By Rose O. Sherman, EdD, RN, NEA-BC, FAAN
Current research indicates that the overall number of nurses evaluating themselves as emotionally healthy has only improved slightly since 2021. While some of this can be attributed to the turbulent healthcare work environment, there is now emerging research that younger staff under the age of 35 have a lower baseline level of mental health. Dr. Jonathan Haidt’s latest book, The Anxious Generation, has spurred a global conversation about youth mental health. His book, which is a review of the psychosocial research on the topic, concludes that the rates of stress, anxiety, and clinical depression are twice that of previous generations for those who spent their formative years after 2010. Interestingly, there is no change in the rates of bipolar and schizophrenia, which are thought to be genetic versus environmental.
Haidt proposes that Generation Z’s baseline mental health is lower because of a trifecta of events, including growing up in a phone-based culture where communication is primarily via text, staying connected to the internet 24/7, and using social media platforms in place of in-person relationships with others. His findings are supported by Gallup researchers who now see the same trends in their data for those under thirty-five in the US population.
Over the past five years, nurse leaders have observed that younger staff talk openly about their stress, depression, and burnout. Nurse leaders often struggle to maintain the line between being a leader coach and a therapist. The issue for leaders is that healthcare work environments are inherently stressful and unpredictable. When the staff’s baseline mental health is lower, it can be difficult for them to maintain resilience.
The challenge with lower baseline mental health in newer generations of nurses is that it is a social determinant of work health. It has an impact on the work environment in the following ways, according to my discussion with nurse leaders:
- Nurses working fewer hours.
- Extension of orientation timeframes is necessary because new graduates feel overwhelmed and unable to absorb new skills and information.
- A massive uptick in the use of unplanned PTO and FMLA.
- Inability to decompress after a stressful work shift.
- Early exits from acute care environments.
- Increased requests for accommodation for mental health issues under ADA (such as cannot work nights).
We are in a healthcare environment where the work has never been more challenging. The transition of new nurses is always complicated, but when you add the problem of high baseline levels of stress, anxiety, and clinical depression, things become even more complex. Just as social determinants affect health outcomes, retaining nurses now requires considering their specific work-related social factors. This is not easy for nurse leaders, especially those on the front lines of care, but it is the reality today.
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