We’ve all heard it before - you can’t care for others unless you care for yourself. But how many of us, especially nurses, actually follow this advice? Ignoring or discounting work-related stress repeatedly instead of taking measures to decrease stress can eventually lead to burnout.
Burnout is widespread throughout healthcare, causing emotional exhaustion, cynicalism, and a feeling of ineffectiveness. Nurses who experience burnout are typically overwhelmed by work and begin to feel detached emotionally and psychologically. Sadly, while all nurses are at risk for burnout, about 60% of nurses who work in critical care units experience it.
Though burnout clearly affects nurses, patients are affected too. In 2018, nurse turnover in the United States was at its highest of the decade at 18.2%. Nurse turnover reduces nurses’ productivity and staff morale. It’s also is associated with lower ratings of patient care quality.
Ideally, nurses should function at their highest level of psychological and physical health to give the best patient care. Unfortunately, 82% of nurses believe they are at significant risk for illness due to workplace stress.
So, what can we do to lessen the chances of getting burned out? Nurses and healthcare workers can effectively fight burnout by improving their resilience. Higher scores of resilience have shown to decrease anxiety, depression, PTSD, and burnout syndrome. Self-care is a large piece of resilience that is powerful in fighting burnout!
The words “self-care” might make you think of drawing a bubble bath with a glass of wine in hand; though that might be effective self-care for you, there is much more to it!
Strengths-based self-care includes strategies that align closely with building resilience and longevity. This includes finding meaning, connecting with a higher power or energy, building relationships with colleagues, appreciating uniqueness, staying positive, and practicing healthy and reflective habits.
These topics were identified by 20 nurses and physicians who work in critical care settings during a recent study. They were given one on one interviews to learn about their perceptions and prevention strategies regarding burnout. Let’s break these strategies down into tangible steps that can be done on a daily or weekly basis.
Find Meaning
Think about why you started your nursing career. What do you tell people when they ask you how you selected nursing? By remembering your initial sense of purpose for your career choice, you may find renewed motivation. Reflect on the ways that you give back to the world by being a nurse. It may sound cliché, but on tough days, it can help to remember that while you might be having a rotten day, your patient is likely having a much worse one. You can be the light that helps brighten their spirits or reassure their family members.
Connect with an Energy Source
Your energy source should be one that restores you. It might be God or a Higher Being, but it may also be support systems such as family members or social connections. For some, it might simply be seeing a patient’s status improve or discharging someone home to their family.
By establishing a support system, you can refuel after or during difficult days and energize for the next patient interaction. Take time in each day to reach out to your energy source. This might be a prayer or simply texting or calling a family member after a shift. Take a moment to breathe and refuel!
Build Relationships
Nurture professional relationships in the workplace to boost resilience and create a caring and healing environment. Trusting work relationships are perceived to reduce work-related stress and improve motivation for coming to work. If you’re already in a leadership position or a position that can introduce change, you can encourage and initiate leadership rounds and physician/provider involvement with the nursing staff.
Involvement in unit or hospital committees and projects help establish a sense of belonging and teamwork. Being offered coverage for meals and bathroom breaks has been shown to improve gratitude and bonding among colleagues, so be sure to ask for help when you need it and offer it when you can!
Appreciate Your Uniqueness
Think about the unique strengths that you bring to your team. Every care team is made up of team players, and each person contributes something different. What is special about you? Do you help nurture new nurses or have the magic touch when it comes to wound care?
Acknowledge and appreciate the unique strengths that you bring to your team and patients and appreciate the contributions of your colleagues. The physician might know what medication the patient needs, but the pharmacist likely knows how to prepare the medication best.
On the other hand, the nurse might know the best route to give this medication and how well the patient will tolerate it (does it need crushed and put in applesauce? Which location is best for the subcutaneous injection?). You might have a coworker that is awesome at deescalating and another who is the IV Queen. The nurses' aid might have the best understanding of the patient’s mobility or even nutrition status as they help ambulate and serve them. Each player contributes differently to patient care and each is important.
Develop a Positive Attitude
Focusing on the positive instead of the negative has been shown to greatly impact resilience and maintain physical and emotional health. An optimistic outlook can reduce feelings of fatigue and stress and boost energy, open-mindedness, and gratefulness. A gratitude journal has been proven to be effective in helping to cultivate this mindset – just jot down three things every day that you are grateful for.
Re-framing adverse events can also help create this mindset – instead of ruminating on the unfair patient assignment, challenge yourself to think about how you can make a positive impact on your patients and your peers during your shift. You might appreciate the teamwork on your unit while a colleague helps you admit a patient or simply be grateful for your aid refilling your patient’s water pitcher. Small thoughts add up to mindset changes. Seeing the good can help you face the demanding aspects of your job with a smile!
Practice Healthy and Reflective Habits
We know how important it is to take care of our physical health with adequate rest, good food, hydration, and exercise. But psychological and emotional habits are just as important! Create a schedule for yourself that includes beneficial habits, such as self-reflection, prayer or meditation, and time with family and friends.
Set boundaries between home and work as well. Practicing mindfulness is a well-documented way to reduce stress and promote resilience. Unwind and/or prepare for your day at work by adding habits like these into your daily and weekly schedule. Improve your emotional health and watch your resilience soar!
Though it sounds easier said than done to reduce your chances of burnout, set small goals for yourself and go from there. Maybe today you focus on a positive outlook and next week you reach out to your loved ones to create a routine (weekly walk with your sibling? Phone call after work once a week with your mom? Monthly coffee with a friend?). These are the things that will refuel and energize you and help keep you motivated to continue giving amazing care to your patients and excellent teamwork to your peers.
What are some things you do to help improve your resilience? How do you work healthy habits into a busy schedule?
References:
Mealer, M., Jones, J., & Meek, P. (2017). Factors Affecting Resilience and Development of Posttraumatic Stress Disorder in Critical Care Nurses. American Journal of Critical Care, 26(3), 184-192. doi:10.4037/ajcc2017798
Penque, S. (2019). Mindfulness to promote nursesʼ well-being. Nursing Management (Springhouse), 50(5), 38-44. doi:10.1097/01.numa.0000557621.42684.c4
Wei, H., Kifner, H., Dawes, M. E., Wei, T. L., & Boyd, J. M. (2020). Self-care Strategies to Combat Burnout Among Pediatric Critical Care Nurses and Physicians. Critical Care Nurse, 40(2), 44-53. doi:10.4037/ccn2020621
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