Has anyone in nursing not experienced burnout at some point in his or her career? At least once, probably all of us have experienced some degree of it. In the last year, however, it took me some time to recognize the symptoms in my own practice.
As a nurse for over 20 years and a nurse practitioner for 10 years, this was the first year I felt I couldn't connect in the same way with my patients and colleagues. I was exhausted and felt I was no longer having an impact on care. A major contributing factor was a change in my duties. For a while I'd been struggling with the idea of making a major change-moving away from the bedside. Ultimately, I made the decision to leave the bedside, but I wasn't feeling happy about that either. I felt too tired to stay, yet I couldn't move on.
I was scheduled to present at a nurse practitioner conference. Despite my sense of upheaval, I kept my commitment, although less than enthusiastically. Spending time with my professional colleagues, listening to inspiring speakers, and seeing the wide range of practices made me feel proud to be a nurse and a nurse practitioner. I returned to work feeling recharged and eager to take on the challenges posed by today's practice environment. Additionally, I reached a compromise with my supervisors that allowed me to continue to practice and grow in my current position.
While I'm happy I've chosen to stay at the bedside, I also learned a valuable lesson about self-monitoring for burnout. It doesn't mean you're not a good nurse if you experience burnout. It can happen to any of us, so we all need to keep an eye on that barometer.
We work in a complex, demanding profession. I often think that if we had to sign an informed consent document to become a nurse, the list of potential risks and complications would read:
* long hours (all hours of day and night), creating the potential for chronic "jet lag"
* physical injuries likely (back and neck at high risk)
* episodes of crying not unexpected
* competing demands of patients, physicians, and nursing management all require immediate assistance, causing a high risk for stress and sour moods
* high risk of insomnia, secondary to worrying about patients.
Nevertheless, nursing isn't a bleak profession. It's one with great honor and satisfaction. I'm continually humbled by the fact that patients trust us at their most difficult times, even though they've just met us. Nursing affords us many opportunities to grow and practice. Nevertheless, just as we care for our patients, we must care for ourselves to prevent and minimize burnout. Striking a work/life balance, employing healthy stress reducers, connecting with our colleagues, using humor, and realizing when it's okay to take a break all help. Most hospitals now have employee assistance programs available, which may include stress reduction classes and more in-depth help, if needed.
The next time you go to work, think about your colleagues and how you support each other to deal with the stress of the critical care environment. Are there creative ways that a group of staff nurses can reach out to colleagues who are experiencing professional fatigue? How about a monthly lunch to share frustrations and brainstorm productive ways to reduce stress in your daily work? Devise a list of the top five stressors in your unit and come up with potential plans for change. If you can't affect change in certain areas, consider modifying your reaction to the stressors.
We need to afford ourselves the same care and dedication we offer our patients. If we don't look after ourselves, who will look after them?
Kate J. Morse
Editor-in-Chief, Director of Nurse Practitioners, Chester County Hospital, West Chester, Pa.
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