Everything You Need to Know about Nurse Burnout

Nurse burnout is the state of mental, physical, and emotional exhaustion caused by sustained work-related stressors such as long hours, the pressure of quick decision-making, and the strain of caring for patients who may have poor outcomes.

As you face these compounding factors, you may start feeling disengaged and detached, the first warning signs of burnout. If you don’t address this situation with good self-care, burnout can lead to feelings of cynicism, hopelessness, and even depression.

Nurses dedicate their professional lives to helping others. This care often impacts their personal lives and wellness. Most of the time, nurses would say it’s for the better – the field of nursing is extremely fulfilling. However, institutions are seeing increased reports of the opposite. Staff shortages, increased responsibilities, governmental regulations, and other job factors have contributed to nurse burnout and overall distress.

Burnout, one of the six dimensions of distress, has many negative implications on both a personal and professional level. Professionally, nurse burnout can hinder job performance, change how nurses view their role, and even put patients in danger. Personally, burnout affects demeanor, relationships, and overall quality of life.

This topic is taking over the healthcare industry and institutions are discovering the benefits and tactics behind measuring, monitoring, and taking the necessary steps to improve well-being.

nurse burnout
nurse burnout

Causes of Nurse Burnout in Nurses

According to the World Health Organization, burnout is an occupational phenomenon. ((World Health Organization. “Burn-out an ‘occupational phenomenon’: International Classification of Diseases.” May 28, 2019. https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases. Accessed: January 25, 2022)).

It is not specific to nursing: Professionals in any industry, from teaching to engineering, can suffer from this type of exhaustion caused by unrealistic expectations, lack of sleep, and other work-related stressors. However, due to their high-stress work environment, nurses and other medical professionals face a greater risk of burnout.

Long Hours

Another contributing factor to nurse burnout is the growing demand for nurses as the Baby Boomer generation ages and the prevalence of chronic disease increases. The U.S. Bureau of Labor Statistics projects that employment for registered nurses will grow by 12% between 2018 and 2028. ((U.S. Bureau of Labor Statistics. “Registered Nurses.” Last modified September 8, 2021. https://www.bls.gov/OOH/healthcare/registered-nurses.htm. Accessed: January 25, 2022)) That’s good news if you are looking for a nursing job. However, the pace of this increase has led to growing pains: understaffed hospitals, overworked nurses, and nurse burnout.

Lack of Sleep

One of the largest burnout risks for professionals in any industry is chronic lack of sleep. This is particularly common for nurses who work long hours and consecutive shifts. In a survey conducted by Kronos Inc., 25% of nurses reported that they were unable to get enough sleep between shifts. ((Kronos. “Wake Up to the Facts About Fatigue.” 2018. https://www.kronos.com/resource/download/24266. Accessed: January 25, 2022))

High-Stress Environment

Every nursing specialty brings its own challenges, but some specialties are naturally more stressful than others. If you work in the emergency department with telemetry or intensive care, you may have to deal with combative patients, traumatic injuries, ethical dilemmas, and a high mortality rate, all of which are linked to high stress levels and an increased risk of nurse burnout.

In a study in Psychooncology, 30% of oncology nurses reported emotional exhaustion, while 35% reported feelings of low personal performance—both symptoms of burnout syndrome. ((Cañadas-De la Fuente, Guillermo A., Jose L. Gomez-Urquiza, Elena M. Ortega-Campos, Gustavo R. Cañadas, Luis Alberndín-García, and Emilia I. De la Fuente-Solana. “Prevalence of burnout syndrome in oncology nursing: A meta-analytic study.” Psychooncology 27, no. 5 (May 2018): 1426–1433. doi: 10.1002/pon.4632. ))

Lack of Support

If your workplace lacks a culture of good teamwork and collaboration practices, burnout may be more prevalent there. ((DeKerel, Alan. “The Biggest Causes of Nurse Burnout and What You Can Do.” Well-Being Index Team. February 24, 2021. https://www.mywellbeingindex.org/blog/the-biggest-causes-of-nurse-burnout-and-what-you-can-do. Accessed: January 25, 2022)) While collaboration is important in most professions, in nursing, it can actually save lives. Poor teamwork—which is characterized by conflict, sub-par communication, lack of cooperation, and even peer bullying—makes for an unpleasant work environment and can lead to medical errors.

Emotional Strain from Patient Care

Patient care is one of the most rewarding aspects of nursing, as you make connections with patients and feel the satisfaction of helping them get better. But if you work in critical or end-of-life care, the emotional letdowns of dealing with lower recovery and higher mortality rates can lead to compassion fatigue and increased rates of burnout. ((LeVeck, Danielle, DNP, ACNPC-AG, CCNS, CCRN. “Nurse Burnout Is Real: 7 Risk Factors and the Top 3 Symptoms.” Nurse.org. October 2, 2018. https://nurse.org/articles/risks-for-nurse-burnout-symptoms/. Accessed: January 25, 2022)) The number of patients you care for is another factor. Nurses with greater than a 1:4 nurse-to-patient ratio have a higher risk of burnout, with each additional patient raising the risk by 23%. ((Gutsan, Ekaterina, Jami Patton, William K. Willis, and Alberto Coustasse, Dr.PH. MD, MBA, MPH. “Burnout syndrome and nurse-to-patient ratio in the workplace.” Marshall University. April 2018. https://mds.marshall.edu/cgi/viewcontent.cgi?article=1196&context=mgmt_faculty. Accessed: January 25, 2022))

Dangers of Nurse Burnout

Nurse burnout is a substantial concern for all concerned: nurses, employers, and patients. Nurses themselves are at risk for developing depressive disorders and other mental health conditions and for quitting their job. For institutions, a decrease in the quality of patient care can affect their reputation and bottom line. For patients, nurse burnout can directly impact their health.

Turnover

In a study in the International Journal of Environmental Research and Public Health, ((Van der Heijden, Beatrice, Christine Brown Mahoney, and Yingzi Xu. “Impact of Job Demands and Resources on Nurses’ Burnout and Occupational Turnover Intention Towards an Age-Moderated Mediation Model for the Nursing Profession.” International Journal of Environmental Research and Public Health 16, no. 11 (June 2019). https://www.mdpi.com/1660-4601/16/11/2011. Accessed: January 25, 2022)) researchers found a correlation between higher rates of burnout syndrome and nurses’ intention to leave. This increased turnover puts more stress on an already overworked environment.

Lower Quality of Care

The most dangerous risk associated with burnout is a decrease in the quality of patient care. Mistakes due to exhaustion can lead to patient discomfort, infection, and even (in extreme cases) death. One study found that the patients of nurses experiencing burnout had an increased incidence of urinary tract and surgical site infections. ((Jeanne P. Cimiotti, et al., “Nurse staffing, burnout, and health care-associated infection,” American Journal of Infection Control,” Aug. 1, 2012: https://doi.org/10.1016/j.ajic.2012.02.029))

Mortality

About 15.6% nurses report emotional exhaustion in nurse burnout

In a study by Marshall University, nurse-to-patient ratios greater than 1:4 were not only correlated with higher percentages of burnout—but for each patient added to that ratio, there was a 7% increase in hospital mortality. ((Ekaterina Gutsan et al., “Burnout syndrome and nurse-to-patient ratio in the workplace.” April 2018: https://mds.marshall.edu/cgi/viewcontent.cgi?article=1196&context=mgmt_faculty))

How Nurses Can Prevent Nurse burnout

Fortunately, it’s possible to prevent nurse burnout before it occurs—and to treat it immediately when it happens. For medical institutions, preventing burnout protects their employees, patients, and their bottom line. Nurse managers and nurse leaders can help lower the risk in their workplace. And nurses themselves can take preventive and therapeutic measures for self-care.

Improve Schedules

Whenever possible, nurse managers should create humane schedules for their staff, with shift lengths of 9 hours maximum. If you’re a nurse, try to work in a facility that treats its workers well. Avoid working overtime, and advocate for a schedule that lets you live a balanced and healthy life, leaving time and energy for loved ones and your favorite activities. 

Take Breaks

Be sure to take your vacation days so you can deeply relax and get a change of scenery. To encourage this, institutions can introduce a mandatory vacation day policy with a quarterly check to make sure their staff are taking the time they need. This helps to increase job satisfaction and decrease the turnover rate.

Seek Out Support

Support groups and work buddy systems can give you an outlet to vent frustrations and discuss conflicts and challenges so that when you go home or on vacation, you can truly relax. When you and your peers feel heard, this can also improve teamwork and collaboration. If you are feeling hopeless or depressed, be sure to seek out the help of a therapist or counselor.  

Learn Coping Methods

One of the best ways to manage your work stressors is to learn coping skills. Methods such as breathing techniques, restorative exercise, journaling, and a post-work relaxation routine can make a big difference in your physical and mental health and well-being.

Change Specialties or Focus

Finally, if your current specialty is too stressful, consider making a change. Earning your graduate nursing degree, such as your Master of Science in Nursing or Doctor of Nursing Practice, can enable you to switch to a specialty that’s a better fit. Becoming a family nurse practitioner could give you more autonomy in your practice, or you might consider mentoring the next generation of clinicians as a nurse educator.

If you’re a nurse who is noticing signs of nurse burnout, be sure to up your self-care game. It’s important for you, your employer—and your patients.

Check out: Efficient Reading Strategies for Student Nurses

Prevention Tips

Finding ways to reduce nurse burnout is essential at any time and has become increasingly important in the face of the COVID-19 pandemic. There are workplace prevention strategies institutions can use to reduce burnout and strategies nurses can utilize on their own to help reduce their potential to experience burnout.

Workplace Prevention of Nurse burnout

There are many things employers and supervisors can do to decrease nurse burnout in their hospitals. Some of these strategies include:

  • Enhancing the meaningfulness of work. Supervisors should encourage purpose in nurses’ work and give meaning to their contributions through praise and acknowledgment, which ultimately increases their sense of worth and motivates them to move forward.
  • Fostering opportunity to participate in decision-making. Supervisors should encourage nurses to express their opinions and participate in making work-related decisions, which can motivate nurses to feel like they are a part of the solution.
  • Expressing confidence in performance. Supervisors should express that they are confident in nurses’ abilities to fulfill work-related expectations and recognize their accomplishments.
  • Facilitating attainment of goals. Supervisors should enhance nurses’ skills, teach them new practices, and provide necessary resources to ensure workplace effectiveness.
  • Providing autonomy and freedom. Supervisors should minimize rules, restrictions, and commands to foster individual nurses’ efficiency and creativity.

Personal Prevention

Hospitals should incorporate workplace prevention practices to help reduce nurse burnout. Unfortunately, not all hospitals will engage in these practices, and even when they do, it may not be enough for each nurse. There are steps individual nurses can take to prevent burnout for themselves. These steps include:

  • Developing strong relationships. Close relationships in the workplace and at home can help combat nurse burnout. These relationships provide a safe space for nurses to vent about their emotional distress. A balance between work and personal life can also be beneficial when dealing with high-stress situations.
  • Setting boundaries. Nurses should leave any thoughts or feelings regarding work at work and focus on family, friends, and enjoyable activities outside of work. Remaining present and mindful can help reduce burnout. 
  • Getting adequate sleep. Sleep is essential for nursing professionals who want to avoid burnout. Nurses may need to adjust their sleep schedule to ensure they are getting at least eight hours of sleep each day or night. Getting enough sleep can foster alertness, concentration, stamina, mood, and motivation.
  • Maintaining Physical and Mental Health. Regular exercise and a healthy, well-balanced diet can help to reduce stress. Nurses should exercise at least 30 minutes a day to feel rejuvenated and take a mental break. It is also essential for nurses to take time off when needed to prioritize their mental health, reduce burnout, and remain effective in the workplace.
  • Utilizing Therapy and Assistance Programs. Nurses should take advantage of any therapeutic or counseling services their institution offers. If they are not available in the workplace, it may be wise to seek counseling or therapy outside of work.\

How To Address and Prevent Nurse Burnout

Prioritize Authentic Leadership

The key to preventing nurse burnout is on a leadership level. Leadership needs to be proactive when it comes to preventing nurse burnout.

Looking at new nurse graduates in Canada, studies found that both personal and organizational resources play a role in protecting new graduate nurses from burnout development and its negative health and work related outcomes.

Leadership that has an open-door policy provides the support that’s needed for creating a good team. It encourages transparency, extinguishes the negative stigma that comes along with burnout, and encourages relationships. These types of leaders are also more able to recognize burnout and job stress before it becomes an issue.

Measure the Strain of Burnout and Find the Core Areas of Stress

The first step to understand and address distress is to get a grasp of where you are and how you compare. Knowing which specialties are most affected by burnout can allow you to tailor your provided wellness opportunities to specific areas.

Using surveys and other methods for collecting data, it’s important to understand where your employees experience distress the most and how they currently deal with the issue.

Implement a Positive Wellness Program

Once you have a baseline for your employees and their well-being, it is important to build a wellness program that directly addresses their issues and areas of concern.

Popular solutions include exercise incentives, food and snack programs, counseling groups, team building activities, extra time off, and other efforts meant to encourage well-being and opportunities to deal with distress acquired on-the-job. There are many ideas, both short and long-term, that aid in reducing burnout among nurses.

Reducing nurse burnout is an organization-wide endeavor that starts with gathering the right information. When you have the opportunity to identify burnout symptoms and understand how they relate to the nurses’ well-being, you can take the right approach towards correcting the issue. It takes time to create a well-being plan for your nurses but putting one in place now can help you avoid major staffing problems in the future.

Leave a Comment

Your email address will not be published. Required fields are marked *

Scroll to Top