While nurse burnout is not a new phenomenon, the COVID-19 pandemic has fueled its rapid increase by ratcheting up the demands, workloads, risks, and emotional tolls nurses experience every day. The nursing shortage is not new either, but increases in burnout will likely contribute to higher turnover rates in hospitals, clinics, and other settings in which nurses work. This could potentially set up a vicious cycle in which more workers quit due to nurse burnout, and lowered nurse-to-patient ratio aggravates nurse burnout.
This developing crisis may threaten your dream of continuing in nursing, a career you’ve put a lot of time, money, and soul into. Recent studies show alarming numbers of nurses being driven away from their jobs by burnout, which has created a national nursing shortage and increased risks to patient safety. In the November 2021 Hospital IQ survey of U.S. hospital nurses, for example, 90% of respondents said they are considering leaving the profession within the next year, citing burnout as one reason for their departure.
You can’t properly care for others if you don’t address your needs first. To someone who’s committed their life to caring for others, this can sound almost counterintuitive. But asking for what you need, knowing burnout warning signs, setting boundaries around your work, and performing self - care when you’re off the clock will put you in a better place to be the best nurse you can be.
To help you out, we’ve taken into account the underlying causes of burnout and compiled a list of things you can do to curb your risk.
A survey by Cross Country Healthcare and Florida Atlantic University’s Christine E. Lynn College of Nursing identifies the effects of the pandemic and burnout on nurse satisfaction levels. In that survey, 37% of nurses identify as being burned out, overworked, and/or stressed.
The survey also asked nurses about their views on what could positively affect the profession and reduce turnover. Respondents believed positive hospital changes could include:
- Increased pay rates and other incentives: 97% agreed that increases to pay rates and other incentives would attract new nurses and retain existing, experienced nurses.
- Increased use of telehealth: 58% agreed that telehealth should be a cornerstone of care delivery.
- Improved cross training: 85% believed that educating nurses to work in numerous units can help the system better adapt to crisis events.
- National licensure: 85% responded that they strongly believe that national licensure, which would allow nurses to practice across state lines, would have greatly benefited the country during the pandemic.
Addressing the Underlying Causes of Nurse Burnout
In 2019, the World Health Organization (WHO) added the term “burnout” to its International Classification of Diseases (ICD). By identifying burnout as an occupational phenomenon, WHO helps bring attention to this public health epidemic and essentially validates the symptoms and suffering nurses experience as the result of their work.
WHO outlines the following ways healthcare organizations can prevent and address burnout:
- Set clear and consistent goals for staff
- Provide frequent training to increase role effectiveness and coping strategies
- Provide work - focused consultations to staff who are experiencing job stress
- Encourage the development of support groups and resource exchange networks
- Maximize staff autonomy and participation in decision - making
- Provide training in conflict resolution
- Organize work to reduce job strain by optimizing workload and working time, ensuring safe staffing levels, encouraging regular breaks and having flexible schedules
- Optimizing shift lengths to avoid fatigue, giving preference to shift rotation in a forward direction
- Provide accommodations for healthcare workers during emergency operations with access to food services, sanitary facilities and recreational opportunities
The philanthropic arm of the American Nurses Association (ANA), known as the American Nurses Foundation, launched the national Well-Being Initiative. The aim of the initiative is to provide access to digital mental health and wellness - related sources, tools, and more to support the emotional well - being of nurses, particularly through the pandemic. Tools and resources include safe places to talk, ways to improve sleep and self - care, podcasts, videos, stress self - assessments, and other mental health and well - being resources.
While nurse burnout is a common experience and is often the predictable result of long hours, exhaustion, imbalanced nurse-to-patient ratios, and poor workplace morale and culture, everyone who has burnout experiences it for slightly different reasons. The best way for individual nurses to address burnout, then, is to identify and address its underlying causes.
Problem: Overwhelming workloads
Solution: Delegate tasks as appropriate. When necessary, ask for help from colleagues; offer assistance to colleagues as needed to maintain team morale. Enlist the help of managers and administration to help even out workloads.
Problem: Nursing shortage
Solution: While you cannot correct the nursing shortage, you can help reduce the effect it has on your physical, mental, and emotional well - being during your shift. After receiving a report on your patients, for example, prioritize the types of nursing care your patients will need and gather the necessary supplies and resources to provide that care. Delegate other types of care to nursing assistants and techs when appropriate.
Problem: Dissatisfaction with administration
Solution: Speak with your nurse manager or appropriate administrator about your concerns. Ask for an official hearing when appropriate.
Problem: You no longer enjoy what you do
Solution: Consider switching specialties or employers.
Problem: No breaks during your shift
Solution: Insist on taking short breaks as legally provided to all employees. Taking a short walk, meditating, reading, or even knitting can help rejuvenate your mental and physical states.
Problem: Lack of sleep
Solution: Practice good sleep hygiene as defined by the Sleep Foundation:
- Set and stick to a sleep schedule.
- Follow a nightly routine, such as winding down for 30 minutes prior to sleep; unplugging from electronics; and engaging in an activity that relaxes you, such as stretching, listening to music, or reading.
- Optimize your bedroom with a comfortable mattress and pillow, blocking out light, keeping the room cool, and drowning out noise.
- Cultivate healthy daytime habits, such as getting in a little sunshine to support your circadian rhythm, being physically active, avoiding cigarette smoking and alcohol consumption, choosing healthy foods over junk food, and cutting down on caffeine late in the day.
Problem: Other stresses
Solution: Stresses outside the job, such as financial problems or mental health issues, can contribute to nurse burnout. Consider counseling services or employee assistance programs to address these issues.
8 Self-Care Practices That May Help to Prevent Nurse Burnout
- Make changes in your physical workspace: Your environment can make a big impact on how you feel. So take the lead on improving it every once in a while. Try adding fresh flowers to brighten it up, hanging up inspirational quotes to lift your teammates’ moods (check out this Pinterest board), or working with your colleagues to reduce clutter and create a more organized space.
- Find a support system: There’s strength in numbers — and in sharing your feelings. See whether there’s a nurse support group you can join, either in your hospital or your local community. Want something less formal? Consider getting together with some co-workers or friends in similar professions with whom you know you can talk openly. Make a point to stress the importance of positivity and confidentiality.
Learn how to support yourself and your team with mental health
- Adopt some go-to techniques to help you decompress: Everyone has their own way of relaxing and recharging. Some people meditate or do deep - breathing exercises, some craft or clean, and others listen to or play music. There’s no one right way to decompress, so try a variety of techniques and see which one works best. Once you find the activity that works best for you, set aside 30 minutes a day to do it as a way to recharge your brain. This will increase your resilience whenever you start feeling burnout symptoms creeping in.
- Add some healthy fun into your life: Disconnecting from work pressures is an absolute necessity in your field. One way to do this is to introduce more fun into your daily life. Try planning one outing a week, spending time at the gym, going out for lunch with a co-worker or friend, or setting up a regular date night with your significant other. Pay attention to activities you find fun, whether social or individual.
- Make exercise a priority: Small bursts of daily exercise will encourage evening relaxation and boost endorphins to help your mood. Try taking a walk during a break or jumping rope when you wake up. If you like to hit the gym or a class or meet a friend, schedule it. If you need to fit it in between other daily activities, you might consider downloading a step - counting app and challenging yourself to hit 10,000 steps a day.
- Take regular time to be proud of yourself: As humans, we have a tendency to focus on what we did wrong rather than what we did right. Consider journaling your experiences and cases, pointing out the value you’ve added, both big and small. (Just don’t include patient names.) This will remind you of everyone you’ve helped and of your successes.
- Find a trusted therapist: Don’t be afraid to ask for professional help. In fact, many hospitals provide an on - site psychologist for their employees to use when they need it. Therapists are invaluable resources because they give you a safe, confidential environment in which to share what you’re feeling and thinking. Therapists are trained to be impartial and objective, so they’re the perfect sounding boards when you have any issues or concerns you need to work through.
- Build your resilience: Resilience is the ability to adapt to major stressful factors and to deal with obstacles, uncertainty, and unpleasant conditions. Developing resilience can help to protect you when you encounter difficult situations, to recover to a more “normal” state quickly, and to prevent your reaching the burnt - out phase. In fact, research shows that nurses who have improved their resilience are less likely to experience burnout.
You worked hard to get where you are, so it’s even more important to stay vigilant and build resilience against burnout. Stay alert and keep these symptoms and warning signs in mind. It’s important to get ahead of burnout too. Regularly practice the self - care remedies — to keep exhaustion, frustration, and stress at bay — before it all gets to be too much. And seek organizational changes. Make suggestions for positive changes and solutions to problems you or your team experience. This can empower and strengthen your team, keeping you all emotionally and professionally fulfilled.
Image courtesy of istock.com/Alexmia