The nursing profession needs to raise awareness on burnout
Nursing is one of the most in-demand jobs in America. It’s also one of the most demanding jobs.
According to the Centers for Disease Control and Prevention’s National Institute for Occupational Safety and Health (NIOSH), healthcare workers have higher rates of substance abuse and suicide than other professions, as well as more depression and anxiety linked to job stress, which can lead to burnout, absenteeism, employee intent to leave, reduced patient satisfaction, and diagnosis and treatment errors.
Burnout Syndrome (BOS) was identified by psychologist Christina Maslach in the 1970s. Her Maslach Burnout Inventory
(MBI) has been recognized as the leading measure of burnout.
German-born psychologist Herbert Freudenberger also studied burnout extensively and described it as a state of chronic stress among people in helping professions. He defined the three characteristics of work burnout as exhaustion, alienation and reduced performance.
Critical-care nurses are considered more at risk for developing burnout due to a highly stressful work environment, including caring for very sick patients and dealing with death more often.
“Nurses exhibit these characteristics in many different ways,” said Vicki Good, former president of the American Association of Critical-Care Nurses (AACN). “Initially symptoms include anxiety, depression, insomnia, lack of compassion, etc., but these symptoms can continue and result in post-traumatic stress disorder and potential suicide.”
Burnout is causing some nurses to leave the profession. A 2017 study by RN Network surveyed
more than 600 nurses and found that nearly half had considered leaving the field mainly due to job dissatisfaction and feeling burned out.
Inadequate staffing or organizational issues are partly to blame, but it’s not just about reducing hours or the patient-tonurse ratio. It’s also about employers being aware of the potential for burnout and creating a supportive environment of teamwork.
“Unit-based leaders and hospital administrators have to be aware of the issue and workload has to be balanced so nurses can help each other,” said Cindy Munro, dean of the University of Miami School of Nursing and Health Sciences and co-editor of the American Journal of Critical Care.
Another major factor contributing to burnout is a national nursing shortage. As the aging population grows, so does the demand for more nurses and other healthcare professionals.
According to Nursing.org, a shortage of openings in nursing schools has created a growing gap between supply and demand of skilled nurses, putting more strain on nurses in the field.
“While each of us entered the nursing profession because we are compassionate and want to care for patients at all phases of their life, most of us never dreamed we would be working during one of the most challenging nursing shortages ever recorded in America,” Good said.
The demand on nurses is taking on toll on their physical health as well. A Health Risk Appraisal by the American Nurse Association (ANA) found nurses are more likely to be overweight, have higher levels of stress and get less sleep that the average American.
In recent years, the healthcare profession has begun paying attention to burnout and looking for ways to prevent and address it, including investing in relaxation lounges and stress-reduction classes for employees.
The Critical Care Societies Collaborative (CCSC) is working to raise awareness. In 2016, it released an official statement on burnout, published in each CCSC member journal. The following year, it held a national summit on Prevention and Management of Burnout in the ICU.
Other organizations offer resources and tools to assess and manage stress, strategies for coping with burnout and guides to self-care.
The AACN, the world's largest specialty nursing organization, has a page on Ethics/Moral Distress. The American Holistic Nurses Association offers a Holistic Stress Management Tool Kit, which can be downloaded for free.
The Well-Being Index, invented by the Mayo Clinic, is an anonymous web-based tool that allows healthcare employers to view and track well-being among staff.
ANA launched the Healthy Nurse, Healthy Nation™ Grand Challenge (HNHN) in May 2017 to improve nurse health and promote self-care.
“This is a bold initiative to transform the health of the nation by first transforming the health of its four million registered nurses,” said Holly Carpenter, senior policy advisor of Innovation Nursing Practice and Work Environment for ANA.
Approximately 87,000 individuals have signed up for HNHN so far, most of them nurses and nursing students, though it is free and open to everyone.
The HNHN initiative focuses on improving health in five key areas, including physical activity, nutrition, rest, quality of life and safety.
Subscribers have access to resources, such as a health survey, exercise tips, stress reduction techniques and healthy recipes, as well as a forum where they can share their thoughts and success stories to keep each other motivated.
Nurses are very caring people, and yet they are often last on their own list of priorities.