Podium Presentation: Nursing and Emotional Health Before and During the COVID-19 Hospital Surges

Background: Occupational burnout, a symptom of chronic work-related stress, can lead to negative health outcomes such as anxiety, depression, diabetes, insomnia, and increased risk for cardiovascular disease. Burnout also augments negative occupational risks such as increased sick days, decreased productivity, disability claims, and turnover. Nurses working in the hospital setting report high levels of work-related stress and burnout related to patient acuity levels and short staffing, and rates have further worsened in the context of the COVID-19 pandemic. The emergence of the virus brought multiple hospital surges, greatly increasing nursing workload as patient acuity climbed and simultaneously, national nurse turnover rates escalated to 19% in 2020 compared to 16% in 2019. In one health system, relationships between providing nursing care pre versus post COVID-19, emotional health, and turnover rates were unknown. Purpose/aims: To investigate relationships between working in the hospital during the COVID-19 pandemic, turnover rates, and nursing self-reported emotional health. Methods/Approach: In this project, we investigated data from two studies conducted at a single, multi-state health system: one between 2018-2019 (considered “pre-pandemic”) and another between 2020-2021 (considered “pandemic”). The sample of nurses (n = 91) working pre-pandemic completed valid and reliable surveys measuring stress (perceived stress scale, short form [PSS]), mood (Scale of Positive and Negative Experience), and sleepiness (Karolinska Sleepiness Scale [KSS]) immediately following a 12-hour day or night shift. The second study included different nurses (n = 57) who completed valid measures on mood (Positive and Negative Affect Schedule), stress (PSS), sleepiness (KSS), COVID-related anxiety, sadness, and stress (Likert-scale items) under similar conditions. Results: Nurses reported more stress during the pandemic (m = 5.9, n = 57) versus before (m = 4.1, n = 91, p \u3c 0.001). Positive mood increased as self-reported stress decreased (r = -0.35 pre; -0.49 post, p \u3c 0.05), and the reverse was true for negative mood (r = 0.32 pre; 0.51 post, p \u3c 0.05) in both studies. Nurse sleepiness following a 12-hour shift during the pandemic compared to prior remained stable (p = 0.25). In the pandemic sample, nurses self-reported increased stress (83%, n = 45), anxiety (65%, n = 35), and sadness (52%, n = 28) due to working during COVID-19 surges. Nursing turnover rates in the health system followed similar trends to the national rates between 2018 -2021 (21% pre-pandemic to 27.5% after). Conclusion: Nurses working full-time, 12-hour shifts during the COVID pandemic are experiencing increased stress and worse mood, while simultaneously, overall nursing turnover rates increased compared to prior. Higher levels of stress related to worse mood for nurses during both conditions. Future work should explore strategies to help acute care nurses manage emotional health while promoting retention. Implications for practice: Providing hospital-based nursing care is demanding. Nursing leaders need to advocate for evidence-based resources to foster emotional well-being of nurses, regardless of whether hospitals are acutely experiencing increased acuity and critical staffing. References: Woo, T., Ho, R., Tang, A., & Tam, W. (2020). Global prevalence of burnout symptoms among nurses: A systematic review and meta-analysis. Journal of psychiatric research, 123, 9-20. Backé, E. M., Seidler, A., Latza, U., Rossnagel, K., & Schumann, B. (2012). The role of psychosocial stress at work for the development of cardiovascular diseases: a systematic review. International archives of occupational and environmental health, 85(1), 67-79. Salvagioni, D. A. J., Melanda, F. N., Mesas, A. E., González, A. D., Gabani, F. L., & Andrade, S. M. D. (2017). Physical, psychological and occupational consequences of job burnout: A systematic review of prospective studies. PloS one, 12(10), e0185781. Sagherian, K., Steege, L. M., Cobb, S. J., & Cho, H. (2020). Insomnia, fatigue and psychosocial well‐being during COVID‐19 pandemic: A cross‐sectional survey of hospital nursing staff in the United States. Journal of clinical nursing. Colosi, B. (2021). 2021 NSI National Health Care Retention & RN Staffing Report. Nursing Soluntions Incorporated. Retrieved from https://www.nsinursingsolutions.com/Documents/Library/NSI_National_Health_Care_Retention_Report.pdf University of Saint Augustine for Health Sciences. (May 2021). The 2021 American Nursing Shortage: A Data Study. Retrieved from https://www.usa.edu/blog/nursing-shortage