Ten areas for ICU clinicians to be aware of to help retain nurses in the ICU

Abstract

Shortage of nurses on the ICU is not a new phenomenon, but has been exacerbated by the COVID-19 pandemic. The underlying reasons are relatively well-recognized, and include excessive workload, moral distress, and perception of inappropriate care, leading to burnout and increased intent to leave, setting up a vicious circle whereby fewer nurses result in increased pressure and stress on those remaining. Nursing shortages impact patient care and quality-of-work life for all ICU staff and efforts should be made by management, nurse leaders, and ICU clinicians to understand and ameliorate the factors that lead nurses to leave. Here, we highlight 10 broad areas that ICU clinicians should be aware of that may improve quality of work-life and thus potentially help with critical care nurse retention.

Exploring promotion factors of resilience among emergency nurses: a qualitative study in Shanghai, China

“…Managers should engage in more communication with nurses to gain a better understanding of their work-related difficulties and needs, assist them in managing negative emotions, and offer prompt assistance and support. Additionally, implementing appropriate salary improvements for nurses as well as mindfulness-based stress reduction techniques, concentrated short-term treatment options and other psychological intervention measures can also prove effective in combating occupational stress 28. Third, managers should proactively encourage nurses to engage in skills training during peacetime, thereby preparing them for future emergencies and fostering a heightened awareness of their professional value.…”

The early impact of COVID-19 on intensive care nurses’ personal and professional well-being: A qualitative study

“…The overall experience of the COVID-19 pandemic has led some nurses to question their decision to become a nurse (Chegini et al, 2019; LoGiudice & Bartos, 2021 ). The shortage of nurses in ICU is not new, but has been exacerbated by the excessive workload, moral distress and perception of inappropriate care during the COVID-19 pandemic ( Vincent et al, 2022 ). Nurses in our study discussed similar misgivings about continuing their nursing careers, signaling that immediate measures need to be taken to sustain a healthy nursing workforce.…”

“…In many places there were shortages of beds, ventilators, medications and staff to care for these severely ill patients (Encarnot et al, 2022). As infection rates surged, standards of care in overwhelmed ICUs shifted to crisis standards ( Butler et al, 2020 , Silverman et al, 2021 ) that included the creation of new ICU bed areas, changes in staffing models and use of non-critical care nurses in the ICU to fill nursing staff shortages (Endacott et al, 2022; Vincent et al, 2022 ). The conflict between a nurse’s commitment to deliver optimal care and the predicament of excessive and altered workload (such as increased work hours and shifts, shortage of ICU beds, lack of personal protective equipment, visiting restrictions, and changing protocols) created an untenable situation and has led to frequent and severe moral distress and burnout ( Bergman et al, 2021 ).…”

What Are the Factors That Influence Job Satisfaction of Nurses Working in the Intensive Care Unit? A Multicenter Qualitative Study

“…Nurses who are proactive and show leadership experience greater job satisfaction and are less likely to leave the profession [33]. Based on our fndings and inspired by previous papers [34,35], we listed several recommendations for practice across seven domains which may help to increase job satisfaction among ICU nurses and thereby retain them for the ICU (Table 2). Although the list focuses on ICU nurses, many of the recommendations we propose here may equally apply to the retention of nurses in other healthcare settings as nurse job dissatisfaction and high turnover are common in other healthcare settings as well [36,37].…”