Front-line Nursing Home Staff Experiences During the COVID-19 Pandemic
Open accessAbstract
Objective The Coronavirus disease 2019 (COVID-19) pandemic is an unprecedented challenge for nursing homes, where staff have faced rapidly evolving circumstances to care for a vulnerable resident population. Our objective was to document the experiences of these front-line health care professionals during the pandemic.Design Electronic survey of long-term care staff. This report summarizes qualitative data from open-ended questions for the subset of respondents working in nursing homes.Setting and participants A total of 152 nursing home staff from 32 states, including direct-care staff and administrators.Methods From May 11 through June 4, 2020, we used social media and professional networks to disseminate an electronic survey with closed- and open-ended questions to a convenience sample of long-term care staff. Four investigators identified themes from qualitative responses for staff working in nursing homes.Results Respondents described ongoing constraints on testing and continued reliance on crisis standards for extended use and reuse of personal protective equipment. Administrators discussed the burden of tracking and implementing sometimes confusing or contradictory guidance from numerous agencies. Direct-care staff expressed fears of infecting themselves and their families, and expressed sincere empathy and concern for their residents. They described experiencing burnout due to increased workloads, staffing shortages, and the emotional burden of caring for residents facing significant isolation, illness, and death. Respondents cited the presence or lack of organizational communication and teamwork as important factors influencing their ability to work under challenging circumstances. They also described the demoralizing impact of negative media coverage of nursing homes, contrasting this with the heroic public recognition given to hospital staff.Conclusions and implications Nursing home staff described working under complex and stressful circumstances during the COVID-19 pandemic. These challenges have added significant burden to an already strained and vulnerable workforce and are likely to contribute to increased burnout, turnover, and staff shortages in the long term.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Working during the COVID-19 pandemic has taken a significant emotional, psychological, and physical toll on the health care workforce.
“Working during the COVID-19 pandemic has taken a significant emotional and psychological as well as physical toll on the health care workforce.[682][683][684]”
From 2023 Alzheimer's disease facts and figures (2023) · cites this paper as [684]
The Results (‘Theme 5: Burnout’) describe mental and physical exhaustion and a significant emotional burden among nursing home staff. The Discussion likewise describes their physical, mental, and emotional burden. The paper studies nursing home staff, so it does not establish the claim for the health care workforce as a whole. (LLM, conf=0.85)
Experimental — accuracy not yet measuredWorking during the COVID-19 pandemic has taken a significant emotional and psychological toll on the health care workforce.
“Working during the COVID‐19 pandemic has also taken a significant emotional and psychological toll on the health care workforce.”
From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [818]
The Results (Theme 5: Burnout) and Discussion describe mental exhaustion and a significant emotional burden among nursing home staff working during the pandemic. The claim extends that finding to the health care workforce generally, which this study did not examine. (LLM, conf=0.86)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Epidemiology of Covid-19 in a Long-Term Care Facility in King County, Washington
McMichael, T. M., Currie, D. W., Clark, S., Pogosjans, S., Kay, M. K., Schwartz, N. G., Lewis, J., Baer, A., Kawakami, V., Lukoff, M. D., et al. (2020) · New England Journal of Medicine · doi:10.1056/nejmoa2005412 · Cited by 1,322 · see citing works
Nurse turnover: the mediating role of burnout
LEITER, M. P., & MASLACH, C. (2009) · Journal of Nursing Management · doi:10.1111/j.1365-2834.2009.01004.x · Cited by 838 · see citing works
Staff Turnover and Quality of Care in Nursing Homes
Castle, N. G., & Engberg, J. (2005) · Medical Care · doi:10.1097/01.mlr.0000163661.67170.b9 · Cited by 426 · see citing works
Characteristics of U.S. Nursing Homes with COVID ‐19 Cases
Abrams, H. R., Loomer, L., Gandhi, A. D., & Grabowski, D. C. (2020) · Journal of the American Geriatrics Society · doi:10.1111/jgs.16661 · Cited by 355 · see citing works
Registered Nurse Burnout, Job Dissatisfaction, and Missed Care in Nursing Homes
White, E. M., Aiken, L. H., & McHugh, M. D. (2019) · Journal of the American Geriatrics Society · doi:10.1111/jgs.16051 · Cited by 297 · see citing works
Self-citationMcGarry, B. E., Grabowski, D. C., & Barnett, M. L. (2020) · Health Affairs · doi:10.1377/hlthaff.2020.01269 · Cited by 263 · see citing works
Zimmerman, S. I., Gruber‐Baldini, A. L., Hebel, J. R., Sloane, P. D., & Magaziner, J. S. (2002) · Journal of the American Geriatrics Society · doi:10.1046/j.1532-5415.2002.50610.x · Cited by 260 · see citing works
Staffing Levels and COVID ‐19 Cases and Outbreaks in U.S. Nursing Homes
Gorges, R. J., & Konetzka, R. T. (2020) · Journal of the American Geriatrics Society · doi:10.1111/jgs.16787 · Cited by 183 · see citing works
Nursing Home Staff Turnover: Impact on Nursing Home Compare Quality Measures
Castle, N. G., Engberg, J., & Men, A. (2007) · The Gerontologist · doi:10.1093/geront/47.5.650 · Cited by 169 · see citing works
Daily Nursing Home Staffing Levels Highly Variable, Often Below CMS Expectations
Geng, F., Stevenson, D. G., & Grabowski, D. C. (2019) · Health Affairs · doi:10.1377/hlthaff.2018.05322 · Cited by 165 · see citing works
Kambhampati, A. K., O’Halloran, A. C., WHITAKER, M. D., Magill, S. S., Chea, N., Chai, S. J., Kirley, P. D., Herlihy, R., Kawasaki, B., Meek, J. I., et al. (2020) · MMWR Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm6943e3 · Cited by 128 · see citing works
Measuring Staff Turnover in Nursing Homes
Castle, N. G. (2006) · The Gerontologist · doi:10.1093/geront/46.2.210 · Cited by 124 · see citing works
Houtven, C. H. V., DePasquale, N., & Coe, N. B. (2020) · Journal of the American Geriatrics Society · doi:10.1111/jgs.16509 · Cited by 124 · see citing works
Variation in SARS‐CoV ‐2 Prevalence in U.S. Skilled Nursing Facilities
White, E. M., Kosar, C. M., Feifer, R. A., Blackman, C., Gravenstein, S., Ouslander, J. G., & Mor, V. (2020) · Journal of the American Geriatrics Society · doi:10.1111/jgs.16752 · Cited by 104 · see citing works
Self-citationKash, B. A., Castle, N. G., Naufal, G. S., et al. (2006) · The Gerontologist · doi:10.1093/geront/46.5.609 · Cited by 89 · see citing works
Thomas, K. S., Mor, V., Tyler, D., & Hyer, K. (2012) · The Gerontologist · doi:10.1093/geront/gns082 · Cited by 80 · see citing works
State Differences and Facility Differences in Nursing Home Staff Turnover
Castle, N. G. (2008) · Journal of Applied Gerontology · doi:10.1177/0733464808319711 · Cited by 40 · see citing works
Sun, C. L. F., Zuccarelli, E., Zerhouni, E. G., Lee, J., Muller, J., Scott, K. M., Lujan, A. M., & Levi, R. (2020) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2020.08.030 · Cited by 38 · see citing works
Muench, U., Jura, M., Spetz, J., et al. (2020) · Medical Care Research and Review · doi:10.1177/1077558720930131 · Cited by 14 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
2023 Alzheimer's disease facts and figures
(2023) · Alzheimer's & Dementia · doi:10.1002/alz.13016 · Cited by 3,212 · see citing works
2024 Alzheimer's disease facts and figures
(2024) · Alzheimer's & Dementia · doi:10.1002/alz.13809 · Cited by 2,536 · see citing works
Konetzka, R. T., White, E. M., Pralea, A., Grabowski, D. C., & Mor, V. (2021) · Journal of the American Geriatrics Society · doi:10.1111/jgs.17434 · Cited by 139 · see citing works
Cimarolli, V. R., Bryant, N. S., Falzarano, F., & Stone, R. (2022) · Journal of Applied Gerontology · doi:10.1177/07334648211040509 · Cited by 36 · see citing works
Fisher, E., Cárdenas, L., Kieffer, E., & Larson, E. (2021) · Geriatric Nursing · doi:10.1016/j.gerinurse.2021.09.002 · Cited by 39 · see citing works
- Authors
- White, E. M., Wetle, T. F., Reddy, A., & Baier, R. R.
- Affiliations
- Brown University (US)
- Corresponding author
- White, Elizabeth M.
- Venue
- Journal of the American Medical Directors Association
- Publisher
- Elsevier BV
- Published
- 2021-01
- Volume
- 22
- Issue
- 1
- Pages
- 199-203
- ISSN
- 1525-8610 (ISSN-L)
- PMC
- PMC7685055
- OpenAlex
- W3109539267
- Cited by
- 405
- References
- 19
- Citations by year
- 2026: 17 · 2025: 56 · 2024: 70 · 2023: 98 · 2022: 112 · 2021: 52
- FWCI
- 68.36
- Type
- journal article
- Language
- en
- Update notices
- erratum (2021-05-01)
- Open access
- bronze
- doi.org
- Locations
- Journal of the American Medical Directors Association (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Office of the Executive Vice President for Research and Partnerships, Purdue University (GR300199)
- Topics
- Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Keywords
- COVID-19 pandemic, nursing homes, long-term care workers, burnout, labor shortage, crisis standards of care, organizational communication, teamwork, employee morale, employee turnover
- MeSH terms
- Personal Protective Equipment, COVID-19, Burnout, Professional, Female, Humans, Male, Nurse-Patient Relations, Nursing Homes, Nursing Staff, Personnel Turnover, Infectious Disease Transmission, Patient-to-Professional, Nurse's Role
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
