A recent editorial in Critical Care Nurse titled “Could It Be Menopause?”1  sparked significant disquiet in the online nursing community. The editorial invited readers to consider the degree to which menopause contributes to nurse burnout, during the COVID-19 pandemic and before. Perimenopause and menopause, along with other health concerns for women and people with uteruses, are poorly understood and poorly addressed in health care,2  for patients and providers alike. Not all nurses experience menopause, not all women experience menopause, and not all people who experience menopause are women. Although the symptoms associated with menopause may mirror burnout, linking the experience of burnout with menopause in the midst of a pandemic introduces an unintended liability that off-loads burnout onto individual nurses and echoes the oft-weaponized notion of “hysteria,” a catchall diagnosis used to dismiss and demean women.

The realities of nursing are more than sufficient to account for the grinding burnout nurses are experiencing. In a study conducted shortly before the start of the pandemic, researchers found that as many as one-third of US nurses were experiencing burnout.3  We entered the pandemic under suboptimal conditions, which have continued to worsen as the pandemic endures.4  Amidst the despair, grind, trauma, and gaslighting, we go on, marking birthdays, anniversaries, holidays, and milestone achievements as well as the more mundane things that shape our lives such as puberty, school, allergies, grading, chores, and even menopause. These daily realities are important; they keep us anchored in an otherwise bleak landscape and push us to navigate the dialectic among the needs, realities, expectations, and desires of the individual nurse and the unremitting strain of a health care system in crisis.

The pandemic is not over and the traumas that nurses face are ongoing. In late December, as many health care providers simultaneously celebrated the holidays and braced for a postholiday COVID surge, both the Centers for Disease Control and Prevention and the American Heart Association put forth deeply troubling recommendations. The Centers for Disease Control and Prevention, acceding to business pressures, shortened recommended quarantine time for health care workers who are COVID positive5  and allowed the possibility of health care workers returning to work with an active COVID infection to mitigate workforce strain.6  Concurrently, the American Heart Association rolled back previous guidelines and now recommends against any delay in the initiation of cardiopulmonary resuscitation, including any pause for a vaccinated health care worker to don personal protective equipment.7  This recommendation exposes health care workers to COVID-19 for heroic but futile efforts, given the abysmal success rate of cardiopulmonary resuscitation for COVID patients.8  Taken in combination, these recommendations suggest the health care workforce is disposable—a message not lost on health care workers.911  The effects of these systemic, structural, and institutional failures cannot and will not be mitigated by nonpharmacological interventions or hormone replacement therapy,1  nor can gratitude practice12  or shower heads13  alleviate burnout, as recent American Nurses Association campaigns suggest. Ultimately, systemic problems cannot be solved by individual-focused solutions and, even more critical, individualist interventions tend to obscure upstream culpability.

1
Bourgault
AM
.
Could it be menopause?
Crit Care Nurse
.
2021
;
41
(
6
):
7
10
.
2
Grose
J
.
Why is perimenopause still such a mystery?
New York Times
.
April
29
,
2021
. Accessed December 27, 2021.
3
Dyrbye
LN
,
Shanafelt
TD
,
Johnson
PO
,
Johnson
LA
,
Satele
D
,
West
CP
.
A cross-sectional study exploring the relationship between burnout, absenteeism, and job performance among American nurses
.
BMC Nurs
.
2019
;
18
(
1
):
57
.
4
Galanis
P
,
Vraka
I
,
Fragkou
D
,
Bilali
A
,
Kaitelidou
D
.
Nurses’ burnout and associated risk factors during the COVID-19 pandemic: a systematic review and meta-analysis
.
J Adv Nurs
.
2021
;
77
(
8
):
3286
3302
.
5
Associated Press
.
US Officials Recommend Shorter COVID Isolation, Quarantine
.
December
27
,
2021
. Accessed January 4, 2022.
6
Centers for Disease Control and Prevention
.
CDC Releases Emergency Guidance for Healthcare Facilities to Prepare for Potential Omicron Surge
.
December
23
,
2021
. Accessed December 27, 2021.
7
Hsu
A
,
Sasson
C
,
Kudenchuk
PJ
, et al
.
2021 Interim guidance to health care providers for basic and advanced cardiac life support in adults, children, and neonates with suspected or confirmed COVID-19
.
Circ Cardiovasc Qual Outcomes
.
2021
;
14
(
10
):
e008396
. doi:
8
Thapa
SB
,
Kakar
TS
,
Mayer
C
,
Khanal
D
.
Clinical outcomes of in-hospital cardiac arrest in COVID-19
.
JAMA Intern Med
.
2021
;
181
(
2
):
279
281
.
9
@BurgartBioethix
.
It’s unethical for the AHA to tell you not to don PPE before starting CPR. You are not disposable
.
(They jumped way too quickly with their Oct 2021 guidance.) Your Local Twitter Bioethicist
.
December
26
,
2021
. Accessed December 27, 2021.
10
@MomRobe
.
Imagine, me… working COVID (+) because we are short staffed, with improper PPE because AHA told me *not to delay CPR* on your mom or dad, and they live through the event only to die of the COVID I gave them
.
This is a thing that could absolutely happen
.
December
26
,
2021
. Accessed December 27, 2021.
11
@RougeDadMD
.
The CDC telling us to go to work when COVID+ and symptomatic, the AHA saying to start CPR without PPE— they are saying out loud what used to be the norm, & what society managed to temporarily hold in at the pandemic’s outset: Health-care workers well-being doesn’t matter
.
December
26
,
2021
. Accessed December 27, 2021.
12
@ANANursingWorld
.
Gratitude can be an antidote to the root causes of burnout, especially among health care professionals
.
Something as simple as thanking a colleague or being mindful of the good things in our lives can be effective selfcare
.
November
13
,
2021
. Accessed December 28, 2021.
13
@ANANursingWorld
.
With long hours on your feet and busy schedules, quick relief is important
.
That’s why we partnered with @waterpikshowers and their line of Power-Pulse Therapeutic Massaging shower heads which help soothe muscle tension, promote restful sleep and more. https://hubs.ly/H0VqsCv0. Published August 18, 2021
. Accessed December 28, 2021.