The COVID-19 pandemic put such a strain on nurses on the frontlines that many are considering leaving the profession

nurses covid coronavirus ppe donning hospital
Dania Lima, right, helps fellow nurse Adriana Volynsky put on her personal protective equipment in a COVID-19 unit at Providence Holy Cross Medical Center in Los Angeles, December 22, 2020.

More than a year into the COVID-19 pandemic, some nurses who have worked tirelessly on the frontlines to help sick patients through uncertainty are considering a step away from the profession.

Some are struggling to cope mentally and many feel underappreciated and undervalued.

For Nikki Motta, a travel nurse who spent the past year working at hospitals along the east coast, the toll of caring for COVID-19 patients left her with stress that has led to hair loss.

Motta told Insider that the hospitals she worked at were badly understaffed and in many cases she would have a higher than normal patient load despite the demand for 1:1 care for some critically ill patients. Motta also had limited help, so tasks like turning patients over or generally taking care of them fell on her alone, which put a physical strain on her body.

“You’re physically turning and lifting people who are incapable of helping you because whether they’re in a medically induced coma or if they are just completely exhausted and de-conditioned so much so that they can’t help you. You are turning them on their sides to assess their skin, to make sure that they don’t get bedsores and you don’t always have another person to help you do that,” Motta said. “You don’t always have a machine to help you do that. So nurses are doing things that are putting wear and tear on their shoulders and their backs and their knees for multiple hours throughout the day for various different people of all body types and physical conditions.”

At least a quarter of travel nurses are looking for other jobs

A Trusted Health report released on Wednesday found that in a survey of over 1,000 travel nurses, 67% of respondents said the healthcare system did not prioritize their mental health and well-being. Additionally, almost half of the respondents said they were considering leaving the profession and 25% of them said they are actively looking for a job outside of nursing or planning to retire.

The percentage of young nurses, those under 40, were 22% more likely than average to report that their commitment to nursing had decreased.

“That’s a big deal because the pipeline of nurses is already small. We’ve had a shortage forever. There’s some statistics saying that there’s going to be 175,000 open roles every single year until 2029 and if we have nurses leaving the profession that early into their career and we can’t train enough then that can create a whole other healthcare crisis for our system,” Dan Weberg, Head of Clinical Innovation at Trusted Health, told Insider.

Liz Evans left her staff position as a cardiothoracic ICU nurse to work as a travel ICU nurse in COVID-19 hotspots.

Evans told Insider that hospitals in California were short-staffed on nurses during the pandemic and that meant she had to take care of five or six patients during a shift, which she described as “unheard of.”

“Usually, in an ICU, you have one patient, max two, and that’s because they’re so critical. You have to be there at all times because they literally could tank in five minutes and if nobody is watching, they could die,” Evans explained.

Limited resources means nurses are doing a lot more

Motta was also frustrated with various demands placed on her that fell outside of taking care of patients. She said she’d spend hours after her shift was technically over just charting patient information and also spent lots of time during her shift running around to get supplies.

After six years as a nurse, Motta said she’s looking to leave bedside care and go into advanced practice.

“I really started looking away from bedside over the last year because the weight was really heavy of what I was doing and I didn’t feel like I was doing the job that I initially signed up for, which is to help people and make people feel better,” she said. “I feel like there are even more and more expectations for nurses and nurses are the type of people who want to help and who want to do what is asked of them but I think that is being taken advantage of in a lot of ways.”

Evans also said that conditions forced her to learn other critical roles and do jobs she normally wouldn’t do as a nurse just to keep patients alive. But the role taxed her emotionally, mentally, and physically.

After only three years as a nurse, a traumatizing moment made Evans consider leaving the profession. She said there was a day where a patient coded, meaning they need life-saving treatment, and no one else responded to her calls for help because two other people on that same floor also coded.

“There were not enough resources and so I was in there doing chest compressions, trying to keep my patient alive while everyone was in a different code and as soon as that code was over they came over to mine, but it was already too late,” she said. “So I might be yelling at the door like: ‘Hey, like I need help. Like, I need someone in here and get a manager, get somebody, somebody should be here,’ and there was nobody there.”

She said that same night, another patient coded and again there weren’t enough people to help until eventually, a nurse manager came over to help her.

“But it was just the two of us. There was no doctor to be seen. There was no other person there,” she said.

Healthcare systems can take steps to keep nurses

While many nurses are considering leaving the industry, the decision isn’t very easy. Both Evans and Motta said they’re still unsure if they want to leave and are looking towards healthcare roles that are less focused on direct patient care. They also haven’t taken the decision lightly, but simply feel overwhelmed and burnt out by the current state of the healthcare system.

However, both said the healthcare system can take steps to ensure nurses feel supported, which could help with keeping them in the profession.

Motta said ensuring there’s an appropriate nurse to patient ratio so that nurses aren’t understaffed should be a priority. So is having experienced nurses around to help newer ones. She added that nurses should also be compensated appropriately for the mentally and physically taxing jobs that they do.

“I think that healthcare systems need to realize that nurses are valuable and that they’re an integral part of healthcare systems and they wouldn’t run without them. And I think that that also goes for the time spent away from the bedside. I think any job where you are emotionally, mentally, and physically taxed, you need to be able to step away from that job,” she said.

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The pandemic made travel nurses the frontline heroes fighting the virus, but the work has taken a heavy toll

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Nurse Cindy Kelbert, left, checks on a critically ill COVID-19 patient through a glass door as she is surrounded by other nurses at St. Jude Medical Center in Fullerton, Calif., Tuesday, July 7, 2020.

  • Travel nurses are in high demand in the US as COVID-19 cases surge and hospitals are overwhelmed. 
  • Unlike early waves of the outbreak, staffing agencies say demand goes beyond just a few hotspots. 
  • Nurses tell Insider they’re burnt out and are unsure how long they can stay on the frontlines.
  • Visit Business Insider’s homepage for more stories.

Travel nurses have been in high demand all across the US while COVID-19 cases surged through the end of 2020 into January this year.

Some nurses who have been on the frontlines throughout the pandemic say they’re burnt out as the country appears to be slowly emerging from what has been the deadliest wave of the pandemic yet. 

Travel nurses were instrumental in the fight against COVID-19 in the early days, but representatives from several staffing agencies that dispatch them to the areas most in need told Insider they’ve been pulled in all directions this time around. 

“Instead of a few hotspots where you could focus a supply of nurses very quickly, now the entire country has almost three times the demand that we did a year ago,” Dan Weberg, the head of clinical innovation at Trusted Health told Insider. If you have a limited supply and a lot of demand, getting nurses to the right spots becomes more difficult.” 

Hospitalizations have set records in the past few weeks. As of February 9, the COVID-19 Tracking Project reported more than 79,000 current hospitalizations in the US. The same day, it also reported slightly more than 92,000 new daily cases. 

Weberg said that at the peak of the winter surge, more critical-care nurses and those who work in the ICU and specialize in telemetry were needed in the Midwestern states that have been especially hard-hit by the virus. 

Many travel nurses have also worked during the first waves

Alan Braynin, the president of Aya Healthcare, a company that hires travel nurses, told Insider demand increased significantly after the second wave in July, but a resurgence in the fall prompted a hiring spree at the agency. A company spokesperson said that in November, the company had more than 27,000 open jobs, a 64% increase over the month prior. 

With no end to the pandemic in sight, Tayler Oakes, a travel nurse working as a public health official for the Navajo Nation said she is unsure how sustainable it is for her to continue at a frenetic pace, citing her six-day work weeks and a hesitation to take any time off.

“There comes a point of being so burnt out that the money’s not even worth it,” she said, lamenting that things got “exponentially worse” in the fall and winter.

“So then you get into this cycle of ‘I’m tired. but I can’t rest while also knowing there’s no end in sight. So you suffer, the patients suffer. It’s just, it’s not sustainable,” Oakes said. 

Nurses on the frontlines are burnt-out and mentally strained

“Honestly, I’m not coping well. I know there’s this whole sentiment of ‘health care heroes.’ I know it’s well-intentioned, but it’s not accurate. And I personally think it’s damaging,” Oakes said. “We’re scared. We’re tired. We’re frustrated. We’re human beings. I think it’s wrong to project this hero expectation on us.”

“It sets us up for feelings of guilt when we feel human emotion, and worse than that, it sets the tone that we can or should sacrifice our safety and well-being for the well-being of others.”

She said the Navajo Nation is vulnerable on multiple fronts – some of which they cannot control, even though they may abide by all the guidelines to help curb the virus. Many community members work outside of town in places where guidelines are not as strictly followed or enforced, meaning they remain susceptible to exposure. 

The Navajo Nation, which spans across parts of Arizona, Utah, and New Mexico, is home to more than 173,000 people. As of February 9, the region has reported nearly 30,000 COVID-19 cases and nearly 1,100 deaths.

With nurses in high-demand, smaller hospitals lose out

Adam Francis, CEO of Host health care told Insider that rural hospitals lose out when the demand for travel nurses grows. Larger hospitals that have more resources are able to hire more nurses. That disparity leads to gaps in care.

“There is a bit of competition right now going on between hospitals in the sense that hospitals are competing nationwide for travelers. They’re also competing within their region,” Francis told Insider in an interview last fall. “As far as rates are concerned, it puts stress on the health systems that may not be as financially stable and may not have the resources to pay these very high rates to bring on travelers,” said. 

Taylor Dilick, a travel nurse who was stationed in Green Bay, Wisconsin, told Insider she wanted to be on the frontlines of the pandemic. 

As COVID-19 erupted all over the US, she worked in New York, then Arizona, before ending up in Wisconsin. Dilick said she’s been able to take care of her mental health, thanks to a strong support system, but she said the circumstances her patients have endured have put her and other health care workers “between a rock and a hard place.” She has found herself playing dual roles of both medical care provider and emotional support for her patients and their families.

Despite the inherent risks of the medical profession during a global health crisis, Dilick said, thanks to ample PPE supplies which had become scarce at the start of the pandemic, she feels safer working with COVID-19 patients now more than before. 

“Whereas say somebody out in the general public at a grocery store risks potential exposure, I feel like, working in the COVID unit, I know what the patients have and I know that I’m protected, so I feel safe,” she said.

Supporting health care workers means taking the pandemic seriously

Dilick said she feels frustrated some people have refused to take the pandemic seriously. She acknowledged it can be difficult for some people to put their lives on pause, but said the reality of COVID-19 is there are a lot of people who go into the hospital and “never leave.”

“People aren’t seeing what we’re seeing in the hospital, which is good,” Dilick said. “I hope nobody has to see it because it is a terrible sight to see. I mean, ignorance is bliss, but at the same time, we’re telling you that this is occurring. So, trust us.” she said.

“I’m not saying that every case of COVID-19 is the extreme case, but there are many extreme cases that people don’t see and even though you’re not seeing it, it’s very real and it’s very unfortunate.”

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