New Study by the Emergency Nurses Association Analyzes Traumatic Stress in Near Real-Time

By studying the Tweets of healthcare workers, new research reveals COVID-related traumatic stress as it unfolded.

U.S. healthcare workers experienced high stress levels due to lack of personal protective equipment (PPE) in the COVID-19 pandemic's first three months, according to an unprecedented study by the Emergency Nurses Association that measured traumatic stress of Twitter users as it happened.

The Impact of the Coronavirus Pandemic on US Healthcare Workers: A Discursive Analysis of Frontline Secondary Traumatic Stress Using Twitter Data examined tweets posted using the hashtags #getmePPE and #getusPPE to explore levels of traumatic stress in the group of people using these hashtags.

Those hashtags started in March 2020 at the beginning of the COVID-19 pandemic in response to a lack of availability of adequate PPE for nurses and physicians on the front lines. A group of clinicians initially created the hashtags as an online petition drive and within a few days, their efforts expanded into a platform for social action that grew to thousands of participants, according to the study.

The study used the availability of PPE as lens to understand the physical and psychological dangers that frontline healthcare workers were feeling.

"In both methodology and in philosophical approach, this is a new type of study for the ENA research team and emergency nursing," Lisa Wolf, PhD, RN, CEN, FAEN, FAAN, lead researcher and director of ENA's Institute for Emergency Nursing Research said in a press release.

One thousand Tweets were randomly selected from a dataset of 443,918 Tweets published by 281,021 unique authors between March 1 and June 30, 2020. In addition to stress levels surrounding PPE, other Tweet topics included fear of illness, concern over the rapid pace of COVID-19 spread, and frustration about being called heroes.

The study tracks the beginning of the hashtag #GetMePPE on Twitter to stimulate stories about shortages of hospital equipment. Early Tweets indicate alarm and panic about the growing pandemic situation in Italy, with warnings to the public.

"The fear (alarm) about the lack of PPE throughout these tweets confirms and reinforces the reality of equipment shortages, and a growing collective conversational outrage from emergency care providers," the study says.

Within days, the #GetMePPE online petition was live and by March 22 there were signatures from hundreds of thousands of healthcare workers demanding the government ensure an adequate supply of PPE, the research says.

As the death toll rises, particularly in New York City, the Twitter conversations move from observations of conditions to more cries for help.

"I feel like we're all just being sent to slaughter," Tweeted a New York City nurse who had contracted the coronavirus.

By late April, the reality of the pandemic is situated within a larger conversation about government response, the study says.

"The findings of this study are illuminating in its message intensity and consistency," Wolf said, "and we hope this study illuminates the need to examine and address the psychological impact of COVID-19 on the future of the U.S. healthcare workforce.