At Work

Combatting Burnout

Finding ways to prevent work overload before it becomes a burden

Nurses who feel overworked and underappreciated, who do their job but can't find the meaning behind it anymore, suffer from burnout-a term embodying the constant fatigue and detachment some healthcare providers are experiencing nationwide. Burnout can happen in any career path, but studies have shown that healthcare professionals tend to burn out more frequently.

Burnout syndrome is a state of emotional, mental and physical exhaustion caused by excessive and prolonged stress. Firefighters, police officers and healthcare providers are in a constant state of "anything can happen," which significantly adds to their stress levels.

"Burnout is a very real phenomenon among healthcare professionals. It's more than 'a bad day at the office,'" said Nancy Brook, RN, MSN, author of The Nurse Practitioner's Bag. "It's a syndrome that affects many aspects of your life, your thoughts and actions, and may have physical manifestations as well."

Is This Burnout?
"I believe many nurses recognize when they are tired and at the 'end of their rope,' but they are unclear why," said Vicki S. Good, MSN, RN, CENP, CPPA, system administrative director of clinical quality and safety at CoxHealth in Springfield, Mo. "We enter the profession to care for other people, so when we realize we no longer are displaying compassion and caring, we don't understand why that is happening."

Ruth Kleinpell, PhD, RN, FCCM, professor and director of the center for clinical research and scholarship at Rush University in Chicago, added, "Nurses experiencing burnout may not realize it at all."

Good, a former president of the American Association of Critical-Care Nurses, and Kleinpell, president-elect of the Society of Critical Care Medicine, have researched burnout in ICU nurses. This intense environment contributes to the overall rate of burnout.

"Nurses are at risk for burnout due to the high-paced and stressful work environment in the ICU," Kleinpell said. "Patient care needs in high-acuity situations may result in nurses not taking breaks or not taking time off the unit for meal breaks."stressed nurse

Symptoms of Burnout
"Nurses can determine if they are experiencing burnout by being educated and aware that this is a real syndrome and common among caring professionals," said Brook, who is a nurse practitioner at Stanford Health. "By being familiar with the symptoms, nurses can more easily identify burnout when it occurs."

Burnout can be identified by a number of factors, such as physical and emotional exhaustion, stress, overworking, feeling underappreciated, feelings of dread when doing everyday tasks, anxiety and more. Some of the major symptoms of burnout include:

• Physical and emotional exhaustion-Physical exhaustion can manifest in a few ways, such as falling asleep while reading a good book or the inability to find energy to do even small tasks.

When emotional exhaustion is reached, Good said, "Some practitioners will revert to silence while others will revert to hostile communication methods, such as being short-tempered or ineffective in communicating with others."

• Feeling underappreciated and overworked -When a nurse starts to feel that her or his efforts go unnoticed, feelings of being underappreciated and overworked can surface. These feelings bring about on-the-job frustration and stress, which lead to higher susceptibilities to illness.

• Anxiety-"My personality was changing and my health was being impacted," said Paula Davis-Laack, JD, MAPP. Davis-Laack was a lawyer who experienced burnout so severe that anxiety-induced stomachaches brought her to the emergency department twice. "That was my last straw. I've always been someone who is willing to give a lot for their career, but I wasn't going to sacrifice my health."

Davis-Laack now runs a burnout prevention and resilience training program, in which she gives talks to members of the medical profession. Her advice to nurses and nursing teams is to incorporate positive emotions into the daily routine to avoid burning out.

• Lack of enthusiasm for work/compassion fatigue-The feeling a nurse gets when she or he no longer cares for the patient as a person but rather as another item on a to-do list is called compassion fatigue. "I think all nurses have experienced burnout," said Good. "The difference is the degree and our resilience from the burnout. For me, I see burnout beginning to set in when I am unable to step away from work obligations, or I begin to experience a void in my personal and professional accomplishments."

Strategies
"Burnout develops after a clinician experiences chronic and excessive stress without adequate coping mechanisms," Good said. "The first step is awareness."

"Healthcare teams have precious little time to spend together as a unit, and it's usually spent talking about what goes wrong," said Davis-Laack. Starting team meetings with "what went right" can improve overall happiness at work. Incorporating breathing exercises also combats burnout. "When we're anxious or angry or experiencing intense emotions, it's important to be able to center yourself."

Sometimes taking a break and evaluating how one has gotten to the point of burnout is the best solution. Nurses should talk to supervisors if burnout is affecting their well-being. Quality of care for patients will decrease if a nurse is burning out.

"Speaking with a counselor, spending time in nature, connecting with friends and managing 'self-care' are all excellent strategies to help combat this issue," said Brook. "Many nurses see working the extra shift or caring for extra patients as a badge of courage. Ironically, the best way to care for our patients is to take excellent care of ourselves. Self-care is never selfish." n

Autumn Heisler is a staff writer. Contact her at aheisler@advanceweb.com.


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