Mental health has recently proven a huge source of concern across the scope of the healthcare industry. Professionals are not only seeing a rise in depression and anxiety among their patients, but also seeing these issues play out among their colleagues or in their own families.
The latest statistics are certainly worrisome. According to findings from the American Nurses Foundation Mental Health and Wellness Survey, two-thirds of nurses report feeling stressed, while half feel overwhelmed and nearly half feel burned out. What’s more, an alarming one-quarter of nurses have revealed that they experience feelings of depression.
There is a silver lining, however, as the public is more aware of — and willing to talk about — mental health in healthcare workers. This has led to rapid reductions in stigma and a greater commitment to building a culture of mental health. Leaders can play a vital role in contributing to and encouraging this mental health discourse, as can individual healthcare professionals.
The Unseen Battle: Mental Health Challenges in Healthcare
Despite the prevalence of mental health issues among clinical professionals, these issues have, until recently, existed largely in the background. As a result, many struggling healthcare workers feel ashamed or lonely, and sometimes less inclined to seek help. That said, things are beginning to change, and mental health awareness and acceptance now feel well within reach.
Recognizing the Signs of Mental Fatigue and Burnout
Mental fatigue and burnout can manifest differently from one employee to the next. Still, certain signs are common and may indicate that nurses need support:
- Feeling cynical about patients or about the healthcare industry in general.
- Worsening job performance, including more frequent medication errors.
- Dreading the workday or complaining about tasks that previously felt manageable or even enjoyable.
- Changes in sleep patterns or eating behaviors.
Factors Affecting Mental Health of Nurses
Mental health has long been a source of concern in the healthcare field, but it is abundantly clear that these issues have accelerated considerably in the last several years. There is no one source of trouble, but rather, a complex web of factors affecting mental health of healthcare workers. Unfortunately, this range of issues means that there is no easy solution, but rather, a need for comprehensive strategies. Commonly cited issues that contribute to feelings of stress, burnout, and depression include:
Long Working Hours and High Stress Levels
It is well-understood that nurses work long hours. Hospitals, in particular, typically call for 12-hour shifts. This approach has its perks, but many nurses report feeling overwhelmed and fatigued following long shifts. Overtime is increasingly common, especially in response to staffing shortages.
Unfortunately, research suggests that nurses who involuntarily work overtime are prone to mental health issues. Working 60 hours per week can be highly damaging, not only prompting fatigue and burnout in the short-term, but also negative mental health implications far into the future.
Exposure to Traumatic Events and Emotional Strain
Emotional strain is a huge issue across the spectrum of healthcare. Every day, nurses are exposed to emotionally wrenching situations. This could be as simple as seeing their patients in pain or mental distress, but grieving families and patients’ financial concerns can also weigh heavily on nurses. While many take comfort in knowing that they can make a huge difference on behalf of these struggling patients, there are some issues nurses simply are not equipped to handle. When these situations arise, nurses may feel powerless or guilty.
Burnout and Compassion Fatigue
Over time, the concerns described above can lead to compassion fatigue, in which constant exposure to suffering or traumatized patients prompts a negative emotional response that makes it difficult for nurses to do their work effectively. This is often accompanied by feelings of cynicism or disinterest. These feelings manifest in changes in professional attitudes and can cause nurses to withdraw from social situations or previously beloved non-work hobbies or activities.
Lack of Support and Resources
Nurses are some of the most resilient professionals imaginable, and they have continuously proven that they can rise to the occasion when faced with crises. Having said that, without proper support, they can be highly vulnerable to mental health issues.
This support can take many forms, but nurses certainly recognize when it’s lacking. For example, nurses want to feel supported by healthcare leaders, but sometimes, they perceive the opposite. When they feel stressed or overworked, their managers ask them to work overtime or take on larger workloads than they can realistically handle. Others lack support in their personal lives. Many cite struggles to find affordable childcare, while a lack of decent housing or transportation may add yet another source of stress.
Work-Life Balance and Self-Care Practices
Long hours and shift work make it difficult to maintain any semblance of work-life balance. Many nurses report feeling as if they are always either working or recovering from work. Research suggests that busy nurses may perceive greater balance if they feel engaged on the job. But when such engagement is lacking, it can be difficult for them to make the most of their time off.
Impact of the COVID-19 Pandemic
No discussion of mental health in nursing will be complete without at least touching on the enduring impact of the COVID pandemic. This exacerbated many issues that existed pre-COVID while also introducing a whole host of new challenges.
Surges in cases prompted dramatically increased workloads, while exposure to the disease led to illness among nurses, and ultimately, staffing shortages. Protocols changed rapidly and nurses struggled to keep up. Many nurses even faced moral distress as they dealt with ethical dilemmas regarding resource allocation.
5 Strategies for Supporting Mental Health in the Workplace
As the healthcare sector finds its new normal following the challenges of the pandemic, it’s clear that a second, silent pandemic is underway: significant psychological burdens faced by healthcare workers. To ease these problems, proactive strategies must be implemented on a widescale basis. Essentials include:
Implementing Regular Mental Health Check-ins and Support Systems
One of the most effective ways to demonstrate that mental health is a priority is to commit to regular check-ins and wellness-oriented feedback systems. Experts increasingly advocate for mental health screenings, which can reveal changes in nurses’ moods and general emotional state. Support systems should also be provided, including counseling services, mental health workshops, and support plans.
Creating a Culture of Openness and Support Within Medical Teams
Healthcare professionals should not suffer in silence. Many feel isolated, but they can find significant relief if they recognize that their burdens are shared across the entire sector. In many cases, simply feeling less alone can drive healing or, at least, remove the stigma as healthcare workers take advantage of counseling and other opportunities. Colleagues should be encouraged to collaborate in tackling mental health issues, with mental health awareness and stigma reduction emphasized to encourage honesty and mutual support.
Providing Access to Resources and Support for Mental Health Concerns
Healthcare employers should never struggle to access or pay for therapy services. Other evidence-based mental health services should also be provided, such as employee assistance programs that offer short-term counseling or referrals. Support groups, teletherapy, and mentors should be readily available, and an overarching culture of mental health should encourage nurses to take advantage of these offerings without feeling stigmatized.
Encouraging Open and Honest Communication About Mental Health
Stigma is often cited as a top barrier to seeking support for mental health issues. Many nurses feel that they will be unfairly judged if they disclose their struggles or utilize counseling services. Communication can break down these barriers, reminding nurses that they are far from alone in their mental health challenges. Open conversations can be promoted through peer support groups and mentorship opportunities.
Recognizing and Addressing Burnout in Healthcare Providers
Leaders and healthcare professionals should receive training on burnout and mental health so that they can easily spot the signs of trouble in themselves and in fellow healthcare workers. There should be opportunities to address the core problems influencing feelings of burnout, including the chance to adjust schedules or workloads if necessary.
Personal Coping Mechanisms for Nurses
The mental health concerns described above are alarming, but there are signs of hope as nurses are aware of these issues and increasingly determined to combat them. Most are in tune with their own health and research even suggests that most make some effort to engage in self-care. While there is a strong need for change at the organizational and societal level, individual initiatives can absolutely make a difference.
Importance of Self-Care and Setting Boundaries
Self-care is a broad concept that includes many practices designed to improve physical and mental health. Often, it involves setting boundaries. The National Council of State Boards of Nursing (NCSBN) refers to these as “spaces between the nurse’s power and the patient’s vulnerability.” From the nurse’s perspective, these can involve any limits that prevent employers or patients from showing disrespect or otherwise taking unfair advantage of nurses.
Accessing Professional Mental Health Resources as a Healthcare Provider
Healthcare employees often enjoy extensive access to mental health resources, including counseling and support groups. While some nurses feel that they lack time or encouragement to make the most of these resources, encouraging findings from the American Nurses Foundation and McKinsey suggest that issues such as the cost of services or a fear of retribution do not typically stand in the way. Experts at McKinsey recommend, at minimum, “well-being support tools and programs,” along with mental health literacy training and even “behavioral-health concierge” to help employees “navigate, find, and access care and support.”
Seeking Support From Peers and Colleagues
Fellow healthcare professionals can form the basis of a strong support system, offering unique opportunities for commiseration along with a much-needed dose of empathy. Many nurses find mentorship especially helpful, as this can provide valuable exposure to different perspectives and potential long-term outcomes. Nurses can take comfort in knowing that their mentors have experienced many similar challenges but have endured and are now thriving.
Utilizing Therapy or Counseling Services
The aforementioned survey from McKinsey references the need for “free or subsidized access to professionally provided therapy or counseling services.” This can make a world of difference for employees showing early signs of burnout or compassion fatigue.
Therapy provides a safe space in which nurses can express difficult feelings and process traumatic events. This can also help nurses develop the boundary-setting and self-care skills cited above. After all, while many recognize that these are important, they often struggle to put these priorities into action and may need support as they set much-needed boundaries.
Taking Breaks and Utilizing Time Off Effectively
Time off is a must for preserving mental health. Unfortunately, nurses struggle to make the most of PTO, just like other professional across industries. Often, the full advantages of time off cannot be realized until nurses manage to unplug, which means staying away from full email inboxes and making it clear that they will be unavailable for work when they’re on vacation.
The Role of Leadership in Addressing Nurses’ Mental Health
The state of mental health may be alarming across the spectrum of the healthcare sector, but these issues are certainly not unsolvable. Leaders set the tone by making it clear that mental health is a priority. Top-down measures can help establish workplace cultures that advocate for wellness in all its forms, such as promoting work-life balance, access to therapy, and more autonomy and empowerment for hardworking nurses.
Leading by Example: Encouraging Mental Health Conversations
The first step to promoting a culture of mental health? Getting honest. Leaders need to be forthright about mental health challenges, demonstrating empathy for struggling healthcare workers while also making it clear that they are determined to drive change. As a guide to wellness-centered organizational best practices (published in the Journal of Occupational and Environmental Medicine) explains, “workplace leaders talk[ing] on roles of wellness champions can be encouraging to employees when they are facing mental health issues.”
Engaging in Stress-Reducing Activities
Recognizing that employees may neglect to pursue stress-reducing activities on their own, many employers are now making these opportunities readily accessible, often within work facilities. Examples include:
- Onsite yoga or guided meditation.
- Green spaces or other opportunities to spend time outside.
- Creative expression such as painting or playing musical instruments.
Policy Changes and Initiatives to Support Healthcare Worker Well-Being
Efforts among individual leaders will only go so far if these are not underscored by actual policies that demonstrate an organizational emphasis on mental health. Some of the most impactful policies relate to scheduling and work-life balance. For example, setting barriers to limit the potential for excessive overtime could make a huge difference. Flexible work policies, although not always realistic, may be worth exploring in some situations. Many healthcare employers now also offer employee assistance programs (EAPs), which include services that promote health and wellness.
Integrating Mental Health Education Into Healthcare Training
The effort to improve mental health should begin long before nurses enter the workforce. Ideally, this will be built into nursing school and other training programs, where aspiring nurses can gain valuable insight into common mental health issues and evidence-backed preventative measures. Students can begin to implement self-care and develop wellness skills while they are still enrolled, and, if the stigma of seeking help is removed at the college level, it is less likely to persist in the workplace.
What are the Common Mental Health Issues Among Healthcare Providers?
Healthcare professionals are particularly vulnerable to burnout and compassion fatigue, which often stem from long working hours and continuous exposure to suffering or traumatized patients. Stress is commonly cited as a significant mental health concern within the field, and many healthcare workers also exhibit symptoms of, or are diagnosed with, anxiety and depression. Addressing these challenges is crucial for maintaining the well-being of those who care for our health.
How Can Healthcare Workers Seek Help Without Fear of Stigma?
Healthcare workers can leverage employee assistance programs, mentors, and counseling services to improve their mental health while dealing with common issues such as stress or fatigue. In many situations, scheduling changes or boundary-setting can alleviate underlying factors that contribute to mental health problems. Stigma can be eliminated by establishing a culture of mental health, in which healthcare workers are encouraged to discuss their concerns openly and honestly.
What Are Some Effective Stress Management Techniques for Healthcare Professionals?
Boundary-setting and self-care are among the most effective stress management strategies in the healthcare field. Many healthcare professionals benefit from working with mentors or seeking counseling services. Other common coping mechanisms include yoga, meditation, exercise, and creative expression.
Be the Change And Promote Mental Health With Nevada State University
At Nevada State University, we are committed to promoting a culture of mental health within the college environment and in the healthcare sector. We offer many opportunities to prepare for the challenges of nursing, including an RN to BSN online program that helps nurses develop critical self-care skills. Reach out today to learn more.