Mary Ann Evely already knew she wanted to be a nurse at age 15, so she started volunteering at a children’s hospital in St Louis.
Fifty years later, Evely’s feelings about nursing haven’t changed in spite of her work during the past 20 months in a hospice unit in Naples, Florida.
In one instance near the start of the Covid-19 pandemic, three young men stood outside their grandfather’s room, not allowed to enter because of the virus. Evely wheeled the grandfather’s bed close to the window so they could at least see his face as he died.
“That was the hardest thing for me,” said Evely, crying as she recounted the story.
While Evely managed to move past that sorrow, her 28-year-old daughter Veronica, an intensive care unit nurse in Nashville, Tennessee, called her a year ago, after seeing three millennials die from Covid and said, “I can’t do nursing anymore.”
That sense of burnout has become more common among nurses in the US during the pandemic because of anxiety, depression and exhaustion due to the increased workload; fears of catching the virus; and the witnessing of so many deaths, among other reasons, according to several studies.
Now healthcare organizations across the country are trying to keep a shortage of nurses from getting worse and searching for answers on how to provide relief to nurses who are ready to quit.
“Everybody has gone through some amount of stress and emotional distress with the pandemic, and nursing is no different,” said Betty Jo Rocchio, chief nursing officer for Mercy, a St Louis-based Roman Catholic healthcare organization. “It seems like our nurses have had that double impact, personally and professionally, and we say it’s created professional burnout, but it’s kind of just life burnout.”
In a recent survey from the American Nurses Foundation, 21% of nurses said they planned to leave their job within the next six months, and half of those who wanted to leave said it was because work was negatively affecting their health and wellbeing.
“They have given their all for a year and a half or two years,” Annette Kennedy, president of the International Council of Nurses, said at a recent press conference. “They have worked long hours. They have worked without breaks and they have been called to do a duty without protective equipment and without support.”
Before the pandemic, Mercy had about 9,000 nurses, which was about 1,000 fewer than the health system needed, Rocchio said. That gap was further exposed as Covid patients started to fill up the hospitals’ emergency rooms and intensive care units.
During the pandemic, the system has lost an additional 500 nurses to burnout, retirement or better paying travel nursing positions, Rocchio said.
The College of Nursing at the University of Missouri–St Louis (UMSL) also saw a 20% decrease in its enrollment this year, according to Roxanne Vandermause, dean of the program.
She doesn’t know the exact reason for the decrease but speculates that it could be because people have found school to be less of a priority during the pandemic or because of how healthcare – with its masking and vaccination requirements – has become an arena for conflict.
“There is a point where I think average citizens say, ‘I don’t want to hear about these conflicts anymore. I don’t want to be part of these situations that are so completely uncontrollable,’” Vandermause said.
The UMSL enrollment is not necessarily representative of national trends. Enrollment in bachelor’s nursing programs across the country increased 5.6% in 2020 from the year before, to just over 250,000 students, according to a survey from the American Association of Colleges of Nursing.
But whatever the reason for the UMSL decrease, Rocchio is concerned because the local nursing schools are Mercy’s pipeline for staff.
To increase the pool of nurses, Mercy is trying to find adults already established in other careers and encourage them to become nurses by offering scholarships and flexible clinical hours for training at its hospitals, Rocchio said.
“We are trying to position ourselves to help anybody interested in nursing school get through nursing school,” she said.
Hospitals across the country have also significantly increased salaries for nurses as they compete with one another and travel nursing companies for staff. The Wall Street Journal reported that the average annual salary for nurses, not including bonus pay, increased about 4% in the first nine months of the year to $81,376.
Mercy is preparing to release an improved benefits and compensation package in order to remain competitive in the local market, though they can’t compete with travel nursing companies, Rocchio said.
“We are looking at what are the things that our workforce needs in order to remain healthy, happy and stay working at Mercy, and it’s not just money but competitive childcare…as well as things around retirement, wellness” and flexible scheduling, Rocchio said.
Evely, the Florida nurse, has not received a pay increase during the pandemic, but her employer did provide nurses an additional week of vacation time, she said. Still, if her husband had become sick with Covid, and Evely had to stay home from work, that would have counted against her vacation time.
“I don’t think nurses take care of themselves, and of course I think they are underpaid and underappreciated – especially nowadays.” But she said before Covid “I felt like that too,” Evely said.
In spite of that feeling and other heartache – she lost a 48-year-old fellow nurse to Covid – Evely remains committed to working in hospice.
“So many people say, ‘How do you do this?’ And I don’t know what the correct response is, but I always say, “It’s part of life, and I am so glad that I was able to be able to help your loved one in the final journey,’” Evely said.
Her daughter Veronica has also continued to work as a nurse. After the phone call, she had three days off.
Evely encouraged her to “regroup and realize you’re helping people,” she said. “After that, she was fine.”