Medical Update – Notes From A Nurse: Burnout

Nurse burnout is a huge problem in this country, and is projected to become even more so in the future. Despite the fact that enrollment in bachelor’s, master’s and doctoral nursing programs is up, there is still projected to be a shortage of registered nurses (RNs) by the year 2030. There are many factors that drive the shortage, including the high burnout rate. Contributing factors to the burnout rate include staffing problems, sicker patients, and working long hours.

The term “burnout” was coined by American psychologist Herbert Freudenberger in the 1970s. According to an article from the American Nurses Association (ANA), he used it to describe the consequences of severe stress and high ideals experienced by people working in the “helping” professions.

It is difficult to tell how many people may actually be affected by burnout, because this term is no longer exclusive to those in healthcare. However, no matter the career path, the symptoms of burnout seem to be the same.

Symptoms

Constant fatigue. You should not go to bed tired and still wake up tired in the morning. When you find yourself without the energy to do common everyday things like exercise, spend time with family or friends, or read a good book, this physical exhaustion could be an early symptom of burnout.

Feelings of being overworked and under appreciated. If you are feeling this way, it may be time to re-evaluate and figure out why you are feeling this way. If you are working too many hours, it may be time to cut back. If you are taking on too much, you may need to figure out how you can cut back. Feeling frustrated and resentful about your job is not good for you, your co-workers, or your patients. If you feel this way, you may need to step back and see how or if being a nurse still fits in with your plans and goals for life, and it’s ok if it doesn’t.

Lack of enthusiasm about work. When you are “just going through the motions,” can be another sign of impending burnout. If you are at home dreading going to work, or are at work and can only think about going home, this can adversely affect patient care since it is vital that you are able to concentrate on what needs to be done for your patient(s) moment by moment. It can also spill over into other areas of life.

Compassion fatigue. This is when you become detached from patients, feel cynical about your work, or feel that you are a failure as a nurse. It is often after years of emotional stress, physical stress, and the experiences on the job.

Contributing Factors

Lack of social support. Many people don’t understand the demanding nature of being a nurse. They aren’t aware of what happens on a daily basis, or the strain that it puts on a person to be able to deal with multiple complex patient care scenarios. Often times, family members expect the nurse to leave his or her work at work, and not to talk about it at home. Many hospitals have an employee assistance program in place, but many nurses don’t use it. Some out of fear that their discussions will be shared with their supervisors. Others don’t use it because of the stigma of “going to see a counselor.”

Inability to control schedules or assignments. Many places set a nurse’s schedule for them, and they have no say in it. Some set schedules force nurses to work 3 days in a row, giving little time to recuperate in between work days. Not everyone can handle this type of scheduling, yet there is little that can be done about it.

Chaotic environment. On any given day in a hospital, things are extremely chaotic. Ask any person who has ever been a patient! If they feel overwhelmed by what is happening in this environment, imagine being responsible for 4 or more complex patients and managing their care! In addition, hospitals are being paid on satisfaction rates by patients’ perceptions. Trying to keep up with everything every one wants exactly when they want it can be extremely daunting.

Work-life imbalance. Sometimes you have issues going on at home that affect your performance at work, and vice versa. When this happens, you aren’t able to give your full attention to one arena or another, and the other suffers.

Staffing issues. This is one of the biggest contributing factors, if not the biggest. Despite enrollment being up, the shortage of nurses persists. Sometimes this is due to budgeting, which often backfires because then patient safety becomes an issue. Other times it is due to the fact hat you can’t keep staff in a department. No matter the reason, it is vital that staffing problems be addressed. Continually running on a “skeleton crew” adversely affects not only nurses, but patients as well. Fixing this one issue has the potential to offset most of the others.

What To Do About It

There are many things that you can do personally to take care of yourself and decrease the stress and likelihood of burnout.

Stretching. Sometimes, just stretching out your muscles helps relieve the tension in them. This can improve strength, flexibility, and posture. You can even teach simple stretches to your patients, giving good self-care at the same time.

Meditation or Prayer. Taking a short break to be able to clear your mind helps tremendously. Even if it is just five minutes. Quiet your mind and spirit. Focus on your breathing and being still, and teach your patient(s) to do the same.

Emotional Freedom Technique (EFT). This is simply a sequence of tapping on different meridian points on the body that can help clear out stuck electrical energy, negative emotions, and stress chemicals. For more information on EFT, you can visit www.thetappingsolution.com if you are interested in learning the basic techniques. If you would be interested in a more in-depth program and coaching, you can visit www.donmilton.net.

Breathing Exercises. Just practice taking long, slow, deep breaths in through your nose and out through your mouth. I’ve often done this with people, patients included. Teaching your patient to become more aware of their breathing is a great way for you to get in touch with your own, and you both benefit.

Nurses, I would be interested in knowing if this has been helpful for you. Let’s beat back burnout together! You can contact me at rachel.athensnow@gmail.com.
By: Rachel Clark, RN, BSN