DiversityNursing Blog

Nurse burnout is not a new concept. Nurses have been experiencing burnout for decades. However, since the COVID-19 pandemic, more Nurses than ever are experiencing burnout, making it a hot topic in the Nursing community. Nurse burnout is often brought on by everyday stressors like insufficient staffing, increased workload, high patient acuity, and even verbal or physical abuse from patients. These stressors result in physical, mental, and emotional fatigue. As a result, Nurse burnout has been a significant factor in the number of Nurses leaving bedside Nursing or even the profession altogether.

Identifying the symptoms of Nurse burnout is the first step in preventing it from progressing. Nursing burnout is not one size fits all, and there can be many different ways it manifests itself. Nurses can experience various symptoms, including fatigue, sleep problems, headaches, anxiety, loss of desire to go to work, feeling underappreciated, overworked, or unsupported, difficulty with interpersonal relationships, and may even isolate themselves or withdraw from activities.

With an emotionally demanding and stressful job, it can be normal to experience some ill feelings toward your job from time to time. However, when the ill feelings begin to linger for weeks or start to affect your personal life or how you feel toward your job, it may be time to take some time for yourself and implement some of these strategies to reduce the risk of becoming burnt out.

Develop Strong Relationships with Coworkers

Nurses work in stressful situations but having a good support system with those you work with can help lighten the load and decrease the risk of experiencing burnout. This is because Nurses in positive environments feel more supported by the people around them. Having good support from Nurse friends can reduce stress levels and the emotional exhaustion you may encounter in the clinical setting.

Prioritize Physical and Mental Health

A great way to prevent Nursing burnout is to prioritize your physical and mental health. Nurses cannot pour from an empty cup. Practicing yoga, meditation, or journaling are all excellent ways to relieve stress and work through frustrations or concerns. Nurses should also try their best to eat well, drink plenty of water, get adequate sleep and participate in physical exercise several times per week.

Set Boundaries

Setting boundaries is essential to prevent burnout. Nurses often work long shifts with varying schedules, which can be challenging to navigate for some Nurses as they work opposite shifts than friends and family. Although working extra hours can benefit your wallet, it may have different personal benefits. Taking the time to disconnect from work stressors and spend time with loved ones is essential for a work-life balance. Sometimes it's better to leave work at work and avoid work-related conversations while on your time off.

Find Support with Loved Ones

The Nursing profession can come with a heavy mental load contributing to burnout. Finding support from family and friends is essential. If you experience trauma in your workplace, sometimes talking to a therapist or counselor can help with coping strategies and processing your feelings. 

Find a Creative Outlet

Having a creative outlet can help release endorphins that can help to prevent Nurse burnout. Research has shown that Nurses with creative endeavors have enhanced mood, more energy, stronger immune systems, and lower stress. Some Nurses enjoy activities like crocheting or knitting, painting, or pottery. So if you have been looking for a way to decrease work stress, now might be a perfect time to learn a new skill and pick up a new hobby.

Consider Advancing Your Career

If all else fails and you continue to experience symptoms of Nurse burnout from chronic job stress, consider going back to school to advance your Nursing career. By advancing your Nursing career, you can become a Nurse leader, Nurse Educator, or a Nurse Practitioner. These career paths can provide autonomy, a change of pace, and remove you from your current clinical environment. Advancing your career also gives you a unique advantage to change how we practice Nursing and help prevent Nursing burnout for future generations of Nurses.

It takes a team effort to prevent Nursing burnout. Administration and Nurse leaders must prioritize the well-being of their Nursing staff, and Nurses themselves must strive to care for themselves as well as they care for their patients.

Even before the pandemic, healthcare providers experienced burnout and other negative mental health issues. Now more than ever, it is critical health systems take steps to support their staff's well-being.

Recently, more healthcare organizations have started to hire Chief Wellness Officers (CWO), as a strategy to address burnout, mental health, and compassion fatigue.

Jonathan Ripp MD, MPH, Chief Wellness Officer at the Icahn School of Medicine at Mount Sinai, said there were only a handful of Chief Wellness Officer positions when he was appointed to the role in May 2018. “There has been at least a dozen more who have been named in the past year, and several more places that are looking to create the position,” said Dr. Ripp. “I would not be surprised if, 10 years from now, it's commonplace for most large organizations to have a Chief Wellness Officer or equivalent, taking this challenge on, and doing so in a way that is effective.”

The ultimate goal of this role is to aid system-wide changes that enable staff to practice in a culture that prioritizes and promotes mental health and well-being.

The CWO is responsible for measuring well-being across their organization. Then, they create and implement wellness programs that address the current environment causing burnout and stress.

The hiring of a CWO is not a remedy all on its own. The CWO works in collaboration with other leaders and staff to prioritize well-being and would ultimately lower costs and improve patient care.

According to Beckers Hospital Review, burnout and depression result in major costs to health systems due to an increase in medical errors, reduced quality of care, and turnover. Research has found that for every dollar invested in wellness, hospitals can see a $3 to $6 return on investment.

Medical Schools are also following the hiring trend.

Holder said, "Mental and emotional wellness is essential to complete health. We simply cannot ignore this fact. I view my role as another way to serve the students, faculty and physicians in Brown’s medical school, and aid them in not just meeting their immediate self-care needs but also creating and developing plans that can help them learn more about how to take care of themselves in a way that's sustainable for a profession that demands a lot."

“Wellness and self-care is more important than ever before. These next few years will be critical for health care workers as we address the mental and physical burdens from COVID-19,” said George Washington University's Chief Wellness Officer, Lorenzo Norris, MD.

Hopefully this position sticks around, even after the pandemic passes, because burnout and mental health have been issues in the healthcare field all along.

In order for a healthcare system to be successful in having high engagement, job satisfaction and retention, the Nursing workforce should be able to combat the stressors of the job and burnout.

Nurses can better accomplish this by having help from peer support groups and mindfulness programs.

According to a report from the National Academy of Medicine (NAM), between 35% and 54% of Nurses and Doctors experience burnout. Among medical students and residents, it is as high as 60%.

Symptoms, the NAM report said, include emotional exhaustion, cynicism, loss of enthusiasm and joy in their work and increasing detachment from their patients and the patients’ ailments. The problem has been linked to higher rates of depression, substance abuse and suicide.

Many institutions are implementing stress management and self-care programs to provide caregivers with easy-to-use tools and resources to build their resilience and help them cope.

The Cleveland Clinic Abu Dhabi implemented a new mindfulness program known as the ‘Compassionate Intension Program.’ The sessions introduce caregivers to mindfulness as a wellness tool they can utilize in both their workplace and personal lives. Currently, there are three sessions in place:

• In Tune Tuesdays: Held biweekly, ‘In Tune Tuesdays’ are 20-minute classes designed to further educate attendees on mindfulness and how to improve mindfulness in their work environment. The classes are held at three different times to accommodate caregiver schedules.
• Mindfulness Rounding: Also a biweekly activity, ‘Mindfulness Rounding’ features a team of mindfulness experts who visit clinical units. The experts conduct learning huddles and one-on-one conversations with caregivers, sharing quick tips. Their pocket cards or guides offer information on easy-to-implement mindfulness techniques.
• Introduction to Mindfulness Workshop: This 8-week workshop, featuring 1-hour weekly sessions, was developed around the evidence-based standards of mindfulness experts, including, Jon Kabit-Zinn, PhD, of the University of Massachusetts Medical School, Center for Mindfulness, and Richard Davidson, PhD, of the University of Wisconsin’s Center for Healthy Minds and Oxford University’s Mindfulness Center. It offers a deeper dive into various mindfulness techniques.

Johns Hopkins Hospital, Pediatric Nurse, Cheryl Connors, RN, MS, created a peer program to provide immediate support for health providers affected by stressful cases.

The Resilience in Stressful Events (RISE) program was developed with a Pediatric Chaplain, a Patient Safety Director, a Doctoral Student, and General Internist Albert Wu, MD, FACP.

According to the American College of Physicians, the RISE program provides a team of 39 peer responders who volunteer their time to support those who call the service. RISE team members include Nurses, Doctors, Nurse Practitioners, Respiratory Therapists, Pastoral Caregivers, and Social Workers. They undergo didactic, video-based, and role-playing training.

The team has been called by more than 700 Johns Hopkins employees. The hospital previously had a program offering free professional counseling but, Ms. Connors said, “They actually prefer somebody who knows what they're going through—another health caregiver who can relate—and when they need it, not a week later.”

As supporters of patients and their families, Nurses deal with a lot of stress. Health systems can help their Nurses by surrounding them with support and offering them the tools to overcome and cope with stress so they can provide the best care for their patients and for themselves.

Burnout 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!