When Burnout Takes its Toll

It doesn’t take much effort to see that burnout afflicts healthcare workers, not only nurses who take the bulk of bedside care but all care givers.  Just stand near the nurses’ station, in their lounge area or in a corner of one of the wards and you can often see or feel their exhaustion.

I remember meeting up with a nurse friend of mine who came to me one day looking haggard after work. She not only looked exhausted, she sounded despairing.  She told me that she could handle long shifts and overtime. She understood that overly stressful shifts were part of the reality of nursing, but there was never any break in the pressure. She was sorry she was late and wanted to have dinner together, but asked if we could reschedule so she could go to bed early. Of course, I understood and felt worried for her emotional and physical health.

Unfortunately her story is becoming more common, while the versions are different, the theme is the same.  Burnout among nurses is taking its toll, and the result is never good for anyone!

What are the Signs of Burnout?

You know you are burned out when you feel you are not rested. There never seems enough time to do the things that you enjoy, like spending time with family and friends. You sleep late, and wake up still feeling tired. You feel like your life is composed of your job and little sleep. You cringe when  your phone rings and upon answering, hear the charge nurse asking you to fill in a shift. Reluctantly you say yes and then find yourself going back to work.

There is also emotional exhaustion, where the emotional and physical stressors take a toll on you. These include having patients dying on your shift or someone lashing out at you and leaving your dignity smashed to pieces. Then you have to deal with someone who makes everyone’s day extra stressful, and as if not content with his or her bullying behavior, your inadequacies are all thrown at your face. Would the student nurse you snapped at earlier think of you as a bully? She looked so hurt.

In time, you see yourself changing. The once enthusiastic learner and compassionate care giver has become irritable, cynical, overcritical, uncaring, indifferent, and distant. You realize that your frustrations at work are piling up. You don’t finish your tasks on time because there is just too much paperwork to be done and too many protocols to keep up with and follow. Help, equipment, supplies and verification measures are constantly unavailable or not working properly. There are too many memos and too little recognition. And the rare recognition, such as, "Thanks for staying on the extra shift" doesn't even feel good anymore! 

What is the Result of Burnout?

The ultimate result of burnout, according to research, is poor patient outcome or dissatisfaction. The consequences could be a myriad of problems that becomes cyclic. Burnout leads to more absences, resignations and legal disputes. Nurses who decide to stay are burdened with more work because of turnovers, and again burnout looms in. The cycle goes on, and like a tornado, more healthcare workers are caught in its path. With the aftermath resulting in poor service and negative patient outcomes.

How to Reduce or Prevent Burnout in the Workplace?

Because burnout is a result of many factors, addressing it poses a great challenge both to nurses themselves and to the management. Although nurses may feel a lack of control over their work conditions, they can still maximize their time while not working to do positive things for themselves. This includes eating right, exercising, meditating, and pursuing a passion or a hobby. They may also reconsider their career options. A change of specialization might do wonders.

Management can rethink their strategies to prevent burnout. There is a need to intervene in several areas of the cycle of burnout so the organization as a whole does not suffer when burnout strikes.

To curtail frustration, the management could provide an electronic platform where nurses can give anonymous feedback regarding their frustrations and provide suggestions to curtail the factors causing burnout.  When feedback is heard and acted upon or acknowledged performance is enhanced. This is a critical part of  

performance management.

 Management can also better strategize their recognition system. Recognition doesn't have to wait a year before the best employees are recognized during the annual meeting. What if tasks are monitored daily, and achievements are recognized in real-time? Wouldn't that make you feel great and in turn improve your engagement as an employee?

Nurses excess time away from patients can be a result of system or process failures. Process improvement initiatives should be in place to help prevent nurse frustration and increase time for direct patient care.

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References

Signs You’re Experiencing Nurse Burnout, UCSF Health

Nurse Burnout and Patient Satisfaction

Nurses’ Widespread Job Dissatisfaction, Burnout, And Frustration With Health Benefits Signal Problems For Patient Care

Benefits Signal Problems For Patient Care

Reduce nurse burnout by treating nurses as well as we treat patients

Job burnout: How to spot it and take action

Performance Management