May is Mental Health Awareness Month, and research indicates that the United States is in the midst of a serious mental health crisis. In 2020, nearly 21% of adults experienced a mental illness. That’s equivalent to over 50 million people, with multiracial Americans at the highest risk, according to studies by the Centers for Disease Control and Prevention (CDC). But as the National Institutes of Health (NIH) reported, there exists a “rarely acknowledged mental health crisis in the nursing profession: an epidemic of deaths of despair from suicide, drug overdose, and depression. Nurses experience problematic rates of depression, anxiety, substance use disorders, post-traumatic stress disorder, and burnout.” If the nation’s caregivers are suffering, it’s critical that their employers understand the reasons and find ways to help. And there are steps we can take.

The Under Acknowledged Mental Health Crisis in Nursing 

Job Stress and Burnout

The rate of self-reported burnout from nurses has increased 350% since the summer of 2020 (American Nurses Foundation, 2021). An American Nurses Foundation (ANF) survey of 4,912 nurses reported that 35% of nurses admitted they were not emotionally healthy while 42% indicated that they’ve experienced varying degrees of trauma. 

Even before the outbreak of COVID-19, which exacerbated the stress nurses typically endured as part of their work, the demands placed on America’s caregivers were already tremendous. Nursing requires physically and emotionally exhausting work that changes over time and across settings. Persistent levels of energy expenditure on the job contribute to burnout, moral distress, and a host of serious psychological consequences. 

In fact, half of all nurses (50%) who expressed plans to retire early or leave the field entirely cited personal mental health, burnout, moral distress, staffing issues, and system-related issues such as being unable to provide quality care due to pressures from administrators or insurers to reduce costs as reasons (Fumis et al., 2017; Ohue et al., 2021; Petrișor et al., 2021; Shah et al., 2021).

Assaults and Bullying

Job stress isn’t the only significant factor. As the NIH explained, violence and bullying are prevalent but seldom disclosed problems: “Bullying and incivility have become ingrained in the profession and are often seen as a ‘rite of passage’ in the field (Crawford et al., 2019; Edmondson & Zelonka, 2019). Violence in the health care field is a pervasive and underreported problem worldwide and the pandemic has highlighted its greater prevalence in the nursing workplace (ANA, 2015a, 2017; Crawford et al., 2019; Teo et al., 2021). Bullying, lateral violence, incivility, prevalent in nursing environments contribute to compassion fatigue and burnout, augmenting nurses’ feelings of depression, unhappiness, and loneliness (Crawford et al., 2019; Eka & Chambers, 2019; Melnyk et al., 2020; Park & Kang, 2020; Stalter et al., 2019).”

The abuse spreads far beyond the cloistered walls of hospitals. Where nurses were once revered as healthcare heroes, the politicization of the pandemic turned members of the public against healthcare professionals. Misinformation from political leaders, anti-vaccine and anti-mask movements, and unfounded conspiracy theories in the media turned people against those sworn to protect them. According to the American Nurses Association, 1 out of 4 nurses is assaulted on the job as a result. 

• Doctors and nurses at a Coeur d’Alene, Idaho, hospital were accused of killing patients by grieving family members who don’t believe COVID-19 is real.
• Hundreds of healthcare workers treating COVID patients around the world have experienced verbal, physical, and sometimes life-threatening attacks during the pandemic, prompting calls for immediate action from human rights campaigners.
• Mary Turner, president of the Minnesota Nurses Association, confessed, “I’ve heard stories of nurses here, in certain communities, getting garbage thrown at them in the grocery stores. I’ve heard nurses having to put up with the public saying to them, ‘You nurses have got to do better,’” she said. “At one hospital, we’ve had three suicides among the nurses.”
• A Canadian nurse was punched repeatedly by a man because his wife received the COVID vaccine without his knowledge. 

The increased hostility has made a difficult job even harder. 

Stigma

We’ve talked about the challenges facing nurses and that, in large part, they haven’t been widely acknowledged. So why is that? As the NIH noted, “The psychological burden derived from a career in nursing is often compounded by ongoing stigma and punitive regulatory measures that prevent nurses from acknowledging mistakes and seeking treatment for mental health and substance use disorders (Choflet et al., 2021, Kunyk, 2015).”

“Stigma as a primary driver of suicide stems from fear that seeking MH or substance use disorder treatment may have a negative effect on the ability to renew or retain nursing licenses or credentials; feeling judged, unsupported, or perceived as weak; or concerns about confidentiality (AHA, 2022),” the NIH continued. “Stigma is a complex dynamic that negatively undermines MH help-seeking behaviors and workplace environments (Knaak et al., 2014) . For a nurse, stigma may mean not being accepted by society, fear of exposure, limits on career advancement, and potential for loss of licensure if one seeks care. Stigma can inhibit disclosure and is additionally a barrier for nurses accessing resources.”

How Can Staffing Agencies Help Support Their Nurses

Healthcare staffing companies play a crucial role in supporting the mental health and wellness of their travel nurses. Here are some steps they can take and innovative approaches they can implement.

Education and Training

Offer comprehensive training programs and resources to travel nurses on mental health awareness, stress management, resilience building, and self-care techniques. This can include webinars, workshops, and online courses that provide practical strategies for maintaining mental well-being.

Comprehensive Benefits Packages

This includes health insurance, dental insurance, vision insurance, life insurance, and disability insurance. It is also important to offer travel nurses access to mental health resources, such as therapy and counseling.

Mental Health Support Services

Establish partnerships with mental health professionals or counseling services to provide travel nurses with access to confidential counseling and therapy sessions. Offer employee assistance programs (EAPs) that provide confidential counseling and referral services to help nurses address personal and work-related challenges.

Peer Support Networks

Facilitate the creation of peer support networks where travel nurses can connect with and support each other. This can be done through online forums, social media groups, or in-person gatherings. Encouraging a sense of community and belonging can help combat feelings of isolation.

Wellness Programs

Develop wellness programs tailored to travel nurses, such as yoga or mindfulness sessions, virtual fitness challenges, nutrition counseling, and meditation workshops. These programs can be offered online or in collaboration with local wellness providers in different assignment locations.

Flexible Scheduling and Workload Management

Strive to provide travel nurses with manageable workloads and consider implementing flexible scheduling options. Striking a balance between work and personal life is crucial for mental well-being, so allowing nurses to have control over their schedules and providing adequate time off can help prevent burnout.

Pre-Assignment Preparation

Offer comprehensive pre-assignment orientations that include information about the local culture, healthcare system, and available support services. Preparing nurses for the unique challenges they may face during travel assignments can help alleviate stress and anxiety.

Regular Check-Ins and Surveys

Maintain open lines of communication with travel nurses and conduct regular check-ins to assess their wellbeing. Use surveys or anonymous feedback mechanisms to gather insights into their experiences, challenges, and suggestions for improvement.

Innovative Technology Solutions

Leverage technology to provide mental health resources and support remotely. This can include mobile apps for stress reduction, meditation, or sleep management. Emerging virtual reality (VR) programs have been successful at promoting relaxation and reducing stress.

Recognition and Rewards

Recognize and appreciate the hard work of travel nurses through various means, such as performance-based incentives, awards, and public acknowledgments. Feeling valued and appreciated can positively impact mental well-being.

Continuous Improvement and Adaptation

Regularly review and update mental health and wellness initiatives based on feedback and evolving needs. Stay up to date with the latest research and best practices to ensure the programs remain effective and relevant.

Creating a Supportive Work Environment

This means fostering a culture of respect, trust, and collaboration. It also means providing travel nurses with the resources they need to do their jobs effectively. When talent feel valued, respected, and trusted, they become deeply invested in their assignments and the overall mission. More than that, they evangelize the organizations they support, which leads to measurable increases in quality, output and the promotion of a superior employment brand. Establishing this relationship is the foundation of everything. Advocate for your staff, be present when they have concerns, listen when they need an ear, and do what you can, within your power, to help them solve challenges on the job.

Wellness Is an Investment with Big Returns

A study by the Harvard Business Review (HBR) found that employee wellness programs can save companies an average of $3.27 for every dollar spent. The study discovered that these programs can help to reduce healthcare costs by up to 10%, absenteeism by up to 5%, and turnover by up to 7%.

More importantly, employee wellness programs improve morale and productivity. A study by the American Psychological Association found that employees who participate in wellness programs are more likely to be engaged in their work and to report higher levels of job satisfaction.

“Healthy employees stay with your company,” HBR wrote. “A study by Towers Watson and the National Business Group on Health shows that organizations with highly effective wellness programs report significantly lower voluntary attrition than do those whose programs have low effectiveness (9% vs. 15%). At the software firm SAS Institute, voluntary turnover is just 4%, thanks in part to such a program; at the Biltmore tourism enterprise, the rate was 9%.”

Caring for Our Caregivers

It's essential for healthcare staffing companies to prioritize the mental health and wellbeing of their nurses. A commitment to the health of our people supports their overall quality of life but also enhances their job satisfaction and performance. Travel nurses may be far from home, but their recruiters and staffing advocates should always be by their side. They’re part of your community, and their jobs truly begin the minute they land in a new city. Be there for them by text, phone, and email 24/7, when they need support or just a friendly ear to listen.

‍Photo by Melissa Askew on Unsplash