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From the Bedside: Nine Strategies for Alleviating Nurse Burnout

Saturday, October 29, 2016
Kelly Hancock, DNP, RN, NE-BC

(Originally published in ConsultQD, an open, online forum from Cleveland Clinic’s Zielony Nursing Institute)
 

Reducing stress benefits caregivers and their patients


Long hours, rotating shifts and the stress of caring for critically ill patients are just a few of the factors that can lead to nurse burnout. “It’s a big problem nationally for all kinds of caregivers, whether you work in an ICU or an ambulatory setting,” says Holli Blazey, MSN, ANP-BC, Nursing Program Coordinator for Employee Wellness at Cleveland Clinic.


The healthcare system’s Wellness Enterprise offers many employee resources to help reduce stress and prevent burnout, ranging from yoga classes and running clubs to educational seminars and electronic coaching. The overall message is the same: Take care of yourself!

“Nurses need to take care of themselves first before they can take care of patients,” says Blazey. “It’s just like when you’re on an airplane and the flight attendant tells you that in case of an emergency, put on your own oxygen mask before placing one on your child.”
 

Defining nurse burnout

 

Earlier this year, Ashley Neuman, LPCC-S, one of Blazey’s colleagues in Cleveland Clinic’s Wellness Enterprise, offered advice to caregivers during a 30-minute Wellness Connection presentation entitled “Managing Burnout in the Workplace: How Caregivers Cope.” She began with a definition of burnout, which can have three components:

  • Emotional Exhaustion – “Burnout can occur when you’re not just physically tired, but you are emotionally exhausted,” says Neuman. “It’s when you don’t have the motivation to get up, get moving and finish that one last clinical note. That emotional weight becomes heavier every day.”
  • Depersonalization – This happens when you have an unfeeling or impersonal response toward recipients of your service, care or instruction. “Nothing sparks passion or you don’t have that intrinsic motivation anymore,” she explains.
  • Dissatisfaction in Personal Achievements – Nurses who experience burnout may lack feelings of competence and achievement in their work. Neuman says, “You become a shell of yourself, losing interest in things you normally enjoy doing.” Maybe you dread going into a patient’s room or going home to make yet another dinner for your family.

It’s important to note that everyone periodically experiences emotional exhaustion, lack of motivation and negative emotions. We’ve all thought, “Today was terrible!” When the three elements happen day-in and day-out, then there’s a problem.

“A prolonged state of stress leads to distress, which can then become burnout,” says Neuman. The question then becomes what can you do about it?

 

Taking steps to combat burnout

 

  1. Stop and breathe. “Most times when we are feeling stressed, we forget to really breathe,” she says. Stop what you’re doing, take a deep breath and collect yourself. “Think about how you can handle the situation rather than spiral out of control,” she adds.
  2. Take inventory of your stressors. Write down the things that are causing you anxiety, then brainstorm at least one way to reduce each stressor. It might be as simple as asking another nurse, your nurse manager or a PCNA for help.
  3. Say “no” to new commitments. If you’re already feeling overwhelmed, don’t agree to participate in a research project or chair your unit’s Shared Governance Committee. “Get whatever it is you are dealing with under control before you add something else to your plate and overextend yourself,” says Neuman.
  4. Delegate where possible. Are you doing tasks at work that a PCNA could do instead? Is there a friend or relative that could help you out at home?
  5. Unplug frequently and daily. With smartphones at our fingertips, it’s easy to be available 24/7. But you should set some parameters, such as no mobile phones at mealtimes and no screens of any kind 30 minutes before bedtime.
  6. Set boundaries. This requires some self-control. If you need to leave work by 5 p.m. to pick up your child from daycare but you’re finishing patient charts at 5:30, then you’re not setting good boundaries at work. If you stay up late to binge on Netflix and don’t get enough sleep, you’re not setting good boundaries for sleep hygiene.
  7. Engage in healthy activities. Get enough sleep, eat healthy foods and exercise. Don’t be too hard on yourself if you’re not perfect. If you can’t walk for 30 minutes at lunch, then walk to a bathroom or refill your water bottle on another floor. If the taco bar is tempting, fix a taco salad rather than a loaded burrito.
  8. Seek support. Like other healthcare organizations, Cleveland Clinic offers support to employees through its Caring for Caregivers employee assistance program. Cleveland Clinic also created a free app, Stress Free Now, which anyone can download to access relaxation practices, a stress assessment, daily strategies to relieve stress and more. It has a “healers” version for nurses and other caregivers.
  9. Practice gratitude. “When you’re feeling stressed, take a second and appreciate the things in your life that are good and bring you some joy,” says Neuman. “That actually can make you feel better.”


 

Kelly Hancock is the Executive Chief Nursing Officer of the Cleveland Clinic Health System, and Chief Nursing Officer of Cleveland Clinic Main Campus. Follow Kelly on Twitter at @kkellyhancock.

 


Tags: nursing, burnout, wellness
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