COVID-19-Related Occupational Burnout and Moral Distress among Nurses: A Rapid Scoping Review

Sriharan, Abi; West, Keri J.; Almost, Joan; Hamza, Aden

doi:10.12927/cjnl.2021.26459

Cited by 73 publications

(73 citation statements)

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“…Our findings suggest that females, younger people and those with existing mental disorders may be more prone to lower moral resilience. Younger nurses may be particularly at risk for the detrimental effects of moral adversity and moral distress [33]. As they are growing their competence in clinical care, they are confronted with complex ethical challenges that many are not fully prepared to address.…”

Section: Table 3 Factors Associated With Moral Resiliencementioning

confidence: 99%

The new frontline: exploring the links between moral distress, moral resilience and mental health in healthcare workers during the COVID-19 pandemic

et al. 2022

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Background Global health crises, such as the COVID-19 pandemic, confront healthcare workers (HCW) with increased exposure to potentially morally distressing events. The pandemic has provided an opportunity to explore the links between moral distress, moral resilience, and emergence of mental health symptoms in HCWs. Methods A total of 962 Canadian healthcare workers (88.4% female, 44.6 + 12.8 years old) completed an online survey during the first COVID-19 wave in Canada (between April 3rd and September 3rd, 2020). Respondents completed a series of validated scales assessing moral distress, perceived stress, anxiety, and depression symptoms, and moral resilience. Respondents were grouped based on exposure to patients who tested positive for COVID-19. In addition to descriptive statistics and analyses of covariance, multiple linear regression was used to evaluate if moral resilience moderates the association between exposure to morally distressing events and moral distress. Factors associated with moral resilience were also assessed. Findings Respondents working with patients with COVID-19 showed significantly more severe moral distress, anxiety, and depression symptoms (F > 5.5, p < .020), and a higher proportion screened positive for mental disorders (Chi-squared > 9.1, p = .002), compared to healthcare workers who were not. Moral resilience moderated the relationship between exposure to potentially morally distressing events and moral distress (p < .001); compared to those with higher moral resilience, the subgroup with the lowest moral resilience had a steeper cross-sectional worsening in moral distress as the frequency of potentially morally distressing events increased. Moral resilience also correlated with lower stress, anxiety, and depression symptoms (r > .27, p < .001). Factors independently associated with stronger moral resilience included: being male, older age, no mental disorder diagnosis, sleeping more, and higher support from employers and colleagues (B [0.02, |-0.26|]. Interpretation Elevated moral distress and mental health symptoms in healthcare workers facing a global crisis such as the COVID-19 pandemic call for the development of interventions promoting moral resilience as a protective measure against moral adversities.

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Section: Table 3 Factors Associated With Moral Resiliencementioning

confidence: 99%

The new frontline: exploring the links between moral distress, moral resilience and mental health in healthcare workers during the COVID-19 pandemic

et al. 2022

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“…Undoubtedly, the well-documented stress of role transition is compounded when met with the severe strain of a global pandemic, and as cases of illness rise, the need for a robust workforce becomes paramount. Emerging evidence suggests that nurses have increased risk of stress, depression and burnout during COVID-19, with younger, less experienced female nurses at increased risk for mental health issues [ 8 ]. Providing appropriate support and resources during this transition is imperative to the satisfaction and retention of new graduate nurses; however, doing so is highly dependent on understanding the experiences of these key personnel during times of extreme stress.…”

Section: Introductionmentioning

confidence: 99%

Novice Nurses’ Experiences Caring for Acutely Ill Patients during a Pandemic

2021

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The Coronavirus pandemic erupted in 2020 and new graduate registered nurses (RNs) found themselves caring for those with devastating illness as they were transitioning into nursing practice. The purpose of this study was to describe the experience of novice nurses working in acute care settings during a pandemic. This qualitative phenomenological study of novice nurses working in facilities providing acute care for COVID-19 patients was conducted in Phoenix, Arizona, USA. Purposive sampling identified 13 participants for interviews. Data were analyzed using thematic analysis. Eight themes emerged: Dealing with death, Which personal protective equipment (PPE) will keep us safe?, Caring for high acuity patients with limited training, Difficulties working short-staffed, Everything is not okay, Support from the healthcare team, Nursing school preparation for a pandemic, I would still choose nursing. Novice nurses felt challenged by the experience and were at times overwhelmed and struggling to cope. Support from peers and coping skills learned during nursing school helped them continue to work during a critical time. Data from this study suggest that some participants may have been experiencing symptoms of anxiety, depression, or post-traumatic stress disorder, and findings provide foundational insights for nursing education and psychological interventions to support the nursing workforce.

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“…Workplace factors that contributed to burnout in nurses prior to the pandemic, including high workload, lack of scheduling exibility, and concern about workplace safety, have increased during the pandemic (43), which may contribute to nurses experiencing the highest levels of emotional exhaustion. In addition, the pandemic has been associated with the emergence of other stresses, including constraints on care that cause moral distress (21,22) and redeployment to unfamiliar types of work (23), which may have disproportionately affected nurses. Although not surprising, rates of high emotional exhaustion in nurses are nonetheless alarming.…”

Section: Discussionmentioning

confidence: 99%

“…Workplace factors that were known to contribute to burnout include high workload, lack of scheduling exibility, the burden of administrative tasks, and concern about workplace safety (14)(15)(16)(17)(18)(19)(20). In addition to workplace stressors that were present prior to the COVID-19 pandemic, additional potential sources of burnout have emerged, including constraints on care that cause moral distress (21,22) and redeployment to unfamiliar types of work (23).…”

Section: Introductionmentioning

confidence: 99%

Trends in Burnout and Psychological Distress in Hospital Staff Over 12 Months of The COVID-19 Pandemic: A Prospective Longitudinal Survey

Maunder

Heeney

Hunter

et al. 2021

Preprint

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Background. The mental health effects of healthcare work during the COVID-19 pandemic have been substantial, but it is not known how long they will persist. This study aimed to determine if hospital workers’ burnout and psychological distress increased monotonically over one year, during which waves of case numbers and hospitalizations waxed and waned, or followed some other pattern.Methods. A prospective longitudinal survey was conducted at four time-points over one year in a cohort of 538 hospital workers and learners, which included validated measures of burnout (emotional exhaustion scale of Maslach Burnout Inventory) and psychological distress (K6). Repeated measures ANOVA tested changes over time and differences between subjects by occupational role and age. The direction and magnitude of changes over time were investigated by plotting rates of high scores (using cut-offs) at each time-point compared to case rates of COVID-19 in the city in which the study took place. Results. There were significant changes in emotional exhaustion over time (F = 4.6, p = .004) and significant effects of occupational role (F = 11.4, p < .001) and age (F = 12.3, p < .001). The rate of high burnout was highest in nurses, followed by other healthcare professionals, other clinical staff, and lowest in non-clinical staff. Peak rates of high burnout occurred at the second or third measurement point for each occupational group, with lower rates at the fourth measurement point. Similarly to the results for emotional exhaustion, rates of high psychological distress peaked at the winter 2021 or spring 2021 measurement point in each occupational group and were highest in nurses.Conclusions. Neither emotional exhaustion nor psychological distress was rising monotonically. Burnout and psychological distress were consistently related to occupational role and were highest in nurses. Although emotional exhaustion improved as the case rate of COVID-19 decreased, rates of high emotional exhaustion in nurses and other healthcare professionals remained higher than was typically measured in hospital-based healthcare workers prior to the pandemic. Ongoing monitoring of healthcare workers’ mental health is warranted. Organizational and individual interventions to support healthcare workers continue to be important.

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COVID-19-Related Occupational Burnout and Moral Distress among Nurses: A Rapid Scoping Review

Cited by 73 publications

References 0 publications

The new frontline: exploring the links between moral distress, moral resilience and mental health in healthcare workers during the COVID-19 pandemic

The new frontline: exploring the links between moral distress, moral resilience and mental health in healthcare workers during the COVID-19 pandemic

Novice Nurses’ Experiences Caring for Acutely Ill Patients during a Pandemic

Trends in Burnout and Psychological Distress in Hospital Staff Over 12 Months of The COVID-19 Pandemic: A Prospective Longitudinal Survey

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