COVID-19 Leaves Lasting Impact on Nursing Practices and Job Satisfaction

The COVID-19 pandemic required an evolution of traditional nursing practices, but the unpredictability led to increased stress, burnout, and job dissatisfaction. | Image Credit: Nina Lawrenson/peopleimages.com - stock.adobe.com

The COVID-19 pandemic exacerbated the difficulties nurses experience, especially in emergency departments, requiring adjustments in practice care settings and continuing to impact their overall job satisfaction.¹

Nursing positions included high-stress situations prior to the pandemic, but the onset of COVID-19 exponentially increased emergency care needs, placed pressure on all health systems, and necessitated changes in practice settings for both hospitals and primary health care institutions.

COVID-19 killed more than 3600 US health care workers in the first year of the pandemic, with reports of dangerous conditions made to both state and federal agencies.² Health care workers, dubbed “essential workers” during the pandemic, feel they deserve more than few public displays of gratitude. Long-lasting COVID-19 symptoms, post traumatic stress disorder (PTSD), and several other complications, some essential workers say, are all they’ve received after risking their lives in the nation’s moment of need, and they are now offered little assistance for the harm incurred.

Nursing Practices Post COVID-19

The COVID-19 pandemic significantly impacted nursing, accelerating transformative changes in practice that have paved the way for future trends in health care.³ Frontline workers were forced to adjust their practices to cope with the unforeseen crises without compromising the quality of patient care or endangering the safety of health care staff.

The role technology plays in nursing practices has been increasingly recognized, highlighting the uptake of telehealth and remote monitoring methods. Various telemedicine platforms were implemented to treat patients while mitigating exposure risk.

Nursing practices were greatly impacted by the imbalance between the need for care and the available resources that were able to be provided within the health care system.⁴ During the pandemic, there were shortages of staff, acute care beds, medical supplies, standard processes, and safe pathways.

The overall psychological, mental, and emotional impacts of the COVID-19 pandemic on nursing practices are resulting in long-standing effects.⁴ Furthermore, mental health services and extensive support structures designed for health care professionals became particularly imperative following the onset of the pandemic.³ The stressors nurses encounter in conjunction with the already overwhelming nature of their responsibilities have increased significantly since 2020. Nurses witnessed global illness and bereavement during prolonged shifts while enduring strain, leading to heightened urgency of prioritizing mental health services.

Additionally, an increased risk of stress-related errors and anxiety surrounding contracting COVID-19 impacted nursing practices.⁴ During the earlier phases of the pandemic, health care workers encompassed 29% of all hospitalized patients. Emotional impacts were particularly severe when nurses had to assist a colleague who became infected or died. The ongoing stress and fear of contracting COVID-19 amid rising infection numbers created an increase in clinical and organizational uncertainty and loneliness that led to physical and psychological complications for nurses.

Nurses had to ultimately learn how to utilizenew technologies, skills, and protocols. Health care management worked across their institutions to reconfigure spaces, reallocate resources, provide more training methods, adjust work schedules to ensure continuity of care, and balance competencies as part of these shifts. The collaborative efforts across health care professionals allowed strong commitment and engagement within the organization, some research found.⁴

Lastly, nursing practices were impacted further through nursing education tactics and degree programs. The pandemic prevented professional internship hours that offer students the chance to gain knowledge and practical skills, leading them to focus on simulation instead.⁴ The termination of these hands-on learning environments for students combined with online teaching courses has caused challenges and dissatisfaction among teachers and students, inciting a gap in nursing students’ skill development.

The COVID-19 pandemic has led to helpful innovations in nursing practices, such as telemedicine, online education, and patient monitoring, but there must be a deeper reflection identifying areas of improvement in health care policies, resource allocation, and health care workforce training, experts say.⁴ Effective solutions to improve preparation and response to future health crises include collaborative thinking that creates a safer, sustainable, and patient-centered environment.

Nurses’ Job Satisfaction

Nurses reported job dissatisfaction throughout the pandemic, depleting them of their motivation that is needed to avoid burnout.¹ During the height of the pandemic, health care workers described daily work related issues that included poor working conditions, lack of personal protective equipment, lack of professionals, increased workload, physical and psychological overload, and low remuneration.

A study that included 1705 nurses conducted in Quebec found the nursing staff caring for patients with COVID-19 perceived less transformational leadership from their superior and had higher chronic fatigue, lower job satisfaction, lower perceived quality of care, and higher intention to leave their current professional position.¹ Nursing staff turnover was highly linked to greater job demands requiring care for patients with COVID-19, transformational leadership, knowledge/preparedness, and strain indicators like chronic fatigue and job satisfaction.

Another study included a survey of 54,025 respondents across 45 states who had active licenses in the US as registered nurses, advanced practice registered nurses, and licensed practical nurses/licensed vocational nurses.⁵ Survey results found more than half of the sample size reported an increase in workload during the pandemic, and there were high levels of feeling emotionally drained (50.8%), used up (56.4%), fatigued (49.7%), burned out (45.1%), or at the end of their rope (29.4%) either a “few times a week” or “every day.”

Nurses with 10 or fewer years of experience had a 28% to 56% increase in their frequency of feeling emotionally drained, used up, fatigued, burned out, or at the end of their rope compared with more experienced colleagues. Nurses earlier in their career who had high workloads were 3 to 4 times more likely to report increased frequencies of these feelings (all P < .001).⁵

Nurses have always risked burnout due to the intense emotions and cumbersome procedures involved in their job responsibilities, but the pandemic exacerbated this situation.⁶ Research shows more than 100,000 nurses decided to leave the workforce during COVID-19, marking the worst exodus in our lifetime.

In a survey of 856 nurses working at acute care hospitals in New Jersey, 64% experienced occupational burnout, 51% screened positive for symptoms of PTSD, 51% reported dissatisfaction with their current jobs, and 42% reported plans to leave their current jobs. The most popular reasons associated with job dissatisfaction and intent to leave were patient workload, nonsupportive work environments, the poor psychological impact COVID-19 caused, and longer work shifts.⁶

Steps Moving Forward

According to researchers, health care systems must work together to mitigate burnout risks, especially among nurses, while offering various assistance methods like counseling, peer support, and training programs providing coping methods and stress management skills.³ Including nurses in the decision-making process offers personal expression, influences teamwork, and increases the sense of belonging an individual has toward the institution.¹

The pandemic underscored nurses’ adaptability and innovative approaches as a response to various challenges.³ It is important to consider the trends and foundational elements that emerged during the pandemic because it has fostered a whole new health care landscape. Although rapid advancements in medical treatments and workflows are promising, health care institutions must provide adequate support to nursing staff to maintain quality patient care.

References

1. Ribeiro OMPL, Coimbra VMO, Pereira SCdA, Faria AdCA, Teles PJFC, Rocha CGd. Impact of COVID-19 on the environments of professional nursing practice and nurses’ job satisfaction. Int J Environ Res Public Health. 2022;19(24):16908. doi:10.3390/ijerph192416908
2. Maxmen A. Nursing aides plagued by PTSD after “nightmare” Covid conditions, with little help. KFF Health News. October 22, 2024. Accessed October 29, 2024. https://kffhealthnews.org/news/article/essential-worker-ptsd-pandemic-massachusetts/
3. Ahmed SK. The impact of COVID-19 on nursing practice: lessons learned and future trends. Cureus. 2023;15(12). doi:10.7759/cureus.50098
4. Ivziku D. Covid-19: The devasting impact of the pandemic on nurses’ working lives. UniCamillus. June 30, 2023. Accessed October 29, 2024. https://www.unicamillus.org/covid-19-the-devasting-impact-of-the-pandemic-on-nurses-working-lives/
5. Martin B, Kaminski-Ozturk N, O'Hara C, Smiley R. Examining the impact of the COVID-19 pandemic on burnout and stress among US nurses. J Nurs Regul. 2023;14(1):4-12. doi:10.1016/S2155-8256(23)00063-7
6. ‌Smith A. Doctoral student’s research finds COVID worsened nurse burnout. Rutgers Health. July 21, 2023. Accessed October 30, 2024. https://rutgershealth.org/news/doctoral-students-research-finds-covid-worsened-nurse-burnout