The insomnia, fatigue, and psychological well-being of hospital nurses 18 months after the COVID-19 pandemic began: Across-sectional study.

Abstract

BackgroundResearch has shown sleep problems, elevated fatigue, and high cases of burnout, as well as signs of post‐traumatic stress and psychological distress among nurses during the COVID‐19 pandemic. Many US hospitals attempted to minimise its impact on staff by providing basic resources, mental health services, and wellness programs. Therefore, it is critical to re‐evaluate these well‐being indices and guide future administrative efforts.PurposeTo determine the long‐term impact of the COVID‐19 pandemic after 18 months on hospital nurses' insomnia, fatigue, burnout, post‐traumatic stress, and psychological distress.DesignCross‐sectional.MethodsData were collected online mainly through state board and nursing association listservs between July–September 2021 (N = 2488). The survey had psychometrically tested instruments (Insomnia Severity Index, Occupational Fatigue Exhaustion Recovery Scale, Maslach Burnout Inventory, Short Post‐Traumatic Stress Disorder, and Patient Health Questionnaire‐4) and sections on demographics, health, and work. The STrengthening the Reporting of Observational studies in Epidemiology checklist was followed for reporting.ResultsNurses had subthreshold insomnia, moderate‐to‐high chronic fatigue, high acute fatigue, and low‐to‐moderate intershift recovery. Regarding burnout, they experienced increased emotional exhaustion and personal accomplishment, and some depersonalisation. Nurses had mild psychological distress but scored high on post‐traumatic stress. Nurses who frequently cared for patients with COVID‐19 in the past months scored significantly worse in all measures than their co‐workers. Factors such as nursing experience, shift length, and frequency of rest breaks were significantly related to all well‐being indices.ConclusionNurses' experiences were similar to findings from the early pandemic but with minor improvements in psychological distress. Nurses who frequently provided COVID‐19 patient care, worked ≥12 h per shift, and skipped rest breaks scored worse on almost all well‐being indices.Relevance to clinical practiceAdministration can help nurses' recovery by providing psychological support, mental health services, and treatment options for insomnia, as well as re‐structure current work schedules and ensure that rest breaks are taken.