This story discusses suicide. If you or someone you know is at risk of suicide please call the U.S. National Suicide Prevention Lifeline at 800-273-8255, text HOME to 741741 or go to SpeakingOfSuicide.com/resources for additional resources.
For eight years, Tiffany Smith worked as a pediatric nurse at Riley Children’s Health hospital in Indianapolis. During the COVID-19 surge, she started working with adult patients. While she had a lot of support from other nurses, she still felt overwhelmed at times.
“The hardest part for me was knowing that the family wanted to be there and couldn’t and the heartache they were experiencing,” she told TODAY. “Everybody struggled with seeing that some people never get to say goodbye to their loved ones.”
Smith and her colleagues often took time holding patients hands while they were dying or calling their families to FaceTime with them. Facing such loss felt so difficult. But Smith found ways to cope. She’d spend time with her pets, four horses, a Great Dane and two cats, or take a long shower. Every morning before work she meditates and she wrote a poem about her experiences. She developed such a robust way of dealing, in part, thanks to a mentor in nursing school.
“I had this feeling that you shouldn’t cry in front of your patients,” Smith said. “And she just rewarded me for feeling so deeply for them and told me that the day that I stopped feeling was the day that I needed to reconsider my own soul ... and whether or not I should stay in bedside nursing.”
Smith luckily has a lot of support. But many nurses are struggling. A recent study from the University of Michigan highlighted how dire the situation has become, especially for women. Female nurses are about twice as likely to die by suicide compared to women in the general population. They're about 70% more likely to die by suicide than female physicians.
Nursing organizations, such as the Emergency Nurses Association, support the Dr. Lorna Breen Health Care Provider Protection Act. This bill includes funding to prevent health care employee burnout and suicide, among other actions, to bolster mental health among medical professionals. If passed, the bill will provide much needed help to nurses experiencing mental health conditions.
“The bill itself brings awareness, obviously, and then also pushes for funding to support programs to help with tackling mental illness and depression and anxiety,” Ron Kraus, an emergency department nurse and president of the Emergency Nurses Association, told TODAY. “Nobody wants to talk about mental health … so I think that conversation has to be there in order for us to move forward.”
‘Nurses are hurting'
Prior to the COVID-19 pandemic nurses Amie Varley and Sara Fung started "The Gritty Nurse Podcast," in part, because they both struggled with their mental health due to toxic workplaces.
“Unbeknownst to a lot of people there’s actually a lot of bullying and harassment within health care and nursing … and myself and Sara were both experiencing both,” Varley, a nurse in Ontario, told TODAY. “We came together and were like, ‘Enough is enough. Nurses are hurting.’”
When the two tried getting help for their mental health, they received very little support. Both ended up leaving their jobs. But their dedication to advocating for nurses’ wellbeing continues, especially as the pandemic has worsened conditions for many.
“There’s actually a lot of data out there that shows that nurses’ pre-pandemic levels of stress and mental injury were high already,” Varley explained. “This pandemic has really just pulled back the veil on how horrible mental health in health care is and how they actually don’t treat it as significantly as someone who might have a physical injury.”
While the first few podcast episodes focused on their own experiences, they started discussing issues that they felt passionate about, including anti-racism, health equity, the need for nurse experts in media and mental health. Even though many might think that nurses might feel less stigma surrounding mental health, that’s not the case.
“When they talk about the stigmatization and marginalization it’s not just the general public, it’s within health care practitioners,” Varley said. “You think that it should be like, ‘Oh I feel so bad for you, I’m going to help you.’ Instead it’s ‘Pull up your big girl, big boy pants and let’s get going.’”
The other thing at play? Nurses excel at tending to others.
“We’re always taught to care for others. You care for your patients. You go home and you care for your family and you put yourself last and that’s the norm,” Fung told TODAY. “We really should be changing the conversation.”
Kraus also said that it’s important to address workplace violence. Few realize that patients sometimes abuse and assault nurses. It can be difficult to even get police or prosecutors to realize it’s a problem.
“One of my colleagues said, ‘It shouldn’t hurt to care,’” he said. “You come to work, you do the right thing and you’re assaulted verbally, physically. It takes a toll on you and it starts to wear you down and it plays on your mental health.”
While Varley and Fung think nurses still face a great many challenges, they have noticed some changes over the past year. Since starting their podcast, they believe the public’s perspective of nursing has changed.
“We’re definitely in a better place than we were a year and a half ago because we know that we’re doing the right thing and trying to ensure that nursing ... voices are heard,” Varley said.
But they wonder if after the pandemic the focus on nurses’ mental health might be forgotten.
“I do worry that if things get better, media requests will be fewer and father between,” Fung said. “But I’m hoping with all the things that we do to build platforms and really make health care a regular part of the news, a regular part of the conversation.”
Kraus said belonging to a professional organization can help many grappling with mental health conditions. The ENA and other nursing associations hosted online support for mental health and self-care over the summer to try to help. But even having a place to share stories, such as conventions or online forums, makes a difference.
“We allow you to have a venue and a place to talk and discuss,” he said.
And, Varley and Fung notice that more people are taking to social media to discuss mental health and that helps removing the stigma.
“There’s a huge culture of fear and silence,” Fung said. “(Some) nurses are willing to be brave and go talk to the media because if we can’t speak on behalf of ourselves, we’re letting others talking about nursing without really understanding what the world of nursing is like.”