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When Michael Odell, an intensive care nurse, died by suicide a year ago this month, it thrust attention on all that nurses had endured during the pandemic.

Odell’s death also motivated his friends in the field as well as other nurses to build on that attention and his legacy. In the year since, they’ve been advocating for health care worker well-being and calling for health systems to offer more support for nurses, historically a group that’s received less consideration than doctors. They also started an organization called Don’t Clock Out.

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Over the last several months, Don’t Clock Out has begun holding weekly online peer support meetings, one specifically for nurses (and nursing assistants and students), and one for health care workers generally. The group is in the process of finalizing its nonprofit status, which will enable fundraising efforts to begin. The organization’s ultimate goal is to start a peer support line available 24/7 that will be manned by volunteers trained to help other health care workers dealing with mental health challenges.

The guiding principles behind Don’t Clock Out’s work are to reduce the stigma of seeking help among health care workers, and to offer a full suite of resources, whether it’s the group’s own peer support network or connecting people to other services, including therapy, help for substance misuse, and emergency help for those in crisis.

“There’s been more people than I ever realized out there in the health care world looking for support,” said Josh Paredes, a nurse in San Francisco and Odell’s friend.

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Odell, a travel nurse, died last January after walking out of his shift one night while working at Stanford Health Care. In a story published by STAT in March that captured how the health care field had historically not prioritized nurses’ mental health or considered their risk of suicide, Odell’s friends remembered him as deeply caring and intelligent.

After Odell died, his friends got linked up with Sarah Warren, a nurse based in Florida who was speaking out at the time about the mental health strain nurses were under, and who is now helping lead Don’t Clock Out.

Warren said the weekly support groups — which sometimes have themes like substance use or grief, and sometimes are just places for people to discuss what they’re facing — are small versions of what Don’t Clock Out hopes to provide with the peer support line. The group is already building a database of volunteers eager to help when the hotline launches.

“It’s been profound and amazing, to be able to provide free peer support,” Warren said.

While the country has broadly moved out of the emergency phase of the Covid-19 era, the mental health consequences could be longer term for health care workers, said Jessi Gold, a psychiatrist at Washington University in St. Louis who specializes in clinician mental health. It can take time for the trauma clinicians experienced to manifest.

Gold also noted that even if Covid patients are no longer swamping hospitals, other stressors continue to challenge health care workers.

“Just because one thing is better doesn’t mean health care is better,” Gold said. “If it’s not Covid, it’s the flu. If it’s not Covid, it’s a nursing shortage.”

Still, Gold said the pandemic has put a spotlight on health care worker mental health. In May, the U.S. surgeon general issued an advisory on health worker burnout. Hospitals are providing more services, and there’s more recognition that nurses need particular support. Pre-pandemic, nurses had higher suicide rates than doctors, but sometimes had access to fewer resources.

A priority for advocates broadly is ensuring that clinicians don’t worry about risking their licenses if they seek mental health help. The Dr. Lorna Breen Heroes’ Foundation — named after the New York physician who died by suicide early in the pandemic — is calling for more states to remove what it says are invasive mental health questions from licensure applications, for example.

A major question is whether the attention and resources will fade as the pandemic does. Gold said that not all health systems have been able to afford investing in mental health resources.

“The challenge will be how much of that will be sustained in the long term, versus how much of that was a Band-Aid?” Gold said.

For Paredes, one goal for Don’t Clock Out is to provide health care workers with another resource —  a group of peers they can turn to — so they don’t have to rely only on the services their health systems offer. It’s like how Michael — who often shared his deep love of travel, as well as Skittles — was such a source of support for his nurse friends, Paredes said.

“Nurses take care of each other,” Paredes said.I think more broadly, health care workers take care of each other.”

If you or someone you know may be considering suicide, contact the 988 Suicide & Crisis Lifeline: call or text 988 or chat 988lifeline.org. For TTY users: Use your preferred relay service or dial 711 then 988.

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