Internal and external forces can create conflict and stress for nurses, and many of these are exacerbated by the pandemic
By Deborah Jeanne Sergeant
Nursing represents a rewarding, yet challenging career. Both internal and external forces can create conflict and stress for nurses, and many of these are exacerbated by the pandemic.
Working Conditions
The nurses unable to come into work, combined with additional demand for nurses have stretched resources thin.
“Everyone’s tired, right?” said Jamie Volkenner, who has a bachelor’s degree in nursing and is a member of the Professional Nurses Association of Western New York. She works at Mercy Hospital of Buffalo. “More often than not, we are digging deep into that extra cup of coffee for the strength to just get through the next couple of hours or days. We are tired.”
Conforming to CDC guidelines for personal protective equipment means nurses must wear PPE for eight to 12 hours straight. That has also caused more fatigue among care providers. They also have more hoops to jump through with daily check-ins to assure they have not been exposed to COVID-19. Any nurses who do not pass their assessment cannot report to work, which causes other nurses to have to cover their shifts.
When patients cannot have family visiting, nurses provide the emotional support and advocacy for patients. That adds another layer of emotional demand on nurses.
Diversity
Especially when sick or hurt, “we want to be taken care of by people who understand our culture and our needs,” said Patricia Losito, who has a master’s degree in nursing and doctorate in education. She serves as executive dean of nursing at Erie Community College. “It’s nice those opportunities are available.”
She said that ECC is working to ensure any student who wants to study nursing has the opportunity to earn an education and that will help diversify the nursing workforce.
“In nursing education, nursing has always talked about ethnicity and culture and its effect on health,” said UB’s assistant dean for undergraduate studies, Cathy Mann, RN, who has a doctorate in education and is a clinical nurse specialist in community health and certified nurse educator.
She believes that the past year’s development of the Black Lives Matter movement and the recent violence against Asians has heightened the importance of diversified workforces in healthcare. She added that the healthcare industry needs to not only diversify the population of nurses, but also improve on reaching target communities with health initiatives.
Educational Opportunities
CNAs seeking to become LPNs or RNs may lack that chance. The American Association of Colleges of Nursing states in its 2019-2020 Enrollment and Graduations in Baccalaureate and Graduate Programs in nursing that US nursing schools turned away 80,407 qualified applicants because they lacked capacity for teaching them. That includes faculty, classroom space and other resources.
“There’s a nursing faculty shortage,” Mann said. “The pandemic has made nursing very visible and nursing schools have seen an uptick. That call to nursing has been elevated. But applicants don’t equate nurses.”
Nurses seeking to become educators must earn a master’s degree to fill those roles.
In addition, Mann said that a limited number of clinical sites means competition among educators for positions for placing nursing students completing their clinical obligation.
“Even if a school says, ‘We have a faculty member so we can increase enrollment by 10 or 20 students,’ you need spots at clinical sites,” Mann said. “There are only a finite number of places at each facility.”
Like other healthcare professionals, nurses are required to take continuing education units (CEUs). Finding the time to do so and the courses challenges many nurses. Joining nursing organizations can help them stay up to date on opportunities to fulfill their CEU obligations and enrichment courses.
Safety
In addition to staffing issues creating the potential for safety problems among both staff and patients, other safety concerns include limited personal protective equipment (PPE), “which has improved, but is still a challenge,” Mann said.
As some members of the community avoid vaccination and/or become lax about ongoing safety protocols, the number of admissions jumps.
“Increased rates in admissions is taxing to the healthcare providers,” Mann said.
It also places more people with COVID-19 in the care of healthcare workers, which increases their chances of infection.
Working Relationships
Nursing is a field based on relationships: caregiver to patient, caregiver to caregiver and leader to caregiver. Mann said that issues can arise in those professional relationships when the people who have risen through the ranks in an organization obtain leadership roles. That can create strife when others with less experience but additional education work under those leaders.
“I’d love to say that someday there will be no lateral/horizontal conflict within the workplace,” Mann said. “We try to prepare our students to ask managers at their interviews how they deal with this.”
New nurses represent the largest group leaving nursing. Mann said to combat this, organizations need to develop zero tolerance policies about bullying. Unit managers should view this as a priority and use these situations as teaching opportunities.