WACO—While pediatric advance practice registered nurses are being affected by the COVID-19 pandemic in multiple ways, the most difficult challenge is mental health struggles experienced by themselves and their families, according to a new Baylor University-led study.
The study—led by Jessica Peck, clinical professor at Baylor’s Louise Herrington School of Nursing and published in the Journal of Pediatric Health Care—examined the holistic effects of COVID-19 on pediatric-focused advance practice registered nurses
Based on a survey of 789 participants, the study shows pediatric advance practice registered nurses experienced increased burnout and mental health concerns during the COVID-19 pandemic.
Pandemic alters pediatric care delivery
A consequential impact of COVID-19 has been the alteration of pediatric care delivery. Pediatric agencies have experienced disruptions in care provisions, patient presentations, clinical practices, immunizations and revenue, according to the study.
Furthermore, some pediatric nursing professionals have transitioned to working with adult populations, while others have been furloughed or laid off due to a strong demand for critical care nursing services and a lower demand for primary care nurses.
“While physical disease impacts on children have generally not been as dire as some historic precedents like polio, they are by no means spared,” Peck said.
“Pandemic conditions have fundamentally altered the norms of pediatric care delivery and, as a profession, we share collective concerns: severe COVID in children with pre-existing conditions, life-threatening multi-system inflammatory syndrome, disturbing disparities in severity of illness and death, particularly for children of color who account for 75 percent of pediatric COVID-19 deaths, and free-falling immunization rates with recovery not yet in sight.”
The research shows that 34 percent of pediatric advance practice registered nurses are experiencing moderate to extreme concern for professional burnout, while 25 percent of respondents feel anxious or nervous and another 15 percent are experiencing depression or hopelessness.
Overall, 20 percent of participants reported feeling moderate to extreme concern for their mental health.
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“As a profession, many pediatric nursing professionals are working far more hours for far less compensation, isolated from professional networks. They are learning new technologies and implementing new policies in little time with even less support. Pediatric clinics are severely disrupted,” Peck said.
“Children’s hospitals received less than 1 percent of all federal relief monies provided to U.S. hospitals, leaving children without access to care. Faculty are exhausted and experiencing vicarious trauma hearing devastating stories from their students. All of this contributes to destabilized pediatric infrastructure, which disproportionately impacts marginalized children.”
Not only has COVID-19 impacted registered nurses, but it also has had significant impact on their families. Most respondents noticed an increase in clinical presentations of child mental or behavioral health concerns (73 percent), isolation and limited socialization (72 percent) and parental anxiety (71 percent).
One of the most alarming findings was the increase in child mental or behavioral health concerns that nurses noticed, Peck said.
“This problem is multifactorial, with isolation, loss of safety net services, family stressors and trauma and deferred care and services all compounding this issue across communities worldwide,” she said.
More than a third of the respondents had moderate to extreme concern over professional burnout due to rapid changes and disinformation.
In addition, lessons learned during the pandemic will shape the next generation of pediatric advance practice registered nurses.
Peck noted three practical implications of the study:
- Nurses are not heroes or angels and should be treated as humans with physical and mental health needs. Nurses should be supported to prioritize individual health promotion behaviors and resource access.
- Health care organizations and leaders need to affirm and reinforce the value of nursing with diverse and equitable representation in decision-making forums and assurance of access to supportive resources without fear of discrimination, stigma or bias.
- Support for public civility towards nursing professionals and public health experts is crucial, with policy support for zero tolerance of violence towards nurses.
Kate Nelson is a student news writer with Baylor University Media and Public Relations.
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