DiversityNursing Blog

Burnout in Nursing

Posted by Erica Bettencourt

Wed, Oct 04, 2017 @ 11:24 AM

20170405_cover.jpgBurnout amongst Nurses isn't a new thing. In fact, it could be getting worse. With a combination of Nurses retiring and an influx of aging patients, this can become too much to handle and some will leave their profession.

According to Fierce Healthcare, several stressors lead to high levels of pressure and Nurse burnout.  These include:

  • High patient acuity (years ago, these patients would have been in the ICU)
  • High nurse-to-patient ratios (not acuity-based)
  • Multiple discharges and admissions (many nurses will discharge and admit an entire team of patients during their shift)
  • Lack of ancillary support and resources
  • Leaders who assume that nurses “can take one more patient”
  • Physicians who expect nurses to drop everything and attend to their needs
  • Interruptions while on their break
  • The expectation that nurses are all-giving.

A survey by travel nursing company RNnetwork, found that almost half of the Nurses they asked were considering leaving the profession. About a quarter said they felt overworked, 46 percent said their workloads had risen and 41 percent said they’d been harassed or bullied by managers or administrators. Making matters worse, with the aging of the baby boom generation, demand for health care is rising at the same time that large numbers of experienced Nurses are retiring.

Ashley Neuman, LPCC-S, one of Blazey’s colleagues in Cleveland Clinic’s Wellness Enterprise, offered advice to caregivers during a 30-minute Wellness Connection presentation entitled “Managing Burnout in the Workplace: How Caregivers Cope.” She began with a definition of burnout, which can have three components:

  • Emotional Exhaustion – “Burnout can occur when you’re not just physically tired, but you are emotionally exhausted,” says Neuman. “It’s when you don’t have the motivation to get up, get moving and finish that one last clinical note. That emotional weight becomes heavier every day.”
  • Depersonalization – This happens when you have an unfeeling or impersonal response toward recipients of your service, care or instruction. “Nothing sparks passion or you don’t have that intrinsic motivation anymore,” she explains.
  • Dissatisfaction in Personal Achievements – Nurses who experience burnout may lack feelings of competence and achievement in their work. Neuman says, “You become a shell of yourself, losing interest in things you normally enjoy doing.” Maybe you dread going into a patient’s room or going home to make yet another dinner for your family.

Here are some tips that may help Nurses dealing with burnout.

1. Identify The best type of Nursing job for you

The field of Nursing is a large and diverse field. People in this profession might work in hospitals, doctors’ offices, nursing homes, office jobs, mobile units, private practices, home care, schools, the military, and even large public venues like amusement parks. And within the profession, there are medical specialties, such as pediatrics, cardiology, ophthalmology, geriatrics, and sports medicine. Spend some time figuring out what you like the most, and then focus your job search in this.

2. Search for workplaces with lower nurse-to-patient ratios

The Journal of the American Medical Association (JAMA) linked hospital Nurse staffing to nurse burnout and job dissatisfaction in their research on the topic of high Nurse turnover. "Nurses in hospitals with the highest patient-to-nurse ratios are more than twice as likely to experience job-related burnout and almost twice as likely to be dissatisfied with their jobs compared with Nurses in the hospitals with the lowest ratios," JAMA reported.  

The more patients Nurses are expected to care for in a given shift, the less time they have per patient. This can make the usually empathetic task of caring for patients feel more robotic, stressful and incomplete.

3. take care of your own body first

Most Nurses are inclined to take care of others first and worry about themselves later. But in order to be an effective nurse with a long career ahead of you, it’s critical that you take care of your own body. Be sure to make time in your life for adequate exercise, good nutrition, and restful sleep. Bring nutritious protein-packed foods during your breaks. And after a long day on your feet, don’t be afraid to just relax!

4.Learn to say “No.”

masmedicalstaffing.com says, For professionals in healthcare, it’s often our natural inclination to jump right in when someone asks for our help.

However, if you already have an overloaded schedule, your first concern should be to keep yourself healthy—otherwise, you won’t be able to take care of your patients properly.

So instead of always extending a helping hand, take a moment to consider whether you really have the time and energy to do so without adding a bunch of new Nurse stress-inducers to your day.

And if you can’t help out, say so firmly yet politely.

The next two tips are from www.travelnursesource.com

5. Eat Healthy and Stay Hydrated

It’s not a secret that the food that you consume plays a big role in your mood and productivity. Increase your fruits and vegetable intake as well as whole grains and lean meat within your diet for an energy-boosting food palette. To increase productivity, eat food that is rich in fiber and carbohydrates. Stick to food with high levels of omega-3 fatty acids to help reduce depression and lift your mood.

 6. Socialize

Having a support system is an integral part of a healthy mental and emotional state. Take some time from your busy schedule to socialize with your friends and family to take a break from your stressful environment. It’s scientifically proven that when we are more likely be happy when we are surrounded by the people who we love – that is why humans are a social creature.

What are some ways you prevent burnout in your life? Comment your thoughts below!

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Topics: burnout, nursing careeer, Nurse burnout

Hospital Impact: Nurse Leadership's Role In Reducing Burnout

Posted by Erica Bettencourt

Thu, Apr 20, 2017 @ 02:52 PM

Nurse-Burn-Out-H-Logo-01-web.pngIn order to provide top quality care to their patients, Nurses must be focused and alert. Burnout in Nurses is worrisome because common side effects are forgetfulness, impaired concentration, anxiety, and depression. As a Nurse leader you want to make sure patient's lives are in good hands and the Nurses are well. 
 
Continue reading below to learn what stressors cause burnout in Nurses and what you can do as a Nurse leader to prevent burnout from happening. 

The problem of nursing burnout has been in a state of evolution for years. For many of these years, the 12-hour shift was the primary focus. However, 12-hour shifts provide nurses time away from the bedside necessary for rest, family time and self-care, allowing for a rested and refreshed start to new shifts.

Several stressors lead to high levels of pressure and nurse burnout. These include:

  • High patient acuity (years ago, these patients would have been in the ICU)
  • High nurse-to-patient ratios (not acuity-based)
  • Multiple discharges and admissions (many nurses will discharge and admit an entire team of patients during their shift)
  • Lack of ancillary support and resources
  • Leaders who assume that nurses “can take one more patient”
  • Physicians who expect nurses to drop everything and attend to their needs
  • Interruptions while on their break
  • The expectation that nurses are all-giving.

However, the most important stressor includes an old mindset held by organizational and nursing leadership: Nurses who voice concerns related to patient safety and workload are viewed as complainers. As nursing leaders, we must recognize the demands placed on our nurses, validate their concerns, and through best practices and common sense, use our leadership to provide support.

The most important skill of a nursing leader is the ability to listen to nurses. The nursing leader must be engaged in the discussions and have a physical presence in the department. Engaging with nurses allows for an open dialogue and a discussion of ideas, and provides validation.

Validation, in turn, lowers nurses’ stress levels because they know they are being heard. Open dialogue provides the nursing leader a forum to foster best practices, find workable solutions for departmental issues, and teach leadership skills through mentoring sessions.

Nursing leaders must hold nurses accountable who are not carrying their load. Modifications in behavior by the nurse will indicate action and support from the nursing leader. In addition, nursing leaders must know, understand and demonstrate a deep caring for their nurses. This is why having a presence on the unit is so important. Actions always speak louder than words, and we must model healthy, professional and supportive behaviors for our nurses.

Staff meetings can be of great benefit and should include discussions regarding new organizational policies, processes and outcomes from higher leadership meetings. One way to engage nursing input in staff meetings is to post an agenda and ask for additional items the nurses would like to discuss or present. Allowing nurses to create ideas, and to volunteer according to their interests and passions, fosters a sense of belonging that is necessary for engagement.

Imagine nurses researching best practices regarding care of a complex patient diagnosis new to your unit. The nurses present their research and provide the education to the nursing staff. Recognition encourages more nurses to contribute to improving the unit.

As nursing leaders, we must teach and empower our nurses to lead. Self-care has become a buzzword in nursing. Nurses are expected to care for themselves, but are sabotaged by the stress and the demands of the patient care environment. However, nursing leaders must provide supportive environments that foster self-care. For example, a competent team can handle discharge and admissions paperwork and patient education, allowing nurses to attend to their patient loads.

Finally, and most importantly, nurses need to be told that it is OK to take care of their own needs during their work shift. They need to feel confident that the nurses who are covering their team are knowledgeable and competent.

Self-care is included in many of the BSN and master’s-level nursing programs. Nursing programs are teaching leadership skills focusing on professional communication and how to achieve self-care in the work environment. Using best practice and leadership practices learned in nursing programs, nurses should present new ideas and evidence-based models to their nursing leadership.

By communicating in a professional fashion with the leadership, nurses will feel empowered and validated by having a voice. This new refreshing outlook is a far cry from the old, when nurses were expected to give up their chairs for physicians.

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Topics: nurse leadership, Nurse burnout

See How Nurses Are Doing Less Walking And More Caring

Posted by Pat Magrath

Thu, Feb 16, 2017 @ 11:11 AM

graduates-nursing-bsn.jpgEvery Nurse I know who works in a hospital, says they are amazed how much walking they do in their 12-hour shift. If you wear a Fitbit or another step tracking device, you know you walk miles during your shift. Here’s a story about a hospital that did a study to see where they could eliminate some steps for Nurses in the design of their new building.
 
The goal was to give Nurses more time to deliver the best patient care. If you have to walk all over the building to fulfill a medication order, perhaps there is a better way to do it with less steps. Maybe the applesauce or ginger ale could be located closer to where the medicine is dispensed. Please read on for some valuable information.

You don't know what you don't know until you know it.

That's the lesson leaders at ProMedica Toledo Hospital in Ohio learned during the design of its 615,000 square-foot patient tower set to 2019.

As part of the design process, the organization took part in research to identify and refine ways to improve nursing care and efficiencies, including distance traveled during a shift.

Architects from HKS, Inc., the firm designing the building, approached Alison Avendt, OT, MBA, vice president of operations, at ProMedica Toledo Hospital about doing the research.

"We have a building that we opened in 2008, so they wanted to look at how we were using the spaces [there], and get feedback from nursing on how it was working," Avendt says.

"That was really attractive to me because I heard we had issues with the building that we were in and there were many things that we wish we could have done better. I thought if we could do a good design diagnostic and learn something from that, it would really help guide our design work."

An Applesauce Moment
During two days of onsite observation, researchers shadowed ICU nurses and intermediate-level medical-surgical nurses. The researchers assessed the existing floor plan, used a parametric modeling tool, and created heat maps to provide a graphic representation of what a nurse's 12-hour shift looked like in terms of workflow and walking distances.

"One of the big [revelations] was around our whole process of medication passing," says Deana Sievert, RN, MSN, metro regional chief nursing officer and vice president for patient care services at ProMedica.

Observation revealed that a nurse reviewed the patient's medication administration record in the patient's room, walked to the supply room to get the medication from the Pyxis machine, and then often had to stop by the patient refrigerator to get something—like applesauce—to aid in the medication pass before walking back to the patient's room to administer the medication.

"It was something that was just so ingrained in our staff nurses' normal daily activities," Sievert says. "When they did the heat mapping it was like…'Wow. [There's a] big pinch point that we as staff nurses didn't really even realize was there.' "

Avendt says the researcher called this realization "the applesauce moment."

"Nurses are masterful at just making things work. There are a lot of things that the nurses knew were not value-added or were problematic, but they would just make it work," she says.

"It was really good to flesh out what those things were by observing because if you just ask[ed] them, the nurse would often not be able to verbalize what the problem was. But by seeing it, it came to light."

The architects used this information to design a unit that would cut down on walking time. Instead of a long corridor with a common area at one end, the unit was broken up into pods and supplies were located in multiple areas so nurses could get them from the location to which they were closest.

"We were able to take them from a three-mile journey on their shift to 1.5 miles. We cut in half the steps that they were taking," Avendt says.

After the tower opens, more research will be done to see how the design is affecting workflow.

"We've since learned that [field research] is not common for people to do. We paid a little bit of money to do that, but in the scheme of things it was well worth the investment," Avendt says.

"Everybody wants to give the nurse as much time as possible to be with the patient [and] try to take away the things that are not value-added in the nurse's day."

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Topics: efficiency, patient care, hospitals, Nurse burnout

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