Nurse Burnout: The Tale of Underappreciated Heroes
Psychologist Freudenberg first described the term burnout in the 1970s as a response to constant stress brought around by dealing with large amounts of people daily. Years later, we see this description laid bare as a mass nurse burnout takes hold during the pandemic.
Nursing is an unapologetically, selfless profession. Nurses are expected to work long hours, deal with patients on the brink of death, provide comfort in trying times, and swallow misdirected patient frustration.
The massive amounts of stress that come with the caregiving profession paired with an unsupportive environment can lead to burnout.
What is Burnout?
Burnout is often described as ‘extreme stress’; however, there is more burnout than simply stress. It is a state of extreme emotional exhaustion that causes a person to become negative and cynical toward their work. All sense of accomplishment is lost completely. A person may feel inadequate.
This affects work performance, which naturally drops, and a person also feels incapable of any emotional response.
The easiest way to explain and identify burnout is by using the Maslach Burnout Inventory (MBI). This inventory hosts six dimensions of work that lead to burnout.
- Excessive workload with no time for recovery.
- Lack of control over necessary resources.
- Insufficient or lack of reward.
- Negative environment and connections with colleagues.
- Suffering from unfairness or injustice in terms of working hours, load, or pay.
- Expectations of going against personal principles and values.
These conditions are seen as characteristic of a toxic environment which leads to mental health deterioration and then nurse burnout.
The Consequences of Untreated Burnout
Burnout is a very real problem that can manifest into some very dangerous health hazards. It is important to identify the common day-to-day stress from the stifling chronic stress that is burnout.
One Step Away from Depression
Constant stress and burnout, if left untreated, can quickly evolve into clinical depression. Nurses may continue to suffer silently and the aspects of their job that previously brought them satisfaction or joy no longer do.
The onset of depression may then lead to other debilitating issues such as chronic fatigue. Nurses may feel unable to muster any form of excitement in their work or personal lives.
The other issue that follows in quick succession may be insomnia. Stress plus exhaustion plus sleep deprivation- the golden trio-becomes the ruination of many a steel-nerved nurse. Burnout may very well be their undoing.
As of 2020, a study by the University of California San Diego School of Medicine and UC San Diego Health confirmed that nurses, both male and female, are at a higher risk of suicide than the general population.
Increased Turnover has Led to a Shortage of Professionals
Caregiving has always been a demanding profession. As a caregiver, you are often expected to stay on top of patient needs. With so much attention given to another person, there often is not much time or energy left to invest in oneself. Hence, nurses are known to feel somewhat dehumanized.
In the present time, the stress and workload have no doubt increased many folds. As the cycle goes, we understand the high stress leads to burnout, and many nurses opt to leave the grueling profession of healthcare entirely.
A report on national healthcare retention in 2020 shows that the average national hospital turnover was 17.8%, an unusually high rate that affects a hospital’s efficiency in providing service and causes serious financial harm to a facility, and directly affects its ability to provide quality care.
Long hours, insufficient time off, the elevated emotional burden of working in a crisis area, and unsustainable nurse-to-patient ratios have created a shortage of qualified nurses. In 2020, amid the pandemic, hospitals scrambled to provide equal care to patient after patient and continue to do so a year after.
Adverse Effects on Patient Care
We understand the way burnout affects nurses. They lose interest and joy in their work and become detached. The usually sympathetic nurse will become apathetic and unable to provide the best care to patients.
Difficulty in concentrating and low self-efficacy will naturally inhibit a nurse from viewing their tasks with positivity and gusto. They may even make the wrong decisions and put patients at risk.
The Onset of Chronic Illnesses
Constant stress and insomnia cause high levels of cortisol to be released into the system. This hormone generally triggers our internal fight or flight response to deal with situations of extreme stress. However, too much cortisol in the body can have serious side effects.
High levels of cortisol cause internal inflammation that can lead to serious health problems. Coronary heart diseases are just one possible outcome. Long-term inflammation may also cause diabetes or even cancer in some extreme cases.
A three-year extensive study on job stress is shown to verify that a supportive work environment with a manageable amount of stress reduces coronary heart disease risk. Such an environment is often absent for many nurses, especially now when the world is experiencing high demand for medical care
Instead, they must consistently deal with a vast number of tasks in high-stress situations.
The Effects of the Pandemic and Technology
Nursing has always been an underappreciated profession with long hours, many patients that need constant, daily care, and low returns. However, the pandemic has taken all that and dialed it up to eleven.
If healthcare isn’t complicated enough already, nurses are now expected to provide patient care without too much contact and constant exposure to a life-threatening virus with no definite cure.
Not to mention that hospitals, clinics, and nursing facilities everywhere are now overcrowded with sick people. The past year alone increased the workload of a single nurse far beyond manageable expectations. Covid I.C.U.s have reported nurse-to-patient ratios as high as one to four, rather than the recommended one to one or two.
Furthermore, there is the matter of the current desire to digitize healthcare. While this is a noble pursuit given its implications for efficiency and quality of care, there is also a negative cost cited by some healthcare workers
Unfortunately, the earliest attempt at digitizing is more destructive than helpful for some. Electronic health records (EHRs) were first introduced to manage patient records; however, nurses and other healthcare professionals claim that technology reduces efficiency instead of increasing it. This is in part because of the burden of learning and re-learning technology and the constant pressure to electronically document which is very time-consuming.
How to Prevent Nurse Burnout
Burnout is dark and serious, yet it can be prevented by employing certain measures to keep morale high.
Work to Improve Technology
Digitization is rightly identified as a friend rather than a foe but only if used correctly. Software such as EHRs needs to be revamped to make them more user-friendly.
Furthermore, a more advanced record-keeping system using bio-integrated devices to track patient health would help manage medical histories.
In other words, we need to hear from the medical staff as to how we can improve the technology because clearly, there is a lot of room for improvement.
Hire a Larger Nursing Staff
Time spent in a stressful environment is a huge variable that should be considered when discussing stress management. Most nurses who work a twelve-hour shift tend to be more susceptible to burnout than nurses working only eight hours.
One way to reduce the hours is to hire more nurses. Larger nursing staff will naturally lead to less overtime and keep the stress relatively at bay.
Employ Creative Methods of Stress Reduction
Many hospitals have found ways to help their nursing staff cope with stress and burnout.
Some facilities are converting their breakrooms into safe spaces with plants and even support animals to help nurses relax completely during their breaks.
University hospitals in Ohio have gone as far as to put up sleep pods as part of a 10-month plan to allow nurses to decompress after a long hard day at work fighting the Covid-19 pandemic.
Anything that allows the staff to take a break and detach from a high-stress situation is welcome when trying to reduce nurse burnout.
Find the Right Job in the Right Environment
A huge factor that cultivates stress and leads to nurse burnout is the environment. A setting with no support, no appreciation, and low rewards is bound to lead to burnout. So, it is important to find the right job at the right facility as a preemptive measure.
Proactive Healthcare Recruiters is a trusted executive search firm because of its emphasis on finding the right talent for your facility.
Not only does the agency find qualified healthcare professionals, but they also coach candidates on their future roles and help eliminate any confusion on the level of authority a position provides.
Proactive Healthcare Recruiters also place candidates on their unique personality using placement tests to zero in on the best possible job for them.
We need to take care of our nurses if we expect them to take care of us. We cannot afford to unnecessarily burden them when their service is so critical, especially in this pandemic. They are human, too – with fears, health concerns, and families. Acknowledging this will be the first step in creating a plan to make their work environment more friendly, more positive, and more fulfilling.
Nurse burnout is a serious problem that in extreme cases can lead to suicide if not identified and treated at the right time.
We can mitigate the stress on these critical employees by shortening the shifts, making sure there is enough protective equipment, providing relaxing break space and opportunities to de-stress, finding the ways that technology can help ease the burden, and increasing our appreciation.