Understanding and Combating Nurse Burnout

Nurses are an important part of our healthcare system, providing compassionate care and advocating for patients at every turn. However, this dedication comes at a cost. Nurse burnout, a state of emotional, physical, and mental exhaustion, is a serious and prevalent issue plaguing the profession.

This comprehensive guide dives deep into the complexities of nurse burnout. We’ll explore what it is, the causes of nurse burnout, the alarming nurse burnout statistics, and the signs and symptoms a burnt-out nurse might experience. We’ll also discuss the far-reaching effects of nurse burnout, including its impact on patient care, nurse health, and the nursing shortage. Finally, we’ll equip you with valuable information on preventing nurse burnout, with actionable tips for nurses themselves, healthcare organizations, and the broader healthcare community.

What is Nurse Burnout?

Burnout in nursing is the state of prolonged emotional, physical, and mental exhaustion that is caused by chronic workplace stress. Though it may feel similar at first, it is different from simple fatigue. When nurses are burnt out, they often feel detached from their patients, cynical towards their work, and they may have a reduced sense of accomplishment.

Here’s a quick breakdown of burnout:

• Emotional exhaustion: Feeling emotionally drained and unable to cope with the demands of your job. Nurses have a lot on their plate, and when healthcare organizations are short-staffed, it can add a lot of tasks to an already busy nurse’s plate. This causes them to have to juggle too many tasks at once and overwork themselves. 
• Depersonalization: Detachment from patients and a feeling of cynicism about the job. It’s not a conscious choice, but rather a coping mechanism developed by the psyche to protect itself from the constant emotional strain of caregiving. 
• Reduces sense of accomplishment: Doubting your abilities and feeling a lack of effectiveness in your role.

Symptoms of burnout can manifest themselves in a lot of ways. We’ll take a deeper dive into the symptoms of burnout later in this blog.

What Causes Burnout in Nursing?

Nurse burnout stems from a lot of complex factors, both within the individual and their work environment. Here are the key contributors to burnout:

• Understaffing and heavy workloads: RN burnout gets worse with overwhelming nurse-to-patient ratios. Staffing shortages lead to longer hours, increased stress, and less time for each patient. 
• Lack of control: Nurses who have little to no control over their schedules, decision-making processes, and patient care approaches, can contribute to burnout.
•  Violence and aggression: Nurses are frequently exposed to workplace violence from patients and families, adding a significant emotional burden.
• Moral distress: Moral dilemmas and ethical conflicts nurses face when dealing with limited resources or inadequate staffing can lead to distress and burnout.
• Administrative tasks: Excessive paperwork and administrative duties can take valuable time away from patient care, contributing to frustration and burnout.
• Lack of support and recognition: Feeling undervalued and unsupported by colleagues, managers, or the institution can be incredibly demotivating.
• Shift work and long hours: Disrupted sleep patterns and the physical strain of long shifts can significantly impact a nurse’s well-being.
• The COVID-19 Pandemic: The pandemic has significantly increased all of these factors, pushing nurses to their limits and contributing to a surge in nursing burnout.

Nurse burnout statistics show a large jump in burnout among healthcare workers during the covid 19 pandemic. In a survey published by the American Nurses Foundation, they found that 58% of nurses were required to work beyond their normal shifts at least once a week. In the same survey, they found that 31% of nurses said they weren’t allowed to take off their requested leave.

The Signs and Symptoms of Nurse Burnout

Nurses experiencing burnout can display a range of signs and symptoms. Here’s the breakdown of the most common symptoms associated with nurse burnout:

Emotional Symptoms

• Exhaustion: Feeling constantly tired or drained, even if you’ve been sleeping well. 
• Cynicism: Detachment from patients and an overall negative attitude about work. 
• Irritability: Nurses who are burned out will show more frustration and impatience with their coworkers, patients, and families.
• Loss of empathy: Empathy is an extremely valuable skill for nurses. When nurses are burned out they have difficulty connecting with patients on an emotional level.
• Anxiety and depression: When nurses are burned out they’ll get overwhelmed easier, and could experience increased anxiety and depression.

Physical Symptoms

• Changes in appetite: Like stress, burnout can cause unexplained weight loss or weight gain.
• Worse sleep: When nurses are burned out, they may experience difficulty falling and staying asleep. 
• Headaches and muscle tension: The added stress and anxiety caused by burnout can lead to muscle tension which can cause headaches in a lot of people.
• Frequent illness: Lack of sleep, and other factors caused by burnout can lead to a weakened immune system.

Behavioral symptoms

• Withdrawal from social activities: Isolating oneself from friends and family, losing interest in their favorite activities.
• Increased absences or presenteeism: Nurses who are burned out will call in sick more often due to physical or mental exhaustion. They may also show up to work but be more disengaged or less productive than normal. 
• Increased negativity: Complaining more frequently about work, becoming critical of colleagues and the healthcare system in general. 
• Increased substance abuse: People who are burned out may turn to alcohol, drugs, or other unhealthy coping mechanisms to numb emotional pain. 
• Changes in performance: Burnout can make your best nurse turn into one of your worst. Nurses who are burned out can make more mistakes, have decreased attention to detail, and neglect important tasks. This could lead to medication errors and hurt patient care.
• Thoughts of leaving the profession: Feeling a strong desire to quit nursing altogether. This was especially true during the COVID-19 pandemic when 22%-32% of nurses were actively considering retiring or leaving the profession in the near future.

How do You Prevent Nurse Burnout?

Burnout is a complex challenge, but there are some steps nurses can take to build resilience and prevent it from taking hold. Here are some key strategies to prevent burnout:

Prioritize Self-Care

• Maintain a healthy lifestyle: Eating nutritious meals, getting regular exercise, and prioritizing sleep can all help alleviate stress and anxiety caused by burnout. Aim to get your full 8 hours of sleep so your body has time to rest and recover from a long shift. 
• Relaxation techniques: Like meditation, deep breathing exercises, yoga, and spending time in nature can help alleviate stress.
• Seek social support: Connect with friends, family, or a therapist. Having people who get your struggles that you can vent to is a great way to release stress and gain perspective. Bonus points if you can vent to friends who work in the same industry as you. They may be able to give you some insights on how they manage burnout.
• Maintain a healthy work-life balance: Make sure you are scheduling time to engage in activities you enjoy outside of work. Disconnect from work emails and calls when you’re off the clock. Setting boundaries not only for work but for yourself can improve your symptoms.

Don’t Be Afraid to Advocate

• Advocate for change: If you see areas where the workload or staffing process can be improved, speak up to your manager or administrator.
• Join organizations: Organizations like the American Nurses Association (ANA) offer resources and support for nurses. Their platform can be used to advocate for better working conditions. 
• Seek opportunities for collaboration: Building strong relationships with colleagues can create a more supportive work environment. It can also foster better working relationships between departments.

Utilize Available Resources

• Employee Assistance Programs (EAPs): Some healthcare organizations offer counseling and support services to their employees. Take advantage of these resources, this could be your chance to confidentially talk to a counselor who can help you get through your work struggles. 
• Continued education: Nurses can increase their job satisfaction and feeling of competence by continuing their education. Earning extra certifications can also help you move into different roles within an organization.

Remember, preventing burnout is a continuous process. Incorporating these strategies into your daily life can build resilience and maintain a sense of well-being throughout your nursing career.

The Role of Healthcare Facilities in Combating Nurse Burnout

The responsibility of combatting burnout cannot be left for the nurses to deal with on their own. Healthcare facilities have a crucial role to play in creating a supportive environment that helps promote a work-life balance and reduces the risk of burnout. Here are some steps healthcare organizations can take to combat nurse burnout:

Invest in Staffing and Reduce Workload

• Adequate staffing levels: Having enough nurses to cover shift times, and maintain positive nurse-to-patient ratios is the first step to combat burnout. Many healthcare organizations partner with PRN agencies to ensure staff ratios are maintained even during unexpected callouts. 
• Flexible scheduling: Offer flexible schedules to accommodate nurses’ personal needs and preferences. Everyone needs to take time off of work to care for themselves. By offering that flexibility, nurses are able to take better care of themselves.
• Workload Management: Delegate tasks appropriately. Everyone has different strengths and weaknesses. When nurse managers are able to recognize these strengths, they can delegate tasks more effectively, and cause less stress amongst nurses.

Empower Your Staff

• Decision making: Involving nurses in decisions shows them that you value their opinions. Any time a big decision is being made that could have a direct effect on nurse staff, you should involve them in the decision-making. After all, they are the ones that do that job every day. They may have insights that you didn’t know about or overlooked. 
• Support development: We already discussed that continued education can help nurses stay fresh on new forms of treatment, earn new certifications, and feel more competent. But, it can also help your facility achieve better retention rates. By investing in your staff they are more likely to stay.
• Excellence rewards: Acknowledge and celebrate your staff’s achievements. Everyone loves being recognized when they do something exceptionally well, and it helps you reinforce great work.

Promote Well Being

• Create a supportive work environment: Foster a culture of respect, collaboration, and open communication. Creating an environment where open communication is the expectation will allow staff to feel like they can talk to management and administrators about issues. This allows you to address friction points before burnout takes over. 
• Offer stress-reduction resources: Provide access to mindfulness programs, on-site fitness facilities, or Employee Assistance Programs (EAPs) to support mental health.
• Promote work-life balance: Encourage nurses to take breaks, utilize vacation time, and disconnect from work outside of scheduled hours. Remember that statistic we talked about? 32% of nurses were told they couldn’t take vacation. If more than one nurse has already taken off, this is a great opportunity to utilize a PRN agency to cover the open shifts.
• Address workplace violence: Implement policies and procedures to protect nurses from violence and aggression.

Nurse burnout is a complex and concerning issue with far-reaching consequences. It not only impacts the well-being of nurses but also affects patient care and contributes to the nursing shortage. However, there’s hope. By working together, nurses, healthcare institutions, and the healthcare community can implement effective strategies to prevent burnout and create a more supportive environment for our nurses.

Nurses can prioritize self-care, advocate for change, and utilize available resources to build resilience. Healthcare facilities can invest in adequate staffing, empower their staff, promote well-being, and address workplace violence. Finally, the broader healthcare community can advocate for policies that support nurses and address the root causes of burnout.

By taking a multi-pronged approach, we can combat nurse burnout and ensure that our nurses have the support they need to thrive in their demanding yet rewarding profession. Let’s work together to create a future where nurses feel valued, supported, and empowered to deliver exceptional care.

If you’re a nurse looking for more flexibility and control over your schedule, consider working for PRN agencies like Cascade Health Services.

Grant Minney