Nearly one in three nurses reported they “are not emotionally healthy,” including almost half of all nurses under 25 years old, according to a survey conducted by the American Nurses Foundation and Joslin Insight in January 2022. The survey was a follow-up to one conducted in January and February 2021 with 22,316 nurses. This follow-up included responses from 12,694 nurses, with 93% answering all the questions.

”Of all the industries impacted by Covid, few would argue that the nursing profession has not taken the brunt of the burden,” the researchers write in their report. “Given everything nurses have been through since the World Health Organization officially declared Covid-19 a pandemic, it is no surprise that nurses are seeking other opportunities.”

The findings come after the US has seen one million Covid-19 deaths, with 60% of acute care nurses feeling burned out and 75% feeling stressed, frustrated, and exhausted. Though the numbers aren’t necessarily surprising, the substantial toll the pandemic has taken on Gen Z, in particular, is concerning. These nurses are just starting their careers, and two out of three of them already feel burned out. Further, more than half of all the nurses surveyed are either planning to leave the profession or considering it, again led especially by younger nurses.

The survey respondents were predominantly white (76%), and the other quarter included similar representation from Black (9%), Hispanic (6%), and Asian (6%) nurses. Just over a third of the nurses surveyed were at least 55 years old or older, and nearly all (95%) reported being currently employed. More than half the respondents (59%) worked at an acute care hospital, 11% worked in primary, ambulatory, or outpatient care, and 6% worked in community or public health facilities. Most of those answering the survey (76%) provide direct care to patients, and 90% reported that they had or may have had direct exposure to a patient with Covid-19. 

The most striking finding was the inverse relationship between age and emotional health. While 30% of nurses reported feeling “not emotionally healthy” or “not at all emotionally healthy,” the number jumped to 47% for nurses under age 25 and 46% for nurses aged 25-34. As age increased, those reporting poor emotional health decreased, with 39% of those aged 35-44 and 29% of those aged 45-54 reporting not feeling emotionally healthy. For nurses age 55 and older, only about one in five (19%) reported not being emotionally healthy.

”Viewed differently, if one entered a room with one-hundred nurses who considered themselves ‘very emotionally healthy,’ fifty-nine would be 55 or older; six would be under 35,” the researchers reported. The same inverse relationship existed for years as a nurse and emotional health, though experience and age typically overlap quite a bit. For example, only 13% of nurses with more than 40 years of experience reported not feeling emotionally healthy compared to 40% of those with less than five years of experience.

The poorest emotional health occurred among those working in intensive, critical, or emergency care, where 46% of all nurses reported not feeling emotionally healthy. The responses were 39% for medical-surgical nurses and 38% for acute care hospital nurses outside of the ICU or the emergency departments. 

The differences by age repeat in trends of anxiety, depression, and burnout reported by nurses. For example, two out of three nurses under age 35 feel anxious and burned out, compared to one in three of their colleagues ages 55 and older. In addition, the under-35 group reported twice as much depression (43%) as age 55+ nurses (21%). 

And younger nurses don’t feel their employer has their back either: Only one in five (19%) nurses under age 35 agreed with the statement, “My organization really cares about my wellbeing.” More than twice as many nurses age 55 and older agreed with that statement. Younger nurses similarly felt far less confident than older nurses that their employer would notice how hard they’re working, take pride in their accomplishments, respond to their complaints, or value their contributions to the organization’s wellbeing. 

It’s not surprising, if alarming, how many young nurses plan to leave the profession or at least consider it. More than three out of five nurses (63%) under age 35 are thinking of leaving, half of whom have already decided to leave while the other half are considering it. Across the whole profession, however, the number of nurses looking to get out has jumped from 40% last year to 52% this year. 

The leading reasons inspiring nurses to jump ship are, unsurprisingly, insufficient staffing and their work having a negative impact on their health and wellbeing. Concerns about inadequate staffing have also grown, with 55% of nurses reporting it as their reason for leaving, compared to 34% last year. Even aside from whether they’re considering leaving the profession, 89% of nurses reported working at a place that’s understaffed, and more than half of them (54%) said it was a serious problem. 

Another key reason for leaving nursing is feeling that they can’t deliver quality care consistently, a number cited by just a quarter of nurses in September 2021 and now cited by more than a third of nurses (36%). Nurses also cited a lack of support from their employer during the pandemic, distrust of them, needing higher income, and a poor organizational response to Covid as reasons they plan to leave nursing. Though it wasn’t cited as a reason for leaving, nurses also reported increased bullying and violence—one-third say violence at work has increased, and two-thirds experience more bullying at work.

While none of these numbers are necessarily a surprise to those working in nursing right now, the next big question is how to address this epidemic of burnout, depression, and isolation. “The goal now is for policymakers, professional organizations, health systems, and leadership to act,” the researchers write. They conclude by noting two initiatives of the American Nurses Association that specifically aim to address nurses’ mental health and wellbeing: the Wellbeing Initiative and the Coronavirus Response Fund for Nurses.