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How Nurse Managers Can Prevent Burnout

Burnout has always been an occupational hazard in nursing. Yet now in the post-pandemic era of healthcare, nurse managers are grappling with its effects daily. They face staff shortages and high turnover, and worry about the employee morale and mental health of those nurses working overtime to pick up the slack. Everyone in healthcare has experienced new levels of workplace stress over the past few months and the risk of emotional exhaustion is high. So how can nurse managers prevent nurse burnout? 

Nurse managers and healthcare leaders can prevent nurse burnout by addressing five key areas relating to job satisfaction for nurses. Managers must emphasize education, promote positive physician-nurse relationships, provide supervisory support, encourage adequate staffing, and watch for early warning signs to avoid the effects of burnout on their organization. 

Before supervisors can mitigate burnout effects, they must recognize burnout, the risk factors, and the repercussions. To better understand nurse burnout, read on. 

What is Burnout?

Burnout is recognized as a syndrome in the 11th revision of the International Disease Classification (ICD-11) official compendium of diseases. It is an occupational phenomenon rather than a medical condition. 

According to the World Health Organization (WHO), burnout results from chronic workplace stress that has not been successfully managed. Three classic signs characterize this condition:

  • Feelings of exhaustion or energy depletion
  • Increased negativism or cynicism related to one’s job
  • A sense of ineffectiveness or lack of accomplishment

Many jobs are stressful. Think air traffic controller, jail warden, or daycare worker. Any worker affected by a stressful workplace can face burnout at some point. Nurses, however, are at extremely high risk. 

Who is At-Risk?

Health care professionals are generally considered one of the highest-risk groups for burnout because their work is particularly stressful. Daily encounters caring for sick patients, the experiences of death and dying, and the strain of working with anxious or grieving families take a toll. 

In 2018, the US Department of Health and Human Services Health Resources and Service Administration (HRSA) conducted an anonymous survey of registered nurses (RNs) in America. The data collected from this National Sample Survey of Registered Nurses (NSSRN) identified trends in burnout among RNs.

The survey indicated that some groups are more at risk for nurse burnout. For example, working in a hospital was associated with 80% higher odds of burnout than nurses working in a clinic. Other findings from the study include a higher incidence of burnout among nurses who:

  • Work more than 40 hours per week
  • Work in facilities with inadequate staffing 
  • Consider their workplace a stressful work environment

Other researchers have found more factors contributing to professional burnout. In 2020, researchers determined that nurses on the day shift were more at-risk than workers on the night shift. On days, burnout is likely to be 11.3% higher because of more hectic work environments and more interactions between colleagues. 

Why We Need to Prevent Nursing Burnout

It’s no secret that the pandemic amplified stress for healthcare workers. As a result, burnout went from an occupational problem to a significant danger to healthcare.

At best, it disrupts patient care. At worse, nursing burnout threatens the entire healthcare system. 

One reason to worry about burnout is the nursing shortage. Many nurse managers already worry about inadequate staffing. Staffing ratios are a critical concern for healthcare workers. While the population is aging, more nurses are retiring, and more patients require services. The deficit is growing. The nursing profession cannot stand to lose good nurses. When RNs become burned out and leave the bedside, the nursing shortage grows. 

Another reason to worry about nursing burnout is financial loss. One study on the impact of nurse-turnover found that losing one nurse can cost a hospital $90,000 directly, with up to $8.5 million in wider associated costs to the health system. Expenditures related to unfilled positions and vacancies, patient deferment, and retraining are substantial. Even outpatient settings can be strained financially by turnover related to burnout. One report on healthcare retention and staffing showed that RN turnover costs average between $33,000 and $56,000 per nurse. 

Aside from corporate effects, nursing burnout leaves its mark on the individual. Signs and symptoms of nurse burnout include:

  • Frequent illness and sickness
  • Headaches and muscle pain
  • Impaired sleep
  • Isolation or detachment
  • Substance abuse
  • Decreased career satisfaction
  • Sense of failure or helplessness

Everyone should be concerned about the problem of burnout because of its impacts on healthcare and our healthcare providers.

Actionable Steps for Nurse Managers

Nurse managers and others in leadership are uniquely positioned to make changes that will mitigate nursing burnout. Interventions should center around easing workplace stress, providing organizational support, and improving job satisfaction. Here are five actionable steps to address burnout in an organization. 

Emphasize education. Patient teaching is integral to the nursing profession. So, this step may be the easiest way to combat burnout. Nurse managers must educate their nurses and other healthcare professionals about burnout and interventions to prevent it. Other topics to teach include stress management, tools for mental health, and signs and symptoms to watch. Education on how to address burnout works on an individual level. 

Promote positive physician-nurse relationships. Nursing burnout comes from on-the-job stress. Incivility in the workplace between doctors and nurses can be a source of anxiety and emotional strain. Research has shown that increased civility at work leads to an enduring reduction in burnout among healthcare professionals. Nurse managers should focus on improving respectful social encounters among team members.

Provide supervisory support. One researcher found 15 studies showing that supervisor support positively influenced intention to stay with an organization. Nurses need understanding and encouragement from their leaders. Supporting the nurses helps safeguard them from burnout.

 The nursing workforce is predominantly female and married. Most nurses have domestic or childrearing responsibilities at home. Work-life balance is key for professional nurses. Supportive supervisors are considerate of their nurses while challenging them to grow and succeed.

Encourage adequate staffing. One study found approximately 60% of nurses attributed burnout to inadequate staffing in their organization. Some facilities have implemented programs where bedside nurses decide on acceptable nurse-patient ratios instead of managers. Optimal staffing levels decrease errors, improve satisfaction, and increase retention in nursing.

Watch for early warning signs. Nurse managers must keep a watchful eye on their team. Then they can see red flags and intervene quickly. Early warning signs of burnout include excessive missed workdays, irritability at work, or complaints about relationship issues. On the other hand, these signs could be problems that contribute to burnout. Managers must keep lines of communication open and be on guard for troubles that might affect their mental health. 

Nurse managers should be proactive rather than reactive when critical incidents happen. Offer nurses opportunities to talk after a traumatic event. A stress debriefing is a structured voluntary discussion to put abnormal events into perspective. When nurse managers are aware of heightened workplace stress, a debriefing may be one way to recover as a unit. 

In 2017, the National Academy of Medicine (NAM) developed the Action Collaborative on Clinician Well-Being and Resilience to address substantial symptoms of burnout among nurses, physicians, and residents. Nurse managers looking for more tools to address burnout can find resources online. 

Summary

Now you have five actionable steps to reduce burnout. Nurse managers have the power to impact their nurses and the nursing profession. We need change now, for a better future in nursing and healthcare.

References

A Literature Review of Nursing Turnover Costs.” pubmed.ncbi.nlm.nih.gov. Accessed March 17, 2022.

Action Collaborative on Clinician Well-Being and Resilience.” nam.edu. Accessed March 17, 2022.

Burnout in Healthcare Workers.” ncbi.nlm.nih.gov. Accessed March 17, 2022.

Critical Incident Stress Guide.” osha.gov. Accessed March 17, 2022.

Impact of Nurse Burnout.” nursingoutlook.org. Accessed March 17, 2022.

New Insights Into Burnout and Health Care.” tandfonline.com. Accessed March 17, 2022.

Nurse Burnout.” mywellbeingindex.org. Accessed March 17, 2022.

Nursing Shortage.” ncbi.nlm.nih.gov. Accessed March 17, 2022.

Nursing Workforce Survey Data.” data.hrsa.gov. Accessed March 17, 2022.

Prevalence of and Factors Associated With Nurse Burnout.” jamanetwork.com. Accessed March 17, 2022.

QD85 Burnout.” ncbi.nlm.nih.gov. Accessed March 17, 2022.

The Determinants and Consequences of Adult Nursing Staff Turnover.” bmchealthservres.biomedcentral.com. Accessed March 17, 2022.

2021 National Health Care Retention & RN Staffing Report.” nsinursingsolutions.com. Accessed March 17, 2022.

Sarah Falcone BSN, RN

Sarah Falcone BSN, RN

Author

Sarah S. Falcone BSN, RN is a dedicated nurse based in Dallas-Ft. Worth, TX. Her first nursing gig, was night-shift floor nurse in women's services (PP, L&D, nursery). Through a series of fortunate events, she found home health and a passion for helping seniors age in place. Connect with her on LinkedIn.

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