Mental Health + Me: The Emotional Challenge of Nursing

“PASS”. That was it. A four-letter word. THE four-letter word that determined what felt like the rest of my life––was finally printed on the letter I received from the National Council of State Boards of Nursing (NCSBN). What happened next is a blur; I only remember hugging my parents in between heavy sobs releasing the stress and anxiety of four failed attempts (yes, four) and one year later of trying to pass this dang test. I hadn’t felt this relieved since nursing school graduation day the prior year. While we were in school, it really confused me how little my professors talked about maintaining our mental health as people collectively seeking to improve the health and well-being of others, especially after the battle I had endured to get to graduation day, let alone becoming a licensed nurse. But there I was, one year later, feeling the most mentally, physically, and emotionally relieved as I had in ages and not really considering much else other than the fact that I was now Raquél Pérez, BSN, RN. 

Five years later, that small moment in time feels simultaneously far away and like it just happened. I think of it often, mostly because it was one of the happiest moments in my life and also because it was the beginning of my understanding that mental health maintenance is not linear. An incredibly joyous moment like passing the National Licensure Exam for Registered Nurses (NCLEX) would not be the one-size-fits-all solution to the stress, anxiety, and overwhelm I had felt (or would continue to feel). Actually––quite the opposite––I was just getting started with my mental health journey. 

The first time I went to therapy was to seek help for test-taking anxiety during my NCLEX saga. The second, third, fourth, and future times after that were for working through the emotional fatigue that comes with being a nurse. What had been my reasoning for entering the profession––helping people through patient care––would also prove to be difficult at times when I would watch my patients go through heartbreaking moments. The most incredible places I’ve ever worked were the women’s oncology and neonatal intensive care units where I met the most resilient, kind, and caring humans. I got to know who my patients were outside of their illnesses, hold their hands through painful procedures, watch them grow from infancy to major milestones, double over in laughter at the funniest retelling of family stories, cry with them after an unfortunate prognosis––and, sometimes, grieve with their families when they passed. 

 

Grief was challenging to process. It would keep me up at night after work and would want to stay as a constant emotion, but I ignored it for as long as I could just to get through my shifts. That became increasingly difficult when the pandemic hit; grief and fear of the unknown felt like a constant, overwhelming fog that not only myself, but my colleagues were also experiencing.   

According to the CDC, 22% of healthcare workers experienced moderate depression, anxiety, and PTSD from June–September 2020. The aftermath is still being played out today as we have seen nurses leaving the profession in droves due to stress and burnout. 

There is an interesting duality that comes with having a career as a nurse. You are privileged to experience some of the highest highs of the human experience and some of the lowest lows, all the while trying to hold it together to maintain self-preservation and just get through the shift. My therapist and I would work through the overwhelming emotions I would be feeling at the time and shed light on some much-needed perspective: being a nurse is hard; nursing school is hard; working through an entire pandemic as a new grad is hard; anxiety, stress, depression, and mental illness, in general, is hard. 

However, hard does not need to mean permanent or alone. So here are some of the resources I turn to that help me the most that may be helpful to you:

1. Therapy Aid Coalition provides free/low-cost therapy for healthcare professionals and first responders.
2. Dugri is a safe and anonymous peer support network where you can unload your emotions with people who have been through the same.
3. Keener is a free self-care app for nurses that comes with modules, journaling, and helpful resources. 
4. Headspace assists with stress management, sleep troubles, and anxiety through meditative practices. 

Here are some additional organizations/resources that are working toward providing mental health assistance:

1. NAMI is the nation’s largest grassroots mental health organization.
2. The Wellbeing Initiative supports the mental health of nurses and is spearheaded by the American Nurses Association.
3. For the Frontlines provides free crisis counseling for frontline workers 24/7.
4. Operation Happy Nurse is a nonprofit working to decrease depression and anxiety for nurses through connection and peer support.
5. Vitalize, an app for healthcare workers,  was co-designed with clinicians and administrators to best understand mental health needs and challenges. 

At this very moment in my life, I am the happiest I have ever been. There is still progress to be made when it comes to my self-care and mental wellness, but the person I was in 2018 has certainly come a long way since. The truth is, there is not a single moment of my career that I would change. Through the hardest moments, I also found the best. However, I hope in the future, every nurse will be provided with standard mental health support right from the start of nursing school because, at the end of the day, we are people first. Nurse second. As Mental Health Awareness Month comes to a close, to whoever is reading this, I hope you are able to recognize how deserving of peace, support, and help you are. Whatever it is that you are going through––nurse or not––I encourage you to seek a community of people who support you fully and make you feel whole.

by Raquél Pérez, Chief Nursing Officer at Gales