Nearly one-third of nurses say they are likely to leave their career because of the COVID-19 pandemic, up 7 percentage points since 2021, according to Dallas-based health care staffing company AMN Healthcare’s 2023 survey of registered nurses.
The survey of more than 18,000 nurses across the U.S. details the dire state of nurse well-being and satisfaction as the dust settles from the highs of COVID hospitalizations. Years of increased patient demand, compounded by staffing shortages and the uncertainty of an evolving virus, led to worsening mental health, especially among younger nurses.
Nurse career satisfaction dropped to 71% in this year’s survey after hovering between 80% and 85% over the previous decade.
“Nurses are showing worsening satisfaction and a declining sense overall of well-being,” said Cary Grace, president and CEO of AMN Healthcare.
“It’s showing up in terms of how they think about what they want to do from a professional standpoint, both in terms of staying in direct patient care or not and how they will personally deal with some of the challenges they’re facing.”
The consequences of nurse dissatisfaction could be devastating. Already, the health care industry will have to combat a large wave of nurses set to retire in the next decade alongside an aging population that requires increased care. Nursing schools can’t keep up with the demand for new nurses.
The end of the pandemic, which exacerbated strains on health care professionals, didn’t mean an end to the mental and emotional suffering of nurses working at the bedside — in fact, nurses reported worse mental health issues this year than at the pandemic’s peak.
The share of nurses who strongly or somewhat agree that they often feel emotionally drained climbed 15 percentage points — from 62% in 2021 to 77% this year. Reports of worry that their job is affecting their health rose 19 points, from 51% to 70%, and reports of feeling misunderstood or underappreciated at work rose 20 points, from 38% to 58%.
Violence against nurses is also on the rise. A National Nurses United survey from late 2022 found that about 40% of nurses reported some level of increase in workplace violence.
The community support nurses felt during the height of the pandemic has since waned, leaving them to deal with the pressures of working in health care without the same recognition.
“You had signs outside calling you a hero, people donating to the hospital, being understanding of what you’re going through, being respectful of wearing their mask, respecting COVID and understanding what it can do. But now it’s kind of like it never happened,” said Spencer Paddyaker, a Dallas-area travel nurse employed by AMN Healthcare. “It almost feels like whiplash.”
There are some positive aspects to post-pandemic work.
Mary Vitullo, director of the Texas Nurses Association, said some of the support mechanisms that disappeared during COVID-19, such as the ability to gather with co-workers or the presence of therapy animals, are starting to return.
This year’s survey, though bleak, is a signal that things need to change to protect and preserve the nurse workforce, Grace said.
“We still have huge demands on our health care systems, especially with an aging population, and we have significant supply shortages. So, while the shape of that doesn’t look like the COVID pandemic, it still is a material issue that we need to address in health care systems,” Grace said.
In the short term, technology can be used to take away administrative tasks that bog down nurses, instead allowing them to maximize the time they spend with patients. Remote monitoring tools can help nurses watch the vital signs of patients from afar so that they can focus on the people with the most immediate needs.
Implementing effective mental health support systems is also critical.
“Remember that with your staff, it’s whatever you can do to help ease that mental strain, whether it be better staffing ratios or just having a support system there after the fact and being ready to face the repercussions that come with having mental strain like that three times a week, 36 hours a week, for 12 hours at a time,” Paddyaker said.
Long-term, the health care industry will have to address an inefficient pipeline for training more nurses. Nursing programs don’t have enough faculty, meaning they often have to turn away qualified students. More than 90,000 nursing school applicants are denied each year, AMN Healthcare reported.
The University of North Texas Health Science Center at Fort Worth announced in February that it will open a college of nursing specifically to address the nationwide shortage, although the school is still in the early stages of developing courses and recruiting instructors.