Baylor-led Study Analyzes Impact of Covid on Pediatric Advanced Practice Registered Nurses

Jessica Peck, DNP, Baylor clinical professor of nursing, considers the effects of COVID-19, including burnout and mental health concerns, on APRNs

by Kate Nelson, student news writer, Baylor University Media and Public Relations

WACO, Texas (Oct. 21, 2021) – Pediatric advance practice registered nurses (APRN) are facing multifocal impacts of the COVID-19 pandemic, with the most difficult challenge being mental health struggles experienced by themselves and their families, according to a new study led by Jessica Peck, DNP, clinical professor at Baylor University’s Louise Herrington School of Nursing (LHSON).

The study, published in the Journal of Pediatric Health Care, examined the holistic effects of COVID-19 on pediatric-focused APRNs through a survey of 789 participants.

The study shows that pediatric APRNs experienced increased burnout and mental health concerns during the COVID-19 pandemic. With its serious impact on society, COVID-19 has burdened medical professionals, which has caused delays of care within the healthcare system. Nurses throughout the healthcare system have been critically impacted by the COVID-19 pandemic.

A consequential impact of COVID-19 has been the alteration of pediatric care delivery. Pediatric agencies have experienced disruptions in care provisions, patient presentations, clinical practices, immunizations and revenue, according to the study. Furthermore, some pediatric nursing professionals have transitioned to working with adult populations while others have been furloughed or laid off due to a strong demand for critical care nursing services and a lower demand for primary care nurses.

“While physical disease impacts on children have generally not been as dire as some historic precedents like polio, they are by no means spared,” Peck said. “Pandemic conditions have fundamentally altered the norms of pediatric care delivery and, as a profession, we share collective concerns: severe COVID in children with pre-existing conditions, life-threatening multi-system inflammatory syndrome, disturbing disparities in severity of illness and death, particularly for children of color who account for 75% of pediatric COVID-19 deaths, and free-falling immunization rates with recovery not yet in sight.”

The strongest impact of COVID-19 has been on APRN’s mental health. The research shows that 34% are experiencing moderate to extreme concern for professional burnout while 25% of respondents feel anxious or nervous and another 15% are experiencing depression or hopelessness. Overall, 20% of participants reported feeling moderate to extreme concern for their mental health.

“As a profession, many pediatric nursing professionals are working far more hours for far less compensation, isolated from professional networks. They are learning new technologies and implementing new policies in little time with even less support. Pediatric clinics are severely disrupted,” Peck said. “Children’s hospitals received less than 1% of all federal relief monies provided to U.S. hospitals, leaving children without access to care. Faculty are exhausted and experiencing vicarious trauma hearing devastating stories from their students. All of this contributes to destabilized pediatric infrastructure, which disproportionately impacts marginalized children.”

Not only has COVID-19 impacted registered nurses, but it also has had significant impact on their families. Most respondents noticed an increase in clinical presentations of child mental or behavioral health concerns (73%), isolation and limited socialization (72%) and parental anxiety (71%).

One of the most alarming findings was the increase in child mental or behavioral health concerns that nurses noticed, Peck said.

“This problem is multifactorial, with isolation, loss of safety net services, family stressors and trauma and deferred care and services all compounding this issue across communities worldwide,” she said.

Another notable finding is that more than a third of the respondents had moderate to extreme concern over professional burnout due to rapid changes and disinformation. In addition, lessons learned during the pandemic will shape the next generation of APRNS.

Peck noted three practical implications of the study:

  1. Nurses are not heroes or angels and should be treated as humans with physical and mental health needs. Nurses should be supported to prioritize individual health promotion behaviors and resource access.
  2. Healthcare organizations and leaders need to affirm and reinforce the value of nursing with diverse and equitable representation in decision-making forums and assurance of access to supportive resources without fear of discrimination, stigma or bias.
  3. Support for public civility towards nursing professionals and public health experts is crucial, with policy support for zero tolerance of violence towards nurses.

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