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Burnout: A preventable occurrence or a likely outcome?

If you work in healthcare, it’s highly likely that you have worked with at least one colleague who has experienced burnout. It’s possible that you have suffered from burnout yourself. We’ve previously discussed nurse burnout and depression on this blog, and there have been several studies on the underlying causes of burnout, such as poor environment, staffing, lack of teamwork, as well as the effects of burnout on patient care. Most recently, a study conducted by researchers at the University of Pennsylvania showed a correlation between a high rate of nurse burnout and the number of healthcare-acquired infections.

As if the findings on nurse burnout were not alarming enough, a study recently published in the Archives of Internal Medicine found that physicians are more likely to experience burnout than other U.S. workers.  In a national survey of 7,299 physicians, 37.9% of physicians were likely to have symptoms of burnout, compared to 27.8% of a sample of 3,442 working adults. Physicians were also almost twice as likely to be dissatisfied with work-life balance than workers in other professions. Physicians practicing general surgery and its subspecialties, as well as physicians practicing obstetrics and gynecology reported the lowest rates of satisfaction with work-life balance, while physicians in emergency medicine, internal medicine, and neurology had the highest rates of burnout.

As the authors of the study point out, burnout can have serious effects on the personal and professional lives of physicians, including alcohol abuse, destruction of relationships, and thoughts of suicide. Several studies have also found evidence that burnout adversely affects the quality of care. The researchers of the physician burnout study state that the high rate of burnout among U.S. physicians “implies that the origins of this problem are rooted in the environment and care delivery system rather than in the personal characteristics of a few susceptible individuals.”

In an interview with HealthLeaders Media, one of the authors of the report noted that physicians affected by burnout are more likely to see other people as objects rather than people, and become callous towards others. He compared the feeling of burnout to constantly feeling emotionally exhausted and “at the end of your rope.”

It is interesting to get a perspective on physician burnout when considering the impact of job dissatisfaction and fatigue in an organization. It seems as though healthcare professionals are experiencing increasingly high rates of burnout, yet little research has been done into methods for preventing burnout. Is it possible that burnout is just a given in healthcare? Should students head into healthcare professions anticipating burnout within a decade?

We want to hear from you: has your organization ever addressed the issue of burnout? If so, how? Leave your comments below!

New nonfiction book encourages nurses to live healthier

As a nurse, it’s your job to take care of people. But, with the stress of long hours and the additional exposure to diseases, it’s important to ask:  are you caring for yourself with the same expertise you give your patients?

A new nonfiction book written by Julia Buss, RN, MS, attempts to motivate the three million registered nurses in the United States to lead a healthier lifestyle. The book is titled Your Care Plan: A Nurse’s Guide to Healthy Living, and is designed to help nurses make a difference in their own lives.

The book provides in-depth discussions on the basics of eating, digestion, and exercise, and is full of tools for nurses to assess their current health and lifestyle, tips on how to improve, and information backed by statistics and professional studies.

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Online breathing technique program helps reduce stress in nurses and patients

Nurses are well aware of the stress that comes with the job. Taking care of numerous patients at varying levels of sickness, and dealing with many competing priorities, is enough to make anyone stressed out. Now, with the help of the BREATHE technique, nurses and patients can lower their blood pressure, heart rate, and experience a decrease in stress.

The BREATHE technique was developed by John M. Kennedy, medical director of preventative cardiology at Marina del Rey Hospital in California. It’s a 15-minute computer program that helps ease the stress of nurses and patients by combining deep breathing with guided imagery.

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Supporting nurses through those terrible, horrible, no good, very bad days

It comes with the job of being a nurse: dealing with the injured, the sick, and the dying; constantly trying to do the best for your patients with limited time; and always asking “How are you feeling?” But nurses are rarely asked that question. Peers, patients, family members, physicians, and even the nurses themselves are too concerned about the health of the patients to take a step back and make sure those giving the care are doing all right.

In a study of 1,215 nurses conducted by the University of Pennsylvania School of Nursing  published in the journal Social Science and Medicine, 25% said moral distress made them want to leave their position. Moral distress can leave nurses feeling powerless because if they feel they did not carry out their duty to the best of their ability, even after exhausting all possible options. [more]

No crisis zone!

Do you have a small space from which you can create a relaxing nook for your staff? It may be just a corner of your break room or one end of your locker room. Designate that space as your unit’s relaxing nook.You could even make up a catchy name for it:

No Crisis Zone! Radiology Rejuvination Area! My Space!

Don’t allow phone calls in the space. Ask staff if anyone has an old lazy-boy recliner they’d donate. Also, see if anyone has a magazine rack they’d like to donate. Have staff bring in magazines after they’ve read them. Or inspiring, pick-me-up books that can be read quickly, like the Chicken Soup series.

How about a poster or two for the space? A lamp? A couple of throw pillows? A CD player with earphones? A tabletop battery operated rippling water fountain? A kitchen timer so no one accidently goes over their allotted break time?

We all know we’re more productive when we take a few moments to re-group, yet so often we run from crisis to crisis and never take that opportunity. Think of our staffs, and the number of crises they manage daily. Would they benefit from a small nook designated entirely to replenishing their soul for a few moments? Would our patients benefit?

“It appears that the techniques which have the greatest motivational impact are practiced the least, even though they are easier and less expensive to use.”
– Dr. Gerald Graham, distinguished Professor of Management; Wichita State University

Put a halt to holiday stress

Here we go again. All of a sudden, like an enormous stack of papers covering your desk on a Monday morning, the holiday season has arrived. Ugh! But hey, look at the bright side: You made it through Thanksgiving and you didn’t eat too much. Okay, maybe you did. And you weren’t one of those people who got up at 3 a.m. to shop on Black Friday. Okay, maybe you were. Either way, now is the time when shopping, eating, and stress really pick up. Here are seven tips to get you through the holidays in one piece.

Whether you’re getting ready to celebrate Christmas, Chanukah, or Kwanzaa, these tips will help you save time, money, and even the hair you want to pull out when the person in front of you at the grocery store clearly has more than 10 items in his or her plastic basket! Phew. Okay, breathe. Relax. Here we go:

Shop in spurts. Lots of people like to pick a day, get up at the crack of dawn, and plow through their holiday shopping in one, crazy 12-hour stretch. Why put yourself through it? Shop a little at a time, chip away here and there, and you’ll be done in no time.

Love to log on. A decade ago, shopping online was a bizarre idea meant for only the highest of high-tech gurus. Now, your cat can do it. If you’re sick of the long lines and your car is sick of finishing last in the parking space game, get a comfortable chair, a nice cup of tea, and shop away.

Less is more. Are you having a tough time deciding which new gaming system to get your kid? Or which cruise package to get your parents for helping you through nursing school? Here’s a thought: Don’t get any of it. Get simple, thoughtful gifts. Spend more time together during the holidays. You (and your wallet) will be happier come January.

Take some vacation. We know, we know, there’s too much going on at the end of the year to take some time off. You’ve got new projects to finish, new people to train, and new ideas to implement. Relax. Take a break. Give yourself a long weekend or take a random Wednesday afternoon off.

Treat No. 1. Guess who that is? You’ve been running around all year, catering to family, friends, and yes, patients. When do you get a break? Now. Go buy those shoes you’ve been looking at for two months. Go to a spa for a few hours.

Early resolutions. Instead of waiting until January 1 to make your New Year’s Resolution, do it now. Do you want to drop 10 pounds? Do you finally want to kick that nicotine habit? Do you want to send at least one thank-you note each week to someone in your life? Start now! You’ll feel much better about yourself through the holidays and you’ll laugh at those people who are racking their brains for a resolution next year.

Smile more. It sounds simple, doesn’t it? But have you ever consciously tried to do it? If you’re standing in a check-out line that starts and ends in two different states, smile. If your roast is drier than the Sahara Desert in the middle of summer, smile. If your shovel snaps like a twig in the middle of an ice storm, smile. It won’t make your problems go away, but it will make everything seem a lot better. Then, (gasp) maybe you can actually enjoy the holidays.

How do you get through the craziness of the holidays? Share your thoughts with your peers.

Make a necklace of conscious moments

by Diana Lang, relaxation expert

I like to think of life’s momentous experiences like beads on a string. Those moments that are important, valuable, or rare are like beautiful colored beads that we lovingly thread onto this string of beads. Each bead symbolically represents a moment, an experience, a special person. As life goes on, a gorgeous necklace of our lives is created, full of these moments that have meant something to us.

This little metaphor is a way to imagine making our lives more conscious. By recognizing these moments more often, we become more fully alive to our experience. It is easy to see how a marriage or a birth of a child would be a bead on our string, but what about today? What about right now?

One of the ways I make my moments conscious is by using my breath. When I awake in the morning or go to sleep at night, I take a conscious breath. In between daily rituals like my morning tea or meditation, or taking a walk or going to the grocery store, I take a breath to establish myself in the place where I am.

This is one of the most valuable tools I have. I use it all day long. Between every client and every class, between every activity in my day, I take a conscious breath. These aware moments then are indelibly written in my consciousness. They become part of me. They are beads on my string.

A conscious breath is a physical/spiritual acknowledgement of the moment. My inhalation and exhalation establish me in the new moment I am in. When we use the breath like this, life becomes a living meditation, seamlessly connecting the dots of our experience, one to another, like beads on a string, and soon we have a collection of moments that is an acknowledgment that this life, and everything in it, is sacred.

Breathe your life in deeply. Live your life completely. Recognize that this moment, right now, is special and add it to your life’s string of magical moments.

For more information on Diana, visit her Web site at www.DianaLang.com.

Your job is a job–not your life

by Pat Maguire, RN, MN, CNAA

It’s the time of year when everything has a tendency to get chaotic–either the budget year is ending and you are worried about your final numbers, or you are putting the final touches on next year’s financial plan and are concerned that your requests may not be approved. The newly licensed nurses are nearing the end of orientation and some feel they aren’t competent to fly solo. One of your expert nurses is contemplating a transfer to a critical care unit and someone who behaves like “poor pitiful Pearl” most of the time has been in your face one more time about her seniority and expectation that she will be off Christmas and New Year’s Eve and day.

You’ve only held your position for a year or two and the stress of the 24-hour accountability and responsibility is starting to take its toll. Where do you turn for support? How do you manage the daily conflicts that tend to pop up regardless of the effort you put into modeling collaboration and teamwork?

Several years ago, a wise colleague who’d seen it all helped me through a particularly tough time. She asked me if I knew what my trigger points were. What made me vulnerable to a self created “pity party?” What part of the chaos did I own? Was I willing to step up to the plate just as I expected my staff to? Wow, those are pretty intense questions, especially if you are willing and able to do some soul searching before you flip back into high gear and try to solve world hunger.

What was the last novel or mystery book you read? What about your friends and family, when did you do something fun with them? Have you had any “retail therapy” lately? How about professional publications–either clinically focused journals or management texts–do you have a favorite? There are so many that offer a world of insight about your team and more importantly, about you and your style. I have found three publications to be most useful:

  • Michael Henry Cohen’s What You Accept Is What You Teach
  • Jim Collin’s Good To Great
  • Carly Fiorina’s Tough Choices

I pick one up whenever I’m down and learn something new about myself each and every time.

Commit to lifelong learning. And at the end of every day, pause and think about the things you did that made a difference for your patients, your staff, and your colleagues. Keep a journal and for heaven sake, don’t be critical and say, “I didn’t do anything.” You and I both know that isn’t true. Above all, be true to yourself. Don’t compromise your values. Know who and what your resources are so you can seek them out whenever the need presents.

The bottom line is make time for yourself every week–both personally and professionally. And never forget, your position is intended to be your job–not your life.

Self-Care 101 for Nurses

by June Marshall, RN, MS, CNAA, BC

Most of us are really good at taking care of others. We’re also great at giving advice about maintaining healthy balance in our personal and professional lives, but how good are we at walking the talk? I dare to say that as nurse leaders, most of us do not practice what we preach.

Employees look to us as role models. It’s tough to mentor nursing staff in the area of healthy work/life balance if we don’t have balance in our own lives. Have you put off exercising regularly because of an impending deadline or because you’re simply too tired after long hours at work? Do you eat at least five servings of fruit and vegetables daily? Do you drink at least 6-8 glasses of water each day? Do you take some time each day to relax and do something you really enjoy? Do you get enough uninterrupted sleep at night? Do you often feel tired? Just think about what kind of role model you are.

How healthy are our work environments? Direct patient care is physically demanding and psychologically stressful. Do we offer adequate time for nurses to have rest periods at work? Do we provide the same healing environments for nurses that we provide for patients? How good are we at providing flexible work schedules to accommodate needs of mature nurses who have difficulty still working 12-hour shifts? How creative are we in offering employee wellness programs where direct care nurses can actually participate?

Take a few moments to assess your unit or department. Have a discussion about self care at your next staff meeting. Make self care a priority. Ask for staff input and develop an action plan. Then implement it and evaluate your progress. Make self care and the care of your staff a priority. Try a few simple actions to improve the care of your unit/department:

  • Use humor. Find something to laugh about with your staff each day.
  • Assess the mature nurses’ needs and create flexible scheduling options for them.
  • Designate a quiet place where nurses can go to relax and get away from the stresses of work for a few minutes.
  • Have a massage therapist come to the unit to give short massages once a month.
  • Limit work hours. Avoid overtime except in a crisis. Take vacation time!
  • Look for the positives each day. Recognize staff accomplishments. Focus on praise rather than problems.

And last, but certainly not least, practice what you preach!