UNAC/UHCP Report—The True Cost of Being A Hero

Burnout, stress, depression, and departures from the profession point to unaddressed issues that threaten patient care and worker well-being. As World Mental Health Day approaches, union members call on hospitals and policymakers to help prevent a mass exodus of distressed caregivers. Read the report: The True Cost of Being A Hero



Anjetta Thackeray | anjetta.thackeray@unacuhcp.org | (909) 455-5146
Jeff Rogers | jeff.rogers@unacuhcp.org | (909) 263-7230

Note: Nurses and other health care professionals are available for television, radio, and print interviews.

UNAC/UHCP Report: The True Cost of Being a Hero

LOS ANGELES—An overwhelming majority of registered nurses and health care professionals are burned out, anxious, depressed in the wake of COVID-19 trauma, but the pandemic has merely amplified the effects of chronic understaffing on the mental health of caregivers on the front lines, says a new report released by the United Nurses Associations of California/Union of Health Care Professionals (UNAC/UHCP).

The report—The True Cost of Being A Hero: Mental Health Strains in Nursing and Health Care—outlines the UNAC/UHCP survey’s findings, includes personal statements from health care workers under siege, and places the survey results into the larger context of academic research and journalistic investigations into issues that will drive the future of health care in our communities:

  • Staffing shortages and the inability to recruit and retain a stable health care workforce
  • Eroding care and safety standards for patients and workers
  • Lack of mental health care and treatment for caregivers

Many of the causes of problems outlined in the report are systemic and entrenched. Solutions do exist.

“There’s no turning away from the stress and burnout of the profession,” said Denise Duncan, UNAC/UHCP president and a registered nurse. “But we can engage the workforce, academia, health care organizations, hospital associations, the people who are designing health care for the future. Unless the major underlying factors of burnout are addressed, an exodus of nurses and health care professionals—without the means to recruit new ones—will place our health care system at great risk.”

COVID Fears and Chronic Understaffing

Between February and April 2021—more than a year into the pandemic—UNAC/UHCP surveyed union members to assess the impact on their mental health. Respondents were mostly registered nurses, but included physical therapists, pharmacists, certified nurse midwives, and other health care professionals.

More than 70% of members surveyed reported experiencing anxiety and burnout. Nearly half were currently suffering from insomnia and depression. More than half said they lacked the mental health support they needed to cope with working during the pandemic. Since that time, the Delta surge hit full force.

The two chief causes of mental health strain reported in the UNAC/UHCP survey:

  • 79.11% reported: “Worried about bringing the virus home”
  • 74.41% cited: “Staffing”

Worries about getting infected or bringing the virus home are specific to the pandemic. Staffing was already a pressing problem among our nation’s health care workforce before the pandemic made the issue worse, the report shows.

Mental health trauma is forcing many in health care to ponder leaving the professions they love—despite having invested in years of education and certification. Most health care workers—among the largest workforces in the nation—are willing to share their stories:

“I’m easily irritable and exhausted. It’s hard to manage my emotions.”—Physical therapist

“I’ve decided to leave the ER in hopes that this helps my mental health. I don’t see myself ever returning to the bedside.”—Registered nurse

“The pandemic has shown how desperately we need a large, stable force of dedicated, well-trained, experienced caregivers to care for us and our families in the crucial, intimate moments of life and death, which we all face,” said Jane Carter, UNAC/UHCP Director of Research, Public Policy and Regulatory Affairs. Carter is a labor economist who led the UNAC/UHCP research.

Cost of Burnout and Turnover

Nurse shortages are sweeping the nation due to large percentages of nurses who will be of retirement age by 2030 and large numbers of new nurses who leave within five years due to increased demands and lack of support in their formative years. A range of reports show the devastating effects of our nation’s front-line caregivers working short:

  • Nearly 8 out of 10 nurses reported unsafe staffing; 4 in 10 reported three or more patients added to their workloads. (American Association of International Healthcare Recruitment)
  • One patient added to a nurse’s workload can increase patient mortality by 7 percent. (National Institutes of Health)
  • Medication errors are linked to poor mental health of caregivers. (American Journal of Critical Care)

Burnout yields expensive turnover rates: Every percentage increase of annual nurse turnover will cost a hospital $300,000, while recruiting and training one replacement for pharmacists is $90,000, and $95,000 for a physical or respiratory therapist.

“When looking for cuts in these hospital systems, everybody talks about the cost of labor,” Duncan said. “Nobody looks at the cost of losing your existing workforce.”


United Nurses Associations of California/Union of Health Care Professionals (UNAC/UHCP) represents more than 32,000 registered nurses and other health care professionals in California and Hawaii, including optometrists; pharmacists; physical, occupational and speech therapists; case managers; nurse midwives; social workers; clinical lab scientists; physician assistants and nurse practitioners. UNAC/UHCP is affiliated with the National Union of Hospital and Health Care Employees and the American Federation of State, County and Municipal Employees, AFL-CIO.