On a rainy night in October 2019, I watched and celebrated as nursing students walked across the stage to receive their hard earned nursing pins. Little did we know that they would be entering the nursing workforce just prior to a global pandemic unlike one that has been seen in over 100 years. Some of these students have reached out to me recently to express their frustration. Just four months into their careers and they are stressed, anxious, exhausted, and scared, and as their recent instructor and mentor I feel helpless. Understanding the mental health impact this pandemic and the shortage of resources is having on nurses is essential. We also must understand the impact on new graduate nurses so we can prevent them from joining the ranks of nurses who leave within their first year of practice.
Anyone with access to an electronic device has heard the stories of the shortage of supplies as the result of COVID-19. Not enough masks, gowns, gloves, and ventilators to care for the growing number of individuals infected with this virus. Nurses and healthcare providers are being required to act in ways that only weeks ago would have been unthinkable. They are being required to make decisions that are often in conflict with the nursing knowledge and values that we, as educators, worked so hard to develop and nurture within them. Such ethical dilemmas are creating psychological discord that over time will result in lasting harm (Foli and Thompson, 2019).
Foli and Thompson’s (2019) middle range theory, Nurses’ Psychological Trauma, addresses this situation. The authors identify insufficient resource trauma as a nurse-specific trauma that with repeated exposure, can result in diminished physical and mental health, unsafe patient care, and can potentially lead to the nurse abandoning the profession (Foli & Thompson, 2019).
The trauma of not being able to carry out one’s ethical, professional, and organizational obligations due to a shortage of resources is what practicing nurses and health care professionals are experiencing every day during the COVID-19 pandemic (Foli, 2019). As educators, have we prepared students for this current reality? Where does this fit in with the patterns of knowing? According to this theory, personal knowing addresses the self-awareness and resilience needed to overcome trauma as each individual’s perception of an event is influenced by multiple personal factors and experiences. However, this kind of self-awareness as a nurse takes time to develop. Where does this leave our new nurses in the face of this pandemic? Are they receiving the support they need from their organizations and experienced nurses to develop the resiliency and ability to grow in the face of trauma?
The search for an understanding of how to help my former students has left me with more questions than answers. If the nursing profession and the organizations that depend on them do not address these questions, we will potentially lose large numbers of nurses. The psychological traumas nurses face on a regular basis must be acknowledged. “If we don’t strategize to sustain and restore our psyches and souls, we are just as vulnerable as our patients”(Foli & Thompson, 2019, p.34). A multipronged approach is necessary to address the reality of nurse-specific trauma. The profession needs to openly discuss the mental health impact that practicing with insufficient resources has on a health care professional.
We are currently seeing this in the media as nurses across the country speak out against the conditions they are being subjected to. Nurses must bring their authentic voice to the current crisis. Additionally, from a nursing educator perspective, there needs to be a focus throughout curriculum on developing personal and ethical knowing. Through self-reflection activities that focus on personal, historical, and patient trauma, a nursing student can begin to develop self-awareness, resiliency, and coping skills (Foli & Thompson, 2019). Lastly, health care organizations need to take a vested interest in the psychological well-being of their health care professionals by providing the necessary physical and emotional support resources and by creating a culture that supports emotional and professional growth. The return on investment is worth it.
The current COVID-19 pandemic has brought the reality of practicing with insufficient resources in health care to the forefront of society. Nurses must take the opportunity to speak out about the conditions they are facing and the choices they are being forced to make. For the nurses who have recently entered the workforce, we know this is not what you imagined. Reach out for help if you need it. Experienced nurses, let them know that you are there for them. Provide them emotional support, be present, and actively listen to the trauma they are experiencing. Nurses will get through this but only if we support each other. Together we are resilient.
Foli, K. (2019, November 12). Nurse-specific trauma: Let’s give it a name. Nursology. https://nursology.net/2019/11/12/nurse-specific-trauma-lets-give-it-a-name/
Foli, K. J. & Thompson, J. R. (2019). The influence of psychological trauma in nursing. Indianapolis, Indiana: Sigma.
About Catherine Quay
I am a doctoral student at Teacher’s College, Columbia and am currently taking a course with Jane Dickinson. We have been spending time exploring this site as part our class. Thank you for your insight and for providing us with many discussion topics. I hope you and your family are staying safe.
2 thoughts on “Nurse Trauma in the Face of COVID-19”
Thank you, Catherine, for this wonderful post. I appreciate the application of my theory to the traumatic conditions facing so many nurses during the pandemic. One point to note might be that so many of these traumas were faced by nurses even prior to COVID-19. For example, insufficient resource trauma has been experienced by nurses for many years, and despite overwhelming evidence to support safe staffing levels. If I had to guess, nurses resources began to diminish when DRGs made their way into accounting spreadsheets in the mid-1980s. Still this horrible virus has made nurses face ethically-challenging situations and experience psychological injuries at an unprecedented rate.
Thank you again, Karen Foli
I agree, Dr. Foli. The current pandemic presents nurses and health care professionals with an opportunity to be heard on the topics of not only working with insufficient resources, which, as you noted has been ongoing for many years, but also the toll that it takes on a nurse’s psychological well being. Thank you for recognizing the multi-factorial nature of nurse trauma in your theory and for your continued discussion of this topic. – Cathy Quay