Research Shows Nurse Burnout Threatens National Healthcare System
In a press release on April 13, 2023, the National Council of State Boards of Nursing (NCSBN) released their findings of a large-scale survey and research effort titled, "Examining the Impact of the COVID-19 Pandemic on Burnout & Stress Among U.S. Nurses". The research was presented for the first time in a panel to the National Press Club in Washington D.C. and combined the work of their nurse workforce research and their prelicensure RN education survey findings.
The study gathered and analyzed data from nurses nationwide and, according to the NCSBN, is the most comprehensive research on the post-pandemic state of nursing in the United States. The results may not be entirely surprising to those of you nurses reading, yet they are alarming as they demonstrate the impact of massive nurse burnout in precise figures.
Findings of the NCSBN Nurses Survey
Key findings of their research shared by the NCSBN were:
- More than a quarter million nurses have left the field since 2020.
- Approximately 100,000 registered nurses (RNs) and 34,000 licensed practical/vocational nurses (LPN/LVNs) left the workforce, specifically due to the COVID-19 pandemic.
- 41% of the 100,000 RNs who left had an average age of 36 years with less than ten years of experience.
- Another 800,000 RNs and 184,000 LPNs/LVNs reported an "intent to leave" the workforce by 2027 due to stress, burnout, and retirement.
- Altogether, about one-fifth of RNs nationally are projected to leave the healthcare workforce.
- 62% of the sample reported an increase in their workload during the pandemic.
- A quarter to half of the nurses reported feeling emotionally drained (50.8%), used up (56.4%), fatigued (49.7%), burned out (45.1%), or at the end of the rope (29.4%) "a few times a week" or "every day."
- These issues were most pronounced with nurses with ten or fewer years of experience, driving an overall 3.3% decline in the U.S. nursing workforce in the past two years.
- 24% of the RN workforce are younger, early-career nurses.
- There is a decline in clinical preparedness of new nurse graduates and reduced practice and diagnostic proficiency in early career nurses, which is attributed specifically to the virtual models of education that were required during the pandemic.
The NCSBN Call to Action
Maryann Alexander, Ph.D., RN, FAAN, NCSBN Chief Officer of Nursing Regulation, stated firmly that the reason for the panel was not only to present the data but that it was reversible if steps were taken decisively and swiftly. The panel discussion that followed focused on looking for various solutions to address nurses leaving the profession and nurse burnout. The panelists participating included; Antonia Villarruel, Dean of Nursing at the University of Pennsylvania; Gay Landstrom, Senior Vice President, and Chief Nursing Officer at Trinity Health System; Congresswoman Lisa Blunt Rochester, U.S. Representative of Delaware; Robyn Begley, CEO of the American Organization for Nursing Leadership and CNO/Sr. VP for the American Hospital Association, and Rayna M. Letourneau, Board of Directors, National Forum for State Workforce Centers.
Panel Discussion for Solutions
The panel discussion lasted close to an hour, and several areas for strategic focus were identified. Overall, panelists agreed that today's nurses need a work environment that is safer, more flexible, and more supportive. In regards to the nursing shortage, one panelist put forth the need to analyze care delivery models, consider how efficiently those models utilize nurses, look for ways to alter them (what work are nurses doing that could be a different staff position's responsibility?), and even work to innovate new healthcare delivery models.
Another panelist expressed a desire on top of the need for a safer environment. We need to see a culture change within healthcare and nursing; historically, nurses have prioritized patient needs and patient care over their own-often overlooking their own well-being and needs, and that is unsustainable and contributes to nurse burnout.
The research brought to light the fact that young/early-career nurses need more support; they need mentorship, and the transition from clinical to practice is challenging. Panelists want to see the creative use of technology to help facilitate mentorship, support, and more preparedness for direct practice. Mentorship and support programs can be developed to bring into the fold the lost experience of seasoned nurses who have retired or left the industry.
A Need for More Academic Practice Partnerships and More
Panelists want more academic practice partnerships; the opportunity to exchange feedback and pool resources and expertise makes for better-prepared nurses. Nurse educators are saying there aren't enough clinical opportunities, so we need to work to create new opportunities. One panelist pointed out that the funding for physician education is very different from the funding for nurse education, Residency programs which are essential transition times for physicians, are not funded for nursing but are needed. Furthermore, nurse preceptors need to be compensated for the time they give and the education they foster.
Overwhelmingly, panelists agreed that nurses need to be allowed to practice at the top of their licensure. During the height of the pandemic, many restrictions were waived, which allowed more fluidity in care delivery and patient coverage with less bureaucracy. The variation among the states between restrictions placed on the different classifications of nurses creates problems, and flexibility is warranted.
Delaware state representative Lisa Blunt announced that with bipartisan support, the Nursing Workforce Shortage Act had been introduced in Congress and will be heard in the health sub-committee.
Nurse Educators In Need of Better Salaries
A call for competitive salaries for nurse educators. The nursing shortage reaches from direct practice nurses to educators as well. In order to expand and/or open nursing programs to avoid the troubling dilemma of turning away qualified nursing student candidates, there must be enough appropriately qualified educators, and many nurses who would meet those qualifications would have to accept a significant cut in their salaries to take an educator position which simply isn't a realistic request for many.