Baylor-led Study Analyzes Impact of COVID-19 on Pediatric Advanced Practice Registered Nurses

October 21, 2021
Jessica Peck

Jessica Peck, DNP, clinical professor at Baylor's Louise Herrington School of Nursing, led a study on the impacts of COVID-19 on pediatric advance practice registered nurses.

Jessica Peck, DNP, Baylor clinical professor of nursing, considers the effects of COVID-19, including burnout and mental health concerns, on APRNs

Media Contact: Kaitlyn Rieper, Baylor University Media and Public Relations, 254-405-9110
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by Kate Nelson, student news writer, Baylor University Media and Public Relations

WACO, Texas (Oct. 21, 2021) – Pediatric advance practice registered nurses (APRN) are facing multifocal impacts of the COVID-19 pandemic, with the most difficult challenge being mental health struggles experienced by themselves and their families, according to a new study led by Jessica Peck, DNP, clinical professor at Baylor University’s Louise Herrington School of Nursing (LHSON).

The study, published in the Journal of Pediatric Health Care, examined the holistic effects of COVID-19 on pediatric-focused APRNs through a survey of 789 participants.

The study shows that pediatric APRNs experienced increased burnout and mental health concerns during the COVID-19 pandemic. With its serious impact on society, COVID-19 has burdened medical professionals, which has caused delays of care within the healthcare system. Nurses throughout the healthcare system have been critically impacted by the COVID-19 pandemic.

A consequential impact of COVID-19 has been the alteration of pediatric care delivery. Pediatric agencies have experienced disruptions in care provisions, patient presentations, clinical practices, immunizations and revenue, according to the study. Furthermore, some pediatric nursing professionals have transitioned to working with adult populations while others have been furloughed or laid off due to a strong demand for critical care nursing services and a lower demand for primary care nurses.

“While physical disease impacts on children have generally not been as dire as some historic precedents like polio, they are by no means spared,” Peck said. “Pandemic conditions have fundamentally altered the norms of pediatric care delivery and, as a profession, we share collective concerns: severe COVID in children with pre-existing conditions, life-threatening multi-system inflammatory syndrome, disturbing disparities in severity of illness and death, particularly for children of color who account for 75% of pediatric COVID-19 deaths, and free-falling immunization rates with recovery not yet in sight.”

The strongest impact of COVID-19 has been on APRN’s mental health. The research shows that 34% are experiencing moderate to extreme concern for professional burnout while 25% of respondents feel anxious or nervous and another 15% are experiencing depression or hopelessness. Overall, 20% of participants reported feeling moderate to extreme concern for their mental health.

“As a profession, many pediatric nursing professionals are working far more hours for far less compensation, isolated from professional networks. They are learning new technologies and implementing new policies in little time with even less support. Pediatric clinics are severely disrupted,” Peck said. “Children’s hospitals received less than 1% of all federal relief monies provided to U.S. hospitals, leaving children without access to care. Faculty are exhausted and experiencing vicarious trauma hearing devastating stories from their students. All of this contributes to destabilized pediatric infrastructure, which disproportionately impacts marginalized children.”

Not only has COVID-19 impacted registered nurses, but it also has had significant impact on their families. Most respondents noticed an increase in clinical presentations of child mental or behavioral health concerns (73%), isolation and limited socialization (72%) and parental anxiety (71%).

One of the most alarming findings was the increase in child mental or behavioral health concerns that nurses noticed, Peck said.

“This problem is multifactorial, with isolation, loss of safety net services, family stressors and trauma and deferred care and services all compounding this issue across communities worldwide,” she said.

Another notable finding is that more than a third of the respondents had moderate to extreme concern over professional burnout due to rapid changes and disinformation. In addition, lessons learned during the pandemic will shape the next generation of APRNS.

Peck noted three practical implications of the study:

  1. Nurses are not heroes or angels and should be treated as humans with physical and mental health needs. Nurses should be supported to prioritize individual health promotion behaviors and resource access.
  2. Healthcare organizations and leaders need to affirm and reinforce the value of nursing with diverse and equitable representation in decision-making forums and assurance of access to supportive resources without fear of discrimination, stigma or bias.
  3. Support for public civility towards nursing professionals and public health experts is crucial, with policy support for zero tolerance of violence towards nurses.


The study, “Exhausted and Burned Out: COVID-19 Emerging Impacts Threaten the Health of the Pediatric Advanced Practice Registered Nurse Workforce,” is published in the Journal of Pediatric Health Care. Co-author Jessica Peck, DNP, APRN, CPNP-PC, CNE, CNL, FAANP, FAAN, is a clinical professor of nursing at Baylor University’s Louis Herrington School of Nursing. Co-author Jennifer Sonney, Ph.D., APRN, PPCNP-BC, FAANP, is an assistant professor at University of Washington School of Nursing.


Baylor University is a private Christian University and a nationally ranked research institution. The University provides a vibrant campus community for more than 20,000 students by blending interdisciplinary research with an international reputation for educational excellence and a faculty commitment to teaching and scholarship. Chartered in 1845 by the Republic of Texas through the efforts of Baptist pioneers, Baylor is the oldest continually operating University in Texas. Located in Waco, Baylor welcomes students from all 50 states and more than 90 countries to study a broad range of degrees among its 12 nationally recognized academic divisions.


The Baylor University Louise Herrington School of Nursing (LHSON) located in Dallas, Texas, was established in 1909 as a diploma program within Baylor Hospital in Dallas, which is now Baylor Scott & White Health’s Baylor University Medical Center, and in 1950 became one of the six degree-granting schools of Baylor University. The first Baccalaureate degrees were granted in 1952, establishing the School among the earliest baccalaureate nursing programs in Texas. In 1999, the School was renamed the Baylor University Louise Herrington School of Nursing after Louise Herrington Ornelas, a 1992 Baylor Alumna Honoris Causa, who made an endowment gift to the School. The LHSON offers Bachelor of Science in Nursing (BSN) degrees through Traditional, FastBacc® (one-year accelerated) and Distance Accelerated BSN programs. Plus, the LHSON offers an online Doctor of Nursing Practice (DNP) program with tracks that include Family Nurse Practitioner, Nurse-Midwifery, Neonatal Nurse Practitioner, Pediatric Nurse Practitioner, Executive Nurse Leadership and U.S. Army Anesthesia Nursing (USAGPAN), which operates at the U.S. Army Medical Center of Excellence at Fort Sam Houston in San Antonio. U.S. News & World Report‘s 2022 Best Graduate Schools rankings include several LHSON programs, including the DNP at No. 60 nationally; “Best Nursing” specialty rankings for LHSON’s USAGPAN at No. 8; and Baylor’s Nurse-Midwifery program at No. 21. To learn more, visit