By Nurse Robbie (Robbie Bedbrook)
We’ve all met that one nurse that makes you think, ‘why on earth did you ever become a nurse?’. You know the one I mean; this nurse is tired all the time and gets by doing the bare minimum. Maybe she rolls her eyes every time a patient’s buzzer goes off or maybe he refuses to work with students. This nurse doesn’t seem to enjoy their work or care much for their patients. This nurse is unhappy.
So is this a simple case of the wrong personality for nursing? Unlikely; while the reality of being a nurse may not be 100% clear at university, I have never met a student-nurse that doesn’t understand that empathy and energy are a must for this career. It seems more likely that what we’re seeing in this nurse are the tell-tale warning signs of Burnout.
Burnout is long-term physical and emotional exhaustion, caused by overwork and/or stress, with a diminished interest and capacity for work. What does this mean in real-talk? Well it’s more than having a bad day or cursing your alarm when it goes off on your last string of shifts for that week. Burnout is debilitating and devastating. Someone experiencing Burnout isn’t actually capable of doing their job to their usual standard across a long-term period. Burnout can weaken your immune system, making you sick, and it can lead to mental health issues such as depression. You might cry uncontrollably, or you might struggle to feel much of anything. Sometimes people turn to alcohol or drugs to cope. Their relationships suffer.
Traditionally Burnout is broken into three main areas, or symptoms: exhaustion, depersonalisation and reduced accomplishment.
Here is a wonderful summary of what that looks like:
|The three areas of Burnout (from Maslach, M. 1982, ‘The Cost of Caring’)|
|Exhausation||Depersonalisation||Reduced accomplishment / efficacy|
|Physical and emotional fatigue||Feeling apathetic||Feeling work is meaningless|
|Emotional detachment or withdrawal||Lacking interest||Doing the bare minimum|
|Indifference to others||Avoiding talking with patients||Avoiding stressful work|
|Judgmental Attributions||Feeling as though you have nothing to offer||Opposition to change|
|Feeling irritable and angry||Feeling alienated from others||Feeling disillusioned|
|Viewing patients as objects, numbers or disease processes||Feeling worthless or incompetent.||Frequent mistakes|
Historically research into Burnout began by trying to identify why there were lowering retention rates for nurses and teachers in the 1970s and was originally coined, ‘compassion fatigue.’ Today Burnout still plays a part in retention rates of nurses. So why is this a phenomenon experienced commonly by nurses? Nursing is consistently regarded as the most highly regarded profession in Australia and a big part of that is because the work is selfless and not easy. Non-stop high-intensity social interactions, demanding hours that place a strain on our body clocks and personal lives, and graphic images and conversations about illness. (I should point out that in this way Burnout is not exclusive to nursing, many other healthcare workers can and do experience Burnout.)
Thankfully there are many strategies that you can adopt to prevent Burnout and allow you to continue loving your work as a nurse for a long, fulfilling career! If you’re a student learning these early will make a world of difference and stop you ever feeling the sting of Burnout.
- First and foremost know when to step away. Part of being a nurse is that innate desire to care but it is possible to give too much of yourself to others and have nothing left-over for self-care. Don’t take that overtime or swap that shift just because it’s offered and you feel guilty; is it the right decision for your health?
- Find the staff member(s) in your organisation responsible for personnel and have a regular meeting to discuss how you’re feeling, even if the answer is consistently, ‘I’m totally fine.’ In this way you’re making your mental health a priority.
- Make sure exercise and being social are parts of your life and give them as much mental weight as you do work. If you have scheduled a yoga class and some overtime comes up, well too bad because you made a commitment to your health and that comes first.
- Take regular leave, even if they’re just stay-cations at home.
- Finally try not to wear the weight of your organisation; when you know that your ward is understaffed or your clinic is making cuts it can feel like you have a duty to over-work. You don’t. Your duty is firstly to yourself and then to your patients; if you are burning-out you cannot be the best nurse for your patients.
If any of this is hitting home for you please talk to your Nurse Unit Manager, HR personnel, whoever is responsible for your wellbeing at work, or even reach out to you GP! There is no shame in needing help. If you recognise these signs in anyone else please reach out to them; they might not know themselves what is going on. To read more about Burnout in nursing and midwifery here is a wonderful feature piece by the Australian Nursing & Midwifery Federation (note: 3,500 feature, approx. 10mins reading time).
When it comes to Burnout remember Nurse Robbie’s motto:
“There is no healthcare without self-care.”
- Three areas of Burnout table: https://www.nurseuncut.com.au/for-all-nurses-how-to-avoid-burn-out/
- Burnout affecting nursing retention: http://www.health.gov.au/internet/publications/publishing.nsf/Content/work-review-australian-government-health-workforce-programs-toc~chapter-7-nursing-midwifery-workforce%E2%80%93education-retention-sustainability~chapter-7-nursing-midwifery-retention
- Roy morgan survey about nursing profession: www.roymorgan.com/findings/7244-roy-morgan-image-of-professions-may-2017-201706051543
- ANMF burnout feature article: http://anmf.org.au/featured-stories/entry/the-rise-of-burnout-an-emerging-challenge-facing-nurses-and-midwives
Please note that all opinions in this article are that of the author and are not necessarily representative of the views of the UTS Faculty of Health.