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Faculty Member Leads Study to Reduce the Pandemic’s Mental Health Toll on Nurses

Faculty Member Leads Study to Reduce the Pandemic’s Mental Health Toll on Nurses

Posted on 18 Aug 2022 by Khadijah

Faculty Member Leads Study to Reduce the Pandemic's Mental Health Toll on Nurses

Thanks to the leadership and compassion of a faculty member and nurse researcher, Goldfarb School of Nursing at Barnes-Jewish College is at the center of a national study aimed at reducing the trauma and moral injury nurses experienced caring for COVID-19 patients during the height of the pandemic.

During the pandemic, Heidi Holtz, Ph.D., RN, assistant professor at Goldfarb, was teaching while also working as a PRN in an ICU alongside her fellow nurses. The pandemic's toll on the full-time nurses' mental health caught Holtz's attention.

"I was watching what nurses were going through and I saw them struggling," Dr. Holtz says. "As so many patients were dying, it took a toll on me personally. I was exhausted even working just one day a week in the ICU. It was especially hard on full-time nurses."

Her experience sparked the idea of a study to help nurses deal with the trauma they experienced. Because nursing can be stressful even beyond the pandemic, the study's intervention is designed to help nurses well into the future.


Building Resilience One Page at a Time

Dr. Holtz came to Goldfarb in August 2020, in the midst of the pandemic. "I was drawn here because of Goldfarb's reputation and its partnership with the best of the best places for research," she says. "It's a great nursing school tied to a great medical school tied to a great hospital so Goldfarb was very attractive to me."

She teaches in the Upper Division and Ph.D. programs at the nursing school. Before arriving at Goldfarb, Holtz taught at the University of Missouri and completed her post-doctoral education at Johns Hopkins University with a focus on building resilience among health care workers.

This foundation prepared her for a pilot study she launched in March 2021 as the principal investigator (PI). Holtz partnered with a colleague at Reading Hospital in Philadelphia, Pennsylvania, to conduct the qualitative study.

In August 2021, Dr. Holtz started interviewing ER nurses at Missouri Baptist Medical Center as phase one of the study and concluded in February 2022. Her Reading Hospital colleague interviewed ICU nurses during the same time period.

The next step in the pilot study is to provide a five-week journaling intervention called NEW (Narrative Expressive Writing). Similar to cognitive behavior therapy, participants will answer questions in their journals. Mental health professionals will read their journals and provide feedback as well as additional individualized questions as part of the healing intervention.

The intervention is expected to begin this fall with ER nurses at Missouri Baptist and Reading Hospital. If the intervention proves to be effective, it could be extended to ER and ICU nurses at Barnes-Jewish Hospital in 2023.

Missouri Baptist Healthcare Foundation provided a grant to conduct the interview phase, while The Foundation for Barnes-Jewish Hospital is supporting the interventional phase.

The mental health professionals assisting in the study include a psychiatry resident and a psychologist from Washington University as well as Lynn Baer, MSN, APRN, PMHCNS-BC, a Goldfarb instructor and strong self-care advocate with expertise in child and adolescent psychiatric services.

"Our goal with this study is that we will keep nurses in the hospitals and in the profession by providing intervention to help them deal with the trauma they experience," Dr. Holtz says. "I'm proud of this study. I want to continue to develop interventions to help nurses because traumatic stress is always present in this profession."

The study's manuscript was recently accepted for publication in the prestigious Journal of Emergency Nursing.

In addition, Dr. Holtz was invited to speak about the study as the keynote speaker for the MU Center for Health Ethics annual conference on Oct. 5-6. The conference is presented by the MU Center for Health Ethics, MU School of Medicine, MU Sinclair School of Nursing, MU Continuing Education for Health Professions, and the MU Extension.


Bridging Research and Teaching

Dr. Holtz brings her invaluable research experience to the classroom.

"The main Ph.D. course I teach is on qualitative research so I use this and other studies as examples," she explains. "While students are often familiar with quantitative research such as surveys, many students don't have a background in qualitative research that includes on-scene interviews. I can show them the process."

She is also passionate about building resilience in both nursing students and health care workers.

"Nurses and students experience a lot of stress," Dr. Holtz says. "In the future, I feel we need to build resilience in nursing students while they're in school so they are better prepared once they're in the health care setting. By building resilience, they can become stronger and have the tools to handle their experiences."

Being a PI on the study also has allowed Dr. Holtz to share the facts about how the pandemic and stress impacted nurses. "I want to make sure students don't go down the same path," she says. "It's important to me to help their well-being."


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