Reducing Nurse Stress: Creating a Culture of Wellness and Support

The importance of technology in easing the workday

As their role expands from the bedside to the waiting room to the board room, nurses are busier than ever and increasingly stressed. Beyond providing direct medical care, nurses are also an educational resource, an advocate for patient needs, and a source of comfort. Combined, these factors are contributing to soaring stress levels and burnout.

A recent study revealed an overwhelming 92 percent of nurses are experiencing moderate-to-very high stress levels. This finding supports another study showing nearly half of nurses under 30 years old—and 40 percent of those over 40—are experiencing burnout. These troubling numbers are reflected in the nation’s growing nursing shortage. As the industry shifts toward value-based care and the demand for nurses intensifies, we need to identify the causes of burnout and find ways to give nurses the support they need.

Psychosocial Stressors and Burnout

Nurses face a variety of psychosocial stressors that combine individual environmental and psychological factors to influence personal wellness and a person’s ability to function. Day-to-day stressors include long shifts, fatigue, heavy workloads, and patient loss. Part of maintaining high-quality, multifaceted care includes getting to know patients and their families, which often means long hours and emotionally taxing conversations amidst nurses’ daily, high-volume shiftwork.

These stressors are exacerbated by secondary factors such as insufficient resources, lack of control and poor collaboration. These secondary factors are more prevalent in today’s working environment given workforce shortages and an inadequate structure of communication flow.

The effects of these stressors may include depression, erratic sleep patterns, self-doubt, disengagement, and reduced job satisfaction. Ultimately, burnout and compassion fatigue may result. The ripple effects can include reduced quality of patient care and low nursing staff retention, fueling the ongoing struggle to provide improved outcomes with fewer staff.

However, with the right mix of three approaches—leveraging the right technology, improving collaboration, and providing support—hospitals can arm their nurses with the tools they need to provide high-quality care without unnecessary stress.

Leverage Appropriate Technology

Today’s health IT revolution can help alleviate some of these daily struggles for nurses. Smartphones with apps that connect nurses with their teams, patients, and the hospital make it easier to access a full view of their daily responsibilities. Centralizing information—whether related to equipment availability, their care team or a patient—helps give nurses the bandwidth to provide accurate and efficient patient care.

Additionally, nurses are often tasked with internal patient record documentation and administrative tasks, which distract from patient care. With a health IT tool that makes documentation of patient data fast, efficient, and accurate, nurses will be able to more fully complete their administrative tasks, freeing their minds to focus on care delivery.

However, it is not enough to provide nurses with these tools; the solutions also need to work effectively. In mission critical situations, nurses short on time must be able to communicate needs to their care teams immediately. Consider usability when selecting new technology – both in terms of the ease-of-use and whether or not hospital facilities are outfitted with the wireless network needed to enable these devices. Along these lines, adequate training for employees on how to comfortably use new health IT tools will mitigate implementation challenges and maximize their impact on patient care and clinician satisfaction.

The time saved through leveraging advanced health IT will translate into more time spent with patients and their families, allowing nurses to act as a patient advocate and reducing stressors that can negatively affect patient care.

Improve Collaboration

Beyond health IT tool implementation, hospitals must also promote collaboration between nurses and other care team members, which helps establish trust in each other’s capabilities. This can go a long way in reducing stress.

One way to connect teams is with standardized processes such as event reviews and mortality and morbidity (M&M) meetings. Fostering a community of mutual respect by promoting open and honest conversation around patient care via these processes puts hospital employees on an even plane. This can create an environment driven by respectful candor and peer-to-peer feedback for higher unit morale and satisfaction.

Technology such as smart defibrillators and patient room cameras take the “he said, she said” component out of the equation, leaving nurses better equipped for a productive conversation about what they and their care team members could have done differently. Where tensions run high in stressful patient care situations, these post-patient care processes create a system of mutual responsibility and accountability, preventing any individual care team member from taking sole blame for an outcome. These processes also help teams understand what went wrong and why, providing nurses with closure following a difficult patient event.

Provide Resources and Support

A 2017 research study examined mid-career nurse attrition considering the estimated 16.5 percent turnover rate of registered nurses in hospitals. The results show that nurses’ intent to stay was closely linked to job satisfaction and career development. Beyond deploying health IT tools and implementing collaborative workflows, hospitals can better support nurses on an individual level by allocating time and resources to programs and management processes that create real, lasting value for nurses.

Peer support groups are one way for nurses to share their challenges with one another and connect with their co-workers on a personal level, making it easier to be more understanding and supportive in a professional environment. In addition to giving nurses time to reflect on patient loss, these support groups help them vocalize the reality of burnout and compassion fatigue. Eliminating the stigma that comes with nurse burnout and compassion fatigue will provide nurses with a more comfortable environment in which to speak up.

Nurses also must make time to care for themselves, both professionally and personally. With an ongoing training and education program that keeps nurses up-to-date on industry best practices, hospital nursing staff will feel valued as employees and more motivated to perform at their highest level daily. Facilitating self-management and helping nurses develop the right work/life balance is crucial as well. Hospitals that actively avoid scheduling the same nurses for the same long hours in the same high stress environment gives nurses the personal time needed to care for themselves.

Ask for Feedback Before You Get Started

These approaches cannot be implemented all at once. Stressors will vary from hospital to hospital and from ward to ward. Each hospital must consider the particular stresses for their own nurses. A leader who actively listens to nurses will have a more accurate picture of day-to-day operations and will be able to readily advocate for these changes.

As day-to-day supporters of patients and their families, nurses must bear a great deal of stress. Organizationally and individually based approaches can help remove the stigma surrounding stress and burnout, equipping nurses with the tools to provide high quality patient care and support that ultimately benefits the entire health system.

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