Sustained qualified and individual effects of the COVID-19 pandemic are putting pediatric nurse practitioners (NPs) at higher threat for burnout and anxiousness, according to survey findings published in the Journal of Pediatric Health Care. The effects of COVID-19 are also observed in their patient population, with more than 70% of NPs noting improved reports of each kid and parental mental overall health issues.
“Urgent response is needed to address pediatric-focused APRN [advanced practice registered nurses] burnout and mental health needs with sustainable strengths-based and resilience strategies to ensure the nursing workforce has the necessary resources and support to address critical health challenges associated with mental health stressors and professional burnout,” stated Jessica Peck, DNP, APRN, CPNP-Computer, CNE, CNL, FAANP, FAAN, National Association of Pediatric Nurse Practitioners (NAPNAP) Immediate Past President and coprincipal investigator, in an interview.
“This problem is, of course, multifactorial, with isolation, loss of safety net services, family stressors and trauma, and deferred care and services all compounding this issue across communities worldwide,” stated NAPNAP Secretary and coprincipal investigator Jennifer Sonney, PhD, APRN, PPCNP-BC, FAANP.
Insufficient staffing is a different element affecting nurses’ pressure, impacting job satisfaction, and driving quite a few nurses to leave the profession, according to the American Association of Colleges of Nursing (AACN). Although nursing college enrollment lately improved by 5.1%, this price is not developing rapid sufficient to meet the projected demand for RN and APRN services, the AACN noted.
The study incorporated 886 APRNs who responded to an anonymous on the internet survey posted February 4 to March 10, 2021. Of these, 796 respondents (90%) completed the whole survey, 612 of whom (69%) had been members of NAPNAP, 87% identified as female, and 89% identified as White. Most respondents (79%) reported pediatric NP principal care certification and 10% reported acute care NP certification (10%).
Three-quarters of respondents (73%) had been completely vaccinated against COVID-19 at the time of the survey. The remainder of respondents received 1 dose (12%) or had been waiting for vaccine access (6%) only 4% indicated no strategy to get the vaccine.
High Levels of NP Burnout, Anxiety Reported
Pediatric NPs expressed higher levels of concern with regards to qualified burnout, nervousness or anxiousness, and coping with pressure. One-third of NPs (34%) indicated moderate or intense concern with regards to feeling professionally burned out, 25% for feeling nervous or anxious, and 15% for feeling depressed or hopeless.
Nearly 20% of respondents skilled the death of a loved 1 from COVID-19 illness, and 10% tested positive for the illness. Twenty % of respondents reported moderate or intense concern for their general mental overall health.
One-third of respondents (34%) reported decreased work hours and 16% reported improved work hours throughout the pandemic. Decreased individual earnings was reported by 39% and improved earnings was reported by 6%.
“In addition to practicing clinicians feeling anxious or burned out, 70% of educator respondents in the study reported moderate or extreme concern with clinical training site availability, delaying the pipeline of new pediatric NP graduates from entering the workforce to increase patient access to care” stated Dr Peck, who is also clinical professor at the Baylor University Louise Herrington School of Nursing in Dallas, Texas.
Barriers to Clinical Practice
Lack of accessibility of COVID-19 testing was the most typically reported barrier with only 40% of respondents reporting COVID-19 testing availability in their practice setting. Responding to disinformation was the second most typically reported barrier with 55% of respondents listing this as a moderate to intense barrier.
Self-Care and Organizational Changes
Pediatric APRNs should really prioritize individual well-being and self-care physically, mentally, emotionally, spiritually, socially, and culturally, Dr Peck stated. “Thoughtfully limit media exposure to avoid retraumatization and continuous exposure to harmful narratives,” she stated. “Engaging with professional and social support networks is a critical source of support to help nurture diverse perspectives and positive self-talk to reframe criticisms.”
The authors also recommend that favorable environments and organizational adjustments to practice environments might guard against burnout.
“Leaders in health care and academic organizations need to affirm the value of and regard for pediatric-focused APRNs in health organizations with enhanced role visibility, respect for professional contributions, equitable representation in research and scholarship efforts, and ensured psychological safety,” Dr Peck stated. “Adopting well-being as an organizational value can normalize and support expressions of wellness-promoting behaviors.”
“Serving together as experts in pediatrics and advocates for children gives us courage and strength to keep working to find a way forward,” Dr Peck stated. “While the care of nursing is loudly applauded, the voice of nursing lacks equal attention and respect. Nursing is a scientific profession of highly educated scholars, experts, leaders, and care practitioners ideally positioned to provide voice and influence for pandemic preparedness and response.”
According to Dr Peck, “Pediatric advanced practice nurses are ideally situated leaders at the epicenter of this global crisis, and must be involved in decision-making processes seeking prompt and effective solutions. Health leaders must assess and respond to pandemic-related trauma we have endured and prioritize sustainable programmatic efforts to cultivate holistic wellness.”
Nurses Need Reinforcements
In an opinion piece published in The Hill, Patricia McMullen, PhD, JD, CRNP, FAANP, FAAN, stated that it should really not have taken a pandemic to recognize the urgent will need for more nurses in the workforce.
According to AACN’s report on 2019-2020 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing, 80,407 certified applicants had been turned away from baccalaureate and graduate nursing applications in 2019 due to insufficient quantity of faculty, clinical web-sites, classroom space, and clinical preceptors, as effectively as spending budget constraints. A shortage of faculty and/or clinical preceptors was cited as the explanation for not accepting all certified applicants amongst almost two-thirds of the nursing schools responding to the survey.
“Our nurses need reinforcements as soon as they’re ready to do the job,” Dr McMullen noted.
Strategies for managing moral distress are also required throughout the COVID-19 pandemic. According to the AACN, moral distress happens when clinicians know the right action to take but are unable to take it, this is in particular prevalent amongst nurses who care for critically ill patients and is also brought on by inadequate staffing, worth conflicts, difficult group dynamics, and duty conflicting with security issues.
“Whether stemming from internal or external factors, moral distress profoundly threatens our core values. It is distinct from other forms of distress experienced by nurses,” AACN stated.
Resources and a tool for recognizing and managing moral distress are readily available here.
Peck JL, Sonney J. Exhausted and burned out: COVID-19 emerging impacts threaten the health of the pediatric advanced practice registered nursing workforce. J Pediatr Health Care. 202135(4):414-424. doi:10.1016/j.pedhc.2021.04.012
American Association of Colleges of Nursing. Nursing Shortage. Updated September 2020. Accessed September 9, 2021. https://www.aacnnursing.org/News-Information/Fact-Sheets/Nursing-Shortage
McMullen P. We’ve asked so a lot of our nurses, it is time to give them reinforcements. August 19, 2021. Accessed September 9, 2021. https://thehill.com/blogs/congress-blog/healthcare/568642-weve-asked-so-much-of-our-nurses-its-time-to-give-them
American Association of Critical-Care Nurses. Moral distress in nursing: what you will need to know. Accessed September 10, 2021. https://www.aacn.org/clinical-resources/moral-distress
This post initially appeared on Clinical Advisor