Managing COVID-19's Mental and Emotional Effect on Novice Nurses

In July, Carol Boston-Fleischhauer, J.D., M.S., B.S.N., managing director and chief nursing officer of Research at The Advisory Board Company, presented a webinar providing suggestions for navigating the increase in novice nurses within the workforce.

She also explained how the decrease in staff experience was heightened by an increase in the complexity of needs for hospitalized patients, as well as the effect of the pandemic and supplied strategies for helping staff cope.

“This is a challenge that was stressing the approach to successfully transition new grads into the practice setting pre-COVID. Of course, today it is further complicated by the pandemic,” Boston-Fleischhauer said.

The pandemic's influence

COVID-19 has led to a decrease in the level of training and experience available to young nurses. Because of the pandemic, health care organizations paused classes, licensure exams, hiring, and onboarding to deal with current or potential patient surges.

As communities have reopened and organizations have adjusted the process of bringing new staff on board with COVID protocols in place, Boston-Fleischhauer said one of the most important aspects to be considered is the handling of moral distress for new and existing staff.

She suggested considering at least two groups of nurses. First, those who were hit by a surge and may be experiencing symptoms of post-traumatic stress disorder (PTSD) and other mental health challenges. Additionally, those who were not hit by a surge and are nervous about their employment status if hours have been cut due to a lack of elective surgeries, fewer ER visits, and other factors which affected hospitals in the midst of the pandemic.

“In keeping with Maslow's hierarchy of needs, at this point, all nurses, including  novice staff, must have their foundational needs met, including an assurance of safety before you can ever expect nurses at any level to learn, achieve or regain their potential.”

Guarding clinicians’ mental health

Children’s Health Dallas implemented a frontline moral distress consult program, which allows staff to ask for help whenever they need it and at the end of any shift during which a triggering event occurred. While this encourages all staff to request a consult whenever they feel moral distress, it can be helpful in allowing novice nurses to learn that it is okay to ask for help. 

Johns Hopkins created weekly moral rounds for all clinicians, including nurses and physicians, in response to the pandemic. Boston-Fleischhauer suggested building on that by creating cohorts specifically for novice nurses to discuss their experiences and present coping mechanisms.

“Pre-COVID, we presented support for moral distress as a strategy to combat workforce burnout,” Boston-Fleischhauer said. ”Post-COVID, for all nurses, in particular your novice nurses, we recommend viewing moral distress support as a priority organizational strategy to support that novice learner’s transition in. This is no longer a nice-to-have but rather a need-to-have.”