A recent survey of nurses finds that while nurses are taking on more leadership responsibilities during the pandemic, they still fall behind in the respect gap with physicians and patients.
As COVID-19 cases and hospitalizations continue to surge, nurses continue to step up and take on leadership roles. However, recent survey data suggests that there's still progress to be made with nurses being recognized as leaders during the pandemic.
A survey of 300 full-time nurses conducted by The Harris Poll on behalf of University of Phoenix between July 30 and August 11 found that 73% said that they had taken on more leadership responsibility since the beginning of the pandemic. Further, 78% reported feeling like other staff members looked to them as leaders.
For example, nurses at Providence Health Care in Vancouver took on more responsibility for appropriate personal protective equipment use, says Agnes T. Black, RN, MPH, director of health services and clinical research and knowledge translation.
Despite a majority (61%) of respondents who reported that they thought their opinions were valued more by colleagues since the pandemic began, even more (84%) would like nurses to have a stronger leadership role. In fact, 55% of respondents said they thought their voices weren't really being heard during the pandemic. Additionally, 41% said no one has taken their opinions/concerns seriously.
"It is always important to listen to the voices of nurses," says Black. "Nurses are the most numerous of the healthcare professions, and most of them are right at the point of care, so they see and hear and can interpret the feelings and experiences of the patients, other nurses, and other members of the healthcare team. Listening to nurses is like putting your finger on the pulse of healthcare itself."
Part of the issue with being taken seriously may be how others perceive the nurse role. Nearly two-thirds (65%) of respondents believed there was a respect gap in how their employers viewed nurses and physicians. This was despite the fact that most believed their employer treated them fairly (80%) and cared about their employees (77%).
Further, many nurses (63%) felt that physicians did not respect nurses as much as they respected other physicians. Similarly, three-quarters of nurses believe a respect gap exists between how patients viewed nurses and physicians.
To stand out as leaders during the pandemic, Black says nurses need to continue being more vocal, and adds, "[Nurses] are smart and capable and have important information to contribute, but too often they allow their voices to be silent. When nurses speak up, patient safety increases, health equity increases, collegial relationships are stronger, and the healthcare system improves."
Beyond how they felt they were perceived by others, survey respondents were also asked how COVID-19 had affected their day-to-day work experiences. Since the pandemic began, 22% of nurses said their work-life balance has improved even though 31% said their work hours have increased. Survey respondents reported working 42 hours per week on average.
While the primary reason for the increase in hours was due to the influx in COVID-19 patients (78%), 37% reported working more to make up for other staff members who had their hours cut or were furloughed or reassigned. Likewise, 28% cited other staff members quitting as the reason for their increase in hours. Additionally, 8% said they traveled to other areas hit hard by COVID-19 to help.
Non-COVID-19 patients also contributed to the increase in work hours: 36% of survey respondents cited an overflow of patients coming from other hospitals as reasons for their increase in hours.
Twenty-one percent of survey respondents reported their work hours decreased during the pandemic. More than half of them (54%) expressed concerns with their job security although only 15% reported that their employers were struggling financially.
Of the nurses working reduced hours, the most cited reason for working fewer hours was fewer patients willing to come into the hospital/office (65%). These nurses also cited fewer scheduled elective surgeries/traumas (42%) and their physical location either being closed or seeing few patients (36%) as the reasons for working less.
Beyond the number of hours worked, the surveyed nurses report that other aspects of their jobs have changed. For example, nearly half (49%) of surveyed nurses reported that their job duties and responsibilities have changed since the beginning of the pandemic. Nurses also reported changes in the type of patients seen (39%), work settings (37%), salary/hourly wage (13%), and job title (3%).
Despite these changes, 52% of nurses said they had the same amount of career options as before the pandemic. For the rest of the respondents, 28% felt as though they have fewer options and 20% felt they have more career options. Regardless of career options, 58% of nurses believed they have become better professionals in the industry and better team members to their colleagues.
In general, 55% believed they have become better human beings since the pandemic began. More specifically, 39% thought they had been better spouses/partners/significant others, 39% better friends, and 27% better parents.
Despite the extraordinary circumstances they find themselves in, most of the surveyed nurses report liking their jobs (90%) and being satisfied (88%). Moreover, most nurses recognized that their jobs are more important than ever (87%) and, if they could go back, they would still choose to be in the profession (86%). This explains why 99% were proud of the work they did, and 96% said nursing is their calling, not just a job.
Despite the demands put on nurses during the pandemic, 52% rate their current physical health as "excellent or very good." And although 45% rate their emotional/mental health as "excellent or very good," they also reported feeling exhausted (65%), fearful (49%), underappreciated (36%), depressed (30%), expendable (24%), and underutilized (8%). This may explain why 58% of nurses said their mental/emotional health has become worse since the start of the pandemic, compared to 31% who reported their mental/emotional health had stayed the same.
Additionally, 78% of respondents said that the pandemic was the most challenging time in their careers, with risk of exposure to COVID-19 being their biggest concern (88%), followed by their organization's ability to keep up with a surge of COVID-19 patients.
Editor's note: This was updated on November 10 with comments from Agnes T. Black, RN, MPH.
While feeling valued and looked to as leaders, many nurses report feeling like their opinions and concerns are not taken seriously.
Despite the demands put on nurses during the pandemic, they like their jobs and were proud of their work.