Stress of pandemic has added to mental health struggles for Austin-area nurses

by Nicole Villalpando | Published by Austin American-Statesman

During the coronavirus pandemic, we've often called nurses and other medical support staff "heroes," even displaying signs outside hospitals that read: "Heroes Work Here."

That might not have helped their mental health, though, said Dawn Webb, the former director of Texas Peer Assistance Program for Nurses at the Texas Nurses Association.

"It's really unfair to them to put them on a pedestal," Webb said. "It adds to more stress."

Webb will be leading a Texas Nurses Association team at the National Alliance on Mental Illness Central Texas event NAMI Walks Your Way on Saturday. The goal for her team, the Discrimination Decimators, is to focus on reducing the stigma of mental illness in the community as well as among medical care providers.

A Trusted Health report from May found that of the 2,500 front-line nurses it surveyed, 1 in 10 reported having suicidal thoughts since the pandemic began, while 75% had experienced burnout, 66% experienced compassion fatigue, 64% have felt depressed, 64% said their physical health has declined, 50% said they experienced PTSD, trauma or extreme stress, and 46% said they had experienced moral distress around an ethical decision such as rationing care.

Webb, who recently started a job in mental health nursing at the Veterans Affairs office in Austin, had been overseeing the Texas Nurses Association's peer assistance program during the pandemic. That program is for nurses to either self-refer that they are having a mental health or substance abuse problem or to be referred by their employer.

You might think with the challenges of being a nurse during the pandemic, referrals to the program would go up, but that wasn't the case. "Referrals have gone down significantly, which is surprising and frightening at the same time," Webb said.

In addition to the things the Trusted Health survey found, nurses also were being asked to pick up more shifts because of staffing shortages and increased demand, Webb said. Families and patients were sometimes scared or frustrated and took that out on nurses. Nurses sometimes had no time to eat or take a break.

Many nurses, Webb said, have post-traumatic stress over all of these things and feel like they couldn't complain about it.

"Any nurse who has experienced a mental health condition is fearful of asking for help," Webb said. "There's a superhero status. It's like you're resilient to all these things. It's not OK to be tired. It's not OK to say no."

Other nurses who weren't working with COVID-19 patients or in hospitals felt guilty about that, Webb said, like they weren't doing enough compared with their peers. Some of them also faced unemployment as people switched from in-person visits to telehealth or clinics shut down during the height of COVID-19, when nonemergency procedures were postponed.

A lot of people might not be able to identify with what nurses went through during the pandemic, but they can understand the stress of uncertainty and the lack of "normal" that everyone faced.

Most people, including nurses, aren't being educated on the signs of a mental health disorder such as PTSD, Webb said.

Watch for these signs:

  • Ruminating about things or constant worry.
  • Flashbacks of things that have happened.
  • Not being able to sleep or sleeping too much.
  • Having recurring bad dreams.
  • Crying often or having unreasonable emotions.
  • Lacking an appetite or overeating.
  • Feeling like something is different, that you can't just bounce back.
  • Feeling withdrawn, like you are there but you are not.
  • Relying on substances or alcohol to get through the day.

Start trying to heal by doing self-care such as going for walks or jogs, meditations, yoga or journaling ― whatever is your healthy coping mechanism.

If that doesn't work, check out your employer's employee assistance program, which offers free counseling sessions.

"I've used my (employee assistance program) half a dozen times for various reasons," Webb said "You have to find ways to take care of yourself and be OK with that."

Webb is also an advocate of companies starting support groups for its employees, creating meditation or quiet rooms, offering regular breaks and allowing people to take them, and having predictable scheduling to prevent burnout or a deterioration of mental health.

"You can't be a good mom or an employee if you're not OK," Webb said.

To find out more about the Texas Peer Assistance Program for Nurses, go to