Nursing Board Well-being Survey Executive Summary : simplebooklet.com

The COVID-19 pandemic exacerbated existing challenges withinour healthcare system for patients and for healthcareprofessionals. Fear, loss, lack of personal protective equipment,ongoing surges, and much more have impacted everyone inways we cannot even begin to understand. Preexisting levels ofstress and burnout were further elevated as healthcareprofessionals faced this unknown and ever-challengingpandemic. Recognizing the need to know more about how tosupport our healthcare professionals in these fields, especiallyas it relates to their emotional welfare, became readily apparent. OhioPHP received a grant from the Federation of State MedicalBoards Foundation that supported the development of anonline survey targeted at healthcare professionals across thestate of Ohio to gauge their pandemic-related experiences,levels of stress, overall well-being, and knowledge and use ofsupportive resources. OhioPHP, in collaboration with 13 of Ohio’sProfessional Licensing Boards, launched the survey in July 2021.Between July 7, 2021, and August 20, 2021, 13,532 professionalsresponded to the survey. This report provides an overview of thefindings.0 1INTRODUCTIONIn October of 2020, the Ohio Physicians HealthProgram (OhioPHP), in partnership with MightyCrow Media, put forth a proposal to conduct astatewide assessment of lessons learned fromthe COVID-19 pandemic as it related to theimpact the pandemic had on the health andwell-being of healthcare professionals. O H I O P H P | C O V I D - 1 9 W E L L - B E I N G S U R V E Y | O H I O B O A R D O F N U R S I N G S U M M A R Y 2 0 2 2

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4,299Respondents0 2This report summarizes data collected from 4,299 respondents from the Ohio Board of Nursing (OBN), which represents 32% of total survey respondents.Data was collected via an online survey administered statewide between July 7, 2021 and August 20, 2021. OVERVIEWOBN LICENSE TYPES:Registered NurseLicensed Practical NurseAdvanced Practice NurseDialysis TechnicianCommunity Health WorkerMedication Aideaverage number of yearsin the fieldTOP PARTICIPATION BYSPECIALTY:2273%of respondents were35-64 years oldO H I O P H P | C O V I D - 1 9 W E L L - B E I N G S U R V E Y | O H I O B O A R D O F N U R S I N G S U M M A R Y 2 0 2 2of respondents wereemployed during thepandemic93%74% REGISTEREDNURSES9% ADVANCEDPRACTICE NURSES20% LICENSEDPRACTICAL NURSES

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Once a Week A Few Times a Week Every Day4 3 2 1 0 0 3Already a well-known issue among healthcare workers, burnout has dramaticallyaccelerated during the pandemic. Depersonalization of patients is an aspect ofburnout. Specifically, depersonalization is when a healthcare worker is unfeelingand impersonal towards the recipients of their service, care, or treatment.Respondents were asked, “How often did you feel you did not really care whathappens to patients?” Despite the essential nature of healthcare work, manynursing professionals are finding less meaning in their jobs and feel apatheticwhile caring for patients.CONSEQUENCES OF BURNOUTAMONG NURSESPrior to the COVID-19 Pandemic During the COVID-19 PandemicAPATHY TOWARDS PATIENTS550%increase in the number ofnurses that reported notcaring what happens topatients every day duringthe pandemic.Percentage of RespondentsO H I O P H P | C O V I D - 1 9 W E L L - B E I N G S U R V E Y | O H I O B O A R D O F N U R S I N G S U M M A R Y 2 0 2 2Survey results indicate that respondents from the OBN were 1.6 times more likely to show apathy towards patients than other healthcare professionals.Suboptimal patient careDouble the risk of medical errorDecreased professionalismLower patient satisfactionIncreased rates of intent to leave the profession Increased rates of substance use, suicide, and mental health disordersConsequences of burnout include:

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0 4O H I O P H P | C O V I D - 1 9 W E L L - B E I N G S U R V E Y | O H I O B O A R D O F N U R S I N G S U M M A R Y 2 0 2 25%25%FEELING EMOTIONALLY DRAINED FROM WORKincrease in the number of OBNrespondents that reported feelingemotionally drained every dayduring the pandemic372%Prior to theCOVID-19PandemicDuring theCOVID-19Pandemic5.84%27.54%Nearly 28% of OBNrespondents indicated theyfelt emotionally drainedevery day!Far more workers reported feeling emotionally drained on a daily basis duringthe pandemic when compared to how they felt prior to the pandemic. Thefollowing data illustrates the degree to which nursing professionals were feelingoverextended and exhausted. When a worker lacks personal accomplishments and the accompanying feelingof competence and success there is an increased chance of burnout.Respondents were asked how often they felt they accomplished worthwhilethings in their job. ACCOMPLISHING WORTHWHILE THINGSincrease in the numberof OBN respondents whonever felt like they wereaccomplishingworthwhile things duringthe pandemic versusprior to the pandemic424%CONSEQUENCES OF BURNOUTAMONG NURSES

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0 5O H I O P H P | C O V I D - 1 9 W E L L - B E I N G S U R V E Y | O H I O B O A R D O F N U R S I N G S U M M A R Y 2 0 2 2Not At All More Than Half the Days Nearly Every Day60 40 20 0 A LOOK INTO MENTAL HEALTH &SUBSTANCE USEHOW OFTEN HAVE YOU FELT DOWN, DEPRESSED, OR HOPELESS?936%increase in OBN respondents feelingdown, depressed, or hopeless nearlyevery day during the pandemicOBN respondents overwhelmingly indicated they had an exacerbation of feelingdown, depressed, and hopeless. Many respondents also indicated more concernfor their own use of alcohol and other substances during the pandemic andsome reported an increase in thoughts of suicide. Prior to the COVID-19 Pandemic During the COVID-19 PandemicPercentage of RespondentsRespondents from the OBN felthopeless during thepandemic more thanmost other healthcareprofessionals.Recent studies have shown that during the pandemic healthcare workers facedaggravated psychological pressure and mental health concerns. Therefore, oursurvey included a series of questions focused on these issues. Respondents wereasked to evaluate core aspects of mental well-being including feeling down,depressed, or hopeless, thoughts of suicide or death, and concerns about theirconsumption of substances. Respondents rated each question based on howthey were feeling prior to the pandemic and during the pandemic to allow forcomparison.

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0 6O H I O P H P | C O V I D - 1 9 W E L L - B E I N G S U R V E Y | O H I O B O A R D O F N U R S I N G S U M M A R Y 2 0 2 2A LOOK INTO MENTAL HEALTH &SUBSTANCE USE421%INCREASE IN OBN RESPONDENTS WHO WERE CONCERNED ABOUT THEIR ALCOHOL CONSUMPTION OR SUBSTANCE USERespondents’ alcohol and substance use as a strategy for coping with workstress, burnout, compassion fatigue, etc., is of concern due to the negativeimpact it may have on one’s mental health. Therefore, respondents were asked ifthey were concerned about their own alcohol consumption or substance useprior to the pandemic and then during the pandemic. They were also asked ifthere were changes in their alcohol or substance use since the pandemic began. There was a 421% increase in respondents who were concerned about theiralcohol consumption or substance use, moving from 2% prior to the pandemicto 11% during the pandemic. Those who were “sometimes” concerned saw apercentage increase of 79%.STRATEGIES FOR COPING WITH STRESS0 25 50 75 100No Yes Sometimes No Response CONCERNS ABOUT ALCOHOL CONSUMPTION OR SUBSTANCE USEPrior to the COVID-19 Pandemic During the COVID-19 Pandemic

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THE STATUS OF NURSES' WELL-BEING0 7O H I O P H P | C O V I D - 1 9 W E L L - B E I N G S U R V E Y | O H I O B O A R D O F N U R S I N G S U M M A R Y 2 0 2 2WELL-BEING ASSESSMENTInsufficient personal protective equipment (PPE)Fear of spreading COVID-19Lack of quality time with loved onesBeing too tiredSurvey respondents were asked about various stressors brought about by thepandemic. Our intention was to assess overall well-being and to see whichfactors played the biggest role in increasing the stress of healthcare workers.Some of the top stressors for OBN respondents during the pandemic were:100 75 50 25 0 STRESSORS DURING THE PANDEMIC77%Insufficient PPE Spreading Covid-19 Lack of Quality Timewith Loved OnesToo Tired77%81%68%OF OBN RESPONDENTS HAD AN INCREASE IN THEIR WORKLOADYes No N/A No Response60 40 20 0 DID YOU GETADEQUATE RESTFROM YOUR JOB?59%33%60%

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0 8O H I O P H P | C O V I D - 1 9 W E L L - B E I N G S U R V E Y | O H I O B O A R D O F N U R S I N G S U M M A R Y 2 0 2 2of OBN respondents indicated that they didnot receive any type of screening, assessment,or monitoring at work regarding the stressorsthey faced specifically due to the pandemic.OF OBN RESPONDENTS DID NOT FEEL PERSONALLYACKNOWLEDGED FOR THE CHALLENGESTHEY FACED DUE TO THE PANDEMICScreening, assessment, or monitoring at work regarding the stressors theyfacedPersonal acknowledgement in the workplaceAdequate rest from the jobEmotional services for any mental health concerns (e.g., burnout, stress,substance use, depression, unstable mood, etc.)Respondents were asked a series of questions about the types of supports theymay have accessed during the pandemic. Supports included:ACCESSING SUPPORTS AND SERVICES40 30 20 10 0 LIKELIHOOD TO PARTICIPATE INEMPLOYEE ASSISTANCE PROGRAM (EAP)Percentage of RespondentsVery Unlikely Very Likely66% of OBN respondentsreported that they wereunsure whether their stateprofessional organizationoffered a program formental health support; 15% said no such programexisted.ASSISTANCE PROGRAMS60%77%THE STATUS OF NURSES' WELL-BEING

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0 9As expected, overall well-being worsened during the pandemic. But results showthat many healthcare professionals were already experiencing significant healthand well-being challenges prior to the pandemic. We hope these findings can beused to find ways to support and improve the lives of healthcare professionalsduring both pandemic and non-pandemic times.SUMMARYDid not know where toturn for support40%Survey results indicate that healthcareproviders are exhausted both physicallyand mentally. They are stressed both atwork and home. Survey respondentsindicated an increase in depression andhopelessness during the pandemic aswell as thoughts of suicide and concernsabout substance use. Yet only 1 in 5 (21%)OBN respondents sought emotional ormental health support.Time commitment55%Respondents who indicated that they did not seek emotional services during thepandemic were asked to identify obstacles to seeking assistance. Below areexamples of obstacles identified.Cost of counseling ortreatment41%O H I O P H P | C O V I D - 1 9 W E L L - B E I N G S U R V E Y | O H I O B O A R D O F N U R S I N G S U M M A R Y 2 0 2 2Survey results indicate that respondents from the OBN were less likely to seek emotional or mental health support than other healthcare professionals.Only 1 in 5 OBNrespondents soughtemotional support duringthe pandemic.OhioPHP supports the health and wellness of healthcare professionals toenhance patient care and safety through connection to resources and services.OhioPHP aims for healthcare professionals to receive confidential andcompassionate support to improve their health and well-being. Survey resultsprovided insight into how few professionals accessed such support despiteindicating mental health concerns.CONCLUSION

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Federation of State Medical Boards FoundationOhio Department of Mental Health and AddictionServicesOhioPHP's Board of DirectorsOur FundersAnd a special thanks to our researchers at Mighty CrowMedia: Gretchen Clark Hammond, PhD, MSW, LSW, LCDCIII, TTSRobert Santucci, PRhRebecca J. McCloskey, PhD, MSW, LISW-SKathleen Gallant, BA1 0ACKNOWLEDGEMENTSWe must thank those who worked tirelessly onthis project and afforded us the ability to collectand capture the stories of Ohio's healthcareworkers. C O N T A C TIf you would like to learn more about this project orschedule a meeting with the OhioPHP team, pleasecontact Sarah Damiani.sdamiani@ophp.org(614) 841-9690 x34Without you, this would not be possible.O H I O P H P | C O V I D - 1 9 W E L L - B E I N G S U R V E Y | O H I O B O A R D O F N U R S I N G S U M M A R Y 2 0 2 2

Nursing Board Well-being Survey Executive Summary

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