Consequences of the COVID-19 Pandemic on Nurses

Only 15% of surveyed hospital-employed nurses plan to stay in their current position in the next year.

The flow of RNs away from hospital employment may be the most damaging healthcare workplace impact of the COVID-19 pandemic, a new study says, and the devastating flow appears to continue.

Only 15% of hospital-employed nurses in the 2023 Survey of Registered Nurses by AMN Healthcare planned to continue working in their current position in the next year, according to the survey. The other 85% are considering taking their nursing skills to a new place of employment, working as travel nurses, part-time or per diem; taking a job outside of direct patient care; returning to school; or leaving nursing altogether.

The survey polled more than 18,000 RNs nationally—69% of whom work in a hospital setting—about career and job satisfaction, mental health and well-being, and nurse shortages. AMN then compared responses based on demographic, historical, and other data criteria.

Findings include:

• Only 15% of nurses employed in hospitals say they will “continue working as I am” in one year.
• 36% of hospital nurses say they will continue working as nurses but seek a new place of employment.
• For nurses in all employment settings, 40% said they will “continue working as I am” in one year, which represents a 5-percentage-point drop since 2021 in the middle of the pandemic.
• 30% of nurses say they are likely to leave their career due to the pandemic, up 7 points since 2021.
• Among surveyed nurses eligible to retire, 18% say it is likely they will retire from nursing due to the pandemic.
• More than half of nurses eligible to retire will do so three or more years from now (57%).

Career satisfaction

Nurses’ career satisfaction and related factors declined significantly since AMS’s 2021 RN Survey, which was conducted in the middle of the pandemic.

For example, nurse career satisfaction has been at 80-85% for a decade; in 2023, it dropped to 71%, the study says.

Nurses with more than five years of experience had higher career satisfactions levels (72%) than nurses with less than five years of experience (64%), comparison data showed. Younger generations are less satisfied with their nursing careers (Baby Boomer 78%, Gen X 73%, Millennials 63%, Gen Z 62%). Nurses eligible to retire now are more satisfied (84%) than those who are not (68%).

The percentage of nurses satisfied with the quality of care they provide at their current job decreased 11 points from 2021, from 75% to 64% in 2023, the study notes.

Just one-third of nurses (33%) say they have ideal time to spend with patients, a 10-point decrease from 2021 at 43%.

Younger generations of nurses are less satisfied with the quality of care they provide compared to their generational counterparts:

• Baby Boomer:  74%
• Gen X: 64%
• Millennial: 58%
• Gen Z: 59%

Nurses who are satisfied with their career show greater job retention, as 73% will continue to work at same facility in next 12 months compared to 62% for all nurses, the study says. The likelihood of nurses who are dissatisfied with their careers continuing to work at the same facility in one year is 32%.

The likelihood of encouraging others to become a nurse is down 14 points from 2021, according to the study, and compared to older nurses, younger nurses are significantly less satisfied with their careers and jobs and are less likely to encourage others to become nurses. However, nurses who respond positively about ideal time with patients and quality of care they provide also have higher career and job satisfaction and are more likely to encourage others to become a nurse, the study says.

Mental health and well-being

Nurses indicated, not surprisingly, that mental health and well-being problems have dramatically increased since the middle of the pandemic and from the 2021 RN Survey.

Nurses who strongly and somewhat agreed that they often feel emotionally drained rose 15 percentage points (62% to 77%), worry that their job is affecting their health rose 19 points (51% to 70%), feeling misunderstood or underappreciated at work rose 20 points (38% to 58%), and often feeling like quitting rose 16 points (39% to 55%).

Most nurses actively work to alleviate their stress, with 65% accessing resources or participating in activities to address their mental health and well-being at least once a week. However, 35% never address mental health and well-being, the survey indicates.

Slightly more than one-fourth of nurses (26%) say their employer supports a culture of wellness a great deal or a lot, which is down from 34% in 2021. Nearly one-half (46%) say their employer supports a culture of wellness a little or not at all.

Finding solutions

Surveyed nurses offered strategies that organizations can implement to reduce stress among nurses. The top five ways are statistically almost equal:

1. Increase support staff (90%)
2. Reduce patients per nurse (89%)
3. Increase salaries (87%)
4. More nurse input into decision-making (86%)
5. Create safer working environment (86%)

Taking these steps is imperative to improving the conditions in which nurses work, the study emphasizes.

“Nurses must flourish as the North Star of healthcare,” it notes. “From our current workforce crisis, we need to develop a unified, collaborative effort, led by nurses ourselves and supported by our allies in multiple sectors of society, to reduce stress and moral injury for nurses through systemic, professional, and personal changes. Uplifting nurses needs to become a national call to action.”