Nurses who binge-drink also multiply their risk for COVID.
Nurses who work the night shift or binge drink may double their risk of COVID-19 infection, according to a study that set out to determine why many first responders develop severe COVID despite not having associated risk factors such as obesity, diabetes, and hypertension.
The report, published in Alcohol: Clinical and Experimental Research, indicates that both night shift work—causing circadian misalignment—and alcohol misuse have been shown to affect sleep and promote inflammation in the body, which has been linked to COVID severity.
“Understanding the mechanisms underlying these risk factors could help to mitigate the impact of COVID-19 on our at-risk healthcare workforce,” according to the report.
Both disruption of circadian rhythms and unhealthy alcohol use decrease resiliency to several inflammatory disorders including respiratory infection/pneumonia and acute respiratory distress syndrome—two features of severe COVID-19—the report says.
Data was gathered from American Nurses Association members who were surveyed about alcohol use, sleep patterns, experience with COVID infection and chronotype, or whether the nurse was a “night owl” or “morning person.”
Findings included:
Unhealthy alcohol use was associated with poor sleep quality.
Nurses with high-risk features for alcohol misuse and binge drinking were both more likely to work the night shift.
Night shift work and binge drinking were associated with an increased rate of COVID-19 infection.
Shift work, binge alcohol use, and high-risk features of alcohol misuse by LCA were associated with a later chronotype.
Of the 750 nurses included in the study, 25% met the criteria for alcohol misuse. The U.S. Centers for Disease Control and Prevention defines alcohol misuse as more than one drink per day on average or four or more drinks on one occasion in a month for women and men, more than two drinks per day, or drinking five or more drinks on one occasion.
Those nurses tended to be younger, were more likely to be white, and reported poorer sleep and greater stress, anger, or worry prior to sleeping, the study reveals.
To improve health outcomes in night shift workers, the report’s authors recommended further study into the mechanisms of alcohol and circadian misalignment.
The funding will help recruit and train the next generation of nurses for 'the most rewarding career imaginable.'
Atlantic Health System (AHS), based in Morristown, New Jersey, is poised to expand and diversify its pipeline of nurses by about 2,000 nursing jobs thanks to a $2.75 million Nursing Expansion Grant it is receiving from the U.S. Department of Labor.
The money will help establish Atlantic Health System’s Pathway to Ensuring Access and Clinical Excellence in Nursing (AHS PEACE), which will create professional pathways for RNs in acute care and critical care specialties, as well as clinical pathways for nursing assistants. Candidates from historically marginalized and underrepresented populations will be included in these positions, according to AHS.
AHS PEACE will support the creation of about 2,000 nursing jobs through the recruitment of graduating high school students, college-level undergraduates, and entry-level incumbent healthcare workers. The program will create partnerships with area colleges and universities, workforce development agencies, and non-profits.
The grant is one of 25 totaling more than $78 million that the labor department recently awarded to nursing programs in 17 states to address critical staffing challenges and to strengthen and diversify the workforce.
“Nurses make up the single, largest group of professional team members at Atlantic Health System and are essential members of the care continuum across all of healthcare,” said Trish O’Keefe PhD, RN, senior vice president, chief nurse executive, Atlantic Health System and president of Morristown Medical Center.
“Nurses have always served on the front lines of care, as a patient’s most direct connection to needed healthcare services,” O’Keefe said. “This program … will help Atlantic Health bolster those front lines while welcoming hundreds of new healthcare workers to the most rewarding career imaginable.”
AHS, a not-for-profit system, offers more than 400 sites of care in New Jersey, Pennsylvania, and the New York metropolitan area, including its seven hospitals.
Dickison, who has served as NCSBN’s chief operating officer (COO) since 2017, will assume his new duties from retiring CEO David Benton on Oct. 1, 2023. Prior to his appointment as COO, he served NCSBN chief officer, examinations, for seven years.
Philip Dickison, PhD, RN / Photo courtesy of NCSBN
The NGN, launched just weeks ago and more than a decade in the making, is an enhancement of the prevailing NCLEX, using real-world case studies to measure a nurse's ability to think more critically and make the right decisions.
At the core of this enhanced exam is the NCSBN Clinical Judgment Measurement Model (NCJMM), developed by Dickison and other NCSBN researchers as a framework for the measurement of clinical judgment and decision-making within the context of a standardized examination.
“Because clinical judgment underlies almost all of a nurse’s activities, it is of paramount importance to NCSBN,” Dickison said when NGN was launched. “We need to be able to measure it effectively to safeguard public protection. We need to help ensure that when a regulatory body licenses a nurse to practice, they are safe to care for you and your loved ones.”
Dickison’s profound knowledge and experience in testing have made him a renowned leader in the world of psychometrics and an in-demand speaker on the subject. He has been active in the certification and licensure community for more than 30 years.
“Although we conducted a global search, it was Philip’s wide-ranging expertise, experience, and passion for public protection that clearly rose to the top,” said Jay Douglas, MSM, RN, CSAC, FRE, president of the NCSBN board of directors. “We are confident he is the right person at the right time for our organization and excited to see how his vision and leadership will further our past successes and advance the innovative work we are currently undertaking.”
The grant also is focused on providing diverse nursing instructors.
A $2.7 million grant to Southwest Adventist University (SWAU) is part of the latest efforts to amplify not only the numbers of nurse educators over the next five years, but of a diverse nursing faculty.
SWAU, in Keene, Texas, will use the grant—Promoting Postbaccalaureate Opportunities for Hispanic Americans Program (PPOHA)—to develop a Master of Science in Nursing Education program to be offered in a completely online format, scholarships for the first cohorts of nursing educators, and a $250,000 Nursing Educator Endowment to support future generations of nursing educators.
The proposed program is specifically designed to prepare educators for post-secondary teaching positions in community colleges and universities that offer nursing programs, particularly in areas where there is a striking disparity between the demographics of the population and the demographics of current nursing faculty.
The PPOHA program, through the U.S. Department of Education, provides grants to expand postbaccalaureate educational opportunities for Hispanic students and expand postbaccalaureate academic offerings in colleges and universities that are helping large numbers of Hispanic and low-income students complete postsecondary degrees.
The need for more nursing faculty is considerable. Nursing schools had to turn away more than 78,000 qualified applications in 2022 alone due to lack of faculty and training sites, according to the American Association of Colleges of Nursing (AACN). Even more concerning, 10,000 applications were turned away from graduate programs, further limiting the pool of potential nurse educators, according to AACN.
SWAU’s grant is among several being awarded with the specific intent to expand nursing programs and faculty. The U.S. Department of Labor recently awarded 25 grants totaling more than $78 million to nursing programs in 17 states, most of which went to colleges and universities to strengthen and diversify the workforce.
“We are excited about this opportunity to expand what we offer and provide this education program through SWAU,” project director Terri Gibson, DNP, said. “We know that patients need compassionate nurses, and quality educators and programs are needed to make this key nurse role more available.”
NTI annually brings together thousands of nurses and other healthcare professionals who care for acutely and critically ill patients and their families. This year, the in-person convention is being held May 22-24 in Philadelphia, with the theme “Starting Now.”
“So, starting now, we’re taking bold steps toward implementing AACN’s HWE standards,” said Bettencourt, also an assistant professor in the Department of Family and Community Health at University of Pennsylvania School of Nursing. “One step will focus on implementing the standards in individual units. The other step focuses on them in hospitals.”
AACN’s HWE standards consist of six pillars:
Appropriate staffing
Authentic leadership
Skilled communication
True collaboration
Effective decision-making
Meaningful recognition
Nurses in AACN’s Clinical Scene Investigator (CSI) Academy have already been making changes that contribute to creating a healthy work environment, Bettencourt said.
Change projects from the CSI program have resulted in significantly improved outcomes such as reduced CLABSIs, CAUTIs, and falls, along with an estimated $84 million in hospital savings, she told attendees.
“This fall, AACN will start to roll out 60 nurse-driven CSI teams to develop change projects focused specifically on unit-based HWE standards implementation,” Bettencourt said. “Several months after that, we have envisioned a multi-site project that will connect 45 hospitals across the country to study how zeroing in on the health of the work environment impacts the patient journey across the continuum of care—including outcomes for patients, nurses, and the organization.”
Next year is NTI’s 50th anniversary, Bettencourt noted.
“What do we want our ancestors to say about us in another 50 years, when they reflect on how critical care nurses took on one of the most difficult times, one of the greatest challenges in the history of healthcare?” she said.
“I’ve been quoted by several media outlets when I said our healthcare system is being brought to its knees. Because it is,” she said. “We can either surrender to that narrative, or we can start to change it—starting now.”
Bettencourt’s comments kicked off three days of learning in such formats as more than 200 educational sessions, supersessions featuring motivational keynote speakers and AANC leaders, online pharmacology classroom sessions, posters, and exhibitors.
NTI also includes the Critical Care Exposition, the largest and most comprehensive trade show expressly for progressive and critical care nurses.
With new structure, OU Health aims to become Oklahoma’s 'employer of choice.'
OU Health in Oklahoma City is redesigning its human resources structure to build a culture of excellence with the goal to become Oklahoma’s “employer of choice.”
Key strategies in the multi-year HR roadmap to achieve that goal include ensuring employees have the tools required to fulfill career aspirations, along with a reward system “in return for delivering an exceptional experience for team members, patients, and the communities we serve,” according to an announcement from the health system.
The redesign follows the layoff of nearly 100 employees in January.
As with other health systems, workforce shortages remain a challenge for OU Health, Carolyn Kloek, MD, the new inaugural chief medical officer told HealthLeaders.
“Our providers, nursing staff, and other key pieces of the healthcare workforce are stretched thin,” she said. “We need to continue to do everything we can to support members of our healthcare workforce and get creative in the ways that we design and deliver care at OU Health.”
The new organizational structure will be led by Jimmy Duncan, SHRM-SCP, SPHR, the inaugural chief HR officer who joined the health system in January 2023.
Those newly named to Duncan’s team are:
David Conkerite II, vice president talent development & organizational effectiveness. Conkerite will develop systems to improve culture, talent, and organizational performance to achieve recognition of being a best place to work.
Berta Lundberg, vice president Total Rewards. Lundberg will manage the Total Rewards program’s five pillars: health, wealth, well-being, recognition, and career journey.
Taylor McCorkell, vice president human resources. McCorkell will serve as the workforce voice and provide strategic consultation to leadership on people and culture initiatives.
Rachel Bolton, administrative director talent acquisition. Bolton will implement systems to make OU Health the “first and best option” for healthcare candidates.
Levi King, associate vice president human resources strategy & performance. King will serve as the strategic thought leader for HR to ensure all initiatives are achieved.
The new leadership structure will ensure “people, culture, and performance excellence for OU Health,” Duncan said. “This is a crucial step in building a comprehensive HR system and transforming our organization to achieve success.”
CNO Rhonda Thompson's collaboration with local nursing schools is redefining curriculum to reduce first-year turnover.
When her first-year nurses were leaving Phoenix Children’s Hospital because they felt unprepared for the harsh realities of caring for their pediatric population, Rhonda Thompson reached out to local nursing schools.
Those collaborations redefined curriculum that is producing well-prepared pediatric nurses and appears to be reducing first-year turnover at Phoenix Children’s, says Thompson, DNP, MBA, RN, NEA-BC, chief nursing officer (CNO) and senior vice president of patient care services.
Thompson, who joined Phoenix Children’s in 2021, is now working on curriculum with about seven institutions of higher learning and expects that number to expand.
She spoke with HealthLeaders about how they are preparing new nurses to provide care to the littlest patients.
This transcript has been lightly edited for brevity and clarity.
Rhonda Thompson, chief nursing officer and senior vice president of patient care services / Photo courtesy of Phoenix Children's
HealthLeaders: What kind of first-year nurse turnover were you seeing before these collaborations began?
Rhonda Thompson: Prior to the pandemic, Phoenix Children’s was seeing the typical national average turnover of about 18% to 20%. Then the pandemic hit, and everybody's statistics were impacted by the fact that many nurses were leaving to go travel. During the pandemic, we were seeing upwards of 50% to 55% turnover of first-year nurses, especially in the very beginning of it, as people were reprioritizing their lives.
The Arizona State University (ASU) relationship and cohort started, and our focus was on, “How do we better prepare a very specific pediatric cohort of nurses that, once they're through their clinical rotation, they will be hired on at Phoenix Children's?” These are nurses who know they want to be a pediatric nurse, and we want to give them that opportunity, so they are part of what we call the Designated Education Unit, where we concentrated all of their clinical hours on the pediatric population and those kids that they would see at Phoenix Children's.
HL: How did you go about approaching schools to collaborate and how open were they to that?
Thompson: When I started at Phoenix Children's in 2021, I immediately did the academic tour, as I call it, by meeting with all the deans of the nursing schools and focusing in on not just the first-year turnover, but the reasons why we were seeing the turnover, because we were seeing a shift. It was no longer folks leaving to go travel; it was more about not being as prepared as they should be or could be, or as they thought they would be, so I focused on, “What are we doing to prepare them specifically for the softer skills?”
When I would talk with the nurses who were leaving, some of them were in tears, saying, “I just had no idea what I was going to see. I had no idea what I was going to have to do. I had no idea what I was going to hear.” Everyone can say, “My patient population is special,” but when it comes to taking care of pediatric patients, there are things that are pretty disturbing that we see and so we needed to help them prepare.
My approach was that we have to remember that we have a generation where swiping is an option for them. On their social media platforms, they swipe for those things that they don't want to see or hear. In nursing, “swipe” is not an option. When they walk into a patient room, they’re going to have to address whatever is happening within that room. They just can’t swipe it away.
HL: What were they not prepared for?
Thompson: I'll give you an example. You can read a chapter about child abuse, but when you see it, it leaves an imprint. I've been a nurse for almost 30 years, and I remember first walking into the room of a very, very severely abused child. There is really nothing to prepare you for that.
You learn about palliative care and hospice care, and you think you understand the fundamentals, and you may even understand the fundamentals, but are you emotionally and psychologically ready for when a child dies?
HL: How did you help to make sure that they were ready for all this?
Thompson: This is an evolution we continue to work on—the softer skills and things just as simple as how they cope with things in their everyday lives because we need to figure out how to build on those coping skills so that they have something to fall back on when they come to work and see the things that could create trauma for them.
The schools have been incredibly receptive. Their goal is not just to graduate nursing students and for them to pass the NCLEX, but for them to be gainfully employed and part of the community. The deans have been incredibly collaborative with me, specifically for nursing students for this patient population in creating an opportunity where they understand their own coping skills, that they have a support system around them, and that they're able to talk about the things they see and that bother them.
HL: How is the nursing schools’ curriculum being redefined?
Thompson: When the initial discussion started with ASU, we focused on pediatric modules in the students’ last year, and how we marry that into the Designated Education Unit and the simulation lab here at Phoenix Children's.
The schools have been adding curriculum around wellness and coping skills and opportunities to spend more time in simulation. But, it’s not the real thing, so some of what we've been talking about is how to create what we would consider a virtual reality environment that would immerse a student into such things as child abuse and the death of a child, so they can experience that emotion and the feelings that would be evoked by that … and curriculum could be built around that.
HL: Are you seeing that new nurses coming to your hospital are more prepared?
Thompson: It’s probably a little too soon to say. We have had an increase with our first-year retention rate, specifically with the ASU cohort, but it's too soon to say with the other schools because this has been an 18-month or so evolution of speaking with them and talking about what we're seeing.
For the ASU students, they get a very focused entire year of pediatric care and so they are better prepared coming into the organization. They already have built up their competencies as well as their confidence, which is key for newly licensed nurses, so they've already got that fundamentally built in on Day One of their work.
HL: What adjustments have you made to your orientation programs or nurse residency programs to preserve retention of new nurse graduates?
Thompson: We just reinvented our nurse residency program from a 12-month residency to an 18-month residency. That does not mean the orientation is longer; what that means is we created more opportunities for the cohorts to meet and discuss working on those softer skills, talking about the things that have been most impactful to them, and have some support system within the workplace.
We're also looking at preceptors—because they have a huge impact on these new newly licensed nurses—and how we can better prepare them to create a more positive work environment for the new hire, so we're revamping the preceptor education and training that will be a part of the residency. When I was a young nurse, you weren't a preceptor until you were a nurse for two or three years and now we're asking nurses at one year to precept newer folks and that creates a lot of anxiety, so we're looking at ways to better prepare them so that they have a positive experience and the new orientee has a positive experience.
The IHP’s Nursing Expansion Grant is one of 25 totaling more than $78 million that the labor department recently awarded to nursing programs in 17 states to address critical staffing challenges and to strengthen and diversify the workforce.
The IHP, Mass General Brigham’s only degree-granting affiliate, will receive $5.885 million over five years, the second-largest grant in the country, just behind the University of California, Davis, which received $5.999 million.
The money will be used to educate nurses who want to teach in nursing programs or be clinical instructors, according to IHP, noting that the new 2023 Massachusetts Board of Registration in Nursing regulations require all nursing faculty to have a master’s degree in nursing or National League for Nursing certification as a nurse educator with expertise in the clinical setting.
The grant will pay the full tuition and expenses of 224 nurses who enroll in one of IHP’s three nurse education programs: MS in leadership in nursing education (MS-LNE), post-master’s certificate in nursing education (PMC-NE), or continuing professional development (CPD) certified academic clinical nurse educator (CNEcl) preparation course.
“This is what we do—prepare the next generation of nursing leaders; it’s what the IHP has been doing for decades and this is simply an extension of that,” said Kenneth White, PhD, AGACNP, ACHPN, FACHE, FAAN, dean of the school of nursing.
“Focusing on the numbers of nurses is not the only solution; we have to focus on the number of instructors, and that’s what this grant is doing,” said White, who also is president of the American Academy of Nursing.
“There’s limited capacity now to train new nurses, and one of the key constraints to increasing nursing pipelines is availability of qualified faculty in nursing schools, said MJ Ryan, senior director of workforce development and economic opportunity human resources for Mass General Brigham.
“Without expanding nursing faculty, you cannot expand nursing classrooms nor grow the workforce that MGB and all healthcare organizations need now, and in the future,” said Ryan, who collaborated with MGB nurse leaders and the IHP to help initiate the grant application.
The IHP’s Nursing Expansion Grant will have a cumulative effect on nursing, Ryan noted.
“When you think about this many nurse educators being trained and multiply that by the impact they could have in a year educating hundreds of future nurses, this is truly a systemic change” she said. “I think anything that we can do to make a dent in the thousands of people being turned away from nursing programs, because of faculty limitations, has the potential to be a total game changer.”
'It is our job to support them,' AHA/AONL executive Robyn Begley testifies to U.S. House legislators.
Healthcare workforce challenges are a “national emergency” that demands immediate attention from all levels of government, healthcare leader Robyn Begley, DNP, RN, NEA-BC, FAAN, testified Wednesday before a U.S. House subcommittee.
Begley, senior vice president of workforce and chief nursing officer of the American Hospital Association (AHA) and chief executive officer of the American Organization for Nursing Leadership (AONL), offered policy solutions to healthcare’s increasing challenges before the U.S. House Committee on Veterans' Affairs Subcommittee on Health and Subcommittee on Oversight and Investigation for their hearing on the healthcare workforce.
“Hospitals and health systems exist and can continually care for patients because of the physicians, nurses, technologists, supply chain professionals, facilities management specialists, and the many other professionals who work in them,” Begley told the committee.
“We cannot care for patients without these caregivers and team members,” she said. “They are always there ready to care, and it is our job to support them.”
Prior to the COVID-19 pandemic, hospitals were already facing significant challenges making it difficult to sustain, build, and retain the healthcare workforce, Begley testified.
She informed committee members that nearly 900,000 nurses—almost one-fifth of the workforce—intend to leave due to stress, burnout, and retirement and that nursing schools turned away more than 78,000 qualified applications in 2022 due to lack of faculty and training sites.
The number of students in entry-level baccalaureate nursing programs decreased by 1.4% in 2022, ending a 20-year period of enrollment growth in programs designed to prepare new RNs, according to new data, she testified.
To counteract the troubling numbers, Congress should consider several polices to help sustain and support the nation’s workforce through protecting, recruiting, revitalizing, and diversifying it, Begley said:
Protect healthcare workers from violence: “Congress should enact H.R. 2584, the Safety from Violence for Healthcare Employees (SAVE) Act,” she said. “This legislation would provide federal protections for healthcare workers against violence and intimidation, as well as provide grant funding to hospitals for violence prevention programs, coordination with state and local law enforcement, and physical plant improvements such as enhanced technology.”
Continue to provide grant funding support to well-being focused initiatives: “Thanks to the Dr. Lorna Breen Health Care Provider Protection Act of 2022, the healthcare field received important funding for projects that help support well-being in their workplaces,” Begley said.
“We encourage Congress to provide additional support for projects and collaborative efforts to scale successful practices on well-being across the healthcare field,” she said, “especially those efforts that link well-being with hospital efforts to improve quality and the patient experience.”
Address nursing shortages by investing in nursing education and faculty: “The Future Advancement of Academic Nursing Act would provide those vital resources to support the needs of nursing students, help retain and hire diverse faculty, modernize nursing education infrastructure, and create and expand clinical education opportunities,” she said.
Provide scholarships and loan repayment: “Title VIII Nursing Workforce Development programs such as Nurse Corps help bolster the advanced practice and nursing workforce by addressing the shortage of nursing faculty and clinical sites, as well as funding nursing schools located in rural and underserved communities,” Begley testified.
“The CARES Act reauthorized these critical programs through 2024. Reauthorizing and funding these programs remain a necessity,” she said. “Congress should ensure nursing students are eligible to receive such benefits to attend nursing schools regardless of the educational institution’s tax status and ensure parity of treatment for hospitals and their workers regardless of tax status in federal health programs, including those enumerated in the Public Health Service Act.”
Reauthorize and increase funding for the National Health Service Corps (NHSC), a program that awards scholarships and assists graduates of health professions programs with loan repayment in return for an obligation to provide healthcare services in underserved rural and urban areas.
“The AHA supports the Strengthening Community Care Act of 2023 (H.R. 2559) to extend funding for community health centers and the NHSC,” she said. “The NHSC is a critically important program for both giving clinicians support to offset the substantial cost of their education, while also incentivizing practice in underserved rural and urban health professional shortage areas across the country.”
Increase graduate medical education (GME) slots: “Address physician shortages, including shortages of behavioral health providers, by increasing the number of residency slots eligible for Medicare funding,” she said. “AHA supports the Resident Physician Shortage Reduction Act of 2023, S. 1302, a bipartisan bill that would lift caps on Medicare-funded residency slots.”
Support foreign-trained healthcare workers. “Support expedition of visas for foreign-trained nurses and continuation of visa waivers for physicians in medically underserved areas,” she said.
Investigate travel nurse agency practices: “We urge Congress to direct the Government Accountability Office to study the business practices of travel nurse staffing agencies during the pandemic, including potential price gouging and excessive profits, increased margins that agencies retain for themselves, impact of increased reliance on travel nurses in rural areas, and how these practices contribute to workforce shortages across the country,” Begley said.
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:
Increase support staff (90%)
Reduce patients per nurse (89%)
Increase salaries (87%)
More nurse input into decision-making (86%)
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.”
