Australian nurses drank more alcohol during the COVID-19 pandemic to cope with a range of workplace stressors including increased workloads, missed breaks, double shifts and staffing and resource shortages, a new study has found.
The changing nature of nursing roles amid the pandemic triggered much of the stress, with participants driven to exhaustion and burnout by long shifts and forced overtime. The toll led to some even considering leaving their jobs.
Worryingly, many nurses who turned to alcohol to reduce stress treated it as a reward for working through such demanding conditions and stretched resources.
Led by Dr Adam Searby, a former mental health and drug and alcohol nurse currently based at Deakin University as a lecturer in the School of Nursing and Midwifery, the study, The impact of COVID-19 on nurse alcohol consumption: A qualitative exploration, set out to explore the long-term impact of the pandemic on the amount of alcohol Australian nurses drink.
The study forms part of a broader research project investigating the prevalence of ‘at-risk’ drinking among the country’s nurses and contributing factors, including the ongoing impact of the pandemic. A previous survey of 1,159 nurses found nearly 37% drank alcohol at ‘high-risk’ levels.
The latest study interviewed 42 nurses from across Australia between July and August 2021. At the time, most participants worked in clinical nursing roles or as nurse managers. Wide-ranging work settings included drug and alcohol, emergency, perioperative, women’s health, and mental health.
The study uncovered two key themes: factors influencing alcohol consumption (workplace factors/external factors) and the pandemic’s influence on alcohol consumption (increased consumption/moderation of consumption, and alcohol as a reward).
Workplace factors that drove nurses to drink more included fatigue and stress, the ‘knock on’ effect of staff absenteeism and the redeployment of nurses, a lack of resources, heightened workloads and forced overtime.
“Even though I work full-time, it is expected that you do overtime; you won’t be replaced … so some days turn into 15-hour days,” one nurse said.
“There’s other nurses on my ward who have just taken two weeks’ off because they just can’t do it anymore, they’re too stressed and not coping,” said another participant.
Nurses who took part in the study admitted that they turned to alcohol to reduce stress experienced in the workplace.
“COVID has created a very unsure working environment, it’s the lack of communication, the mixed communication, the not knowing what’s going to happen next. We used to be able to come to work and almost predict that every day we’d come to work, now we’ve got to look and see are we working today, are we not. So all of that unstable work environment is causing anxiety and people are drinking more,” a nurse revealed.
In addition to workplace factors contributing to increased alcohol consumption, participants also reported external factors emerging during the pandemic, particularly lockdowns, influencing their drinking behaviour. During lockdowns, nurses said they drank more due to fewer opportunities to exercise and socialise and the impacts of remote learning and working from home.
The second key theme that emerged from the study was the influence of the pandemic on the amount of alcohol nurses drank.
For the most part, nurses who drank alcohol prior to the pandemic increased their intake during COVID, with many escalating the number of days that they drank each week. Many reported subsequently coming to the realisation that they needed to curb their consumption.
In one alarming example, a nurse spoke of a colleague who was sacked after turning up to work drunk.
“At the start we were so quiet because people stopped presenting to hospital. [Work was] dead and everyone was getting time off, so we were drinking a bit more. And then when we started getting slammed, because they’d put a pause on all the elective surgery, so when all they started coming in as emergencies was when it picked up as well. And then you have a really bad shift and then you come home and just take the edge off,” a nurse said.
Meanwhile, the study also found many nurses treated alcohol as a reward for working under conditions where resources were stretched, the workload heightened, or more hours were worked due to colleagues being off sick.
The terms ‘bring wine’ and ‘wine o’clock’ came up frequently in interviews.
“I think when they’ve had a really rugged day they often go home and … if they haven’t got other things in their life, they often reach for what’s closest and that’s probably a nice glass of wine and that obviously starts off with one then leads to two and then next comes the bottle I think. I hear that from a lot of people,” one participant recalled.
Researchers argue that while the long-term impact of the COVID-19 pandemic on nursing is focused on attrition, burnout and mental health issues, their study suggests that alcohol consumption must be included in the conversation.
“I think alcohol is just the icing on the cake,” Dr Searby told the ANMJ.
“Many nurses are probably wondering whether nursing is actually worth it, and we know we have lost quite a few to retirement or other jobs. When you look at the historical literature on alcohol’s relation to burnout and retention, it is easy to see that alcohol is part of the problem.”
Dr Searby, president of the Drug and Alcohol Nurses of Australasia (DANA), says the sheer number of nurses who are drinking alcohol at ‘high-risk’ levels to reduce stress signals alarm bells, and must be urgently addressed.
“If alcohol consumption continues among nurses at the rate our studies have found, it is easy to speculate that this could become a substantial threat to workforce sustainability,” he says.
“For individual nurses, we know high rates of alcohol consumption are a risk to health. We have seen a link between drinking and the stressors nurses are experiencing. Investment in the workforce has gone beyond filling vacancies; it is now about the health of individual nurses. We have been called heroes through COVID, now we need some investment in our wellbeing in return for the conditions we have endured.”
The next part of the research project, which is being conducted in partnership with the Nursing and Midwifery Health Program Victoria (NMHPV), will examine the feasibility of technology-based interventions, typically delivered via mobile apps, to help nurses curb their drinking.
Specifically, the research team is aiming to develop a targeted app to help nurses address their risky alcohol consumption.
With nurses continuing to work under incredibly stressful conditions, Dr Searby encourages seeking help sooner rather than later.
“There are some great tools for nurses who want to reduce their consumption, including some great apps. But none of these are nurse-specific, so to speak, so I would always recommend either the Nursing and Midwifery Health Program Victoria or Nurse and Midwife Support. Both are fantastic programs, run by nurses, and can help. Even if you are a little concerned and thinking about cutting down your drinking, both services are there to help.”
Read the full study here
Victorian nurses, midwives and students can access the Nursing and Midwifery Health Program Victoria (NMHPV) by calling (03) 9415 7551 or visiting http://www.nmhp.org.au for more information.