Opinion: If nurses are heroes, your heroes are in crisis

I know it first hand. I am a family nurse practitioner as well as a researcher. Over the past few months, as Omicron cases have increased, my colleagues and I have been pushed to our limits.

I see patients of all ages and backgrounds, many of whom don’t have a primary care provider. I help them deal with multiple aspects of Covid – screening, vaccination, treatment – in addition to filling those gaps in primary care. Right now, there are no quick and easy medical visits, and there are not enough nurses to meet the needs. It has been heartbreaking to turn away patients due to the lack of available appointments.

But for many patients I treat, the reality of the pandemic today may seem better than it did in 2020. We have vaccines and boosters, better treatment plans, and a much more plentiful supply of masks and other personal protective equipment (PPE) . Much of the public, for better or worse, has found a balance in life while trying to mitigate the risk of contagion.

Inside the hospitals and clinics where I work, however, the reality is quite different. For nurses, 2022 can often seem much darker than what we experienced at the start of the pandemic. We have vaccines and more PPE now, yes, but being on the front lines of waves of infections has carried an extreme physical and emotional burden that leads to immense burnout.

Sometimes I received requests to take extra extra shifts or to “donate” my time at a local hospital when other nurses were away. When I receive these requests, I feel much worse apprehension than I felt that day in early April 2020 when an emergency alert popped up on my iPhone, “Attention all healthcare workers: the New York City is looking for licensed health care workers to support health care facilities in need.” When I read those words, I knew we were in crisis. What I didn’t know was is how much our workforce would suffer.

It’s more than the job of caring for more patients that is boring. It’s also the despair that comes from seeing no end in sight and meeting people who won’t see the truth in the face. I meet fellow Americans who still deny that the pandemic is a real threatthat the SARS-CoV2 virus that causes Covid-19 is airbornethat people can die from it (currently more than 5.5 million worldwide) or suffer from long-term complications. This rejection of reality feels like a betrayal.
While my colleagues and I do our best to care for patients despite our own exhaustion, there are still patients filling waiting rooms who have not been vaccinated or who have not taken preventative measures like wearing masks to protect themselves and help curb the influx of new Covid-19 hospitalizations. And while parts of the public may choose to “get over” the pandemic, or live as if it doesn’t exist, for healthcare workers like me, there has been no escape.
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So now when I get a request for overtime due to a shortage of staff, I face a dilemma: take on the job and add to my already considerable burnout or refuse it and know that the patients and nurses stretched the staff will suffer. Many times I choose to take on the job.

My friends and colleagues in the nursing profession have said they face the same tug of war between taking care of themselves and taking care of others. “If I don’t show up, who will? We don’t have enough nurses to care for our patients safely,” a colleague told me. Our burnout is caused by a systemic mess that we did not create but are forced to tackle daily.

The pandemic has broken the cascade of problems leading to this nursing emergency. We don’t have enough qualified nurses to handle the number of patients in all health care facilities. On top of that, we have a pipeline problem: to train more nurses, we need more educators, but universities are struggling to fill faculty backlogs because, unfortunately, the salaries of nursing teachers are much lower (on average $20,000 less) than clinical or private sector roles.
Without financial aid to nursing schools, expand loan relief for nurse educators and researchers, and funding health insurance from the Ministry of Health and Social Services Demonstration of graduate nurse training, nursing schools may continue to face faculty shortages. In addition, the American workforce is undergoing rapid transformation under the “Big Resignation” as American workers seek better work-life balance than the generations before us.
For nurses, that means turning to options like travel nursing — short-term work contracts in hospitals and regions that need it most but also offer compensation that easily eclipses the salary of local staff nurses. These types of assignments are not new, but they are now in strong demandto create a precarious impact on the financial health of hospitals.
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Every day I am tempted by the emails I receive from travel nurse recruiters for registered nurse and nurse practitioner positions. And I know I’m not the only one asking: why should nurses tolerate excessively high workloads and verbal and physical abuse without the higher pay that traveling nursing assignments offer? Especially since inadequate remuneration is a factor that contributes to nurse burnout.
Earlier in the pandemic, there were brief glimpses of light. I remember the overwhelming emotion I felt receiving my first Moderna vaccine as a cancer survivor and frontline worker in a New York City Department of Health building in Harlem in early January 2021. And for a while, browsing social media, I’d find a friend or family member proudly posting that they got a vaccine. Speaking to other nursing friends who worked in intensive care units, there was also a shift towards better treatment plans for Covid-19. While we were exhausted, we remained hopeful.
Now, as we enter our third year of the pandemic, those helpful sentiments are hard to hold back. Many nurses suffer in silence as they deal with overwhelming feelings of exhaustion, irritability, anxiety and sadness that undermine our mental health on a daily basis. A recent study published in JAMA Psychiatry found that, compared to the general female population, nurses are at twice as high risk of death by suicide.
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This begs the question: in a pervasive pandemic with the potential for ongoing infection and disease, Can the United States Afford to Ignore the Suffering of Nurses? Neighbors performatively applauded nurses for our resilience, but our leaders failed to provide essential support for nurses that goes beyond performance.
Ensuring the staffing of mandated nurses ensure that patients can continue to receive high-quality care, by offering higher pay and providing mental health support are three starting points. More directly, a January 20 letter from the Massachusetts Nurses Association to Governor Charlie Baker explicitly details 14 steps what he and hospital administrators should be doing to address this nursing health care crisis.
Earlier this year, the nursing profession was once again in first place honesty and ethics – an honor he has boasted about for 20 years. But now this honest and ethical profession is shrouded in extreme exhaustion. The human and emotional toll that nurses have been asked to bear has reached its climax, and we need your help. We ask the public to mask up, get vaccinated and stay home if you have symptoms or test positive. And we’re calling on more leaders, inside and outside the field of nursing, to advocate for higher wages and education programs for nurses.

Nurses have long been advocates for our patients, and now we need patients and employers to value our lives and our work and advocate for us. Let’s all show compassion and patience, not just to our nurses and healthcare workers, but to each other. At this rate, our workforce will continue to crumble unless bold changes are made.

Since the start of the pandemic, nurses and other frontline workers have been called heroes. I often balk at hero title; it perpetuates the idea that nurses’ self-sacrifice is acceptable and that no help is needed. But in fact, we need help, and we need it fast.

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