The National Association of Pediatric Nurse Practitioners (NAPNAP) released a position statement that recognizes the significant, long-range impacts of the experienced trauma stemming from the COVID-19 pandemic. The organization advocates for sustainable strategies to ensure the pediatric-focused advanced practice registered nurse (APRN) workforce has the necessary resources and support to address critical health challenges associated with mental health stressors and professional burnout.

“Very early in the COVID epidemic, we saw a lot of news coverage about how devastating this was on adult-care providers,” said Jennifer Sonney, PhD, APRN, PPCNP-BC, FAANP, the Elizabeth C. Giblin Endowed Professor of Symptom Science at the University of Washington School of Nursing in Seattle, Washington. “That was true, but one thing that my colleagues and I noticed was that nobody was looking at how this was impacting the pediatric workforce,” said Dr Sonney, president-elect of NAPNAP, in an interview.

The pediatric provider shortage disproportionately impacting rural and medically underserved communities, which existed before the pandemic, was exacerbated by the COVID-19 global public health crisis. “When we look at the [pediatric] workforce, our colleagues are having high rates of burnout, anxiety, and depression. Academic programs that train the next generation of nurses have been impacted and our pipeline of new graduates has been constrained, and we saw research studies shut down,” said Dr Sonney.

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In a survey of 886 pediatric-focused APRNs conducted from February 4 to March 10, 2021, one-third of respondents reported moderate or extreme concern for feeling professionally burned out.

“To build and support resiliency in the workforce, NAPNAP believes it is critical to prioritize the promotion of physical and emotional safety and basic needs for health care workers and their families and health care system changes that promote professionalism.” In the position statement, the association offers strategies for pediatric-focused APRNs, health care and academic organizations, and professional organizations (Table).

Table. Strategies to Support Resilience Among Clinicians

APRNs• Prioritizing personal well-being
• Seeking mental health support and resources (eg, mindfulness-based stress reduction techniques, CBT, intentional gratitude)
• Committing to healthy lifestyle behaviors (eg, limit alcohol intake, stop smoking, exercise regularly, eat a healthy diet, and prioritize sleep)
• Mindfully limit consumption of and exposure to pandemic-related media and social media discussion forums
• Seek mental health support early when symptoms first appear
Health care and academic organizations• Reinforce the value of and regard for pediatric-focused APRNs
• Ensure occupational safety
• Eliminate stigma for those seeking mental health care and enhance access to those services via telehealth options
• Promote team cohesion, support time for collaboration and social interactions
Professional organizations• Provide opportunities for clinicians to connect and share lived experiences
• Develop programs focused on peer support
• Advocate for policies that enable work-based employee support
APRNs, advanced practice registered nurses; CBT, cognitive-behavioral therapy
Source: NAPNAP; Gigli et al.

“As frontline providers, pediatric-focused APRNs have stressful jobs and often limited resources,” said NAPNAP President Andrea Kline-Tilford, PhD, CPNP-AC/PC, FCCM, FAAN. “It’s essential that we identify and address clinician burnout and mental health concerns so that we can move forward to provide high quality, equitable, accessible, evidence-based care for the more than 72 million children in this country.”


National Association of Pediatric Nurse Practitioners, Gigle KH, Sonney J, Lee AM, et al. NAPNAP Position Statement on Resilience and the Postpandemic Pediatric Nurse Practitioner Workforce. J Ped Health Care. 2020;36(2):205-209.