BACKGROUND The COVID-19 pandemic has presented unprecedented levels of prolonged strain on healthcare systems and healthcare workers (HCWs) globally, with nurses are at the forefront. OBJECTIVES To describe types and prevalence of occupational disruptions and exposure to COVID-19, and their impacts on mental health, moral distress, coping strategies, and help-seeking behaviours of Australian nurses. DESIGN A cross-sectional online anonymous survey distributed amongst Australian healthcare workers between 27th August and 23rd October 2020. METHODS Data was collected on demographics, workplace disruption, personal relationships, and mental health. Predictors of mental health impacts and coping strategies were identified through multivariate regression analyses. RESULTS 7845 complete responses were returned, of which 3082 (39.3%) were from nurses and 4763 (60.7%) were from all other professions ('other HCWs'). Occupational disruption was common, with nurses specifically reporting additional paid hours (p<0.001). Nurses were exposed to, and infected with, COVID-19 more frequently than other HCWs (p<0.001) and were more likely to report concerns around stigmatisation from the broader community (p<0.001). Symptoms of mental illness (anxiety, depression, PTSD and burnout) were significantly more prevalent in nurses than other HCWs, despite both groups scoring high on resilience. Common predictors of mental health symptoms included exposure to COVID-19 and worsening of personal relationships. Nurses reported a variety of coping strategies and were more likely than other HCWs to increase alcohol consumption. Engagement with formal support services was low for both groups. Personal and professional predictors for coping strategy use were identified. CONCLUSIONS Urgent action is needed to address staff shortages and burnout which have been exacerbated by COVID-19. Initiatives which recognise the importance of nursing staff and incentivise current and future nurses to join and remain in the workforce are essential. IMPACT STATEMENT Nurses faced significant occupational disruption, infection risk, and psychological harm during the first year of the COVID-19 pandemic in Australia.
Cross-sectional survey of COVID-19-related impacts on mental health of nurses: Occupational disruption, organisational preparedness, psychological harm, and moral distress.