Dealing With COVID-19 Post-Traumatic Stress

Strategies for Preserving the Nursing Workforce and Supporting all Vital Frontline Personnel

Therese A. Fitzpatrick, PhD, RN, FAAN; Nancy M. Valentine, PhD, DSc(hon), MPH, FAAN, FNAP President


Nurs Econ. 2021;39(5):225-238, 250. 

In This Article

Manifesting Professional Stress

TF: Based on your observations and scholarly work, how have these trends manifested in both nurses and nursing? How do nurses often manifest professional stress?

NV: Nurses and many other clinicians are not only expected to be resilient but hate to admit they need help. There is an internalized sense of shame and stigma attached to asking for help. Physicians and nurses are used to being held in high esteem and seen as "above" such issues. They are used to being in charge, not vulnerable. It is a badge of courage to rise to any occasion. These attitudes are deeply held traditions that are not easily swayed. Rolling out a new wellness approach might not work. Staff must be directly involved in program design; they must own it for it to be successful.

In reviewing literature, I learned nurses are more reluctant to seek help compared to physicians and members of the legal profession. One reason is that nurses can move around and change jobs before serious problems are detected, which then leads to greater levels of illness once uncovered; a vicious cycle.

Also, team members are often reluctant to confront a coworker or discuss concerns with their manager. Problems are ignored and people "work around" a troubled staff member, often commenting to others about their frustration in working with such an individual but not taking clear, direct action to address it. An individual's distraction, lack of focus, and inability of team members to speak up often leads to errors, both small and large.

It's our tradition to be selfless, work long hours, go the extra mile, and ask for little in return. The education and overall orientation for clinicians is to focus on service to others, not self. This practice is rooted in the very origins of early medicine and nursing. Selflessness may be laudable, but it is not realistic in today's world of work complexity. We must recalibrate this orientation to how we educate and role model for students and how we support everyone in the workplace, not just those who are visibly stressed.

As a profession, many nursing organizations have studied stress factors. There are exemplars and process improvements of varying types. Because these chronic organizational problems are still with us, there is a mountain of work to be done. Building such environments starts with building a welcoming space for students (Domino et al., 2020).

Professional nursing organizations can take the lead in supporting healthcare leaders. Nursing organizations can showcase and share best practices in organizational remedies, such as how to stop bullying behavior or how to roll out a peer-to-peer outreach effort. In addition to showcasing, there are opportunities for organizational practice research to measure and identify effective interventions.