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While the COVID-19 pandemic rages on worldwide with new variants, the urgency for Kentucky nurses to continue to be on the frontlines now extends out to a massive vaccine campaign. Just like Florence Nightingale, mother of modern nursing, and Mary Jane Seacole, British-Jamaican nurse and business woman, did in the Crimean war, nurses today are working 24/7 to get the mission accomplished.  Although the practice settings may change from a critical care unit one day and the next day a large parking lot tent or football stadium or drive-through clinic, the shepherding of public health in the commonwealth, its citizens and students remains the same.

A key question is, “Who is shepherding the mental health and wellness of nurses?”  What about turning up the call for action with a “warp speed mission for the mental health and wellness for Kentucky nurses,” like a “vaccine to help build up immunity” from the pandemic’s triple impact on health, daily life disruption and economic downturn. For well over 10 months, Kentucky nurses have felt the stress of their circumstances, on the job and at home.

In the middle of one crisis after another, they provided comfort and care to patients as well as their own families and friends—some of whom faced hardships due to lack of childcare, job loss, active COVID symptoms and a divided country.  Now with the additional stressors of trying to meet the supply and demand challenges to vaccinate millions of Kentuckians, nurses still need to provide care delivery, teach students, conduct research and offer community/professional service.

On top of everything Kentucky nurses are doing, we must remember nurses are human too and experience the same worries and anxieties from the pandemic as all Americans.  The pandemic has brought a toll on the mental health of Kentucky nurses including stress, anxiety, depression and burnout. Pre-COVID, the prevalence of nurse suicide was higher than the United States. general population and now with compassion fatigue escalating, the urgency is greater for evidence-based interventions so another life is not lost to suicide.

Leaders of the Kentucky Nurses Action Coalition (KNAC) have been actively engaged to boldly address “the silence of nurse suicide.”  Recognizing that PPE (personal protective equipment) is a household acronym, the vision is to integrate “emotional” PPE (e-PPE) as the first line of protection. After the release of the American Nurses Association (ANA) campaign for “Healthy Nurse, Healthy Nation” and the National Academy of Medicine (NAM) campaign for “The Action Collaborative on Clinician Well-Being and Resilience.” KNAC leadership launched a statewide effort for sustainable action.

Leveraging the recently passed Kentucky Nurses Association (KNA) and the Kentucky Nursing Deans and Directors (KNDD) resolution (October 2020), “A Call to Action for Kentucky Nurse Leaders to Promote Practices for Optimal Resilience and Suicide Prevention in Schools of Nursing,” multiple venues are unfolding to “break the silence.”  In collaboration with the KNA Professional Practice and Advocacy Cabinet, KNAC leaders will trail blaze ahead for Friday, May 7 to be declared Kentucky Nurse Suicide Prevention Day.  In honor of the American Nurses Association (ANA) and the World Health Organization extending the Year of the Nurse and Midwife, in May the KNA will expand “nurses’ week” for a whole month of free continuing education programs to include evidence-based strategies to build resiliency in nurses and shift the paradigm from mental health crisis intervention to prevention.

Later in an upcoming legislative session, KNAC and the KNA Governmental Affairs Cabinet will partner with the Kentucky Board of Nursing for a legislative proposal to require suicide prevention training as a required continuing education course for nurse licensure. Crisis management research has repeatedly demonstrated that adversity such as a pandemic in the middle of a country needing to unite and heal does not have to hold back Kentucky nurses from reaching their greatest potential.  By working together, committing time and resources to implement intentional strategies, such as below, we will emerge stronger and healthier:

1. Staying focused on what we can control – stopping COVID-19 single handedly is out of our hands but we can control how we react to the challenges by following CDC recommendations for double masking, handwashing, physical distancing and vaccination.
2. Taking time to breathe and reflect – thinking about how our new world with COVID-19 brings opportunities for creative adjustments and family connections by returning to simpler times in our lives with walking outdoors, eating dinners together and playing board games.
3. Practicing gratitude – finding something positive every day and being grateful for simple things like beautiful days of sunshine or spending more time with pets is vital to health and mental wellness.
4. Taking care of ourselves – prioritizing “me time” in the middle of a crisis is challenging but critical if we are going to come out healthy on the other side. We must get adequate sleep, exercise and eat healthy so we can take better care of others and our communities.
5. Embracing helpful resources – accessing a plethora of ANA tools and resources for well-being such as “a nursing state of mind podcast series”, “confidential 24/7 calls to talk about wellness, recovery and resilience and the “national suicide prevention lifeline” 1-800-273-TALK (8255)

We encourage nurses to visit the ANA’s web page, Nurse Well Being for myriad of mental health resources that can help during these challenging times.

Our nurses, along with thousands of health care professionals and service industry workers, are keeping our state and nation afloat right now.  Kentucky nurse leaders are grateful for the relentless efforts of so many who continue to build a culture of health and now we invite you to help us strengthen the mental health and wellness of our nursing workforce. #TogetherKY #KYNursingStrong. #STOPnurseSuicide

Janie Heath, PhD, APRN-BC, FAAN, FNAP, FAANP, dean of the University of Kentucky College of Nursing and Warwick Professor of Nursing and president of the Kentucky Nurses Action Coalition

Teresa Villaran, MS, MSN, CCRN, CNE, CNN, hemodialysis anemia manager, Fresenius Medical Care of North America and chair of the Kentucky Nurses Association Professional Nursing Practice and Advocacy Cabinet

Brittany Welch, DNP, RN, adjunct faculty, Galen College of Nursing, CQI/compliance officer at FONEMED, community manager, American Nurses Association and chair of the Kentucky Nurses Association Governmental Affairs Cabinet

Delanor Manson, MA, BSN, RN, chief executive officer, Kentucky Nurses Association, Kentucky Nurses Foundation and Kentucky Nurses Action Coalition