Post-COVID, nurses still ‘lack confidence in management to act in the best interest of patients’

A new academic survey suggests hospital nurses are no less burned out now than they were before, during and soon after the COVID-19 pandemic.

Right around half the study cohort—close to 25,000 of 50,000 nurse respondents—reported the workplace mental-health malady, which is characterized by chronic exhaustion and unremitting stress, in all three periods of interest. 

What’s more, nurses’ dissatisfaction with work peaked after the pandemic had passed. As of 2024, some 32% indicated they were still unhappy on the job.

Relatedly and no less troublingly, more than a quarter, 27.4%, said they wanted to quit work. 

The study was conducted at the University of Pennsylvania and published Feb. 24 in Medical Care, a journal of the American Public Health Association. 

Corresponding author Karen Lasater, PhD, RN, and colleagues used survey data from New York and Illinois. 

All the researchers were and are affiliated with Penn’s School of Nursing, its Center for Health Outcomes and Policy Research and the Leonard Davis Institute of Health Economics. 

Things were bad then and are no better now

One of the team’s prime objectives was ascertaining whether hospital-based nurses believe their respective institutions have returned at least to pre-pandemic levels of patient safety, care quality and hospital management responsiveness. 

Surprisingly, the researchers found, nurses’ job dissatisfaction and intentions to resign not only failed to rebound but also “rose significantly over time.”

“Nurses’ evaluations of their working conditions are at their worst post-pandemic,” Lasater and co-authors remark. 

Their key findings support that observation. In the post-pandemic study period, the four-month window ending in March 2024, half the field (49.2%) reported unfavorable work environments.

In addition, 61.5% reported not having enough staff. Indeed, objective measures of staffing ratios on medical-surgical units were 6.0 patients-to-nurse as of 2024—up from 5.7 pre-pandemic. 

“Evaluations of patient safety, quality of care and management responsiveness were significantly worse post-pandemic,” the researchers underscore. 

A vote of no confidence in management 

Key indicators of trouble, the authors note, were high before COVID-19 and reached “alarmingly” elevated heights during the pandemic. 

That effect wasn’t hard to understand. However:   

“Job dissatisfaction and intentions to leave employment continue to rise even after the pandemic has receded, and more nurses lack confidence in their management to act in the best interest of patients,” Lasater et al. write. 

“New policy approaches seem warranted, including setting minimum safe hospital nurse staffing requirements,” they conclude. 

Study abstract here, full study behind paywall.