Challenging COVID-19-related workplace conditions contributed significantly to nurses' stress and anxiety at the height of the pandemic, suggests new analysis by UBC researchers.
An earlier survey conducted by the team last year found that many nurses in B.C. were reporting symptoms of PTSD, depression, anxiety and emotional exhaustion. Their new analysis, published recently in the journal Healthcare, links these mental health outcomes to specific issues at work, including frequent changes in COVID-19 policies and protocols, and perceived low levels of organizational support.
In this Q&A, lead researcher Dr. Farinaz Havaei, a professor of nursing at UBC who studies workplace psychological health and safety, talks about her team's findings and what they could mean for future health care planning and management.
What prompted this new analysis?
Our initial findings last year were concerning. Forty-seven per cent of those surveyed reported symptoms of PTSD, 41 per cent suffered from depression, 38 per cent experienced anxiety, and 60 per cent reported feeling emotional exhaustion. We wanted to explore the factors that could have led to those outcomes, so we analyzed five categories pertaining to the workplace:
- perceptions of workplace safety-for example, how often did they have direct contact with suspected or confirmed COVID-19 cases
- resourcing-did they feel that they were adequately trained to work with COVID-19, and related questions
- workplace relationships with their peers, supervisors and management
- institutional preparedness-were there crisis policies in place?
- feelings of being supported by their organization during the crisis
What did you find?
Generally speaking, nurses who had negative responses in all five categories were more likely to report experiencing PTSD, anxiety, depression and emotional exhaustion.
Nurses who reported dealing with staffing inadequacies, poor workplace relations, and low levels of organizational support, were at higher risk for all of these negative mental health outcomes.
And nurses who dealt with frequent changes in COVID-19 policies and protocols were more likely to experience high PTSD, anxiety and depression scores. On average, the nurses had to adapt to changes in COVID-19 policies and protocols more than once a week. Nearly 30 per cent of those surveyed reported daily or multiple daily changes to these protocols and policies.
What does this mean for future health care planning?
Knowing where the pain points lie can help put us in a better place in the future.
Many of the workplace risk factors that nurses face are not new. We urgently need to work on creating better workplace policies and practices to prevent and mitigate sub-optimal nursing working conditions.
However, we cannot change everything overnight so we should look at tools that can ease the situation while we're working on the long-range plan. I'm currently developing a workload management tool that creates a better fit between patients' needs and nurse competencies. Tools like these, along with teamwork training, can hopefully support nurses in their work and protect their mental health.
"Nurses' Workplace Conditions Impacting Their Mental Health during COVID-19: A Cross-Sectional Survey Study" was published January 2021 in the journal Healthcare.
