Running head: MENTAL HEALTH AND WELLNESS IN NURSING STAFF 1

Amanda F. Johnson

Mental Health and Wellness Amongst Nursing Staff Research Paper

Nursing Research

Delaware Technical Community College

Introduction

Health care professionals, take care of patients in all different types of medical settings,

and we [health care professionals] tend to solely focus on the health and well-being of our

patients. Our patients expect a certain level of care when they enter our facilities as they are

typically at a vulnerable time in their lives. Generally, they need us and medical therapies and

interventions in order to feel better. We address our patients’ medical diagnosis and make sure

their mental health is in working order. Health care workers prioritize the needs of their

patients and tend to neglect their own.

As a result of neglecting our own needs, health care professionals like nurses and

doctors have reported an increase in mental health illnesses such as anxiety, depression,

insomnia, and Post-Traumatic Stress Disorder (PTSD). In order for us as health care

professionals to create and maintain an ideal patient experience, we ourselves must be healthy.

This paper is designed to discuss the relationship between health care professionals with

mental health disorders and the care they provide to their patients.

Statement of the Problem

A concern with treating patients with mental health disorders is that the health care

professional may also be dealing with mental illness. One’s needs should not be placed above

the other, so the question lies: How can a nurse personally dealing with mental health illnesses

effectively treat patients dealing with the same or similar mental health conditions?

Literature Review
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In efforts to provide an adequate answer to the aforementioned research question, I

reviewed several research articles regarding mental health disorders in nurses. In general, there

has been an incline in reported mental health disorders in various health care professionals.

An article published by Public Health in May 2021 discusses the prioritization of the

mental health and well-being of health care workers. Highlighting the COVID-19 pandemic as

being a reason for an increase in mental health disorders among staff, this article addresses the

challenges we as health care workers face serving on the front lines. Factors such as “heavy

workloads, long shifts, a high working pace, lack of psychological safety, chronicity of care,

moral conflicts, perceived job security, and workplace bullying” contributed to the increase

stress on health care workers (Sovold, et al., 2021). The authors also reported an increase in

nurse burnout. Burnout is defined as “a syndrome conceptualized as resulting from chronic

workplace stress that has not been properly managed” (Sovold, et al., 2021). Burnout can also

be described as multi-dimensional due to (1) feelings of energy depletion or exhaustion, (2)

increased mental distance from one’s job or feelings of negativism or cynicism related to one’s

job, and (3) reduced professional efficacy (Sovold, et al., 2021).

Elsevier Public Health Emergency Collection published an article called “Mental health

problems faced by healthcare workers due to the COVID-19 pandemic – A review” and

summarized how the vast spread of the virus across the nation challenged the mental health of

medical staff members. The authors of this article mentioned how health care workers were at

a greater risk of contracting the virus, and this alone caused a mental strain on medical

personnel. Reasons such as “excessive workload/work hours, inadequate personal protective

equipment, over-enthusiastic media news, feeling inadequately supported” contributed to the

increased psychological outcomes in health care workers (Spoorthy, Pratapa, & Mahant, 2020).

In addition to the previous factors mentioned, the article states the virus also took a mental toll

on staff members as the number of staff members decreased as they too were contracting the

virus (Spoorthy, Pratapa, & Mahant, 2020). This research included socio-demographic variables

regarding mental health disorders in staff members. Older staff members reported exhaustion

as a result of the increased workload during the pandemic. Staff members between the ages of

31-40 were concerned about infecting their loved ones who were higher up in age and causing

death. All of the staff members included in this study were concerned with the strain the

pandemic had on their coworkers (Spoorthy, Pratapa, & Mahant, 2020).

The next article reviewed was published by JAMA network back in 2020 titled “Factors

Associated with Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus

Disease in 2019”. In this article, the authors did a cross-sectional study of health care workers

across 34 hospitals that treated COVID-19 patients and found that a large portion of the

participants reported symptoms of depression, anxiety, insomnia, and distress related to the

care and treatment of COVID-19 patients (Lai, Ma, & Wang, 2020). Contributing factors to those

reporting mental health disorders were the fear of spreading the virus to others, being

stigmatized for working with COVID patients, high levels of stress on the job due to increased

workloads (Lai, Ma, & Wang, 2020). The increased stress levels caused these employees to

contemplate resigning as a way to escape the mental strain of the workplace.

An observational study written by nurses and doctors titled “Assessment of Mental

Health Among Nursing Staff at Different Levels” also assessed the effects of mental health

disorders in health care professionals. This study was completed throughout the entire month
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of April 2018 and focused on 447 randomly selected staff members at a teaching hospital in

Guangdong, China (Man-Li, et al., 2020). The participants held various job titles and were asked

to complete a packet of surveys in efforts to better assess their mental health status. Nursing

staff in this study reported symptoms of depression, hostility, mental degeneration, anxiety,

fear, obsession, somatization, and bigotry (Man-Li, et al.,2020). This study concluded that the

increased demands of the current nursing workforce has a negative impact on the physical and

psychological well-being of caregivers (Man-Li, et al., 2020).

Analysis

After reviewing these studies and articles, the common methodology used were

surveys. In all of the studies mentioned, they used surveys to assess the mental health of

various health care workers. For example, in the article titled “Assessment of mental health

among nursing staff at different levels” written by several PhD and Masters-Prepared nurses, an

anonymous survey was completed on a volunteer basis to further assess the mental health of

staff. In order to move forward, they had to sign a consent form allowing their survey results to

be used in this study. The article published by JAMA titled “Factors Associated with Mental

Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease in 2019” used a

survey to assess the mental health of nursing staff at a hospital primarily treating COVID

patients during the pandemic (Lai, Ma, & Wang, 2020). Similarly, in the article titled “Mental

Disorders Among Workers in the Healthcare Industry: 2014 national health insurance data”,

these authors used several surveys to place emphasis on the presence of mental health

disorders in health care staff (Kim, et al., 2018).

On the other hand, the article “Mental health problems faced by healthcare workers

due to the COVID-19 pandemic – A review”, used literature search to support their topic.

Databases such as PubMed, Google Scholar, Cochrane Library, and Embase were utilized to find

articles and studies that were in support of the subject (Insert Citation). These databases are

credible sources and are used for many different research projects today.

Recommendations

As mentioned, mental illness is no stranger to the dedicated workers of the health care

industry. All while treating patients with varying disease processes, we (health care

professionals) are dealing with our own health, and sometimes, serious mental illness. We

strive to provide the ultimate patient experience, but in order to uphold that standard, we must

have our own mental health intact.

As a result of the studies and articles reviewed, mental illness in health care

professionals are partially due to the stress of COVID-19 pandemic and its increasing cases,

isolation resulting from caring for COVID-19 patients, increased workloads, workplace hostility,

the feeling of not being heard, being burned out, increase in people quitting and finding other

jobs, and pre-existing mental health disorders. An effective way to address these barriers is to

frequently survey health care professionals and focus on their well-being. Employers send

surveys out frequently and the focus is on improving the establishment. If the focus was also on

the health and well-being of staff members, the occurrences of mental illness due to the stress

of the job. These surveys would also highlight non-work-related stressors and afford health care

professionals the opportunity to seek guidance with internal barriers. Therefore, administrators
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should push for more input from their employees to have a clearer understanding of their

mental health.

To ensure their rights are protected, prior to distributing these surveys, the surveyors

need to fully disclose the details and reasoning of the survey. In order for participants to make

an informed decision regarding, they need to fully understand how their responses will be used.

Additionally, they need to create a consent form that can be signed by the participants as proof

for participation. The surveyors need to convey trust with their participants, so they are willing

to give honest feedback. The results should only be used as intended to stay within HIPAA

guidelines and to respect the privacy of the participants.

For nurses, or other health care staff that are participating, their role in this survey is to

understand this will be used for research purposes and their participation is needed. In order

for the surveyors to get adequate results and work towards solutions, the participants should

be completely transparent as this will help them in the long run. I can see there will be some

hesitancy in being transparent out of the fear of relation, so this is something that should be

included in the signed consent. The goal is to decrease stress levels within staff as a way to

better their mental health and not to punish them for participating in the survey.

Even before implementing surveys, employers can start to eliminate stressors at work by

advocating for safer nurse-patient ratios, increasing the morale of the workplace, and assisting

with the workload when nurses are feeling burned out. Active participation from management

when staff is feeling the stress of the workplace is one way to retain staff and decrease the load

on existing staff. Creating positive work environments, positive learning environments, enabling
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technology solutions, supporting staff, and investing in research are other ways to prevent staff

burnout (Melnyk, et al., 2021).

In reality, stress is something we experience at home, work, and even during leisure

activities. And while some stressors cannot be controlled, workplace stressors can be

eliminated with the help of administration, management, and fellow health care professionals.

Together, we can improve the mental health of health care professionals around the world.
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References

Kim, M.-S., Kim, T., Lee, D., Yook, J.-h., Hong, Y.-C., Lee, S.-Y., . . . Kang, M.-Y. (2018). Mental

disorders among workers in the healthcare industry: 2014 national health insurance

data. Annals of Occupational and Environmental Medicine.

Lai, J., Ma, S., & Wang, Y. (2020). Factors Associated With Mental Health Outcomes Among

Health Care Workers Exposed to Coronavirus Disease 2019. JAMA Network.

Man-Li, D., Wan-Xin, D., Wen, S., Ching-Wen, C., Tao-Hsin, T., & Xin-Chun, Z. (2020, February).

Assessment of mental health among nursing staff at different levels. (B. P. Coulagai, Ed.)

Medicine, 99(6).

Melnyk, B., Hseih, A., Davidson, J., Carpenter, H., Choflet, A., Heath, J., & Hess, M. (2021,

January 8). Promoting Nurse Mental Health. Retrieved from American Nurse:

[Link]

Sovold, L., Naslund, J., Kousoulis, A., Saxena, S., Qoronfleh, M., Grobler, C., & Munter, L. (2021,

May 7). Prioritizing the Mental Health and Well-Being of Healthcare Workers: An Urgent

Global Public Health Priority. Public Mental Health.

Spoorthy, M., Pratapa, S., & Mahant, S. (2020). Mental health problems faced by healthcare

workers due to the COVID-19 pandemic - A Review . Elsevier Public Health Emergency

Collection.