Young and Already Burned Out By Nursing – Part 2

Welcome to part 2. Here we’ll identify burnout signs and triggers as well as strategies for coping with and hopefully avoiding burnout as a young healthcare provider.

Identifying Signs and Triggers

The first way to learn to differentiate between a normal level of stress and an unhealthy level is to accept that people can and will react to stress in many ways –and that that’s normal in and of itself, said Bryant, who encourages management and individual employees to be on the watch for indicators of burnout. “The first signs of burnout can vary by individual,” she said. “As a manager, I would pay attention to the staff members’ moods — did I notice someone being more irritable than usual, or did a situation cause someone to be upset more than usual? I might look at their schedules to see if they have been working more than usual. Burnout can also be seen in watching staff interact with one another, as sometimes co-worker relationships suffer. Another sign is nurses wanting to change patient assignments because they ‘just need a break from a certain type of patient or a certain diagnosis.’” To an extent, it is fair for the employee to lean on the employer to know the signs of potential burnout and raise questions or offer options for relief when it’s suspected, according to Bryant. “Employers who do not recognize burnout are concerning,” she continued. “I think burnout is inevitable and occurs multiple times throughout a nurse’s career, no matter what setting he or she works in. Stressful times in our lives make us more susceptible to burnout, especially if we do not have a support system in place for self-care and rejuvenation. It is really difficult to take care of patients every day throughout an entire career without taking care of oneself first. Sometimes nurses lose sight of that.”

For Kaitlyn S., recognizing the culprits that are responsible for her burnout is the easy part. The maxed-out nurse-to-patient ratios, which she said is 1:6 in her hospital, the “excessive” amount of responsibilities that are expected of the nursing staff that go beyond direct patient care, a lack of support from nursing techs (because they too are maxed out at their ratios), and the unfair demands of patients and their families (at times) add up to a difficult equation that can cause physical and mental struggles, she said. Some of the first signs of burnout that Hertel tends to look out for include an inability to put forth the appropriate physical and mental effort needed to accomplish the work required, increased feelings of apathy and frustration, and changes in sleeping and eating habits. Loss of camaraderie with fellow nurses is also a red flag, she said.

Strategies For Coping With And Avoiding Burnout

To avoid burnout, Hertel said it is vital to engage in daily self-care, which she describes as “building personal resiliency so that the difficult days can be effectively managed.” Components of self-care include making time for regular rest periods to restore physically and spiritually. “I know that many nurses will insist that there is no time some days for even any type of break, but even a period as short as 60 seconds spent deep-breathing away from the unit can help,” she said. Other self-care practices include strengthening exercises and finding a mentor to provide emotional support and guidance. From a professional development standpoint, Hertel said keeping current on evidence-based practices by attending a conference, viewing a webinar, or even participating in a journal club can help. “By promoting our own professional development, we can increase our self-assurance in the care we deliver and decrease stress,” she added. Hertel said that self-care is also a focal point of the AMSN’s strategic plan, which includes articles, continuing education, podcasts, and convention sessions on the topic. “In the near future, we plan to develop a toolkit for nurses that promotes self-care activities and provides links to resources,” she said.

Until then, Bryant makes it a point to encourage nurses to “know themselves” and to be willing to acknowledge mental and physical burnout cues in order to stop symptoms before they get worse. This can sometimes be accomplished by scheduling paid time off specifically to decompress and get away from the workspace. “It may be a good idea to speak with your manager about occasionally using time off to rest and/or have a break from the physical and emotional demands of the job, which can be very refreshing,” she said. “And more employers are willing to have those proactive conversations about planning for time off for this reason for the benefit of everyone. Some work areas create fun, supportive activities, or staffing/scheduling workgroups. Starting a group like this can bring co-workers together and provide a voice that was missing before.”

The Blame on Burnout

The pointed finger can sometimes actually be directed at employees, even if their actions are inherently innocent and laced with good intentions meant to improve the lives of patients. “As a new nurse, it is easy to become consumed with your new role and volunteer to work additional hours,” said Hertel, “and a lack of work-life balance can quickly lead to burnout. Lack of good health habits can also lead to burnout – eating poorly, lack of exercise and poor sleep habits increase the negative effects of stress and can contribute to burnout.”

Bryant agrees. “Nurses must care for themselves first,” she said. “When that is lacking, they may not be providing the very best care to their patients, and that can lead to burnout.”

Kaitlyn S. is not shy in admitting that there are some days at work where she needs to vent to co-workers in order to validate her frustrations. But that can result in a positive for her because she also knows that her peers are listening to her concerns and have an intimate understanding. On her days off, she said she’s better at concentrating on her self-care, which for her includes sleeping, taking walks outside, reading, stretching, getting her nails done, binging on her favorite shows, and going out with friends. “Also, I make sure I eat relatively healthy to maintain my immune system and overall to help me feel good,” she said.

Still, she is not yet certain that her efforts will be enough to overcome those times of burnout. “Some days it’s difficult to differentiate whether it’s because I’m relatively new or not, but overall, I often question whether this is a profession I can handle for several decades until I’m ready to retire,” she said.

Did you miss the first part of this series? Read more about burnout here.

References

  1. Youth Hub, Global Health Workforce Network, World Health Organization. Youth and decent work in the health and social care sector: an evidence synthesis. GHWN. 2019. Accessed online: www.who.int/hrh/network/YouthPaper-PS-SR_23May2019.pdf
  2. Survey reveals factors behind millennial burnout. Yellowbrick. 2019. Accessed online: www.yellowbrickprogram.com/blog/survey-reveals-factors-behind-millennial-burnout
  3. Gordon L. Special report: the world’s youngest populations. London: Euromonitor International; 2012.