eNews: Volume 21, Number 7 (November 2023)

Volume 21, Number 7 (November 2023)

From the Director’s Desk

John Howard, M.D., Director, NIOSH

Impact Wellbeing: Addressing the Mental Health Crisis of our Nation’s Health Workers

A recent CDC Vital Signs report puts a spotlight on the mental health of our nation’s health workers. The report shows that our health workers continue to face a mental health crisis, experiencing greater declines in mental health measures compared with other workers. The data show that 46 percent, or almost half of health workers, reported often feeling burned out in 2022. This is an increase from 32 percent in 2018. In addition, the number of health workers who reported harassment at work more than doubled between 2018 and 2022.

To help address this crisis, NIOSH is launching a social marketing campaign, Impact Wellbeing. This effort speaks directly to hospital leaders on meeting these challenges at the operational level. The newly launched Impact Wellbeing campaign is built on NIOSH Total Worker Health® principles. It aims to provide hospital leaders with much-needed support to improve the wellbeing of our nation’s health workforce. Its design will help leaders to focus on the organizational factors contributing to the worsening mental health of their health workers.

We know that work in health occupations is historically stressful due to many factors. These include long hours, difficult working conditions, and exposure to workplace hazards. The pandemic made these challenges worse. When workers experience high levels of demand and low levels of control, they’re at high risk. Many of their jobs reflect this very dynamic.

While hospitals have made strides to address healthcare worker wellbeing, it is critical to go beyond encouraging self-care. Addressing workplace policies and practices is the best way to reduce burnout and strengthen professional wellbeing. By making practical adjustments within the organization, hospital leaders can improve the work experience. These changes will help health workers continue doing what they do best—delivering the highest quality patient care.

Although some causes of burnout may take time to address, there are many feasible ways to champion a healthy workforce and hospital system. The Impact Wellbeing campaign provides ideas for actions hospital leaders can take right away. These include steps like creating a professional wellbeing team and having regular two-way communication with their workforce. Removing intrusive mental health questions on credentialing applications can also markedly improve professional wellbeing. These actions can help reduce burnout while improving patient outcomes and addressing costs that come with staff turnover and lost revenue.

Research Rounds

A Scoping Review of Sleep Education and Training for Nurses

Study authors: Beverly M. Hittle, NIOSH; Janie Hils, Cincinnati Health Department; Sherry L. Fendinger, NIOSH; and Imelda S. Wong, NIOSH

Why is this study important?
Shift work and associated sleep impairment among nurses can increase their risk for poor health, work-related injuries, and errors in patient care. Sleep education and training programs for nurses are recommended as part of a larger fatigue-risk management system. However, little is known about programs specific for nurses. This study addresses the gap by describing training content, delivery methods, and effectiveness of current programs.

How did you do the study?
In this study, we reviewed scientific literature about sleep education and training programs for nurses. We searched four databases for terms such as “nurse,” “sleep hygiene,” “shift work,” and “education.” We included original research and studies written in English meeting this criteria:

  • Focused on sleep education, training, or sleep hygiene interventions
  • Studied nurses engaged in shift work
  • Used sleep as a primary measure
  • Published in 2000 or later

We screened the studies to confirm they included information on training content and delivery method (in-person vs. technology-based). Of 17,236 studies, only 9 met those requirements for inclusion.

What did you find?
We found these common topics among sleep education and training for nurses:

  • Sleep hygiene
  • Sleeping strategies for shift work
  • Behavior change approaches to support healthy sleep habits
  • Mental health support to address poor sleep from job stress

Among the studies, sleep education and training delivery and frequency varied. We found limited information about what nurses prefer or what is effective.

What are the next steps?
The health and safety of nurses and their patients depend on understanding the role of sleep among nurses working nonstandard schedules. The differences we found in training content, delivery methods, and program effectiveness suggest a need for further research. We need to learn more about what constitutes an effective sleep education and training program for nurses.

Can Better Leadership Reduce Nursing Home Staff Turnover?

Study authors: Jessica A.R. Williams, Department of Health Policy and Administration, The Pennsylvania State University, State College; Jamie E. Collins, Department of Orthopedic Surgery, Brigham and Women’s Hospital; Ashvin Gandhi, Strategy, UCLA Andersen School of Management; Huizi Yu, School of Public Health, University of Michigan; Leslie I. Boden, Department of Environmental Health, Boston University School of Public Health; Jeffrey N. Katz, Gregory R. Wagner, and Glorian Sorensen, Harvard T.H. Chan School of Public Health

Why is this study important? 
Reducing high turnover among nursing staff may improve patients’ health outcomes. Prior research has associated high turnover with more likelihood of pressure ulcers, pain, urinary tract infections, and readmissions among patients. Understanding why turnover occurs will help employers and managers reduce turnover rates.

How did you do the study? 
This study used survey information from 495 participating nursing homes in California, Massachusetts, and Ohio from October 1, 2018, to September 30, 2019. We examined how leadership commitment to workers’ safety, health, and well-being affected nursing staff turnover. We did this by using a new measure of leadership commitment to safety, health, and well-being.

What did you find? 
Nursing homes where leadership communicated and showed commitment to worker safety, health, and well-being had fewer nurses leave during the study period. Their turnover rates were about 10% lower than homes without leadership commitment. These results suggest that leadership may play a significant role in reducing staff turnover.

What are the next steps? 
The measure we used in this study came from the Workplace Integrated Safety and Health Assessment. Next steps are to see if different measures in the assessment can explain other workplace outcomes. This may include how measures of leadership at the organizational level compare with how employees report experiencing the work environment.

Impact Wellbeing image of smiling healthcare worker. Text reads 'Healthcare workers deserve to feel safe seeking mental health care.'

Photo by ©Maskot/Getty Images

NIOSH eNews is Brought to You By:

John Howard, M.D., Director
Christina Spring, Editor in Chief

Managing Editor
Tanya Headley

Section Editor
Anne Blank, Research Rounds
Kiana Harper, Highlights & Monthly Features

Contributing Editors
Sarah Mitchell

Copy Editor
Cheryl Hamilton

Technical Support
Steve Leonard, Technical Lead
Steven Marra, Web Developer

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Highlights

New Burnout Prevention Training for Public Health Supervisors
Burnout is a widespread problem in public health. However, managers can play important roles in changing work practices for the better. A new online training from NIOSH offers ways to prioritize employee well-being and prevent burnout. Each unit takes about 15–30 minutes, making it easy to fit into your busy schedule. Continuing education credit is available at no cost.

Free Total Worker Health® Webinar on Decent Work
Join us on Wednesday, November 15, at 2 p.m. (ET) for a presentation and discussion on decent work. The NIOSH Total Worker Health® Webinar Series will host Drs. Preethi Pratap from the University of Illinois Chicago School of Public Health and Paul Landsbergis from the SUNY Downstate Health Sciences University. NIOSH Consultant Dr. Paul Schulte will moderate a question-and-answer session after the presentation. Free continuing education is available. Register now!

Publication Supports Global Worker Safety and Health
A NIOSH coauthored paper was recently published in a Lancet journal series on Work and Health. NIOSH Director Dr. John Howard and NIOSH Consultant Dr. Paul Schulte contributed to the paper, titled Monitoring Workers Health—Focus on Rights, Determinants, and Equity. The series, organized by the World Health Organization, reinforces NIOSH’s continued support and involvement in global worker safety and health.

NIOSH Nurses Shift Work Training Reaccredited
The NIOSH Training for Nurses on Shift Work & Long Work Hours has been reaccredited. The purpose of this free training is to educate nurses and their managers about the health and safety risks associated with shift work, long work hours, and related workplace fatigue issues. The training offers strategies for the workplace and for nurse’s personal lives to reduce these risks.

New Workplace Solutions on Fighting Fires in Strip Malls
NIOSH recently published a Workplace Solutions to help fire departments prevent deaths and injuries while operating at strip mall fires. Firefighters face significant risk of injury or death when fighting fires in strip malls. These fires present challenges that may cause firefighters to become disoriented while conducting interior search and firefighting operations.

Survey icon

NIOSH National Employer Survey of Respirator Use and Practices
On November 2, NIOSH launched a national survey of employers to assess current respirator use and practices in their workplaces. The Survey of Respirator Use and Practices is the first effort to collect updated data about respiratory protection across all U.S. industries since the initial survey in 2001. Read the NIOSH Update to learn more.

NIOSH award graphic

NIOSH Announces Winner of the 2023 Prevention through Design Award
The third annual Prevention through Design (PtD) Award was presented to the Port of Portland for their outstanding leadership in reducing workplace hazards through design methods. The port authority oversees the Portland International Airport and operates other transportation infrastructure in Portland, Oregon. For more information on PtD, visit the NIOSH PtD website.

NIOSH Congratulates

  • NIOSH researcher Kenny Fent received the International Association of Fire Chiefs (IAFC) President’s Award. It was given to several researchers to recognize their dedication to firefighter health and safety. Recipients received their awards at the opening ceremonies of the IAFC Fire Rescue International Conference in August.
  • NIOSH Division Director Lauralynn McKernan was recognized by the American Conference of Governmental Industrial Hygienists (ACGIH) with their Meritorious Achievement Award. This award recognizes ACGIH members who have made an outstanding, long-term contribution to the progress of occupational health and environmental hygiene.
  • NIOSH epidemiologist Ethan Fechter-Leggett was selected for a NextGen Public Service Award in the Diversity, Equity, Inclusion, and Accessibility Champion category.

Monthly Features


NIOSH Science Blog

Sign up to receive updates about new NIOSH Science Blogs delivered directly to your inbox! Here are the blogs from last month:


News from Our Partners

University of Texas Researcher Awarded Grant to Improve Health in Fishing Industry Workers
Associate Professor Shannon Guillot received a NIOSH grant to study the relationship between work-related injuries and substance abuse in the commercial fishermen population in the Galveston, Texas, area. Dr. Guillot is affiliated faculty with the Southwest Center for Occupational and Environmental Health, a NIOSH Education and Research Center and NIOSH Total Worker Health® Affiliate.

OSHA Announces Meeting of Maritime Advisory Committee
The Occupational Safety and Health Administration (OSHA) will hold an in-person and online meeting of the Maritime Advisory Committee on Occupational Safety and Health on November 14, 9 a.m.–5 p.m. (ET). Find out more about the presentations and register here.


Federal Register Notices

Mine Safety and Health Research Advisory Committee
The notice was posted on October 24. The meeting will be held on November 15.

Advisory Board on Radiation and Worker Health, Subcommittee on Procedures Reviews, National Institute for Occupational Safety and Health
The notice was posted on August 28. Comments must be received by November 9. The meeting will be held November 16.  

Solicitation of Nominations for Appointment to the World Trade Center Health Program Scientific/Technical Advisory Committee
The notice was posted on October 6. Nominations must be received by November 20.


Conferences, Meetings, Webinars, & Events

This page provides a list of publicly available occupational safety and health-related conferences, meetings, webinars, and events sponsored by NIOSH as well as other government agencies, and nongovernment agencies, such as universities, professional societies, and organizations.