A stressed nurse

Nurses have lost a lot of sleep during the COVID-19 pandemic, and their sleep problems are closely tied to new mental health issues that can affect well-being, according to a new study. The results reveal opportunities to better support the healthcare workforce, investigators said.

The researchers surveyed 629 nurses working across healthcare settings in 19 states. They also conducted interviews with 34 nurses between June and August 2020. Participants were asked about their work experiences during the first six months of the pandemic.

More than half of the participants reported difficulty sleeping during this time period, with 55% saying that they suffered from insomnia. In addition, 22% reported high rates of depression and 52% reported anxiety. Difficulty sleeping contributed to poor mental health in some cases, and was an outcome of poor mental health in others, wrote lead author Amy Witkoski Stimpfel, Ph.D., RN, of NYU Rory Meyers College of Nursing.

“Nurses are already at risk for higher rates of depression and insufficient sleep compared to other professions, thanks to the stress of patient care and the nature of shift work,” she said. “The pandemic seems to have further exacerbated these issues to the detriment of nurses’ well-being.”

The findings may help explain why — along with other pandemic stressors such as understaffing, lack of equipment and patient deaths — some nurses are now leaving their jobs, the researchers said.

“We know that getting sufficient sleep fosters mental and emotional resilience, while not getting enough sleep predisposes the brain to negative thinking and emotional vulnerability,” Witkoski Stimpfel said.

Better support for burned out workers

To better support these workers, employers must address work stress and other factors that influence sleep, the authors said. 

“In addition to making sure that nurses have the resources like staffing, beds and personal protective equipment to effectively do their jobs, employers can offer training on stress management and provide referrals to mental healthcare professionals for those in need,” they wrote.

It is also crucial to attend to scheduling, preventing excessive overtime hours and shifts that quickly switch between day and night, to ensure that nurses have time away from work. Flexible work arrangements can also be helpful, they said.

“Our findings help us better understand the difficulty nurses are facing … but also reveal opportunities for hospitals and other employers to support this critical workforce,” Witkoski Stimpfel said.

Full findings were published in the Journal of Occupational and Environmental Medicine.