Industry Voices—2020 is the year of the nurse. 2021 should be the year healthcare leaders act on their feedback

A female nurse is shown wearing an N95 mask in a hospital room
The results of an online survey of 300 full-time nurses nationwide conducted for the University of Phoenix by Harris Poll found nurses still feel that their voices aren’t being fully heard by leaders within their institutions and that they don’t receive the level of respect they’ve earned. (Getty/JohnnyGreig)

The COVID-19 pandemic has placed unprecedented demands on nurses, creating intense levels of stress in both their professional and personal lives, and once more highlighting their value to the healthcare system and broader society.

For coronavirus patients connected to ventilators and isolated from their families, nurses have been the vital source of care, humanity and comfort. Nurses embrace caring for people when they are most vulnerable, and it is a sacred privilege that has rarely been so apparent.

It could hardly be more fitting that 2020 is the official Year of the Nurse. The crisis has brought a lot of attention and praise to our “healthcare heroes” in nursing. But that won’t mean much if it doesn’t translate into tangible action by healthcare leaders to address the nursing pain points that have been highlighted and exacerbated by COVID-19. That makes a strong case for 2021 to be the year when their concerns are taken seriously and the reality of burnout addressed.

The results of an online survey of 300 full-time nurses nationwide conducted for the University of Phoenix by Harris Poll provide some key insights that can help healthcare leaders understand what the profession needs and the opportunities for change.

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One of the most important survey findings is that nurses still feel that their voices aren’t being fully heard by leaders within their institutions and that they don’t receive the level of respect they’ve earned. That’s despite the fact that they’ve played such an essential role in the coronavirus response and shouldered greater responsibilities with their added duties.

Nearly three out of four respondents said they had assumed more leadership responsibility since the crisis began, with 78% reporting the healthcare staff view them as a leader. Yet 55% felt that their voice is not being heard and 41% believe their opinions and concerns are not seriously considered.  The vast majority (84%) said they wished nurses had a stronger leadership role in the pandemic crisis.

Nurses’ feeling that they lack professional respect is a long-standing concern, driven partly by the traditional gender differences between nurses and physicians. But the fact that they have felt it more acutely during this crisis when they are eager and positioned to take on more responsibility is a call for healthcare leaders to act.

It’s an opportunity to give nurses greater leadership responsibilities and to ensure they have a significant place at the table. This can help to close the gap at many institutions between nurses at the bedside, those in middle management and the leaders making decisions.

Healthcare executives should include nurses on patient safety and ethics committees, technology, policy committees and, on management committees that make the decisions on budgets and resources. In turn, they must provide the training and development opportunities that will enable nurses to handle greater responsibilities successfully, by having their experience more widely recognized and valued within the institution.

The other key findings of the survey revolve around the increase in mental and physical stress that nurses are experiencing as a result of the pandemic. Causes of burnout are multi-factorial however, there are overarching trends that have led to a rise in stress among nurses.

Since the pandemic began, 65% of nurses report feeling exhausted, with half saying they were fearful, and around a third feeling underappreciated or depressed. More than half (58%) said their ability to maintain their mental/emotional health has become worse, with 46% saying they had thought about quitting at some point.

These findings highlight the unprecedented stresses that nurses have faced as a result of the pandemic. Every patient had to be treated at the highest level of risk due to the infectious nature of the virus. For nurses, that has meant a heavy workload, with long shifts worked in full PPE gear, accompanied by the added fear of exposing their families at home. The once common and stable elements that nurses depend upon for providing patient care were eliminated and replaced with a groundswell of inconsistencies.

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Nurses are of course trained to deal with high-pressure, crisis situations. But that doesn’t make them immune to the cumulative effect of stressful, tragic events.

This is something that healthcare executives can improve in terms of recognizing the problem and taking action to mitigate it.  It’s important for employers to invest in nurses by learning how to better listen to them and understand their needs. They should be holding focus groups and meeting with nurses to find out what their specific stresses are and how they can be eased. Leaders can design and implement policies and programs to respond to their expressed needs and begin addressing the mental and emotional wellbeing of nurses in the same way they assist employees with personal physical and financial concerns.

The good news is that despite these stresses, nurses still overwhelmingly believe that their profession is altruistic and a calling. It is noble in nature with care and compassion offered to every patient humanely and unselfishly. Nine out of 10 nurses said they like their job and are satisfied with it. And true to their reputation, they are selfless, with 48% saying that if their institution wanted to show gratitude for their services, they would prefer it give a large philanthropic gift to the field of nursing rather than receive a small individual gift.

Successful healthcare leaders will recognize the opportunity to nurture and leverage nurses’ passion for their job. They will take action to build resilience in the nursing profession to make sure there will be sufficient nurses to meet the U.S Bureau of Labor Statistics projection of needing 11 million additional nurses by 2022.

The pandemic has taught us that healthcare institutions will be made stronger when nurses’ qualities, experience and contributions are valued and appreciated, and when they afford nurses greater influence and control over the decisions associated with the practice of their profession.

Kathleen Winston is dean at the college of nursing for the University of Phoenix.