Daily changes in COVID-19 protocols led to symptoms of PTSD for nurses say researchers

A nurse puts on her personal protective equipment prior to entering a patient's room in the COVID-19 intensive care unit at St. Paul's hospital in downtown Vancouver, Tuesday, April 21, 2020. THE CANADIAN PRESS/Jonathan Hayward

Vancouver — Nurses who had to adapt to frequently changing COVID-19 protocols were more likely to experience symptoms of post-traumatic stress disorder, anxiety and depression, according to new research conducted by the University of British Columbia.

Researchers surveyed nearly 3,700 B.C. nurses online in June and July of 2020, and say that their data shows there’s a link between negative mental health outcomes and the challenging work environments that many nurses face.

Among those challenges were the frequent changes in COVID-19 protocols.

“Nurses who dealt with frequent changes in COVID-19 policies and protocols were more likely to experience high PTSD, anxiety and depression scores,” says U.B.C. Nursing professor Farinaz Havaei.

“On average, the nurses had to adapt to changes in COVID-19 policies and protocols more than once a week. Nearly 30 per cent of those surveyed reported daily or multiple daily changes to these protocols and policies,” she said.

The survey, funded by the BC Nurses Union, looked at how unique conditions around COVID-19 might be contributing to nurse mental health outcomes. Researchers found that some workplace conditions had more of an impact on nurses than others.

“Workplace safety, access to resources and supplies, organizational support, and workplace relations most significantly influenced nurse mental health,” reads the study, published in the Healthcare journal in January.

Rapidly changing COVID-19 protocols, which fell into the category of organizational support, was cause for discussion in the study.

“It is possible that frequent changes in policies and protocols required nurses to quickly respond to and constantly adapt to the shifting landscape of COVID-19, a stress-provoking experience, especially in the context of a highly contagious infectious disease,” the study reads.

Research before the pandemic found that nurses were likely to be stressed out by fast and continuous changes in the workplace.

“Pre-COVID-19 evidence has linked feelings of stress with rapid and continuous changes in the workplace. This source of stress, known as “change fatigue”, is associated with adverse nurse outcomes, including EE (emotional exhaustion).”

Staffing shortages, a well-documented issue in the nursing profession, have also had negative impacts on nurses’ wellbeing during the pandemic.

“Our study highlights how persistent staffing inadequacies may compound risk of adverse mental health outcomes for nurses.

Notably, researchers say that some of the issues having negative impacts on nurses can be addressed.

“The bottom line is nurses’ mental health can be improved through modifying the conditions of their work environments,” it reads.

New policies and practices to address the specified workplace conditions are “urgently needed” especially during the COVID-19 pandemic, it concludes.