Changes in nurses' quality of work life prior to and during COVID: A repeated cross-sectional analysis

The COVID-19 pandemic had a profound impact on nurses in Long Term Care settings, who are responsible for resident care, clinical leadership, and staff training. These nurses face challenges such as supporting residents with complex health conditions, high workloads, and staffing shortages- challenges that intensified during the pandemic. Research suggests that these factors have affected nurses' well-being, and the quality of care provided to residents.

This study aimed to compare nurses' (RNs/LPNs) quality of work life before and after the pandemic, focusing on changes in work-related stress, burnout, and well-being.

We conducted a repeated cross-sectional analysis of data from a stratified random sample of 39 urban Long Term Care homes in Anonymized and Anonymized that are part of the Translating Research into Elder Care Program. Data were collected pre pandemic (February 2020) and during the pandemic (December 2021), with only homes participating in both waves included. Two-level random-intercept regression models were used, adjusting for demographics and Long Term Care home characteristics. A total of 389 and 430 nurses completed surveys in 2020 and 2021, respectively.

The 2021 sample reported working significantly more hours (B = .04, p<.001), with increased emotional exhaustion (B = 0.17, p = .038, 95% CI: 0.09, 0.32), a key component of burnout, and a small but significant decline in mental health (B = -0.03, p = .007, 95% CI: -0.05, -0.01). Another component of burnout, cynicism, was significantly lower during the pandemic (B = -0.28, p<.001, 95% CI: -0.42, -0.14). No significant changes were observed in job satisfaction, professional efficacy, or physical health.

Despite rising emotional exhaustion and declining mental health, cynicism did not follow the pattern expected under crisis conditions, suggesting that components of burnout may respond differently to pandemic stressors. Our findings have implications for supporting Long Term Care nurses through targeted interventions, particularly in managing workloads and mental health.