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September 18, 2019

By: Lisa DiBlasi Moorehead, EdD, MSN, RN, CENP

Nurse managers: Please intervene when a staff nurse shows signs of burnout

Earlier in my career, my nurse manager told me I was exhibiting signs of burnout. I was offended.

When I was oriented as a new nurse almost 40 years ago, we were socialized to be self-sufficient about everything. Asking for help was frowned upon and work environments weren’t the friendliest.

My manager was forward-thinking in raising the issue of burnout with me at the time. When I thought more about it, I realized I was becoming cynical, which is a classic sign of burnout. I was fortunate enough to be able to change my schedule and add more work-life balance. For me, any activity that makes me lose track of time—like crafting or reading—helps re-charge my batteries.

Every manager should keep burnout on the radar. According to a national nursing engagement report released in April 2019 by PRC, of the more than 2,000 health care partners responding to the survey, 15.6% of nurses self-reported feelings of burnout, with emergency department nurses being at a higher risk.The Joint Commission issued a Quick Safety on developing resilience to combat nurse burnout (jointcommission.org/assets/1/23/Quick_Safety_Nurse_resilience_FINAL_7_16_191.PDF). It lists some excellent strategies for nurses, but there’s also a lot of opportunity for manager intervention.

Recognize susceptibility

Nurses are particularly vulnerable to burnout. The desire to help people, which is the overarching characteristic that draws people to nursing, can be exhausting.

Even the most compassionate nurses can run out of energy to care.

Healthcare is more complex than ever and nurses are suffering from cognitive and decision fatigue. When every decision can be a life or death matter, the responsibility can weigh so heavily on the decision maker he/she starts making poor decisions.

There’s increased recognition around physician suicide and it’s an issue for nurses as well. I’ve lost colleagues to suicide. One of the most important messages we can share with our colleagues is that none of us are alone. We’ve all been stretched to the breaking point in this profession and we must help each other.

Initiate critical conversations

It can be awkward, but nurse managers need to open discussions not only on burnout, but on issues related to the work environment.

Nurses need to know that it’s acceptable to speak their minds without fear of retribution. It’s not always easy to establish a reporting culture. However, once nurses know they can raise concerns about the work environment without being punished, morale improves and patients are ultimately kept safer as well.

It’s important to be honest with your direct reports (or even other colleagues) if you’re noticing signs of burnout. These warning signs include

  • skipping meals
  • increased negativity at work
  • sleeping less than 5 hours a night
  • loss of interest in hobbies
  • increased use of drugs or alcohol.

One way to initiate these conversations is with a simple statement like, “I’ve noticed a changed in your attitude and more negativity about work and the organization. We all get compassion fatigue. It’s not a healthy work environment if we can’t talk to one another.”

Finding solutions

These conversations are futile if there’s no follow up action on work-related issues that arise. Staffing is often identified as an issue. There are no easy fixes when it comes to balancing skill mix and competency levels but it’s a leader’s responsibility to look at the workflow, if a nurse is concerned. Ask nurses about the specifics of their day and their frustrations and identify possible new processes that would reduce inefficiencies

I’m forever grateful my manager raised this topic with me and that we worked together to restore my passion for the profession. Like all of you, I became a nurse because I want to make a difference. Please invest in your staff’s mental wellness. You have the power to help your nurses re-fuel their tank and this will empower them to provide better, safer patient care.

Lisa DiBlasi Moorehead is an associate nurse executive at The Joint Commission in Oakbrook Terrace, Illinois.

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