What we can all do to help identify and prevent burnout among nurses
As COVID-19 increases the pressures on nurses, we must look out for colleagues and ourselves
The COVID-19 pandemic is placing unprecedented demands on nurses and nursing students.
As they try to cope with the situation, the increased stress puts them at high risk of burnout. This is especially the case for newly qualified nurses or students who may be less familiar with the demands of the job.
That burnout is particularly prevalent among nurses is unsurprising given the many stressors they experience every day, even before you factor in the demands of a global pandemic.
How burnout can affect nurses
Burnout can manifest itself in different ways. In nurses, it has been associated with a reduced sense of personal well-being, strained relationships with others, including patients, and the need for time off work.
Burnout can hamper your effectiveness at work, with reduced energy and impaired decision-making. The development of burnout explains, at least in part, the high dropout rate for newly qualified nurses.
Recognising the symptoms is essential in preventing burnout. Stress-related changes in behaviour, such as increased irritability, will be noticeable to others, and people are often able to identify feelings of stress and exhaustion in themselves.
What is burnout?
The concept of burnout was first recognised in the caregiving professions in the mid-1970s. The term describes the process of gradual exhaustion and loss of commitment observed in those working in these settings.
Defined as a psychological syndrome that develops in response to chronic work stress, it is comprised of three symptoms:
- Reduced professional efficacy No longer feeling like you are competent and successful at work
- Cynicism The development of a cynical and impersonal response toward recipients of care
- Exhaustion Heightened feelings of being emotionally overextended and exhausted by work
Self-report questionnaires can be used to assess burnout in nurses
For closer and more accurate monitoring of staff well-being, simple, self-report methods can be used. One of the most common methods is the Maslach Burnout Inventory – a 22-item self-report questionnaire that can be used to recognise symptoms of burnout in nurses.
The questions relate to the different symptoms, with responses rated on a scale of 0 (never) to 6 (everyday). For example:
Symptom: Reduced professional efficacy. Example: ‘I have not accomplished many worthwhile things in this job.’
Symptom: Cynicism. Example: ‘I feel I treat some patients as if they were impersonal objects.’
Symptom: Exhaustion. Example: ‘I feel emotionally drained from my work.’
The questions are responded to on a continuum, so the higher the score, the more likely it is that the nurse is experiencing burnout. This tool can be used as part of the routine and ongoing monitoring of the well-being of nursing staff.
Habits and strategies to prevent burnout
Strategies that reduce stress and enhance recovery can be used to prevent burnout. Getting regular exercise is an excellent first step; this helps alleviate stress and boost sleep quality as well as having long-term health benefits.
Finding time to exercise can be hard, so use whatever time or means you have available. Free guides on physical activity are available and teaming up with colleagues could help you get started and provide the necessary support to keep going.
The psychological aspect of burnout means that developing resilience is vital. Meditation and other relaxation techniques can help you to deal with stress, as can positive thinking and self-talk; research suggests that staying optimistic and maintaining a positive internal dialogue are important in reducing levels of stress.
These types of strategies can be facilitated with smart phone apps, which are particularly useful when you are busy and have only brief periods of time to spare.
Perfectionists can be more prone to burnout
We also know that some people are more prone to burnout than others. Being perfectionistic, for example, is a major risk factor for burnout so it is essential that the standards you set for yourself and others are realistic.
If you tend to be perfectionistic, being kind to yourself and others will help you to cope when things don’t go to plan. High standards are important in most workplaces, but being perfectionistic isn’t necessary and will make things more stressful for you and your colleagues.
When to seek professional help
Everyone experiences stress at work, but if the stress starts to become overwhelming it is time to seek help from a qualified mental health or well-being professional.
Health professionals are surprisingly bad at self-care, and the stigma associated with mental health problems can be a significant barrier to seeking help, so it is important to remember that asking for help is not a sign of weakness.
By offering support and encouragement to one another before problems arise, especially those new to nursing, we can help to prevent burnout and ensure that those who do experience burnout receive the care they need.
Where to access support
Daniel Madigan is a senior lecturer in performance psychology at York St John University
Andrew Hill is acting pro vice-chancellor for research and group director of the motivation, performance and well-being research group at York St John University