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World’s nurses face mass trauma: ICN

The world's nursing profession is reporting signs of "mass trauma" which experts believe will impact the profession for generations.

In the wake of continually rising COVID-19 figures across most of the world, nurses are facing high levels of infections, increased workloads and psychological distress, and there are fears that many will leave nursing all together.

New evidence from the International Council of Nurses (ICN) shows that since the first wave of the pandemic the proportion of nurses reporting mental health distress has risen from 60 per cent to 80 per cent in many countries.

“We are witnessing a unique and complex occupational trauma that is affecting the global nursing workforce," said ICN Chief executive Howard Catton.

"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."

Using data from its 130-plus National Nurses Associations (NNAs), coupled with studies by its NNAs, the ICN found that COVID-19 inflicts a unique kind of trauma, in both the short and long term, on healthcare workers. With a global nursing shortage estimated at six million and another four million nearing retirement age, the data suggest a mass exodus of nurses could be dire for health systems.

The new data found that in Australia 61 per cent of healthcare workers reported burnout and 28 per cent have reported depression.

Other nations fare much worse, such as Japan which reports that 15 per cent of hospitals across Japan had nurses resigning their jobs, and some 20 per cent of nurses reported that they had experienced discrimination or prejudice amid the spread of the first wave of the pandemic.

In the US -- which has seen 24 million cases, nearly 400,000 deaths and 100s of thousands of cases daily -- the American Nurses Association reports that 93 per cent of healthcare workers were experiencing stress, 76 per cent reported exhaustion and burnout, and nurse-to-patient ratios increased three-fold.

Anxiety is high among nurses around the world. 80 per cent of Spanish nurses reported feeling burnt out and symptoms of anxiety, while 40 per cent of nurses in Israel admitted they feared caring for COVID-19 patients.

 The ICN report points to increasingly unsafe workplaces, where nurses are subjected to violence and discrimination, high workloads, lack of PPE and social and mental health support, as issues that could all have serious impacts on society going forward and longer term impacts of the pandemic, such as PTSD and long COVID, are looming.

“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," Catton said.

"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 per cent 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 the 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.”

Current estimates place the death toll of nurses due to COVID-19 at 2,262, based on reporting by 59 countries, with the US accounting for 60 per cent of fatalities. 

It is estimated that 10 per cent of all confirmed COVID-19 infections are among healthcare workers. While in some countries, such as Iran, up to 45 per cent of the nursing workforce has contracted the virus.

To date there have been 95 million confirmed cases of the virus with 52 million recoveries and over two million reported deaths.

Australia has had 28,721 cases of the virus with 909 deaths.

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