Caring for Nurses on the COVID Front Line: New Data Identify Improvement Targets

Added on Dec 10, 2020

Caring for Nurses on the COVID Front Line: New Data Identify Improvement Targets
By Diana Mahoney

Front-line nurses are the backbone of our nation’s fight against COVID-19, and they are suffering. New data from Press Ganey confirm that RNs treating COVID-19 patients in acute care and critical access hospitals score much lower on key engagement indicators of employee well-being, resilience, and job satisfaction than both the nursing average overall (Figure 1) and the mean performance of physicians and other employees in COVID units (Figure 2). The data reflect more than 32,000 responses to Press Ganey’s COVID-19 Caregiver Needs and Support Pulse Survey administered from late April through early September 2020 at 50 locations across the country.

“The lowest overall scores among nursing employees providing COVID care are related to confidence in senior management’s leadership and communication practices, workplace safety, and teamwork between employees and management and across units related to COVID,” according to Press Ganey Chief Clinical Officer, Dr. Jessica Dudley. “This tells us that health systems can improve the support they provide to front-line nurses by adopting and adapting leadership, communication, and teamwork strategies and tactics.”

This means doubling down on proven best practices for improving nurse engagement, such as leader rounding on staff and transparent management communication, said Mary Jo Assi, Associate Chief Nursing Officer and Strategic Consulting Partner at Press Ganey, who offered health system leadership the guidance shown in the sidebar to ensure that nurses feel supported, respected, valued, and physically and emotionally safe.

In addition to implementing some of these short-term tactics to address the acute needs of nurses during the pandemic, leadership should continue to build the necessary infrastructure and resources for improving nurse engagement and retention over the long term, including nurse leader onboarding and skills development, shared governance, interdepartmental collaboration, and action planning.

“In order to create and maintain safe, effective practice environments that meet the needs of patients, health care organizations must also be vigilant in protecting the physical and emotional well-being of those providing care,” Assi said. “While this is especially critical during times of crisis, when caregivers are being asked to work under conditions that pose substantial risks to their overall health and well-being, it is also important during noncrisis periods to help ensure a responsive and resilient nursing workforce,” she said. In this regard, she noted, pulse surveys are a valuable tool for identifying areas of particular vulnerability and for monitoring the effectiveness of solutions designed to address them.



To build nurse confidence in senior management and improve perceptions of teamwork and communication, nursing leaders should double down on some of the following practices, according to Mary Jo Assi, Associate Chief Nursing Officer and Strategic Consulting Partner at Press Ganey.

  • Increase senior leaders’ visibility with nurses working on the front line of care. This could be through rounding, town halls, or virtual communication. The objective is to ensure that senior leaders are making themselves available for two-way dialogue.
  • Provide opportunities for nurses to share concerns and solutions relative to their safety as well as the safety of the patients on their units.
  • Share relevant policies and procedures, including information on how to access employee assistance programs, to spread awareness of the processes and resources in place that are designed to keep them safe and available to them during this very difficult time.
  • Focus on improving teamwork, between nurses and others on their shifts, including managers, nonclinical staff, and physicians, and between departments, especially in the ED and on floors where COVID patients are being seen.
  • Share stories of success highlighting the efforts of nurses working on COVID units and in the ED. Focusing on their impact as “health care heroes” can help ground them in the impact their work is having on patients and families.
  • Utilize “caregiver checklists.” Either before or after every shift, nurse managers should check with nurses to make sure they are okay, help them process their experiences, and give them an opportunity to get ready for the transition to work or home.

Figure 1

Figure 1


Figure 2

Figure 2