As clinician workloads increase, nurse burnout is becoming a major problem in the U.S., further exacerbated by the COVID-19 pandemic.
The highly contagious nature of the virus has increased the need for personal protective equipment (PPE), distancing, sanitation practices and the ability to provide compassionate care to sick patients, thus contributing to nurse burnout.[i] In addition, a recent study analyzing data from 3.9 million registered nurses shows that burnout comes from a variety of sources—demanding workloads, stressors in their work environment ranging from poor staffing ratios, to lack of organizational leadership, which increase their sense of burnout.
Of the nurses who reported leaving their current employment (9.5% of the sample), 31.5% reported leaving because of burnout. That number is almost double what it was in a 2007 version of this study, when only 17% of nurses reported leaving due to burnout.[ii] This shows that there is an urgent need for health systems to implement solutions to alleviate nurse burnout. Here are 3 strategies shown to have a positive impact on staff wellness and help reduce nurse burnout:
Focus on staff wellness
According to a study in Applied Nursing Research, workplace stress management interventions are effective at reducing stress for nurses dealing with burnout.[iii] Cognitive Behavioral Training (CBT) interventions show the highest efficacy, followed by relaxation techniques. CBT teaches nurses to identify and name their stressors, notice the consequences of stress, and identify the relationship between stress and self-awareness.[iv] It also offers alternative ways to think about stress and negative emotions. Relaxation techniques[v] can include diaphragmatic breathing, meditation and visualizations, exercise, or speaking with a mental health care professional.[vi]
Deanna Andel, MSN, senior clinical consultant (post-acute care) for Cardinal Health told Becker's Health Review that leaders instituting simple suggestions such as mindfulness meetings and words of encouragement can go a long way toward improving how nurses feel at work. She suggested, “Lead by example; you as the leaders, everyone's watching to see what you're going to do and how you're going to do it. Make a commitment to yourself and to your team to take care of you." [7]
Schedule flexibility
Since overworking and stressful work environments are noted above as causes of burnout, enabling flexibility in schedules could be key to alleviating burnout, especially if it allows nurses to take time off or work schedules that better fit their lives, according to Andel.[vii]
According to the authors of a paper titled “Flexible Work Practices in Nursing, by The International Center for Human Resources in Nursing," schedule flexibility could include a number of options, from allowing part-time work, to choosing their own schedules for younger nurses, and phased retirement for older nurses. Other flexible options that nurses report wanting to have are: the ability to take time off to care for a sick child without penalty; the choice to choose their start and stop times; the ability to work part- or full-time; and, when relevant, the option to work from home.
Overall, the report authors, Maura MacPhee and Lene Svendson Borra, state that, “Flexible work practices are an important organizational strategy for building an effective, sustainable workforce of substantive nursing staff."
Set boundaries between work and life
Tina Gerardi, a registered nurse, told Nurse Journal that healthy boundaries can make a big difference in reducing stress. “When your shift ends, leave any thoughts, feelings and grievances about work at work and make a point to focus your time spent at home with family, friends and doing activities that you enjoy. Be present and mindful."[viii]
Additionally, a 2019 study in Clinical Practice and Epidemiology in Mental Health [9] found that a variety of different interventions could make a difference in nurse burnout, including: resilience training programs that emphasize dealing with cognitive behavior; mental health exercises; therapeutic massage and guided imagery; and emailed tips for handling work stressors. This literature suggests that employing any intervention is better than none.[ix]
Nurse burnout will not go away on its own, and as the pandemic stretches into a second year, the need for healthy, happy, adjusted nurses will be greater than ever.
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[i] https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2775923
[ii] https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2775923
[iii] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5159423/
[iv] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5637151/
[v] https://www.nursechoice.com/traveler-resources/nurse-stress-management-five-relaxation-techniques-for-the-busy-nurse/
[vi] https://www.registerednursing.org/articles/how-manage-stress-nurse/
[vii] https://www.beckersasc.com/leadership/how-to-promote-clinician-self-care-in-ascs-5-strategies-from-cardinal-health-experts.html
[viii] https://nursejournal.org/resources/tips-for-avoiding-nurse-burnout/
[ix] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6446475/