nurse burnout

Nurse Burnout: Warning Signs and Prevention Techniques

We can all relate to the feeling of returning home after a long day of work, and wanting to fall face-first on the bed and grab some zzzs, can’t we? But what if you suddenly start feeling fatigued and irritable all the time? What if you suddenly feel unmotivated to do basic tasks and have trouble sleeping despite being so tired? Chances are you’re burnt out.

And you’re not alone. Nurses go above and beyond every single day to make sure that patients receive the best quality care. But to do so, they often put taking care of their own health on the back burner. The long shifts, unhealthy cafeteria food and workplace stress can eventually catch up to them, leading to various health issues. Alongside disrupted circadian rhythms and digestive issues from irregular schedules, nurses also face high risk of experiencing burnout.

Burnout rates in nursing in the US are steadily on the rise. The ANA reported the almost two-thirds of nurses experience burnout. It was more commonly reported among younger nurses, especially those under 25.

Understanding burnout

2.7 million nurses in the US have reported they feel burnt out. It’s obvious that the rates have already reached alarming proportions. At this time, it becomes especially important to raise awareness and take preventive measures.

Contributing factors

While burnout affects individuals the most, the causes rarely lie with them. That’s why preventive efforts focused on the effects are an inadequate strategy for dealing with it. Targeting the root causes of burnout, that lie within the organization, would be far more effective. Let’s understand the most common factors of burnout:

Staff shortages

The nationwide shortage of nurses has resulted in a high workload with fewer personnel to tackle it. Dealing with constant pressure of meeting patient needs can be physically and emotionally draining. Frequent overtime and taking on more responsibilities can also be overwhelming for nurses and upset their work-life balance.

Emotional Strain

Providing constant support to patients and families can be emotionally straining. Sometimes, patient suffering can also create emotional conflicts which can be hard to distance oneself from. All these can culminate in emotional exhaustion.

Work environment

While long work hours and high nurse to patient ratios are already stressful, a hostile work environment can make it much worse. Unsupportive colleagues and demanding supervisors can add to stress, making it difficult for nurses to cope.

Lack of autonomy

As nurses try their best to advocate for patients and themselves, the influence they hold can be limited. Most decisions are left to higher management and may not always be in the nurses’ favor. This can make them feel helpless and frustrated.

Personal factors

Often, factors in personal life can also influence one’s state of mind. If they’re already dealing with intense workplace stress, stressful situations outside of work don’t make it any easier to cope. The combined effect of both can lead to burnout as well.

Identifying the symptoms

Despite its far-reaching consequences, burnout is preventable. If you understand its symptoms early, combating it becomes a lot easier. There are physical, emotional, and behavioral markers of a burnout, so, you should be on the lookout for these or a combination of these symptoms:

Physical symptoms:

  • Headaches and migraines
  • Sudden body aches
  • Gastrointestinal issues
  • Constant tiredness or fatigue
  • Changes in appetite
  • Changes in sleep patterns
  • High blood pressure
  • Weakened immune system

Emotional symptoms:

  • Increased feeling of helplessness
  • Cynicism
  • Decreased productivity
  • Overwhelming self-doubt
  • Loss of motivation
  • Loneliness
  • Constant urge to isolate oneself

Behavioral symptoms

  • Low performance at work
  • Procrastination
  • Sudden outbursts
  • A lack of empathy
  • Decreased satisfaction

Effects of burnout

Burnout can take its toll on you, especially in the long run. The consequences can be far-ranging and significant. It can cause emotional dysregulation which can be dangerous not only for the individual but also to others, especially in a healthcare setting.  The effects of burnout include:

Cognitive dysfunction

Burnout affects the physiological functions of the body and also endangers mental health. A study published on NLM links burnout with cognitive dysfunction. According to the paper, “…overload of work tasks and/or task complexity can lead to a depletion of an individual’s resources resulting in cognitive failure.” Due to staffing shortages, nurses across the country are already overworked. As shown in the study this can cause “high rates of psychological distress, depression, anxiety and post-traumatic stress disorder.”

Chronic illnesses

While nurses are already at elevated risk of developing chronic illnesses from their demanding jobs, adding burnout to the mix doesn’t make it any better. Burnout can result in disrupted circadian rhythms which can snowball into a host of other physical illnesses. Conditions like reduced immunity, high blood pressure and type II diabetes can emerge from the effects of disrupted physiological functions.

Low job satisfaction

It is no secret that workplace stress can lead to reduced performance. That’s why nurses often find themselves at the lower end of the job satisfaction spectrum. Feelings of demotivation, exhaustion and anxiety can deter nurses from concentrating on their jobs which can lead to reduced efficiency.

Poor quality of life

The effects of burnout aren’t limited to the workplace. As nurses already deal with irregular schedules, a work-life balance can be difficult to maintain. Add insomnia, loss of appetite and emotional dysregulation, and boundaries of what is intact and what is disrupted are completely erased. This can lead to a poor quality of life.

Poor patient care outcomes

When nurses aren’t at their 100%, the quality of patient care can fall. Burnout has been linked to emotional exhaustion which can lead to a loss of empathy and coldness when it comes to perceiving patient needs. It can also lead to errors in professional outcomes which can compromise patient safety.

High turnover rates

Low job satisfaction can affect turnover rates as more nurses will be more motivated to leave their job for better opportunities or leave the nursing profession altogether. As per the BLS, turnover rates in healthcare rose from 32% in 2016 to 45% in 2020. This can be especially challenging when it comes to the prevalent staff shortages in nursing.

Preventing burnout

It’s high time that burnout began to be treated as an occupational hazard and measures for combating it are enforced by individuals and organizations. A International Journal of Nursing Studies article investigating the impact of nurse burnout on organizational outcomes states that, reframing burnout, as an organizational & collective phenomenon is necessary.’

And considering its epidemic proportions, knowing how to prevent burnout becomes key to maintaining both nurse and patient welfare. These preventive measures can help nurses cope with the physical and mental impacts of burnout while securing a better quality of patient care.

Self-care strategies

As professionals in healthcare, stressful situations pretty much can’t be avoided. And the brunt of it is borne by nurses. That’s why ingraining healthy habits can go a long way in ensuring a better quality of life. Nurses can take the following steps to minimize the impact of burnout:

Get proper sleep

With shift schedules that keep changing from time to time, a fixed sleep pattern is difficult to maintain. But with good sleep hygiene, it is possible to get good sleep so you can wake up well rested.

Creating a disruption free sleeping environment is the first step. Invest in good black out curtains, ear plugs and sleep masks. You can also get a speaker for playing ambient sounds to contribute to a soothing environment.

Indulge in self-care

It’s okay to spoil yourself occasionally! Appreciating yourself can help you maintain a positive outlook and get through tough times. Invest in hobbies that can help you unwind when you’re away from work. Find a creative outlet to express yourself. Don’t feel guilty about putting yourself first every once in a while.

Maintain a healthy diet

Food is an integral part of physical and emotional well-being. Eating a nutritious and balanced diet can help with reducing the effects of stress on the body. High fiber foods like oats, nuts and vegetables can reduce the impacts of stress on the body, especially on digestive processes. Drinks like chamomile tea and comfort foods can also have an impact on emotional well-being by calming anxiety.

Exercise regularly

Research has shown that exercise has direct links to reduced stress. Endorphins released from physical activity trigger a ‘runner’s high’ which can help alleviate the effects of stress. These endorphins also serve as mood boosters which can combat the emotional and behavioral symptoms of burnout. Exercise also increases blood circulation which boosts digestive and cardiovascular health which can increase energy levels and stamina. The combined effect of all these can help you prevent and recover from burnout.

Taking adequate breaks

If you’re working in a high stress environment the majority of the time, it’s easy to lose yourself to the flow. You could be pushing yourself without even realizing it. So, getting in the habit of taking proper breaks can prompt you to be mindful. Plus, stepping away every once in a while, can improve clarity of mind which can boost cognitive functions.

Practice mindfulness

Stressful situations can easily get overwhelming. Being mindful can help you clear your head and focus on the present, making it easier to navigate stressful scenarios. Incorporating mindfulness exercises in your daily routine like journalling, meditation or yoga can help you build coping habits. You can also use apps to explore tools like guided meditation or other mindfulness exercises to gradually build a habit of practicing mindfulness.

Interpersonal relationships

Having a supportive community that you can discuss your issues with can greatly negate the consequences of stress. A supportive community becomes a pool for sharing knowledge, advice, and resources. Finding emotional support in the people around you who have experienced similar circumstances can be comforting and contribute to a constructive environment.

Establishing boundaries

If you’re constantly facing circumstances that can burn you out, it’s important to find time to distance yourself from those scenarios every now and then. Establishing healthy boundaries can give you a window to recenter your emotions, chart out priorities and restore balance.

Workplace Strategies

The causes of burnout are structural, and the individual only has the ability to minimize its impact. Hospital managements, on the other hand, have the ability to manage the causes by implementing staff friendly policies. Here’s how employers can contribute to reducing burnout rates:

Empathetic leadership

Nurse managers have the power to promote a positive work environment. By encouraging open communication channels and fostering recognition and appreciation for individual effort, they can contribute to creating a community that is productive, efficient, collaborative, and innovative.

Managing workload

By implementing staff friendly policies like flexible scheduling, self-scheduling and assigning more staff in times of demand surges managers can help balance out the workload. Nurse managers can also implement tools to identify potential causes that contribute to excessive workload and work out solutions to address them.

Encouraging support programs

Mental health services and peer support groups can take the pressure off nurses from dealing with workplace stress on their own. It can give them the space they need to be heard and build meaningful connections. This can, in turn, create an environment of mutual support which can strengthen solidarity among the workforce.

 Professional development

Nurse managers can also encourage nurses to seek continuous professional development so they can become more confident in their roles. Offering training programs can help nurses stay motivated towards career growth, which in the long run can also contribute to a fulfilling career.

Combating burnout: A collective imperative

Recognizing the symptoms of burnout early and adopting timely preventive measures is important for both individuals and organizations. Both nurses and nurse managers must work collectively to combat burnout. From identifying stressors to implementing supportive policies, organizations must actively promote a work environment that prioritizes individual being on the organizational level.

Meanwhile, nurses can communicate their challenges and encourage their coworkers to do the same so they can contribute towards forming a supportive community that promotes a healthy work-life balance. Thus, by working together, nurses and organizations can create a more sustainable work culture that is effective against the impacts of burnout.



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