Nursing may be a rewarding career, but it is also a demanding one. In fact, the pressures of the job become so intense that nurses are prone to a condition known as “burnout.” Nurse burnout is more than just needing a vacation. It’s an ongoing condition that is an emblem of the extraordinary amount of stress that nurses are forced to assume. Numerous factors contribute to burnout, and that means that there are several possible approaches for preventing it. Understanding and implementing these approaches may be the key to reducing turnover rates and increasing nurse confidence and well-being.
The U.S. has been in the grip of a nursing shortage for several years. Part of the problem is that not enough students are entering nursing programs. However, the bigger issue is that experienced, qualified nurses are leaving their employment in increasing numbers. They don’t leave their career as a health care professional because they no longer feel that it is their vocation. Rather, they leave because they have become unable to perform the basic, necessary responsibilities of their jobs.
This inability to perform essential nursing duties is at the heart of nurse burnout. A complex combination of factors works to undermine the skill and confidence of even the most capable of nurses. Perhaps the most significant of these factors is the nurse to patient ratio. In recent years, this ratio has become increasingly skewed, with nurses expected to care for a greater and greater number of patients. Nurses are stretched so thin in many hospitals that they simply don’t have time to provide the quality care that their training dictates. Studies have already demonstrated that patient outcomes are much more likely to be negative in hospitals where the nurse to patient ratio is particularly unfavorable while the reverse is nearly always true when nurses have fewer patients to care for.
Clearly, asking nurses to take on more and more patients is a mistake that contributes to the nurse burnout phenomenon. As the nurse rushes from one patient to the next, confidence gets lost. The nurse knows that steps may be missed or that symptoms could be overlooked. Often, nursing staff feels like they are merely heading off one disaster after another rather than providing quality care. It’s the patients that suffer, but the nurse’s well-being erodes as well.
When nurses feel that they may not be providing the type of care that is an essential part of their responsibilities, it’s easy for them to feel overwhelmed. They cannot even begin to keep a semblance of a schedule. Their blood pressure skyrockets, heart rates increase and feelings of total exhaustion begin to take hold. It begins to be difficult to make quick decisions that knowledge and experience would make clear in better-controlled circumstances. Is it any wonder that more nurses are choosing to leave the profession?
In addition to facing extraordinary stress on the job, nurses work long hours. Some are challenged by having to work shifts that put them at odds with their circadian rhythm, further contributing to burnout. Fortunately, measures are beginning to be taken that are aimed at reducing the number of nurses who are subject to this condition.
It is not always the long-time, experienced nurses who suffer from burnout. Sometimes, it is those who are newest to the profession. There is a definitive gap between completing a nursing program and starting a first job. Many novices simply are not fully prepared for the rigors and stresses that come with working full hospital shifts. Their budding confidence is almost more likely to be decreased than be built up as they are catapulted from the classroom to the hospital floor.
Fortunately, a new crop of nursing residency programs is working toward changing that. Residency programs offer an opportunity to bridge the gap between learning and practice. New nurses work closely with an experienced preceptor who continues the process of education in the work environment. Novices get feedback and support that is desperately needed, giving them the insight and confidence they need to do their job well. This, in turn, is believed to protect nurses from falling prey to the factors that contribute to burnout. With the mentoring of a residency program, nurses are more successful at finding a practice niche and able to learn better coping skills.
Hospitals are also focusing on ways to balance the nurse to patient ratio. Studies show that nurses who are not overworked and overwhelmed have enhanced self-esteem and confidence. This translates to more positive outcomes for their patients. Lowering the nurse to patient ratio is thought to also contribute to a more stable, predictable workday for nurses, which further builds their ability to provide quality care. Just as importantly, this additionally builds the nurse’s well-being, another key factor that helps to ward off burnout.
In fact, nurses across the country are demanding laws that would enact a fixed nurse to patient ratio. Currently, only California has this type of a law on the books. Legislators there were forced to act after extreme cases of nurse burnout plagued the state for years.
Hospitals are also examining stress-reduction classes, counseling and the addition of designated relaxation spaces where staff can unwind as additional means of combatting nurse burnout. With the demand for qualified nurses continuing to rise, it seems likely that these and other measures will be needed to prevent losing staff to burnout.