A worldwide study reveals a severe mental health crisis among nurses, exposing the long-term effects of the COVID-19 pandemic on healthcare workers. The study, which appeared in International Nursing Review, highlights rising burnout and emotional distress. It also points to workplace violence, threatening the stability of healthcare systems globally.
The research was led by Professor Allison Squires of NYU Rory Meyers College of Nursing. It surveyed 9,387 nurses from 35 countries between July 2022 and October 2023. The findings show a widespread mental health struggle, with anxiety and depression rates between 23% and 61%.
“Nurses are overwhelmed by the unrelenting stress of their jobs,” said Squires, the study’s lead author. “This pressure doesn’t stop at work—it follows them home. Many are also grieving personal losses.”
While burnout in nurses from high-income nations has been extensively studied, this research broadens the focus to low- and middle-income countries, revealing similar struggles across the globe.
ANXIETY, EXHAUSTION, AND OVERWHELM
The study found nurses experience more mental health symptoms at work than at home. The most common issues include:
- Fatigue – 57%
- Anxiety – 44%
- Feeling overwhelmed – 41%
Mental health symptoms varied by country, with cultural differences affecting stress levels:
- 69.9% of Brazilian nurses reported workplace-related anxiety, compared to 23.8% in Indonesia.
- 80.9% of Turkish nurses felt overwhelmed at work, while only 6.7% in Thailand reported the same.
LOSS AND VIOLENCE: A DOUBLE BURDEN
The study also highlighted the emotional toll of COVID-19 on nurses.
- 20% lost a family member to the virus.
- 35% lost a friend.
- 34% lost a coworker.
Beyond personal grief, violence and aggression emerged as another major challenge. Nearly half (48%) of nurses said they experienced verbal or physical aggression from the public due to their profession.
“This is a serious safety concern,” Squires emphasized. “Nurses should never face hostility while providing care.”
LACK OF MENTAL HEALTH SUPPORT
Despite the alarming mental health crisis, only 24% of nurses reported that their employers provided sufficient mental health services.
With limited institutional support, many turned to self-care strategies, like:
- Exercise
- Spiritual practices
- Emotional support from family and friends
“Increasing self-care practices shows nurses are finding ways to cope,” said Squires. “But self-care alone isn’t enough—they need real mental health resources and support systems.”
NURSING EXODUS: A GROWING GLOBAL PROBLEM
The mental health crisis is pushing them to leave the profession, worsening an already critical nursing shortage. Many are:
- Switching to lower-stress jobs.
- Leaving their home countries for better working conditions.
- Exiting the profession entirely.
“This could collapse healthcare systems, especially in vulnerable regions,” warned Squires. “Many systems were struggling before the pandemic—now they’re at risk of breaking entirely.”
URGENT ACTION NEEDED: INVESTING IN NURSES
Healthcare leaders are calling for immediate government intervention.
Pamela Cipriano, President of the International Council of Nurses (ICN), stressed the urgent need to retain and recruit nurses.
“We’ve been warning about this since the pandemic began,” she said. “Burnout is forcing experienced nurses to leave, and with an aging workforce, the global shortage will only get worse.”
ICN research confirms that investing in nurses improves:
- Patient care
- Health system sustainability
- Economic growth
