well: the same duties that we owe to others we owe to ourselves. It goes on to say that “as professionals who assess, intervene, evaluate, protect, promote, advocate, educate, and conduct research for the health and safety of others and society, nurses have the duty to take the same care for their own health and safety.”
To avoid reaching a self-care deficit, Rush says the resiliency and stress support program at North Memorial Health strives to meet team members where they’re at, much like Regions. “[Our wellness department] has offered a free, 24/7 fitness center for all team members, so they can get personal training and nutrition coaching," she says. "We brought in certified trainers who can teach employees ways to help them level their emotions and come back to a balanced state, through evidence-based techniques.”
Last year, Abbott Northwestern Hospital implemented a peer-to-peer support group for frontline workers with six- to eight-week sessions, rooted in topics like “managing difficult emotions” or “how to do meditation.” They clinched participants, but the pervasive issue that employees were confronted with was how to make the time. “How can organizations like ours actually create time and space to join … while lightening the load? So they don’t have to participate at the beginning or end of a very busy day?”
While coaches, peer-to-peer support, and resiliency training all have a place and a purpose, nurses also have a shared understanding that discretion is sometimes the better part of valor.
Not the Typical Check-up
“Making rounds” in the healthcare world has historically referred to the act of medical teams getting together as a group to review a patient’s status and care plan. Lately, that term has adapted to mean that rounds (or rounding) is getting the team together to check in with one another. “We’re doing more frequent rounding with teams and sitting and talking when there’s time,” says Williams. “Having real conversations right now more than ever—I’m seeing more transparency across the board with being human.” If there’s a day where she’s not in a great spot mentally, she says, she knows other people will rally to cover for her (and vice versa).
“We are encouraging Regions Hospital colleagues to use their time off,” says Chris Boese, chief nursing officer and vice president of patient care services at Regions. “Many have valiantly picked up shift after shift as patients are in bed and need care. Leaders are doing a lot of rounding, supporting, and thanking colleagues, trying to get them resources and help they need.”
As we head into the 22nd month of the pandemic, nurses say one way we can all help them is to do our part in stemming the tide of this fourth wave.
“Get your COVID-19 vaccine,” says Boese. “That is the number one way we can all work to end this pandemic … We are seeing young adults in their 30s, extremely sick in the intensive care unit on ventilators. We know the public is tired of the pandemic, masks, and restrictions. But healthcare workers are tired, too. The pandemic won’t go away until everyone does their part to end it.”
Williams adds, “Wash your hands, be kind, and give grace. It’s hard for everyone right now.”
