Practice Tip of the Week | Nursing Wellness: Strategies and Organization Tools

By Claudia Cruce, MS, BSN, RN, CCRN; Betiel Bekel, BSN, RN; and John F. Garzon-Vasquez, BSN, RN, CCRNSummer is in full swing and with it comes family gatherings, beach time and an overall sense of relaxation.  Summer is here and
fun foods are calling! Queue the sizzling barbecue and smell of freshly mowed grass with the symphony of cicadas as the playlist —albeit the Texas size mosquitos!  We welcome July with open arms!  But, did you know that July is Black,
Indigenous, and People of Color (BIPOC) Mental Health Month?

Mental Health issues affect 1 in 5 US adults.   For many, summer can bring quite the opposite of fun, especially for certain ethnic minority and racial groups. 
Texas has seen a vast growth in its population within the last decade.  According to the US Census Bureau, the Hispanic/Latino group along with the Black (non-Hispanic) community are two of the fastest-growing racial groups residing in Texas. 
Both groups combined encompass 52.7% of the overall state population.  Rates of mental illnesses in some BIPOC communities are comparable to the White community, however, mental illness can be more persistent, and bears a higher burden of disability within BIPOC groups.  In both the Latino and African American communities, there exist barriers, such as stigmas, distrust of the health care system and lack of providers from diverse racial/ethnic backgrounds that preclude these marginalized
groups from accessing the help they need.  So what does this mean for nurses and the nursing practice? How do organizations navigate stigmas and prepare our nursing workforce to be adequately proficient
in handling such imperatives?

Strategies:First, with introspection.  It is imperative we look at the current Texas nursing workforce demographic because along with changes in our patient population, the demographics of the nursing
workforce are changing as well. As of 2019, the demographics of the working nurse force include a median age of 44 with white/Caucasian nurses being the largest in the workforce. However, as of 2010, that number has been on a steady
decline. The look and makeup of the nursing workforce is changing and with it come unique opportunities that can be honed to concurrently bring mental health awareness to our nursing workforce and in turn our patient population.To
elucidate, our 2023 Nurse Residency Program cohorts self-reported racial/ethnic groups equivalent to the most recent US Census Texas demographics. Meaning, over half the entering class self-identifies as belonging to a BIPOC group. Organizations
should take this opportunity to recognize and learn how people’s diverse backgrounds perceive and experience mental health. For example, US-born Hispanics report higher rates of mental illness compared to their parents’ generation.  Only
1 in 3 African Americans who report mental illness receive mental health care. Asian Americans/Pacific Islanders report the lowest rate of mental illness, however, such numbers may be skewed with stigmas of shame or weakness among their community.  

Wellness Resources: As healthcare organizations and stakeholders continue to learn and implement mental health tools, it is important to consider the approach and effectiveness. Advocating for nurses to seek professional
health is simply not enough. In May of 2023, the American Nurse Foundation and McKinsey found, mental health challenges among nurses continue to be high and despite these high levels, two-thirds of the surveyed nurses were not receiving any
type of mental health support.  Organizations should be asking…what is preventing nurses from seeking help? 

StigmasUnfortunately, the concept of mental health continues to be viewed differently when compared to other chronic
health conditions, despite it being rooted in genetics and biology. There are additional barriers that may need to be considered concerning the BIPOC community. According to the American Nurses Foundation Survey Series, one-third of nurses
report stigma around seeking mental health. As we strive to become comfortable with mental health conditions in health care, organizations must become more aware of the impact stigmas have on accessing the necessary tools to aid their nursing staff. Addressing the “elephant in the room” should be the first step in securing a safe space for current and new cohorts of nursing professionals entering the workforce. Setting the ground rules and establishing a culture of inclusivity can
begin to change the context of our more traditional models. 

TimeWithin the most recent post-pandemic surveys, lack of time has been the second largest reason cited for NOT seeking professional mental health. Providing staff
with quick, confidential and easily accessible resources may help in alleviating this matter. Some organizations have begun offering a variety of popular online subscriptions, such as Headspace and NOOM at no additional cost to the nursing staff. Additionally, the combination of on-site wellness teams can help with the time constraints by providing in-person or virtual counseling sessions. The session can be tailored to the needs of each individual and cover a variety of well-being topics. 

AwarenessOrganizations should invest in the marketing of their resources and ensure the tools are being utilized.  One idea is having a “mental-health concierge app” where nurses have access to self-assessment tools, action steps they
can take within their organization, daily goals, and a mood tracker, to mention a few.  Hospitals can further support such endeavors by establishing communities of support, such as peer-to-peer support groups, mental health forums and expressive
writing workshops. Introducing mental health resources to each new cohort of nurses along the continuum of hospital orientation through training sessions and seminars can begin changing the landscape of accessibility and awareness.    Reflection:As we continue to see robust changes in Texas demographics, organizations have the opportunity to equip their nurses with tools and resources to improve their mental health
and in turn be better advocates for their patients. The conversations must be had to break down the barriers and stigmas associated with mental illness. We must be able to have open dialogue and break down stereotypes that challenge mental
health in the nursing workforce. The unique lived experiences of the BIPOC community must be supported in order to implement programs with positive outcomes. As we continue to care for an ever-changing Texas population, a healthy community
begins with healthy nurses.

REFERENCES

Prioritizing Minority Mental Health | Health Equity Features | CDCTexas population by year, county, race, & more | USAFactsU.S. Census Bureau QuickFacts: Texas2019 Nurses in Texas