Survey: Nurses don’t want to be heroes

From the beginning of the coronavirus pandemic, nurses and other front line workers have been called heroes for the sacrifices they’ve made. That’s not what they want, however, according to recent survey.

Three instructors asked health care workers to share voicemails about their experiences providing care during the COVID-19 pandemic. “What we have found across our studies is that nurses are struggling, and without help from both the public and health care systems they may they leave nursing altogether,” the trio wrote for the Conversation.

Jessica Rainbow, assistant professor of nursing at University of Arizona; Chloé Littzen, assistant professor of nursing at University of Portland; and Claire Bethel, adjunct instructor of nursing at Arizona, shared five takeaways from their study, which is ongoing.

Calling nurses heroes is harmful

As of the end of December 2020, more than 1.6 million health care workers worldwide had been infected by COVID-19, and nurses make up the largest affected group in many countries. It’s natural to call them heroes. But the nurses say that’s a dangerous label.

“With this hero narrative, expectations of what nurses should do become unrealistic, such as working with inadequate resources, staffing and safety precautions,” the three wrote. “Consequently, it becomes normalized for nurses to work longer hours or extra shifts without consideration for how this may affect them personally.”

One young nurse responded: “There was a palpable tenseness being there … nobody knew what was going on or what was expected. There was no real protocol yet. If a patient was admitted and you had to take care of one, you kind of felt like you were being thrown to the wolves as an experiment.”

Inadequate resources or support

“Lack of resources, lack of staffing, lack of getting all our concerns addressed, things like that,” one nurse responded. “Those are very draining, especially when we’re supposed to provide patient care and do a good job. All the drama from work and things like that, those don’t help. If anything, it just makes the environment more toxic and unbearable, definitely, and at one point, it will start affecting … your mental health and your physical health, even your spiritual health.”

Although some health care organizations are paying travel nurses extraordinary amounts, full-time staff haven’t been so lucky. According to the study authors, many organizations require overtime and don’t provide adequate resources, such as personal protective equipment or support personnel, for safe patient care. “This has left many nurses feeling unappreciated, undervalued and unsafe,” they wrote.

Loss of trust in health care organizations

“Our policies were changing so rapidly that oftentimes anesthesia would have a different understanding (of the policy), the doctors and residents would have a different understanding, and nursing would have gotten a different email always within like a half-hour,” one nurse said in a voicemail. “It was extremely frustrating. It was very, very stressful.”

Nurses said they felt their organizations weren’t being open about why policies were changing.

“They just weren’t telling us much of anything,” one said in reply to the survey. “We have three managers and seven clinical coordinators on our unit. There were definitely enough people to be sending emails and to be giving updates, but they were so unsure as well that they just kind of opted for radio silence, which was really frustrating and made the whole situation more challenging. When they were giving us information, a lot of it was, ‘You guys are overreacting. You don’t need to wear N95s all the time.’”

Put in morally traumatic situations

Shortages of oxygen supplies, ECMO machines, hospital beds and staff have forced nurses to make decisions that cause moral trauma. This happens when they “witness, perpetuate or fail to prevent something that contradicts their beliefs and expectations,” the study authors wrote.

“We were told very early on … if this person needs a ventilator, they are not going to get it,” one nurse said. “So, in a way, we were determining code status without really consulting the patient, which to me is very problematic and unethical.”

Frustrated by the public

According to the Mayo Clinic’s vaccination tracker, only 69.4% of Americans have received at least one dose of the COVID-19 vaccine, as of Sunday. Only 59.3% have received both doses. Nurses must treat patients regardless of vaccination status.

One nurse shared her story of having to chase after an unvaccinated pregnant woman with COVID-19 who attempted to leave the ICU against medical advice.

“This was so early (in the pandemic), we didn’t know how far (the virus) would travel,” she said. ”So I’m, like, is she going infect the staff in the lobby? Are there people down there? You know, she’s just going to go home and give this to her newborn. And … her husband looked at me and said, ‘You know, basically Western medicine isn’t real and this isn’t real,’ and I’m, like, OK, this is real. And I’m, like, you’re going to give it to your newborn and your five kids.”

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