Pandemic Year 1: Survey Reveals the State of Nurses

Nurses who say they're quitting cite well-being and insufficient staffing as reasons.

Marking today's one-year anniversary since the World Health Organization declared COVID-19 a global pandemic, the American Nurses Foundation, philanthropic arm of the American Nurses Association (ANA), has released a new survey of 22,000 nurses about their experiences in the past year.

The Pulse on the Nation's Nurses COVID-19 Survey Series: Year One COVID-19 Impact Assessment, held from January 19 to February 16, 2021, covered topics currently facing the nursing profession, including mental health, vaccines, Personal Protective Equipment (PPE), financial impact, and work environment.

"This pandemic has illuminated nurses' critical role in health and our economy," said Kate Judge, the foundation's executive director, in a press release. "Through these surveys, we're able to better understand what our nation's frontline providers need to continue caring for patients and our communities—and provide solutions."

Among the findings:

Mental Health

Early-career nurses under age 34 reported the most mental toll, with 81% reporting feeling exhausted, 71% feeling overwhelmed, 65% being anxious or unable to relax, and 47% feeling sad. Nurses 55 and older reported some mental distress, but less than half reported feeling exhausted (47%), overwhelmed (37%), sad (31%), or anxious or unable to relax (30%).

"Nurses' sustained exhaustion, stress, and depression is a hit to their overall well-being and also takes a toll on our health system," Judge said. "This is especially so when you look at the disproportionate impact the pandemic is having on nurses who are early in their careers. As the future of our nursing profession, it is critical we give Millennials and Gen Z nurses the tools and time to recover and rebuild."

Vaccines

While 70% of the nurses surveyed have received the COVID-19 vaccine, hesitancy still exists. Of the 30% of nurses surveyed who have not been vaccinated, nearly half (46%) identify as Black or African American. About one-fourth of surveyed nurses reported they are undecided about receiving the vaccine, with reasons including being fearful of short- or long-term side effects and not having enough information about the vaccines.

Personal Protective Equipment

Only 73%, report they currently have adequate PPE. They also report continued issues related to PPE, with 33% of nurses reporting that their practice site does not communicate the status of PPE inventory to clinicians and staff.

Financial Impact

Family finances and debt is a top concern among surveyed nurses, with 41% reporting this as an issue they worry about outside of work. Nearly 20% say they are financially worse off now than prior to the COVID-19 outbreak. The foundation has addressed this problem, providing $2.6 million in financial aid to more than 2,000 nurses across 45 states since the start of the pandemic.

State of the Profession

Despite the adversity COVID-19 has caused, most nurses report they do not intend to leave the profession (85%) or their current position (60%). Among nurses who indicated they do intend to leave their current position, top reasons included work negatively affecting their health and well-being (47%) and insufficient staffing (45%).

"Prior to the pandemic, we faced a worldwide nursing shortage, and a need to fill more than one million nursing positions in the U.S. by 2022 to avoid a further shortage," said Judge. "Nurses' well-being and mental health—especially among Millennials and Gen Z—are of the upmost importance, and we will do all we can to ensure they receive the help they need."