For years, nurses have struggled with mental and emotional well-being due to the inherent demands and stressors of their profession. Nurses experience higher rates of mental health issues, substance abuse, and even suicide compared to the general population (Choflet et al., 2023). Tragically, the stigma surrounding seeking support perpetuates a culture of silence, where nurses suffer in solitude, fearing repercussions such as losing their license or enduring professional setbacks (Murthy, 2022). Because these issues have not been adequately addressed, they have resulted in a nursing workforce mental health crisis, which has been compounded by the COVID-19 pandemic. Large numbers of nurses are vacating their positions or leaving the profession altogether, exacerbating an already severe workforce-existing shortage and increasing the burden on remaining staff (Naegle et al., 2023; National Academy of Medicine [NAM], 2022). Nurses must feel that it is safe to access care in order to practice at their highest level and ultimately remain in the workforce.

These realities, along with my own difficulties accessing mental health support without jeopardizing my career, spurred me to take action. Earlier this year, I submitted a policy proposal to the American Nurses Association (ANA) aimed at promoting nurse workforce well-being. My proposal to promote nurse well-being was selected for presentation at the 2024 Membership Assembly held in Washington, D.C. in June. As ANA’s governing body responsible for setting policies and positions, the Membership Assembly holds significant influence.

After my presentation, many attendees approached the microphone to share stories of mental health challenges, stigma, and difficulties with licensure or employment, experienced by themselves or their colleagues. Additional recommendations and considerations were provided, underscoring the depth and breadth of the issue. All comments expressed overwhelming support for the proposal. The following day, after the ANA Professional Policy Committee summarized the discussion and endorsed all recommendations, the policy was nearly unanimously approved by the delegates, with 99.6% in favor.

Titled, “Breaking Barriers to Nurse Work- force Well-Being: A Call for Reform in Licensure and Employment Policies to Combat Stigma,” my proposal advocates for broad changes to regulatory and employment practices concerning mental health. Specifically, ANA was urged to advocate for the removal of barriers deterring nurses from accessing care, including “eliminating policies that reinforce stigma and fear about the professional consequences of seeking mental health treatment” (The Joint Commission [JC], 2020).

The following recommendations were adopted as ANA policy:

1. Reduce mental health–related stigma in health care settings at all levels (ANA, 2020; Naegle et al., 2023).
   1. Support education and awareness campaigns on burnout, moral distress, and well-being (Murthy, 2022).
2. Accelerate changes to mental health reporting requirements and normalize the process for nurses to seek help for workplace-related stresses (NAM, 2022).
   1. Advocate for changes to state licensing statutes and regulations to support nurses’ health and wellness and ensure that they are not deterred from seeking mental health and substance use care. (American Medical Association [AMA], 2023a; Dr. Lorna Breen Heroes’ Foundation, 2020; Murthy, 2022).
   2. Advocate for state licensing boards to abstain from using stigmatizing and punitive language on applications and establish a national requirement to adhere to the Americans with Disabilities
3. Encourage employers to foster an organizational culture that prioritizes health worker well-being, normalizes open communication about mental health challenges, supports prevention, and promotes care-seeking as a sign of strength (Murthy, 2022; United States Substance Abuse and Mental Health Services Administration [SAMHSA], 2021).
1. Encourage licensing boards to develop partnerships with employers to facilitate the successful return to practice of nurses participating in ATD programs (Choflet et al., 2023).
2. Encourage federal and state governments and regulatory agencies to incentivize employers to hire individuals in recovery and adopt recovery-oriented employment standards and policies (SAMHSA, 2021).
3. Encourage employers to review and revise policies and questions on applications and renewal forms for jobs and hospital credentialing to adhere to ADA guidelines and ensure nurses are not discriminated against or deterred from seeking care for their physical health, mental health and/or substance use challenges (Murthy, 2022; Naegle et al., 2023; NAM, 2022).
4. ANA will work in collaboration with the NCSBN to update and revise the guidelines and best practices for alternative to Discipline programs.

A fundamental shift in culture and a united organizational response are imperative to dismantle the systemic barriers obstructing personal and professional well-being. Nurses must be able to access mental health assistance without compromising licensure, confidentiality, or employment. Seeking help should not be perceived as evidence of impairment, but rather as a sign of strength that underscores an individual’s commitment to the well-being of the patients in their care. Regulatory and employment policies should serve legitimate purposes and not act as barriers preventing those who do not pose a threat to public safety from professional practice. We must eliminate discriminatory policies that perpetuate stigma and fear and instead foster a culture of support and compassion that prioritizes the mental health and well-being of nurses.