Mayo Clinic study sounds alarm on nurse mental health

A registered nurse closes the door as staff treat patients at a hospital
A registered nurse (right) closes the door as staff treat patients in the COVID-19 ward at Ochsner Medical Center in Jefferson, La., on Aug. 10.
Chris Granger | The Advocate via AP file

A new, large-scale study from Mayo Clinic finds that nurses are more likely to experience suicidal ideation than other workers in the U.S. And the findings are not limited to these stressful times; the team behind the study collected its data well before the pandemic hit, and says the situation needs urgent attention.

Dr. Lotte Dyrbye co-authored the study and co-directs the Physician Well-Being Program in Mayo's Department of Medicine.

The following is a transcript of the interview, lightly edited for clarity. Listen to the full conversation by using the audio player above.

Dr. Dyrbye, run through your findings for us.

There are really three main findings. One is that nurses are experiencing suicidal ideation at an alarming rate, and much more so than other U.S. workers. We also found that nurses who are having thoughts of suicide are very reluctant to seek care, more so than individuals who don't have thoughts of suicide. And then third, that burnout, which is unfortunately very common in all health care workers, is a risk factor for nurses experiencing thoughts of suicide.

Did you gain any insight into why those who experienced suicidal ideation were less likely to talk about it?

Well, other research has found that stigma is really getting in the way of nurses seeking care, and also just difficulties getting time off. As many people have experienced, it's hard to get an appointment with a mental health professional, and it's even harder if you don't have a lot of flexibility in your schedule.

Then nurses also have concerns about confidentiality and potential ramifications to their license if they were to seek care for mental health concerns.

Until very recently, doctors had to disclose any and all mental health conditions when they apply for their licenses. Is there something like that for nurses that might make them worry about job security if they came forward?

It really varies by state, but there are some states where that is still a problem. It's fair to ask people if they're currently impaired from a mental health problem or substance use disorder, but it's certainly not fair or appropriate to ask if people are currently being diagnosed or treated with a mental health problem. Because you have depression or you have anxiety doesn't mean that that's impairing your ability to work.

What is the rule specifically here in Minnesota?

Historically, the question for doctors in the state of Minnesota has been overly intrusive, but I'm happy to report that starting in January, the question is going to focus more on current impairment.

Now what it is for nurses is definitely the next step of our work to make sure that we don't have that barrier here in the state of Minnesota for our nursing professionals.

What kind of system change is needed to address the issue of work stress and mental health, and at what level? National or just organizational?

It's really at all levels. We need interventions that are focused on the local work environment to address the workload, to make sure tasks are distributed across the whole team, that everybody is participating in the care of the patient to the top of their licensure. And then we need efforts at the national level to address factors that are contributing to work stress in health care workers.

One of those factors is the electronic health record. Although it has many good attributes, it can also be very difficult to work with. It’s adding a lot of time to our day. And if you've had any health care recently, you certainly experienced that nurses are spending way more time at the computer and way less time at the bedside. And that's something we need to address.

Listen to the full conversation by using the audio player above.

If you are having thoughts of suicide, call the National Suicide Prevention Lifeline at 800-273-8255 (TALK), or go to SpeakingOfSuicide.com for a list of additional resources. You can also find more resources here.

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