The House Committee on Energy and Commerce’s subcommittee on Health recently held a hearing relating to legislation aimed supporting patients, caregivers and health care providers. ENA President Ron Kraus submitted the following written statement in support of the Dr. Lorna Breen Health Care Provider Protection Act of 2021.

Introduction

On behalf of the Emergency Nurses Association (ENA) and its more than 50,000 members, I am submitting this testimony in support of H.R. 1667, the Dr. Lorna Breen Health Care Provider Protection Act of 2021. ENA has been an early and strong advocate on behalf of this important, bipartisan legislation to reduce and prevent suicide, burnout, and other mental and behavioral health conditions among health care professionals. 

I am the 2021 President of ENA, the largest professional health care organization focused on improving emergency nursing care. We are dedicated to defining the present and future of emergency nursing through advocacy, leadership, research and innovation. ENA members have expertise in all aspects of emergency health care, including mental health, trauma care, injury prevention, pediatric emergency care and public health emergencies. Our members have been on the front lines of the COVID-19 pandemic since day one, risking their lives to care for their patients and communities.

The Impact of COVID-19 on Emergency Nurses

As you are aware, the global COVID-19 pandemic has taken an enormous toll on the mental and behavioral health of Americans. A February 2021 Kaiser Family Foundation study found that approximately 40 percent of adults in the U.S. reported symptoms of an anxiety or depressive disorder, up from about 10 percent from January to June 2019, before the pandemic.

 This followed a CDC survey from August 2020 that reported that symptoms of anxiety and depressive disorder in the U.S. had risen substantially in April – June 2020 as compared to a year earlier, with 40.9 percent of respondents experiencing “at least one adverse mental or behavioral health condition.” Further, the CDC reported that more than one-quarter of survey respondents aged 18-25 had seriously considered suicide in the prior 30 days.

Even before the pandemic, emergency nurses and other health care professionals were already suffering from stressful working conditions caused by such factors as workplace violence and long hours. Consequently, nurses suffer from higher-than-average levels of mental and behavioral health conditions. Data from the National Violent Death Reporting System indicate that nurses commit suicide at significantly higher rates than non-nurses, with the suicide rate 43 percent higher among female nurse and 22 percent higher among male nurses versus the non-nurse female and male population, respectively.

The COVID-19 pandemic has only exacerbated these problems. Social isolation, increased workload, long hours with limited breaks, the fear of contracting coronavirus which has been made worse by a shortage of critical personal protective equipment are just some of the new stressors that frontline health care providers have experienced.

In fact, last year the CDC reported that 54 percent of essential workers, a category that includes emergency nurses and other health care professionals, reported having at least one negative mental or behavioral health condition. In addition, a recent survey conducted by the American Nurses Foundation found that 75 percent of nurses across all roles said the felt “stressed” and more than half of nurse between the ages 25 and 34 reported feeling “not emotionally healthy.”

The fatigue and burnout caused by these stressful working conditions and the constant specter of contracting a dangerous virus and spreading it to your loved ones is troubling enough. Additional fears of being stigmatized by coworkers for seeking assistance, or that their career will be put in jeopardy by asking for help are pervasive barriers to the seeking of treatment by health care professionals. Beyond the immediate effect on the provider and their family, this reluctance to seek treatment negatively impacts the quality of the care patients receive.

The bottom line is that we must do more to provide evidence-based resources to these professionals, but also provide a supportive environment in which they can seek and receive the help they need. If we do not, we risk losing even more of these critical professionals at a time when the nation cannot afford to lose their experience and expertise in patient care. McKinsey & Company reported in May that as many as 22 percent of nurses they surveyed were considering leaving their positions providing direct patient care during the next year, which would only further contribute to the ongoing nursing shortage in the United States.

The Dr. Lorna Breen Health Care Provider Protection Act of 2021

The Dr. Lorna Breen Health Care Provider Protection Act of 2021 is bipartisan legislation that provides resources to help emergency nurses and other health care professionals deal with these challenging circumstances. Beyond launching a national education and awareness campaign, the bill would lead to the identification of best practices to prevent suicide and promote resiliency among health care professionals.

Importantly, it would also provide funding to train health care professionals in strategies to address mental health and substance use disorders, as well as funds for ongoing support, education and training through employers. It also includes provisions to review the broader issue of burnout and behavioral health issues among health care workers, including the impact of COVID-19 on these populations and their reluctance to seek treatment.

Conclusion

As a country, we need to take immediate steps to address the mental and behavioral health crisis among frontline health care workers. ENA stands with dozens of national patient advocacy and professional organizations such as the American Academy of Pediatrics, American College of Emergency Physicians, American Foundation for Suicide Prevention, American Hospital Association, American Medical Association and American Psychiatric Association in support of the Dr. Lorna Breen Health Care Provider Protection Act.

Emergency nurses are critical to providing emergency care to millions of Americans, and it is crucial that we do more to address their mental and behavioral health needs. We appreciate your interest in addressing this critical issue as a part of this hearing and urge the passage H.R. 1667 in the Energy and Commerce Committee and in the full House of Representatives as soon as possible.