# data[].attributes.body
What is the problem?
Increased job dissatisfaction and burnout related to increased stressors caused by the global COVID-19 pandemic are causing nurses to leave the profession (Lavoie-Tremblay, 2021). Nurses have become overwhelmed with increases in patient-nurse ratios, death of patients, unsafe working conditions, and PPE and supply shortages (Falatah, 2021). Choosing between taking dangerous patient loads, risking their job, or keeping patients alive is becoming too much for nurses to burden.

Who is affected?
Nurses have been affected emotionally, physically, and psychologically by the COVID-19 pandemic (Alameddine et al., 2021). Patients have also been affected by nursing burnout as well.

How?
As frontline workers in hospitals, nurses spend the most face-to-face time with the patients. Nurses took on unsafe patient loads and dealt with the emotional toll of patients dying and suffering without family members at their sides (Lavoie-Tremblay et al., 2021). In addition, in the early stages of COVID, many nurses quarantined away from family members to avoid exposing them (Lavoie-Tremblay et al., 2021). Because of these experiences, there has been a significant increase in stress, anxiety, and depression among nurses (Lavoie-Tremblay et al., 2021).

Where?
Nurses providing direct patient care during the pandemic experienced the highest rates of burnout (Lavoie-Tremblay, 2021).

When?
Beginning in early 2020 at the beginning of the pandemic through current time.

Why?
Nursing shortages are not a new phenomenon in healthcare. However, due to the COVID-19 pandemic, the issues they bring along are only becoming intensified. Nurses are taking heavier patient loads, working in unsafe conditions, and people are calling out sick at higher rates (Lavoie-Tremblay et al., 2021). Career satisfaction has taken a nosedive as nurses look elsewhere for employment that takes less toll on them.

# data[].attributes.body
Patient Safety & Evidence Based Practice
The two curricular concepts I chose to discuss were patient safety and evidence-based practice; these two concepts go hand in hand, in my opinion. Patient safety is something we learn from the very beginning of nursing school and is paramount when providing care to our patients. We started with the basics of washing our hands to prevent spreading infections and using patient identifiers, the five rights of medications, and so on. All of these patient safety measures are rooted in evidence-based practice. Someone came before us and researched to find out the best way to do things and laid the pathway for us to follow through. As a leader in practice, these two concepts will always be something I encourage and demonstrate. Holding ourselves and each other accountable for keeping our patients safe should be part of our culture. I will not be afraid to professionally remind someone of the right practice if I see safety concerns on my unit. In the same way, I won't stop learning and following the research to provide my patients with the most up-to-date care. If new research emerges showing better ways to do things or safer ways to provide care, these will be things I will incorporate into my work life. Nursing is constantly evolving and changing. As a leader, I want to be an example for providing the most up-to-date and safe care I possibly can for my patients.

# data[].attributes.body
1. Taking Time For Self-Care
The unchecked effects of this pandemic experienced by nurses are cumulative and lead to burnout (Hossain and Clatty, 2021). Taking time to care for themselves is crucial for nurses. Self-care comes in many forms and activities; it doesn't have to mean spending money either. Nurses working during this pandemic have experienced traumatic things and need to prioritize taking time to step away for a break (Hossain and Clatty, 2021). Self-care activities may include spending time outdoors, meeting with friends, exercising, or even taking time to read a book in silence. Self-care is individualized, and no one size fits all.

2. Mental Health Resources
Since mental health is a critical player in burnout and attrition, it's no surprise that improving this will get nurses more involved. The first step to improving mental health among nurses is for leaders and organizations to recognize that nurses are individuals who have experienced trauma and need healing (Hossain and Clatty, 2021). Once this happens, change can begin. Recognizing and acknowledging the success of nurses, no matter how small, is an excellent first step. This acknowledgment helps cultivate a positive culture reinforcing that this stressful time will pass and normalcy will return (Hossain and Clatty, 2021). Incorporating mental health resources into the organizations offers nurses an amazing resource for improved mental well-being. Cognitive processing therapy and emotional freedom techniques are two resources that help to alleviate and address the emotional strain nurses have been placed under during this pandemic (Hossain and Clatty, 2021). When we support our nurses and show them they are supported, they become invested in their work and their organization. These are system-wide changes that will take time but make a huge difference.

3. Increase Nursing Pay
During the pandemic, hospitals faced unprecedented nursing shortages and staffing callouts. In response to these shortages, they hired travel nurses at significantly higher pay rates than floor nurses (Gottlieb and Zenilman, 2020). In particular, the two units that experienced the most significant impact from the coronavirus pandemic were the ICUs and ERs. The travel nurses hired to work these units were paid 50% and 27%  respectively, higher than average floor nurses on these units, in addition to daily stipends and lodging (Gottlieb and Zenilman, 2020). Is it any surprise that nurses who felt unsupported and underpaid left to travel nurse during this time? Travel nursing offered nurses the flexibility to choose their schedules and better pay for the work they did; while also offering self-care in the form of travel. If hospitals can afford to hire so many travelers, perhaps they can incentivize their own nurses to stay by increasing their pay. Increasing pay for nurses who are already familiar with the units makes more sense than paying travelers who require so much to start. Travelers need training and orientation, and still often have to ask floor nurses for help when working in unfamiliar settings. Why not recognize the hard work and dedication of nurses who already belong to the organization and increase their pay as a show of appreciation.

# data[].attributes.headline
Why is Nurse Involvement Important & What Are Some Barriers?

# data[].attributes.subject
Why is Nurse Involvement Important & What Are Some Barriers?

# data[].attributes.body
The nurse's involvement is pivotal in helping to prevent burnout and attrition. Nurses can help implement change and policy development to improve the issues contributing to these problems. Nurses need to speak up and demand change. Becoming involved in hospital boards and department committees that work on improvements and nursing issues is a great place to start. If their hospital doesn't have any nurses can even create committees dedicated to the mental health and well-being of nurses. Nurses can advocate for change through voting on hospital boards and in local elections as well. Writing to local lawmakers and encouraging their support for needed policy change is critical also. Change doesn't just happen within the hospitals. Sometimes to get the results you want, you have to fight for them yourselves, and nurses are in a great position to do just that.

Some barriers to nursing involvement include burnout itself. When nurses feel they have nothing left to give and are already feeling apathetic, they have no motivation to get involved. The mental health strain from the pandemic contributing to burnout is also a challenge for nursing involvement. Nurses are struggling to improve their mental health and have to heal themselves before contributing to a bigger cause. Another barrier to nursing involvement is a lack of support. When leadership and hospital administration do not support their nurses, nurses do not feel a connection to their facility. Nurses have asked for help and shared they are overwhelmed during the pandemic, and still, they are asked to work harder and longer.

# data[].attributes.body
The nurse's job description has remained unchanged. Nurses are still needed to show up at the bedside and provide high-quality patient care. However, the role of the nurse changed drastically during the pandemic. Nurses became people who wore many hats. They became tech-savvy and came up with ways to allow the family to visit loved ones in the hospital when visitors were not allowed. They were designers when finding new ways to develop, and reuse personal protective equipment (Hossain and Clatty, 2021). They became people on a screen when they were quarantined and could only facetime their family to ensure their safety. And they became heroes working overtime to ensure your family members survived this novel disease. They sacrificed their physical and mental health every day they entered the hospital, not knowing what they would face each day.

Is This Improving The Situation?
The nurse's role during the pandemic has contributed to the increased rate of burnout and attrition. Nurses place their patient's well-being before their own, and it can cause increased mental strain and burnout (CDC, 2021). Nursing as a profession is full of people who have an innate want to help others. However, nurses need to be reminded that they can't pour from an empty cup. Nurses faced challenges in healthcare before the pandemic, but the unique circumstances this pandemic has brought have only intensified the demands on nurses and increased the mental strain they experience (CDC, 2021). Nurses are taking on more than they should and not considering their physical and mental health beforehand. They are giving all they have until they become entirely burnt out.

# data[].attributes.body
The COVID-19 pandemic was a shock to the world and healthcare specifically. Research on the impact it has had on healthcare and nurses is still emerging. However, the current evidence is alarming. According to a study by Lavoie-Tremblay et al., 2021, thirty-six percent, a sixteen percent increase from pre-pandemic, of nurses are considering or planning to leave the profession due to increased burnout related to COVID-19. Upon reviewing the literature, the mental health impact this pandemic has had on nurses revealed itself to be a crucial player in burnout and attrition of nurses. According to Lavoie-Tremblay et al. (2021), an ICN survey showed that 90% of national nursing associations believe that mental stress and burnout are the driving forces behind nurses leaving the field.

Mental Health In A Pandemic
This first study was a meta-analysis looking at anxiety, depression, trauma, and sleep disorders in nurses who cared for COVID-19 patients. All seventy articles were peer-reviewed and went through a quality assessment before being included in the analysis. This analysis included 101,017 participants in total. This particular analysis looked at both physicians and nurses. 30% of the participants had anxiety, 56.5% had acute stress, 31.1% had depression, 31.4% had psyhotraumatic disorders, and 44% had sleep disorders. These findings were significant, showing that at least 1/3 of all participants in this study were struggling with mental health during the pandemic (Marvaldi et al., 2021).

The second study used the Job Demands Resource Model to assess how caring for COVID-19 positive patients influenced nurses' perceptions of chronic fatigue, poor quality of care, job satisfaction, and intention to leave the profession. The study was conducted through an anonymous survey of nurses in Quebec, Canada. All nurses were licensed and registered to be contacted for research purposes; 1,705 participated. Unfortunately, all four factors were rated significantly higher for nurses who treated COVID-19 patients than those who did not. The study did find, however, that nurses that were well prepared and felt "in control" rated all four factors significantly lower (Lavoie-Tremblay et al., 2021).

The final study looked to integrate pre and post-pandemic study results to compare attrition predictors and rates. After reviewing and assessing 176 studies, the results of 43 were included in this study. Thirty-two of the studies were done pre-COVID, and the rest were post-COVID. Pre-COVID predictors for attrition were job satisfaction, job commitment, and leadership style; compared to post-COVID, the predictors for attrition were fear of COVID, stress, and anxiety. The mean attrition rate for nurses increased post-COVID in the study as well (Murat, 2021).

# data[].attributes.body
(NBC News, 2021)

# data[].attributes.attachment_link.title
Burnout, Stress: Nurses Share Toll Fighting Coronavirus Is Taking | NBC News NOW

# data[].attributes.body
The global COVID-19 pandemic of 2020 has caused a tremendous increase in nurse burnout and attrition from the field altogether. Increased patient-nurse ratios, supply shortages, and increased risk of infection made nurses across the globe question their career choice and ability to continue with the weight of stress on their shoulders (Falatah, 2021). Nurses are leaving the bedside at alarming numbers, and the future of healthcare will look different because of it.