Beating Nurse Burnout: how to care for yourself when you care for others

What to do when it all gets too much

It’s a rare nurse who will tell you that their career has been easy. There’s no doubt that this is a stressful, difficult job that will, at times, feel overwhelming. Burnout however, is another matter and one that needs awareness and strategy to deal with in the nursing profession.

Prevention and Cure - you need a deliberate plan

Everyone gets tired, very tired. We all have bad weeks when we doggedly drag ourselves through to our next break. The last few years with Covid have been particularly exhausting and harsh. Few have had to deal with the incredibly heightened stressors that the medical community has had to endure. Nurses often feel under-appreciated, that’s no secret. The pandemic has been pretty much the last straw.

But it’s not just the pandemic. This profession is demanding of human beings in mind, body and soul like no other. It always has been and always will be. And we’ve no doubt you were quite aware of that when you signed up. It’s what makes being a nurse an amazing life choice you can be eternally proud of. We hope you hold your head up every time you say “I’m a nurse”. Because you should. You deal with life – and death – at the sharp end. You help people through life-changing events,  you comfort frightened and grieving people and contribute to healing with hard-won professional skills and experience. You witness both tragic and joyful outcomes on a daily basis. Then you wave goodbye and turn back to help the next one.

It takes its toll. And sometimes that toll reaches a critical point and your physical and internal resources just aren’t coming through any more. When you are tired, a rest will do and you’ll bounce back. The impact of burnout when it creeps up on you is much more pervasive and less easy to shake off. You need to understand it, realise it can happen, have a strategy to recognise its onset, and a deliberate plan to stave it off or recover.

What is burnout? What nurses need to know.

According to a study conducted in 2017 (before we ever heard of Covid, please note), Nurses’ Burnout: The Influence of Leader Empowering Behaviors, Work Conditions, and Demographic Traits by Rola H Mudallal, Wafa’a M Othman and Nahid F Al Hassan,

“Nurse burnout is a widespread phenomenon characterized by a reduction in nurses’ energy that manifests in emotional exhaustion, lack of motivation, and feelings of frustration and may lead to reductions in work efficacy.”

The National Academy of Medicine (NAM) highlights concerns that the “alarming” high incidence of burnout impacts patient care:

“…clinicians of all kinds, across all specialties and care settings, are experiencing alarming rates of burnout. Among the most telling of statistics, 35-54% of nurses and physicians as well as 45-60% of medical students and residents (“learners”)  experience substantial symptoms of burnout. Burnout is a syndrome characterized by a high degree of emotional exhaustion and depersonalization (i.e., cynicism), and a low sense of personal accomplishment at work.

Clinician burnout can have serious, wide-ranging consequences on individual clinicians and learners, health care organizations, and patient care.”

That is, it impacts you and it impacts your patients and your facility. But with stats like those we hope you are catching on that if you find yourself going under into a burnt-out state, this is NOT any sort of failure on your part. The job is very hard in “normal” times, it’s part and parcel of the profession, and as NAM notes, this is a time of “unprecedented stresses”. You can however learn to do something about it. And to do that, for yourself, or perhaps for a colleague, you need to know the signs. Typically, nurses on the verge of burnout may experience:

Exhaustion in such a way that a couple of early nights just doesn’t help.

Insomnia is a likely companion to this syndrome. The real cherry on the cake this one.

Dread of going to work that in the worst scenario starts to manifest in panic attacks.

Resentment or emotional distress at being under-appreciated and over-worked.

Constant worry that they cannot keep up with their necessary tasks at work or at home.

Compassion Fatigue which leaves normally dedicated caregivers feeling cynical and disengaged.

Relatable? If these are the kinds of feelings you have on more than the odd day here and there, you are very likely heading for a burnout episode and need to move self-care to the top of your priority to-do list.

Self-care tips to prevent or stave off burnout

Build friendships.

In good times, build a strong and caring social support network both in and out of work – real world friendships, not just online. In bad times, pick up the phone or message someone – tell them it’s all getting too much and you need someone to talk to or lean on, or maybe just a catch-up and a good gossip with someone you’ve known for years. Sometimes colleagues are the ones who really understand the specific nature of what you are dealing with. Help eachother. If you feel you cannot talk to colleagues, look for a Peer Support group for front line and healthcare workers – to find a free and confidential group that suits your needs. They are an invaluable resource to enable you to talk about the pressures of the job with people who have trodden the same path as you are on. Every Travel Nurse needs that link in their bookmarks.

Draw boundaries.

Learn to leave work behind at the end of your shift. Seriously, this is important. The nature of the job is that you are in daily contact with suffering people, you see situations that would make a stone weep. It’s your job and you are a hero for doing it, your work and your dedication is so very needed. You don’t – you can’t – carry it with you into your own life. Some people in caring professions develop little rituals, or routines to symbolically leave the stress and heartbreak behind before they walk into their home. A walk through the park, a stop-off for a snack at a nice cafe, a browse in a book or music store, a quiet 10 minutes in a local place of worship. Walk in with the stresses of the day, walk out and leave it all behind till the next shift. 10 minutes to change gear, that’s all it takes.

Get some good sleep.

This can be easier said than done. Insomnia might in fact have been an issue you’ve been dealing with for a time and has contributed to your depleted state. So that needs to be dealt with. In any case, the obvious thing to do as soon as you start suspecting that you are not coping too well, is call off all engagements and commitments and get some early nights. It may not be the whole answer but it certainly will help.  If insomnia is becoming regular for you, do please address it. See your doctor. There are lots of resources online with tips and resources like audio meditations and hypnosis recordings to help you sleep better.

Fresh Air and Open Spaces.

No therapy comes close to what Nature provides. Get out of your area for an afternoon. Go for a hike somewhere lovely. As a travel nurse, it’s a great idea to look for local hiking clubs and see if you can join others on regular walking expeditions. As a bonus, you’ll get to explore the area and that’s what travel nursing is all about.

Exercise.

Yes, we know you’ve been on your feet for the past 10 hours. You need to move to release pent up anxiety and emotional distress from your body. You need a type of movement that suits you. It can be anything from a dance class to kick-boxing or a favorite team sport. Take it easy at first if you are not used to it and find a teacher or video course that chimes with you personally. And of course gentle eastern methods like yoga or t’ai chi are famous de-stressors that teach you much more than a set of exercises.

Enjoy yourself!

“Fat chance!!” I hear you reply! Nope, not listening. You absolutely must be intentional about doing things that you love, that make you laugh or access your happiness. It might art, sport, theatre, movies, books or cooking a special meal (or better still go out and have someone else cook it for you.).  Even if you can’t muster the enthusiasm for more than a sofa night in front of the TV, don’t just sit there idly browsing Netflix. Make a plan, alone or with friends or family. Get some good food delivered and watch a great movie beginning to end.

Nutrition.

How are your eating habits lately? Too many takeaways? So much easier when you are too tired to shop and cook. But it’s really amazing what a boost to your fresh food intake can do very quickly. All the stores deliver now, send out. Over on our healthcare workers’ discount page there’s at least one national chain that will deliver prepared meals that you can easily put together with a minimum of fuss. Another great idea is to get some easy to make superfood shakes from the health store. Pick up a bottle of good multi-vitamins while you are at it. Good nutrition doesn’t get easier than that. Just make sure you are getting some fresh food too.

Professional Mental Health Support

If things are really getting you down and nothing seems to be lifting your mood or your energy, you should consider finding yourself a therapist or counsellor. Ask HR at your facility if there are any Mental Health services available to you. Or find someone yourself privately. Don’t neglect your mental health any more than you would your physical wellbeing. Many good therapists across the US now offer their services online via Zoom and similar platforms. This can be a great help for travel nurses as you can continue your sessions wherever you happen to be located. To reach out for help, NAMI (National Alliance on Mental Illness) is a good place to start. As well as sound advice on how to deal with emotional traumas and distress typically experienced by healthcare professionals, you will also find a resource list of several free, confidential and virtual support services available for frontline health care professionals. You can also contact the NAMI HelpLine between 10 am and 8 pm ET at 800-950-6264 to access confidential, professional support. For immediate assistance, text “SCRUBS” to 741741 at any time.

Building Resilience

We cannot better this great advice from NAMI

Whether you are building your resilience as a preventative measure, or are seeking to add to your resiliency skills in new ways, you do have options. Health care professionals already know and understand the importance of their physical health, so you need more than the usual list of coping skills. Before getting into specific strategies, start with these essential steps.
 
  • First and foremost, have compassion for yourself. Your work is demanding and difficult, and it’s normal to be negatively affected by stress and trauma. It’s especially normal that these feelings are magnified by the pandemic.
  • Identify your emotions: shock, sadness, anger, guilt, fear, relief, etc. These are expected emotional responses, and it is okay to feel them, in any combination. Calling them what they are helps you gain perspective, and focus on your approach for feeling better.
  • Identify the symptoms that are bothering you, as well as how they impact you daily. Then talk to someone about it, whether through professional channels or peer support.
  • Explore resources and keep track of go-to coping strategies. Every step you take to manage stress and trauma puts you in a powerful position to improve and protect your mental health.

National Alliance on Mental Illness (NAMI): Health Care Professionals

Burnout and travel nursing

There are a few important things to be said about burnout and travel nursing. For some nurses, the freedom and change of environment that travel nursing provides in contrast to a perm job, can be just the tonic they need. A chance to escape the internal politics and soured relationships that may have been occuring in your permanent position. A chance to spread your wings and find yourself. It can be really refreshing and restore your enthusiasm for your profession.

It can be easier for travel nurses to detach from work, to apply themselves to their skills and not feel so trapped or limited. You might find it easier to take an airier view of every day stresses and other people’s moods and quirks of character when you know you are not depending on this job forever. You are usually really needed where you go and that can be a real pleasure to experience.

There are some things that can be hard to deal with too. You can feel quite isolated and rootless away from your home town support network. Homesickness and the lack of old friends and familiar faces can be a source of sadness and loneliness, especially when times are tough. It’s something to think about as you consider hitting the road.

One thing we can assure you of. Wayward Medical is a small team and we care about our nurses. We are only a phone call or email away if you have problems. If there are issues with your shift scheduling for instance, let us know and we’ll step in. If things aren’t going well or you feel you aren’t thriving at your facility, please let us know. Wayward is made of real people who listen. You are not alone in this, we are right behind you.

Arrange a chat with a Wayward recruiter

We’ll help you to create a personal plan for success as a travel nurse, and make sure you know exactly what you can expect from us and when. Arrange a chat with one of our travel nursing experts to discuss your individual situation today:

CALL WAYWARD NOW!

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