Stress Management in the Nursing Profession
What is Burnout and what does it look like?
If you are anything like me, you don't want to admit that maybe, just maybe, you are burning out. We have all witnessed the obvious form of burnout from nurses who loudly complain and use burnout as an excuse to be rude to patients and staff. These individuals suck the air out of the room and we all secretly wish they would just quit. But experiencing burnout can be much more subtle.
I was slow to realize that I was experiencing burnout -- after nine years in the MICU, I just didn't have the same enthusiasm for the work that I used to. I carried a tension in my body that I relied on a massage therapist to work out. Often on my drive home, I would turn off the radio to rest my ears and mind in complete silence. I reasoned with myself that I could not be burning out because I still felt so much love for my patients and profession.
Types of Burnout
There are different types of burnout; depending on your personality, you may experience different symptoms. One nurse may find a challenging assignment exhilarating while another feels completely anxious and overwhelmed.3
The term burnout was first coined by Herbert J. Freudenberger in 19744 and used to describe the effects of chronic stress in jobs that have direct interactions with people. Burnout is usually described and divided into three components:
- Emotional Exhaustion – Feeling fatigued at work.
- Depersonalization – Developing feelings of not caring or becoming calloused towards patients and staff.
- Reduced Personal Accomplishment – Feeling like you are not accomplishing or doing anything worthwhile at work, thus decreasing your motivation and performance.
Symptoms of Burnout
The symptoms of burnout (Nguyen, 2011) can stem from different sources, such as being:
- Frenetic – Ambitious to the point of sacrificing health or personal life for the job.
- Under-challenged – Bored without personal development.
- Worn-out – Feeling unacknowledged or neglected with little control over work results.
What causes burnout and how can I prevent it?
Stress is a part of nursing and always will be. So, how can you avoid burnout?
Studies show that social support (coworker and organizational support) reduce work stress and increase mutual respect, security and positive feelings. The more stressful the job, the more social support is needed.
Work empowerment is also vital in decreasing levels of stress and burnout. When nurses practice autonomy, they feel more confident at work with increased purpose and impact. The Swedish Council of Health Technology Assessment 2014 shows that those who have high influence over work-related decisions and see workplace justice have lower levels of burnout.
Reports also show that there is less burnout in organizations that have supportive managers who use participative management styles. This style of management encourages empowerment which has been shown to increase job satisfaction and decrease stress and therefore burnout (Leveck,1996).
What if I’m already burned out?
A psychologist might suggest a two-week vacation1 but the feeling of burnout may return within weeks. Another way to fight burnout is to look for emotional support and focus on the positive aspects of the job.2 Burnout could also be a sign that it is time for a change or a new position; stepping up into a challenging new assignment within your current position could also re-energize you. Maybe you need a year or two off from your specialty. (I know several ICU nurses who take time off from critical care but always return to it.) Don’t be afraid of change -- try something new and see what works for you
1 Fritz, C., & Sonnentag, S. (2006). Recovery, well-being, and performance-related outcomes: The role of workload and vacation experiences. Journal of Applied Psychology, 91(4), 936–945. doi:10.1037/0021-9010.91.4.936
2 Kahn, J. H., Schneider, K. T., Jenkins-Henkelman, T. M., & Moyle, L. L. (2006). Emotional social support and job burnout among high-school teachers: Is it all due to dispositional affectivity? Journal of Organizational Behavior, 27, 793–807. doi:10.1002/job.397
3 French, JRP, Caplan, RD. Organizational stress and individual strain. In: Marrow AJ, editor. The failure of success. New York: AMACOM; 1972. pp. 30–66.
4 Freudenberger, HJ. Staff burn-out. J Social Issues. 1974;30(1):159–85.