“Covid-19 Is ‘Probably Going to End My Career’” is the title of my recent column in the New York Times. The nurse who made that statement spoke to me on the condition of anonymity because her hospital doesn’t like having nurses speak out. So—nurses are afraid to publicly complain about their difficulties on the job, struggle with a lack of PPE and short-staffing, and are overwhelmed by the number of deaths they are seeing. All this has led to the nursing profession being in crisis.

The six ideas below could help nurses drowning in difficulties imposed by Covid find their way back to solid ground.

  1. Staffing legislation. This could mean ratios, or some other way to insure that nurses are not expected to work short. The legislation should also require robust nursing float pools and keep secretarial and nursing assistant support at their usual levels. Units have to be staffed in a way that maximally benefits patients, not just to help balance a hospital’s bottom line.
  2. Mental health support. Nurses as a group are not always open to counseling, but during Covid nurses have spoken out about the emotional toll of the work and their ongoing PTSD. They have recognized their need for mental health support. Hospitals must give nurses health insurance that covers individual counseling, and have mental health resources available on the job for nurses. “Covid broke me” is being said by too many nurses, too often.
  3. Whistleblower protection. No nurse should be penalized for speaking out when their job has suddenly put their life at risk and management is not providing the needed protective equipment or support. Every nurse should be able to publicly protest when working conditions put patients’ lives at risk. If we want health care to be as safe as possible, then nurses’ speech needs to be better protected.
  4. Abandon the scarcity mentality. When health care became big business, all health care workers were told to “do more with less.” At some point, this scarcity model becomes unsustainable and less is just less. Hospital CEOs and insurance company executives are getting rich from health care. Workers’ “less” is their “more.” That equation needs to be flipped on its head.
  5. Care for nurses. All nurses know that saying, “A nurse is a nurse is a nurse.” It encapsulates the idea that all nurses are interchangeable and therefore don’t need to be cared for as employees. Covid nurses profoundly felt this lack of caring, to the point that many of them quit their jobs, if not nursing altogether. Doughnuts and pizza parties are nice, but count as chump-change when nurses are risking their lives to care for patients and working every day to the point of exhaustion. Caring is a sign of respect and involves dedicated resources. Management needs to give nurses the respect they deserve.
  6. Provide needed equipment and supplies. No one sends firefighters out with buckets instead of hoses, no one expects SWAT teams to use pea-shooters instead of real guns, and yet during Covid nurses often did not have PPE or other supplies they needed. The U.S. is the richest country in the world—these shortages are shameful, and should not have happened.

Theresa Brown, nurse and writer, is a frequent contributor to the New York Times, as well as the author of The Shift: One Nurse, Twelve Hours, Four Patients’ Lives (Algonquin Books, 2015). She also writes AJN’s What I’m Reading column.