“It is the most beautiful thing I have ever seen,” I crowed and then fell silent before the ephemeral spectacle of the total solar eclipse. I was one of the millions of people who traveled to the path of totality, which passed through my hometown of Cleveland, Ohio. For four minutes, I was absolutely present, witnessing the beauty, filled with joy and wonder.
I returned to work and the final push of the semester energized by the beauty, joy and wonder, yet quickly came up against the stress and anxiety that seem omnipresent among nursing students and faculty alike. Within the emails that had piled up during the day I was out, I found one from the American Nursing Association about addressing burnout.
The previous day’s joy and wonder were replaced by a familiar fatigue.
Most of us enter nursing because of our strong desire to help alleviate the suffering of others. Those of us who stay find joy and beauty in that work. Yet, hoards are leaving nursing due to burnout, contributing to the nursing shortage.
Burnout in nursing is not new, yet it seems to be growing at alarming rates. In 2020, an American Nurses’ Association survey found that 62% of nurses experienced burnout even before the COVID-19 pandemic, with more than 30% citing burnout as a reason for leaving the profession. Even more distressing, 69% of younger nurses stated that they were experiencing burnout in 2022.
Burnout is more than physical and mental exhaustion. According to the World Health Organization, burnout is also characterized by mental distance from the job, cynicism or negative feelings about the work and reduced efficacy.
Burnout is the antithesis of joy and wonder.
The main causes of burnout are related to the workplace culture and environment. In 2020, the nurses who left or considered leaving their jobs due to burnout cited a stressful work environment, inadequate staffing, high turnover, and a lack of good management or leadership as the top reasons. A 2019 National Academics of Sciences Engineering and Medicine report also cited inadequate control or autonomy, moral distress, and work-life balance as contributors to burnout.
And this is not just an issue of job satisfaction, but rather of quality of care. In Massachusetts, 56% of nurses identify inadequate staffing as the biggest barrier to delivering high-quality patient care. The burnout not only affects the nurses but patients, too.
The American Nursing Association concurs that systemic issues contribute to burnout. Yet in a recently published article, the methods for preventing or addressing burnout focus on individual behavior: rest, ask for help, exercise, eat well, take a break or request training.
The focus on the individual to solve a systemic problem is a recipe for further burnout. There is no number of downward dogs that are going to prevent burnout or bring anyone back from the brink.
In my experience, it is being present with my patients and having the time and space to truly engage that help me find the beauty, joy and wonder in the work that I do. It is what has helped me keep burnout at bay.
We need to focus on changing the systems in which nurses work in order to reduce our burnout.
Mandating manageable nurse-patient ratios is key to providing us the time and space to do our work well. Research shows that states such as California and Massachusetts, with laws that enshrine healthy nurse-patient ratios, have lower levels of burnout and turnover; likewise, hospitals with such policies fare similarly.
Adequate staffing, flexible scheduling, a manageable workload, opportunities for learning and advancement, greater autonomy, and supportive technologies that enhance our engagement are necessary to create the safe environment that gives us the space to do our jobs well and find the joy and beauty that drew us to nursing in the first place. It is also the environment that is going to foster care that benefits our patients.
Nursing burnout is real. And there are steps that our healthcare delivery systems can take to address it. We should not have to wait another 20 years for the celestial bodies to align and action to be taken.
