The year 2020 was both collectively and personally stressful for healthcare workers. As a group, physicians, nurses, emergency response professionals and hospital staff had to come together to battle COVID-19 and all its challenges. The "team" mentality provided a much-needed level of support, even when dealing with such a devastating crisis.
But what happens when those individuals go home? All the pressures of the day — the trauma, sadness, death — can weigh on healthcare workers. When it becomes too much to handle, they enter a dangerous territory: burnout.
What Causes Burnout?
Burnout is also referred to as "compassion fatigue," which is somewhat limiting. There are times when the act of caring for patients can lead to symptoms of burnout — especially when nurses aren't achieving the results they'd hoped or expected. However, other causes can lead to burnout in nurses as well.
For example, a 2017 Joint Commission study of more than 2,000 nurses worldwide found that the most common factors related to burnout are:
- exclusion from the decision-making process
- the need for greater autonomy
- security risks
- staffing issues
The National Institute for Occupational Safety and Health (NIOSH) adds to that list, including factors such as work overload and time pressures, sleep deprivation, role ambiguity and/or conflict and exposure to infectious diseases and needle-stick injuries.
How Common Is Burnout Among Nurses?
While the COVID-19 pandemic heightened the intensity and volume of stress across all corners of healthcare, burnout has long been prevalent in the industry. The National Academy of Medicine (NAM) reports that "at least 50% of caretakers across medical fields report serious symptoms of burnout, including emotional exhaustion, cynicism, and low sense of professional accomplishment." Last year, a survey from Kronos revealed that a disturbing 63% of nurses say their job has caused burnout.
Burnout and the Nursing Shortage: A Vicious Cycle
The Kronos survey also found that more than four out of five nurses believe hospitals fail to retain staff because other employers offer a better work/life balance. Given the widespread nursing shortage, retaining healthcare employees is especially crucial. It's estimated that one million registered nurses (RNs) will retire by 2030, and the lack of nurse educators at schools across the U.S. are failing to keep up with incoming students in healthcare programs.
Rita Trofino, RN and Associate Dean of the School of Health Sciences at St. Francis University, notes how the nursing shortage contributes to burnout:
"With a shortage, many nurses are asked to work longer or double shifts. Exhaustion is a factor in burnout. Overworking leads to job dissatisfaction. … It's also easier to feel burnout when your hospital is already understaffed and nurses continue to turn in their letter of resignation. You know that you'll be picking up the extra work because nurses are leaving faster than they're being hired."
5 Strategies for Reducing Burnout
It's impossible to remove all stress from the nursing field; stress is something that really "comes with the job" given the high stakes of monitoring patient health. Even the NIOSH recognizes that "the most conscientious efforts to improve working conditions are unlikely to eliminate stress completely for all workers." Instead, the organization proposes a combination of organizational change and stress management strategies.
In a recent Nurse Journal article, Tina Gerardi, MS, RN, CAE, and Executive Director of the Tennessee Nurses Association (TNA) and LaCresha Sims, a productivity and mindset coach and former nurse, join Trofino in offering the following five tips to prevent nurse burnout.
- Establish strong interpersonal relationships
This doesn't just apply to the workplace environment. It is important to have solid relationships with colleagues, management staff and even hospital administrators. However, nurses also need to develop strong relationships outside of work. Someone who can "listen to their concerns, and give the emotional support needed to help nurses return to their next shift feeling present and prepared," says Gerardi.
2) Set boundaries between work and personal life
Creating healthy boundaries is important for any career, but it can be especially difficult in healthcare — and severely challenging in some sub-specialties. A study published in 2020 by the National Center for Biotechnology Information (NCBI) found that pediatric nurses experience high levels of burnout because of the "specialized nature of providing care to children who are typically seen as a vulnerable population, the high potential for empathetic engagement, and the inherent complexities in the relationships with families."
Gerardi urges nurses to really focus on being mindful when not at work, making time to engage in activities they enjoy — and be more present around loved ones.
3) Invest in proper sleep
The adrenaline of working on little or no sleep can only last so long. Nurses who operate under sleep deprivation are more likely to make mistakes, among other negative consequences such as falling asleep at the wheel.
Conversely, the American Nursing Association says that nurses who get enough sleep have the benefit of "heightened alertness, boosted mood, increased energy, better concentration, more stamina, greater motivation, better judgment, and improved learning."
4) Pay attention to self-care practices
Exercise is clearly beneficial for improving physical health, but it's also instrumental in bettering mental health. Even a 15-minute walk can provide a necessary mental break, rejuvenating the body and mind.
Sims also advises nurses take time off when they need it and not try to push through. "Being sick shouldn't only mean physical symptoms such as a fever or cough. Not feeling well mentally should also constitute a sick day," she says.
5) Turn to therapy or other employee assistance programs
Asking for professional help is never an indication of failure. Sometimes, therapy services are offered through your employer. If not, Trofino suggests nurses enlist the help of their human resources department to locate employee assistance programs or individual or group therapy options.
Solutions Also "Start at the Top"
Nurse management and other department leaders need to also do their part to recognize when their nurses are on the verge of burnout and implement ways to prevent staff from heading down this dangerous path.
Tactics may include improving nurse-to-patient ratios, reducing the non-clinical tasks nurses perform, involving nurses in their own scheduling, providing opportunities for nurses to contribute to policies and creating support programs within the department to make getting help more accessible (and, in some cases, more acceptable).
Many of these leadership responsibilities are emphasized within Registered Nurse (RN) to Bachelor of Science in Nursing (BSN) programs. Specifically, the online Nursing Leadership & Management course through The University of Texas at Arlington's program covers "exploration of organizational strategies, leadership theories and societal trends with implications for decision making in healthcare."
The healthcare industry will never be able to eliminate its employees' stress and exhaustion. However, with a collective effort among hospital leadership, nursing management, and nurses themselves, employees can mitigate stress and successfully avoid burnout.
Learn more about The University of Texas at Arlington's online RN to BSN online program.
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