Psychotherapy Impact on Nursing Shortage and Burnout

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Table of Contents

Introduction
Nursing Shortage During COVID-19
Mental Health Among Nurses
Coping Mechanisms and Therapy Interventions
Concluding Remarks
References

Introduction

The outbreak of the COVID-19 pandemic has, by all means, affected the patterns of providing quality care and the well-being of nurses in general. Hence, the PICOT question of the research concerns the extent to which the implementation of psychotherapy or counseling might affect the call-off and shortage rates among nurses. The present paper is comprised of the relevant research articles that would serve as a foundation for the research. Such platforms as PubMed, Springer, Wiley, and Elsevier were used to search for the material using such keywords as “nursing shortage,” “therapy,” “intervention,” “COVID-19,” mental health,” and others. The articles found were then grouped according to the topic: nursing shortage during COVID-19, the level of mid-pandemic emotional distress among nurses, and the therapeutic interventions and coping mechanisms to reduce the stress.

Nursing Shortage During COVID-19

The workload and systemic distress of the global pandemic have significantly affected the nurses’ motivation and resources to work. In a primarily quantitative study presented by McGarry et al. (2020), the researchers attempted to analyze the extent to which the pandemic period was associated with the pandemic outbreak. Data collected from the Centers for Medicare and Medicaid Services (CMS) COVID-19 Nursing Home Database demonstrated that more than 95% of the nursing homes in question reported both the shortage of staff and personal protection equipment (PPE) at the time (McGarry et al., 2020). Hence, lack of protection and safety is highly associated with distress and mass nurse call-off (Halcomb et al., 2020). Another primary cohort study on nurses in nursing homes also reported an interrelation between the lack of PPE, nurses’ distress, and abundant shortages (Xu et al., 2020).

The turnover intention, however, was detected not only among practicing nurses. According to the primary quantitative online survey conducted among nearly 1,000 undergraduate nursing students, the fear of the pandemic and low life satisfaction are the prevailing factors that make the respondents reluctant to pursue a career (Lin et al., 2021). Finally, in a qualitative study that conducted semi-structured interviews with 40 nursing professionals, the shortage reasons included lack of preparedness, PPE shortage, and anxiety and fear (Nyashanu et al., 2020). Hence, it becomes evident that anxiety and fear become the priority mental concerns associated with the shortage.

Mental Health Among Nurses

Undeniably, the mental health status of the workers faced with a pandemic crisis has been affected significantly. In a quantitative survey conducted among more than 4,000 Chinese healthcare employees, the prevalence of anxiety, depression, and psychological distress has been associated with working with COVID-19 patients and being a nursing professional (Liu et al., 2020). Another primary study focused on both long-term effects and interventions for psychological distress reduction among nurses, concluding in the higher issue probability for the insecure frontline workers (Cai et al., 2020). The prevalence of anxiety among nurses was also recorded in the study by Xiong et al. (2020), as this cross-sectional survey of 223 nurses demonstrated that nearly half of them manifested anxiety symptoms.

One quantitative study even demonstrated evidence that the COVID-19 pandemic could be perceived as a traumatic experience potentially leading to post-traumatic growth (PTG). Thus, according to Cui et al. (2021), guided deliberate rumination of the COVID-related events may become a beneficial healing technique for the employees. Hence, given the justification of prevalent depression and anxiety issues, it is necessary to dwell on the other potential intervention techniques.

Coping Mechanisms and Therapy Interventions

Some of the most commonly mentioned coping strategies with the stress associated with the pandemic are self-care and self-efficacy. The latter stands for one’s ability to believe in oneself to such an extent they one cope with the challenges faced along the way (Xiong et al., 2020). Hence, as far as self-care is concerned, the quantitative survey by Labrague and de Los Santos (2021) demonstrated that it could be achieved through building personal resilience toward a stressful environment. Other interventions that contributed to the reduced levels of anxiety included social and organizational support (Labrague & de Los Santos, 2021). Self-efficacy, for its part, has demonstrated a negative correlation with depression and anxiety in a large cross-sectional survey by Hu et al. (2020), which means that higher self-efficacy interventions could potentially lead to the better mental health of the staff.

Psychological resilience has also demonstrated positive outcomes in terms of reducing distress and anxiety in a cross-sectional descriptive study by Yayla and Ìlgin (2021), as an intervention on building resilience contributed to the lack of compassion fatigue and, as a result, improved nurses’ well-being and meaningful communication outside the hospital. Another cross-sectional study conducted by Engelbrecht et al. (2021) revealed the need for psychological intervention for South African nurses working during the second pandemic wave. This study had also demonstrated that apart from the psychological help and counseling, tangible solutions such as rotation and PPE access increase should be encouraged in the first place (Engelbrecht et al., 2021).

The variety of intervention tools based on the examples of previous health crises was found in a systematic review by Zaçe et al. (2021). The interventions include resilience training, peer support groups, increasing access to PPE equipment, personal resilience planning, counseling, and education on anxiety and stress precursors (Zaçe et al., 2021; Fiol-DeRoque et al., 2021). Finally, a primary quantitative study by Shen et al. (2020) surveyed 85 practicing COVID-19 nurses and planned organizational psychological interventions based on their concerns. Hence, since some of the major concerns included anxiety, lack of preparedness, worry, fatigue, and distress, the interventions included:

Presenting a professional psychologist to every team;
Preparedness interventions;
Emotional support in peer groups;
Enhancing teamwork and unity through online and offline communication;
Regular check-up meetings;
Counseling;
Social support systems (Shen et al., 2020).

Although unable to track long-term results so far, the aforementioned interventions proved positive for the overall stress levels among nurses and their perception of job complexity during the pandemic. Hence, it may be concluded that currently, psychological interventions are vital for the nurses to cope with the existing scopes of the COVID-19 pandemic in order to increase the rates of job satisfaction and decrease the levels of nursing shortage.

Concluding Remarks

The implementation of psychotherapy and counseling for nurses as a preventive tool for shortage and burnout has been proven to be a positive tendency in terms of battling the complications of the global pandemic. Out of the studies discussed in the paper, the five major primary studies that relate to the PICOT question include the researchers by Shen et al. (2020), Liu et al. (2020), Fiol-DeRoque et al. (2021), Hu et al. (2020), and Cai et al. (2020). These studies tend to provide major insights into the patterns of psychological distress, anxiety and their impact on the nursing shortage in the US and other countries affected by the pandemic.

References

Cai, Z., Cui, Q., Liu, Z., Li, J., Gong, X., Liu, J., Wan, Z., Yuan, X., Li, X., Chen, C., & Wang, G. (2020). Nurses endured high risks of psychological problems under the epidemic of COVID-19 in a longitudinal study in Wuhan, China.Journal of Psychiatric Research, 131, 132-137.

Cui, P., pan Wang, P., Wang, K., Ping, Z., Wang, P., & Chen, C. (2021). Post-traumatic growth and influencing factors among frontline nurses fighting against COVID-19.Occupational and Environmental Medicine, 78(2), 129-135.

Engelbrecht, M. C., Heunis, J. C., & Kigozi, N. G. (2021). Post-Traumatic Stress and Coping Strategies of South African nurses during the second wave of the COVID-19 pandemic.International Journal of Environmental Research and Public Health, 18(15).

Fiol-DeRoque, M.A., Serrano-Ripoll, M.J., Jiménez, R., Zamanillo-Campos, R., Yáñez-Juan, A.M., Bennasar-Veny, M., Leiva, A., Gervilla, E., García-Buades, M.E., García-Toro, M. and Alonso-Coello, P. (2021). A mobile phone–based intervention to reduce mental health problems in health care workers during the COVID-19 pandemic (PsyCovidApp): Randomized controlled trial.JMIR mHealth and uHealth, 9(5).

Halcomb, E., McInnes, S., Williams, A., Ashley, C., James, S., Fernandez, R., Stephen, C., & Calma, K. (2020). The experiences of primary healthcare nurses during the COVID‐19 pandemic in Australia.Journal of Nursing Scholarship, 52(5), 553-563.

Hu, D., Kong, Y., Li, W., Han, Q., Zhang, X., Zhu, L. X., Wen, S. W., Liu, Z., Shen, Q., Yang, J., He, H.-G., & Zhu, J. (2020). Frontline nurses’ burnout, anxiety, depression, and fear statuses and their associated factors during the COVID-19 outbreak in Wuhan, China: A large-scale cross-sectional study.EClinicalMedicine, 24.

Labrague, L. J., & de Los Santos, J. A. A. (2021). Resilience as a mediator between compassion fatigue, nurses’ work outcomes, and quality of care during the COVID-19 pandemic.Applied Nursing Research, 61.

Lin, Y., Hu, Z., Danaee, M., Alias, H., & Wong, L. P. (2021). The impact of the COVID-19 pandemic on future nursing career turnover intention among nursing students.Risk Management and Healthcare Policy, 14, 3605–3615.

Liu, Z., Han, B., Jiang, R., Huang, Y., Ma, C., Wen, J., Zhang, T., Wang, Y., Chen, H., & Ma, Y. (2020). Mental health status of doctors and nurses during COVID-19 epidemic in China.The Lancet.

McGarry, B. E., Grabowski, D. C., & Barnett, M. L. (2020). Severe staffing and personal protective equipment shortages faced by nursing homes during the COVID-19 pandemic: Study examines staffing and personal protective equipment shortages faced by nursing homes during the COVID-19 pandemic. Health Affairs, 39(10), 1812-1821.

Nyashanu, M., Pfende, F., & Ekpenyong, M. (2020). Exploring the challenges faced by frontline workers in health and social care amid the COVID-19 pandemic: Experiences of frontline workers in the English Midlands region, UK.Journal of Interprofessional Care, 34(5), 655-661.

Shen, X., Zou, X., Zhong, X., Yan, J., & Li, L. (2020). Psychological stress of ICU nurses in the time of COVID-19.Critical Care, 24(1), 1-3.

Xiong, H., Yi, S., & Lin, Y. (2020). The psychological status and self-efficacy of nurses during COVID-19 outbreak: A cross-sectional survey. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 57.

Xu, H., Intrator, O., & Bowblis, J. R. (2020). Shortages of staff in nursing homes during the COVID-19 pandemic: What are the driving factors?Journal of the American Medical Directors Association, 21(10), 1371-1377.

Yayla, A., & Eskici İlgin, V. (2021). The relationship of nurses’ psychological well‐being with their coronaphobia and work-life balance during the COVID‐19 pandemic: A cross‐sectional study.Journal of Clinical Nursing, 30(21-22), 3153-3162.

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