Effect of Russia Ukraine war on nurse trauma and mental health

100+ — days passed since Russia invaded Ukraine.

200+ — the amount of attacks on healthcare institutions since the war began.

28 million — the number of nurses globally who stand in solidarity with their Ukrainian colleagues.

Undetermined — the level of trauma nurses serving in Ukraine have absorbed.

These stats are sobering, and generate a sense of compassion for Ukrainian nurses that stems from heartbreak, urgency, and unity. From firsthand accounts, we learn of the incredible tests of professionalism and duty that nurses there are enduring. 

A war beginning on the heels of a pandemic is an incredible test of one’s resolve, strength, and courage—but just as we have seen in this country, we know that equating nurses with superheroes is problematic. The separation that comes from “we don’t know how you do it!” is isolating; in times like these, we need to draw closer. 

Much is unknown about the state of nursing in Ukraine. What will the totality of ongoing war be? What will there be to return to when wartime ends? How will nurses recover themselves during reconciliation?

Here’s what we know, and how we can support. 

Right now, the majority of nurses working in Ukraine are living in the hospitals  they serve. Their day-to-day existence is fraught with danger and uncertainty. Supplies are hard to come by, yet nurses there are doing what nurses do best—finding work-arounds with what they have on hand in order to continue caring for their patients. Constant triage is necessary, not just for the injured and sick, but for managing the inconsistent availability of supplies as well.

The amount of emotional support these nurses need is great. They are both caretakers and crisis managers; not a single one is performing in these roles from a place of strong support. Many have families that have left the country, seeking safe shelter. The psychosocial impact of maintaining focus on the patients in front of them, while at the same time, worrying about their families is incredibly difficult. 

Attacks on hospitals, supply chains, and medical transport—like ambulances—have led to just under 100 healthcare worker deaths, as reported by WHO. The risk to self just in showing up to work is a constant and valid fear. This, an added layer to the complex mental gymnastics already required in order to carry on.

Ukrainian nurses seem to be managing this mental burden by keeping themselves busy; always moving forward, hoping for diplomatic peace. Knowing that they have support and solidarity from an international nursing community is something many nurses working in Ukraine cite as bringing great comfort. 

So, who are the players supporting Ukrainian nurses? The International Council of Nurses (ICN) is a major benefactor, and this past spring, hosted a webinar   with other global nursing organizations that focused on providing targeted nursing aid. A joint statement was issued, condemning the continued violence toward healthcare workers in particular, and offered three opportunities for those interested in supporting Ukrainian nurses from afar.

First, interested nurses are invited to co-sign the petition for peace, which summarily states,  “The world’s nurses demand that the health and well-being of the people of Ukraine is safeguarded and that can only be achieved through lasting peace, because peace and health are inseparable.”

Second, we as nurses can help to promote awareness for the Ukrainian nurses’ plight via social media channels. The hashtag #NursesforPeace can be used to show your support, as well as sharing any one of the downloadable files and images linked here. 

Third, the ICN has a designated humanitarian fund, which allows nurses from afar to donate. Initially, this fund was created in 2010 to assist with the crisis in Haiti following the massive earthquake that occurred there. In the past decade, the fund continues to support humanitarian efforts following both natural disasters and wartime destruction. 

As of this writing, there is no end in sight to war in Ukraine. Nurses there—along with their global community—have weathered the uncertainty of COVID, but they now must endure the hardships of war. As refugees continues to pour out of the country, neighboring regions are doing their best to absorb and provide for these fragile populations. A number of reputable organizations are helping these efforts, too. Here is a list of all the ways you can help.

As a boy, Mr. Rogers was counseled to “Look for the helpers. You will always find people who are helping.’ While that statement provides a bit of comfort and necessary reframing to those of us trying to make sense of any number of horrors, we must not forget the toll helping takes on frontline workers. 

As nurses, we understand the strength it takes to care for patients under the best of circumstances. Riding out wave after wave of COVID, we also have a fresh perspective on the collateral damage such weathering of storms kicks back into our laps—residual trauma.

Recently, a WHO-led Mental Health Coalition was formed with the express purpose of focusing on Ukrainian resilience and mental health needs. At a meeting in May, the most urgent mental health needs were highlighted, and plans were put in place “…to position mental health as not merely one sector of the health-care system but as the heart of any functioning society…Coalition members are working on identifying good practices and tools and then delivering a framework for these practices to be easily adapted to specific settings and cultures.” 

The Coalition specifically addressed the needs of healthcare workers, who routinely see the worst of wartime violence and who continue to work under the possibility of attacks on their institutions. The main theme of the two-day meeting drove home the importance of continued “hope for change, and determination to see that change through.”

We must see it through.

Let’s agree to keep our global nursing colleagues close. Enduring extreme hardship is bad enough—enduring hardship alone is simply not something we will turn a blind eye too. The mental health of nurses everywhere depends on us standing by this shift.