4 Behavioral Health Resources for Nurses

May is mental health awareness month. Here is a roundup of four HealthLeaders articles to raise awareness of behavioral health issues affecting nurses. 
 

In a given year, 43.8 million adults experience mental illness, according to the National Alliance on Mental Illness, and mental illness will affect one in five adults in their lifetime. Healthcare professionals are not immune from experiencing issues such as depression, anxiety, burnout, and suicide. In fact, they may have higher rates of behavioral health issues than the overall public.

For example, a 2007 National Academy of Medicine discussion paper shares some grim statistics:

• Thirty-five percent (68,000) of hospital nurses have a high degree of emotional exhaustion.
   
• In a study of 1,171 inpatient RNs, 18% had depression compared with 9% of the national population.

With May being Mental Health Awareness month, here are four HealthLeaders articles to raise awareness of behavioral health issues affecting nurses.  

1. Nurse Suicide Is Real. Don't Ignore It.
 

Suicide rates are rising in every state, and in 2016 nearly 45,000 Americans age 10 or older died by suicide, according to data from the Centers for Disease Control and Prevention. While it's estimated between 300 to 400 physicians die from suicide in the U.S. each year, the same type of national data on nurse suicide rates is lacking, says Judy E. Davidson, DNP, RN, FCCM, FAAN, a nurse scientist at UC San Diego Health.  

However, that lack of data doesn't mean nurse suicide isn't an issue.

"We had nurse suicides in our own workforce and when we started talking to people, we found that many knew someone who had a nurse suicide in their organization. So, it wasn’t just us," she says. "It really brings up the concrete message that we cannot hide this. The more we talk about it the more lives we can save."

In the article, Davidson outlines three actions nurse leaders can take to prevent nurse suicide. These include offering confidential suicide screening, providing behavioral health referrals, and knowing the risk factors for suicide. 
 

2. Nurse Resilience and Burnout Vary by Generation
 

Despite all the talk about burnout in healthcare, its rates among nurses still remain high. According to a 2017 Kronos survey of RNs employed in hospitals, 63% report experiencing burnout.

To make progress in reducing burnout, healthcare leaders must delve into its many layers to find solutions that work for their specific organizations and nurses.

The Press Ganey report, "Performance Insights: Resilience for a Multigenerational Nursing Workforce," teases out some of the variables of burnout, and its "antidote" resilience.

By analyzing engagement data to measure the key components of nurse resilience, the researchers found resilience varies according to nurse demographics such as generation, role, and shift.

Among the findings:

• Millennial nurses working the night shift have an even further activation (i.e., the degree of respondents' engagement with work) disadvantage
   
• Nurse managers have better activation than non-managers 
   
• Non-managers have a greater ability to decompress than managers
   

3. The High-Cost of Nurse Bullying

Caring is the cornerstone of the nursing profession. Yet, nurses are often on the receiving end of uncaring behavior.

Over 50% of 3,765 nurses and nursing students experienced ver­bal abuse in a 12-month period, according to the 2014 American Nurses Association Health Risk Appraisal survey.

Interestingly, bullying's effects cause damage beyond the victim. A December 2018 study in the Journal of Occupational and Environmental Medicine found workplace bullying increases employees' psychological distress and intent to leave their job—even for workers who aren't personally being bullied.

When the results were adjusted for bullying on the business division and department levels, researchers found division-level bullying had a greater impact on both psychological distress and intention to leave, compared to individual exposure to bullying.

Another study in the same journal found that non-bullied coworkers in work units where bullying was reported, had 15%—22% more long-term sickness absences than employees in work units without bullying.
 

4. Reduce Disruptive Nurse-to-Nurse Behavior With These Strategies
 

As many nurses sadly know, bullying, incivility, and disruptive behaviors among nurses are prevalent in the healthcare work environment. In fact, the released a in 2015 calling for nurses to "create an ethical environment and culture of civility and kindness, treating colleagues, co-workers, employees, students, and others with dignity and respect."

How can this be achieved?

For starters, nurse manager visibility is key. Being present on the unit, especially at shift change, can help identify disruptive behaviors, says Kathleen Bartholomew, RN, MN, author of . Also, addressing disruptive behavior as a team helps individuals feel supported by management.

"[Managers] need to watch for the non-verbal [clues], such as raising eyebrows, making faces, etc., and make it about ALL of us as a team instead of an individual issue," she says.

For Jenny Shrapnel, BSN, PICU manager at in San Diego, a series of disruptive behaviors and low employee engagement scores on her unit indicated it was time to reevaluate how to effectively address these issues.

Shrapnel had the nursing team undergo personality testing to help them understand the strengths and weaknesses of each personality type present on the team. The goal was to help team members gauge how receptive another person would be to a difficult conversation and how to address individuals based on their personality type, Shrapnel explains.

The team members also used role-playing to practice positive communication among nurses. In addition, Shrapnel distributed handouts to help nurses brainstorm how to respond in a positive way during difficult conversations or conflicts with other nurses.