The inadvertent harm of nurse resiliency — and how leaders can help

Nurses may be the first people to use the old airline advice about putting one's own oxygen mask on before helping others. 

But they often do not follow this advice, according to various reports that reveal nurses are admitting to experiencing mental health issues but are not getting the care they need. 

"Rates of nurse mental health and substance use disorders are high," according to an article published in May in the journal Nursing Outlook. "... Nurses are challenged to care for patients in ways that often jeopardize their own health and increase risks for their families."

Nurses are "hesitant or even decline to use available resources to support their well-being," the article said, noting a "stigma embedded in the culture of nursing and licensure reporting requirements [is] likely a contributing cause of reluctance to use well-being and mental health services."

The stigma is real, said Robyn Begley, DNP, RN, CEO of the American Organization for Nursing Leadership. "This is a big issue. We are confronting it head on and advocating that leaders be very transparent about the programs available to help nurses feeling burnout," Dr. Begley told Becker's. "It's OK to not be OK."

It is incumbent on nursing executives to attempt to reduce stress as much as possible from the nursing environment, she said, noting that leaders are not immune to feeling burned out themselves. 

"One of the most important things a nursing leader can do is to talk about how they are feeling," Dr. Begley said. "Connect with your staff. I mean really check in with your people. Make sure they know about all the resources available and talk them up with your teams."

However, the Nursing Outlook article cautioned that many nurses "expressed concerns about the confidentiality" of mental health resources such as the federal Employee Assistance Program.

Bob Dent, DNP, RN, vice president of patient care services and chief nursing officer at Emory Decatur Hospital in North Decatur, Ga., said hospital leaders must help each other manage stress so they can help clinicians. "Create psychologically safe spaces to have conversations about feelings, emotions and mental health. Be present for your teams," he said.

Dawn Webb, MSN, RN, director of nursing practice and professional development of the Texas Nurses Association, said it is not unusual for nurses to feel as though they have to be superheroes, according to an article published in 2022 by Healthy Nurse Healthy Nation.

"Having anything wrong isn't permitted. They're supposed to be strong, resilient and not experience the same issues that other people in society experience — including mental illness," she said, noting that many do suffer from and might even be more likely to experience depression, anxiety and burnout due to the intense nature of their work.

When nurse leaders talk about how they are feeling, especially with other members of the leadership  team — "all the way up to the CEO," Dr. Begley said — it helps to spotlight the issue.

"It makes it easier to get support that's needed," she said. "It sends a message that we aren't living with the stiff upper lip of the past. It's OK to say, 'What more can we do about this? How do we help our teams achieve wellness?'"

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