Voices from the frontline: Perspectives from certified nurse practitioners, clinical nurse specialists and physician assistants at an Academic Medical Center.

Abstract

Background: The COVID-19 pandemic has exacerbated already existing stressors within health care. In August 2020, a campus-wide COVID-19 well-being survey indicated high levels of burnout, stress, and mental health concerns among certified nurse practitioners (CNPs), clinical nurse specialists (CNSs), and physician assistants (PAs) within our Department of Medicine.

Purpose: In response to this survey, an interdisciplinary task force was formed by CNPs, CNSs, and PAs across departmental specialty divisions to conduct focus groups to gain a deeper understanding of workplace experience both prepandemic and during the COVID-19 pandemic.

Methodology: As part of a quality-improvement project, 14 focus groups involving 34 CNPs, CNSs, and PAs within our department were conducted to better understand their experiences before and during the COVID-19 pandemic. A rapid qualitative analysis was used to identify themes and subthemes. In this article, we explore these themes and review potential solutions solicited from the focus groups.

Results: The following themes were identified: (1) the importance of being valued; (2) the need for career development opportunities; and (3) the significance of professional fulfillment.

Conclusions: Each of these themes existed before, but was exacerbated by, the ongoing COVID-19 pandemic. The manifestation of these stressors is unique to the CNPs, CNSs, and PAs experience, although the larger themes may overlap with physician colleagues.

Implications: To improve the professional experience and well-being of CNPs, CNSs, and PAs at our institution, it will be critical for leadership to acknowledge these differences and develop specific initiatives to address these concerns.