According to the Bureau of Labor Statistics, there are almost 3 million nurses working in the United States, making it the country's largest health care workforce.
The vast majority -- 85% -- are women. It's been especially difficult for them, juggling the demands at work, along with potentially caring for their children or elderly parents during the pandemic.
“This last 13 months has been the most death that I’ve seen, and I’m used to seeing people not survive their illnesses,” Celia Nieto, 44, said recalling the months during the worst of the COVID-19 pandemic.
Nieto said she's been fighting for months as an intensive care nurse. She fought for her hospital to give her the proper PPE, and she fought for her kids, so they could navigate distance learning during the pandemic. Her children are in 4th and 5th grade.
“I felt responsible for every moment... at home, at work,” Nieto said.
Nieto, who lives in Henderson, Nevada, said she also lost two nurses on her unit — one to COVID-19 and the other to suicide.
“And that affected everyone ... in such a hard way," Nieto said. "People were very close to her and knew she wasn't doing well. It was very difficult."
Nieto's own breaking point came suddenly last October.
“I thought I was losing my mind a little bit,” Nieto recalled.
Nieto said she was driving to a dentist appointment and started crying uncontrollably.
“And I thought, ‘If I got into a really bad car accident right now, I would be OK with that,' " Nieto said/
Experts said these types of thoughts -- and, even worse, suicidal ones -- were not uncommon for nurses even before the pandemic.
According to a new study in JAMA Psychiatry, published by the American Medical Association, female nurses are about twice as likely as the general female population to take their own lives and 70% more likely than female physicians to do so. Researchers analyzed mortality data from the Centers for Disease Control from 2007-18, identifying 2,400 suicides among nurses.
The study also showed that, among male nurses, the risk of suicide is no higher than the general male population. Researchers found no difference in the suicide rates of physicians and the general public, which differs from previous studies.
Christopher Friese is one of the study's co-authors and a professor of nursing at the University of Michigan.
“Nurses are historically caregivers," Friese said. "We pick up the slack. We are not only caregiving in our workplace, but we are caregiving for our families and our loved ones, with no end in sight."
The study does not include data from the pandemic, which makes some like Friese and Nieto worry. Even before COVID, nurses reported enormous work stress, including long hours and reduced staffing.
“So many of us are trying to keep our families and our loved ones and our systems going,” Friese said. “I am worried that nurses will be in a difficult position when the adrenaline runs out. I’m worried about post-pandemic.”
Friese said that the study's findings highlight the need for high-quality wellness programs for nurses.
“A lot of systems are stepping, up recognizing this need," Friese said. "Since our paper has been published, many hospitals have reached out, saying, ‘What should we be doing?’ Or talking about whether their programs are effective.”
Meanwhile, since that October incident in her car, Nieto has been receiving professional help.
Nieto called her insurance company's mental health line and started therapy. As a member of National Nurses United, Nieto also speaks about her own struggles with other nurses across the country, which is helping in her own healing process.
“I've seen nurses break down, saying, ‘I can’t do this anymore because it's just so difficult,’ " Nieto said. "So I am speaking out to let that person know they are not alone. There is help out there, whatever it looks like, but just reaching out and asking for it” are what's important.
If you or someone you know is in crisis, you can call the National Suicide Prevention Lifeline. There is someone available 24/7 at 800-273-8255.