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AIMS AND OBJECTIVES: To describe levels of insomnia, fatigue and intershift recovery, and psychological well-being (burnout, post-traumatic stress, and psychological distress), and to examine differences in these measures based on work-related characteristics among nursing staff during COVID-19 pandemic in the United States BACKGROUND: The COVID-19 pandemic has created a major physical and psychological burden on nursing staff in the United States and worldwide A better understanding of these conditions will lead to tailored support and resources for nursing staff during and after the pandemic DESIGN: Cross-sectional study METHODS: Hospital nurses and nursing assistants (N=587) were recruited online between May-June, 2020 The survey included measures on insomnia (Insomnia Severity Index) fatigue and intershift recovery (Occupational Fatigue and Exhaustion Recovery-15), burnout (Maslach Burnout Inventory-Human Services Survey), post-traumatic stress (Short Post-Traumatic Stress Disorder Rating Interview) and psychological distress (Patient Health Questionnaire-4), and questions on work and demographics The STROBE checklist was followed for reporting RESULTS: The sample had subthreshold insomnia, moderate-to-high chronic fatigue, high acute fatigue, and low-to-moderate intershift recovery The sample experienced increased emotional exhaustion and depersonalization, increased personal accomplishment, moderate psychological distress, and high post-traumatic stress Nurses who cared for COVID-19 patients had significantly scored worse on almost all measures than their coworkers Certain factors like working hours per week and the frequency of 30-minute breaks were significant CONCLUSION: Nursing staff experienced poor sleep, fatigue, and multiple psychological problems during the COVID-19 pandemic Moreover, staff who were involved in the care of COVID-19 patients, worked more than 40 hours per week and skipped 30-minute breaks showed generally worse self-reported outcomes RELEVANCE TO CLINICAL PRACTICE: Nursing administration is recommended to monitor for fatigue and distress on nursing units, re-visit current scheduling practices, reinforce rest breaks, and provide access to mental-health and sleep wellness resources with additional support for their frontline nursing groups
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