IntelyCare Research Group: Nurses Are Beyond Burnout, Suffering From PTSD as Spiraling Work Demands Force Them to Sacrifice Their Mental Well-Being

IntelyCare Research Group: Nurses Are Beyond Burnout, Suffering From PTSD as Spiraling Work Demands Force Them to Sacrifice Their Mental Well-Being

QUINCY, Mass. — A majority of nurses (56%) report that they’re sacrificing their mental health for the job, reveals survey data from the IntelyCare Research Group. IRG is the research arm of IntelyCare, the largest digital staffing platform for nursing professionals seeking per diem positions.

The third-party data demonstrates that working conditions during COVID-19 have taken a significant toll on nurses’ mental, physical and emotional well-being, and suggests why more than two-in-five (41%) are considering leaving the profession for good.

IntelyCare commissioned the third-party survey from Reputation Leaders, which surveyed more than 500 nurses in Q4 2021 to discuss opinions, thoughts, and trends in the nursing industry.

At a time when the country faces a potential shortfall of 1.1 million nurses, the pandemic has brought the demand on nurses to a whole other level. Pre-pandemic, suicide risk among nurses was twice as high among female nurses compared with American women as a whole. Now, higher levels of acuity and patient deaths, longer working hours, and increasing shortages of staff have combined with the inherent risks of treating COVID-19 infections to cause even more significant harm to nurses.

“Our nurses are not experiencing fatigue or burnout, they are experiencing significant moral injury and critical distress to their emotional foundation,” said Rebecca Love, IntelyCare’s chief clinical officer, a nurse, and well-known advocate for nurses. “We know that most of what is being offered to the frontlines in terms of whole-person support does not address the moral injury that nurses are experiencing.”

“Working in facilities with COVID can be terrifying,” said Nefertiti Graham, a certified nursing assistant working in long-term care. “There have been many residents who have passed away. I honestly feel really scared working with patients that have COVID, but it’s not the resident’s fault and they still need me to care for them and help them. There is also a lot of shortage of staff, so assignments are tough. There have been many times when I had to take care of 12-15 patients on a single shift. It can be incredibly stressful due to the heavy workload.”

Nurses are the primary factor affecting patient outcomes. In the acute care setting, they spend more time bedside with the patients than the attending physician. In long-term care, they are the healthcare providers who are with patients, day in and day out. When a loved one dies, it is often the nurses that share the devastating news with the bereaved family. Yet while 32% cite the death of patients as the job’s biggest stressor, well over half (58%) report they are not regularly offered grief counseling to deal with the traumas of counseling patients’ families or processing the losses for themselves.

Over a third (37%) of nurses do not feel supported in their mental health at work and 41% feel that they lack overall support from their system’s senior management. While the majority of nurses (72%) do have some form of access to mental healthcare through their employer, just 10% of those who have access use it.

“The question we should all be asking is ‘Why aren’t they using it?,’” said Love. “Is there a stigma we need to address to get our nursing workforce the help they need to manage the post-traumatic stress of being on the frontlines of our health system? Nurses are actively seeing dead patients in their waking hours, experiencing nightmares while they sleep and suffering from constant flashbacks triggered by their places of employment.”

The mounting pressure of understaffing is amplifying the burden on nurses, further denying them the time or ability to find care or even a break to process and heal. More than a quarter (29%) of respondents hadn’t taken a vacation in 2021; 27% hadn’t taken a day/weekend off during the previous month, and nearly 40% can’t take time off when they want to.

“Five patients per nurse is the optimal ratio for general medicine floors in the U.S., but we’re seeing one-to-12 at some of our rural hospitals. The hours are too long, there are constant overtime demands, and nurses are phoned with questions and requests to work on days off. While the problem existed well before the pandemic, the crisis has eliminated all the pressure valves,” according to Love.

With the dramatic increases in death that nurses are managing throughout COVID, many at times are facing more death in a single day than they experienced in a full month prior to COVID.

Three-quarters (74%) of nurses came into the role to simply just help others. But for many, their profession is causing them to sacrifice their personal lives and time with their families. More than a third (39%) said they prioritize their job over everything else in life — before friends, family, marriages, finances, even their own health.

  • 61% have had been told by a family member or friend that they work too much
  • 44% miss important family milestones to be a nurse
  • 68% have missed social events for work in the last month

“Healthcare administrators owe it to nurses and to patients to empower and invest in the nursing profession,” David Coppins, IntelyCare CEO. “We need to seek out new tools and systems. We need to reinvent reimbursement and scheduling models around work-life balance, career paths, and education. The challenges nurses face are built into the system; to facilitate real change we have to begin with that understanding.”


Reputation Leaders surveyed 500 nurses in late Q4 2021 from across the U.S to discuss opinions, thoughts, and trends in the nursing industry, covering both acute and post-acute workplaces, and including Certified Nursing Assistants (CNAs), Licensed Practical Nurses (LPNs), and Registered Nurses (RNs).

About IntelyCare

IntelyCare is the largest digital nurse staffing platform in the United States. Through advanced machine learning and behavioral science, IntelyCare’s easy-to-use app matches nursing professionals with open assignments at its post-acute partners. In doing so, IntelyCare is leading the work evolution for nurses, empowering them with the freedom to choose when, where, and how often they work, for the wages and benefits they deserve.


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