'It really take a toll': Nurses dealing with pandemic burnout to get federal help

Several times during the last two years, Audrey Buban has questioned her career choice and whether to stay a bedside nurse.

“What really makes me stay are the good days,” said Buban, 27, of Des Plaines, a registered nurse working in the cardiac telemetry unit at Advocate Lutheran General Hospital in Park Ridge.

Since the early days of the COVID-19 pandemic, nurses in Buban's unit have been working 12- to 16-hour shifts without much of a lull in patient flow. Those experiences have worn out many front-line nurses such as Buban, with some suffering from severe pandemic fatigue and burnout.

“It's honestly hard for me to speak about specific instances. ... The amount of people that I have seen die, and we would have to do post-mortem care ... it really takes a toll,” Buban said.

New legislation aimed at helping nurses, physicians and other health care workers overwhelmed from caring for unrelenting waves of COVID patients over the past two years has passed both houses of Congress and is awaiting President Joe Biden's signature.

The Dr. Lorna Breen Health Care Provider Protection Act will earmark much-needed funding to establish grants for training health care professionals on ways to reduce and prevent suicide, burnout, substance abuse and other mental health conditions.

Its provisions include grant funding for employee education, peer support programming and behavioral health treatment, and the creation of a national education and awareness campaign focused on encouraging health care workers to seek support and treatment.

“I still don't know if I have effectively dealt with my emotions and my mental health because I love being a nurse,” Buban said. “What I do is I go home and decompress. I don't really talk about it. But I think eventually, for nurses to heal, and for any health care worker to heal, is to talk about these stories.”

Pandemic burnout

According to a January 2022 survey by the American Nurses Association, 60% of acute care nurses report feeling burned out, and 75% report feeling stressed, frustrated and exhausted. The results are even more stark for nurses under 35.

A total of 12,694 nurses nationwide took the survey. Of those, 76% identified as white, 9% Black, 6% Hispanic or Latino and 6% Asian; 35% were 55 or older, 77% provide direct care to patients and 90% have had direct exposure to a COVID-19 patient.

For all nurses, 30% acknowledged they are “not emotionally healthy.” For nurses under 25, that number is 46%, and for 55 or older, 19%, survey results show.

Another survey of nearly 1,500 nurses by Nurse.org revealed only 12% are happy where they are, and 36% would like to stay in their current jobs but want more pay and safer staffing levels.

“We see this in our suburban hospitals. We're seeing it in large hospitals within the cities, and we're seeing it in our critical access hospitals as well,” said Jeffrey Murphy, Illinois president of the Schaumburg-based Emergency Nurses Association. “All of them are suffering from pandemic-related burnout, short-staffing and many of the things that we were seeing before the pandemic.”

Illinois has 1,786 emergency nurses statewide. Though specific numbers for burnout and nurses leaving the profession aren't available for the state, these are major concerns for its hospitals and health systems. A dramatic increase in violence against health care workers over the past five years has exacerbated the problem, Murphy added.

Mental health

Safer working environments, adequate staffing levels and personal protective equipment, counseling and mental health supports to deal with the trauma of the pandemic are among the needs workers have identified.

“Nursing is a very selfless profession,” said Faviola Alcalde, 36, of Addison, who works as an emergency room nurse for a Northwest suburban hospital.

Alcalde said with rising COVID-19 cases, she saw among her peers “an extreme increase in burnout, depression and usage of mental health days off.” As the pandemic dragged on, they also dealt with a shift in attitudes from patients and visitors who began to exhibit pandemic and mask fatigue, rebel against the rules and lash out against the hospital staff.

“We want to care for everyone while keeping everyone safe. And it becomes very hard,” Alcalde said.

Alcalde said her employer allows flexible scheduling, which helps alleviate some of that daily stress from exposure to patients.

“I would definitely want to see more access to those mental health days without impacting our paid time off,” she said. “I would want to see an equality for mental health days for all staff members, regardless if you've been there six months or six years.”

Hospital employees also should have access to social workers, just as patients and their families do, she said.

Buban believes resilience is built through teamwork and being there for one another as a “work family.” Her unit is one of the largest at Lutheran General with about 12 nurses working per shift.

The hospital's spiritual care team offers support in group sessions where employees can unload. Providing group therapy is one way hospitals can help workers decompress, Buban said.

“We are experiencing these things, but then you know you have to go to the next patient to take care of them because they need you,” Buban said. “It's just about having help, having someone professionally to guide our emotions and what feels like PTSD from all of this.”