The COVID-19 Effect: World’s nurses facing mass trauma, an immediate danger to the profession and future of our health systems

13 January 2021
Photo from the Report

New evidence gathered by the International Council of Nurses (ICN) suggests COVID-19 is causing mass trauma among the world’s nurses. The number of confirmed nurse deaths now exceeds 2,200, and with high levels of infections in the nursing workforce continuing, overstretched staff are experiencing increasing psychological distress in the face of ever-increasing workloads, continued abuse and protests by anti-vaccinators.

Preliminary findings from ICN’s new survey of its 130-plus National Nurses Associations (NNAs), coupled with studies by its NNAs and other sources, suggest that the COVID-19 Effect is a unique and complex form of trauma with potentially devastating consequences in both the short- and long-term for individual nurses and healthcare systems they work in.

The pandemic risks damaging the nursing profession for generations to come unless governments take action now to address the COVID-19 Effect, which our survey suggests could trigger an exodus from the profession. The world is already short of six million nurses, with another four million due to reach retirement age in the next ten years. With the COVID-19 Effect potentially leading to even more nurses leaving the profession, governments must act now to protect the nursing profession and our already fragile healthcare systems, or jeopardise the health of their nations and the World Health Organization’s goal of Universal Health Care.

ICN CEO Howard Catton said:

“We are witnessing a unique and complex occupational trauma that is affecting the global nursing workforce. Nurses are dealing with relentless, unprecedented demands from their patients, resulting in physical exhaustion. But they are also facing enormous mental health pressures leading to serious psychological distress. Around the world, looking after COVID-19 patients involves dealing with an increased number of deaths, having to stand in for relatives who are not able to be with their loved ones, even as they are dying, being concerned over the lack of personal protective equipment, facing abuse from members of their communities and pandemic deniers, and fearing transmitting the virus to their loved ones at home.”

ICN’s data shows that, since the first wave of the pandemic, the proportion of nurses reporting mental health distress has risen from 60% to 80% in many countries. ICN has also gathered together studies from every region of the world which confirm rising trauma, anxiety and burnout in the nursing profession.

Mr. Catton added:

“This unique mass trauma is having an immediate and profound effect, but it is also highly likely to have a significant long-term impact as it contributes to a wave of post-traumatic stress disorder (PTSD), depression and anxiety, the scale of which we cannot yet determine.

‘There can be no doubt there will be a large COVID-19 Effect on the size of the nursing workforce, which is already heading for a 10 million deficit. Even if only 10 to 15% of the current nursing population quits because of the COVID-19 Effect, we could have a potential shortfall of 14 million nurses by 2030, which is the equivalent of half the current nursing workforce. Such a shortfall would impact all healthcare services in the post-COVID-19 era to such an extent that I would argue the health of the nursing workforce could be greatest determinant of the health of the world’s population over the next decade.

‘With the emergence of new, highly infectious variants of the virus, and increasing evidence of the effects of long COVID, ICN urges governments not to underestimate the scale of this crisis: COVID-19 has exposed the fault lines in our healthcare systems, but if nations do not take immediate action to shore them up unbreachable chasms will be created with potentially devastating effects.”

The COVID-19 Effect – a global snapshot:

  • Japanese Nursing Association says 15% of hospitals across Japan had nurses resigning their jobs, and some 20% of nurses reported that they had experienced discrimination or prejudice amid the spread of the first wave of the pandemic.
  • American Nurses Association reports 51% ‘overwhelmed’. Other reports from US show 93% of healthcare workers were experiencing stress, 76% reported exhaustion and burnout, and nurse-to-patient ratios increased three-fold.
  • Brazil - 49% of nurses report anxiety and 25% report depression.
  • China – 60% of nurses report exhaustion and 90% report anxiety.
  • Africa – A survey conducted in 13 countries in Africa revealed 20% of healthcare workers surveyed reported daily depression symptoms during the pandemic, compared to 2% prior to the pandemic.
  • Spain – 80% of nurses report symptoms of anxiety and increasing burnout.
  • Israel reports over 40% of nurses fear caring for the sick and COVID-19 patients.
  • Australia - 61% of healthcare workers report burnout and 28% report depression.

See ICN report for more information

Download the press release here