Trends in mental health indicators among nurses participating in healthy nurse, healthy nation from 2017 to 2021

Background American healthcare workers face unprecedented stress and trauma in the workplace during COVID-19, putting nurses at increased risk for poor mental health. Examining trends of mental health from before and during COVID-19 can illuminate the toll of the pandemic on nurses well-being. Methods Nurses enrolled in Healthy Nurse, Healthy Nation receive a prompt to take an annual survey (n = 24,289). Mental health was assessed by active diagnoses of anxiety and depressive disorder, and feeling sad, down or depressed for two or more weeks in the past year. Logistic regression models were used to calculate predictive probabilities of health outcomes in year 4 (May 1, 2020 - April 30, 2021) compared to years 1-3 (each from May 1 to April 30), controlling for age, sex, race/ethnicity, and nurse type. Models were also stratified by work setting and nurse type. Results In year 4, nurses had a 19.8% probability of anxiety disorder, significantly higher than year 3 (16.3%, p < .001), year 2 (13.7%, p < .001), and year 1 (14.0%, p < .001). Similarly, nurses had a 16.7% probability of depression disorder in year 4, significantly higher than year 2 (12.9%, p < .001) and year 1 (13.9%, p < .01). Year 4 nurses had a 34.4% probability of feeling sad, down or depressed for two weeks, significantly higher than previous years (year 1 = 26.8%, year 2 = 25.9%, year 3 = 29.7%, p < .001). Trends in probabilities of mental health indicators were similar among each nurse type and work setting. Nurses in medical/surgical work settings and those with licensed practical nurse and licensed vocational nurse titles consistently had the highest probability of poor mental health. Linking Action to Evidence In 2020-2021, nurses faced challenges unlike any experienced in previous years. Unsurprisingly, nurses reported increased instances of poor mental health indicators. Positive disruptive strategies are needed to systemically change organizational culture and policy to prioritize and support nurses' well-being.

Automated summary

American healthcare workers, particularly nurses, have faced increased risk for poor mental health during COVID-19. This study found that nurses had higher probabilities of anxiety disorder, depressive disorder, and feeling sad, down or depressed in the past year compared to previous years. Nurses in medical/surgical work settings and those with specific titles had the highest probabilities of poor mental health. Positive disruptive strategies are needed to prioritize and support nurses' well-being.