How to Recognize and Prevent Burnout Among Nurses

By: Blyss Splane, BSN, RN, CNOR; GoodRX Health Blog

Burnout has become a common term in American culture to describe feelings of being overwhelmed or the inability to carry on with a certain level of stressors. The COVID-19 pandemic has only exposed and accelerated extreme levels of burnout among healthcare providers, or HCPs, and more specifically among nurses.

With more than 6 million nurses in the United States, these professionals account for 30% of the healthcare workforce. It’s essential to understand what nurse burnout is, how it comes about, and the ways to prevent it.

What is nurse burnout?

Nurse burnout can be defined as “exhaustion of physical or emotional strength or motivation, usually as a result of prolonged stress or frustration.” Generally, this term is associated with work-related stressors from situations such as the following:

  • Absence of a sense of community
  • A lack of resources, control, and justice
  • Compassion fatigue (see below)
  • Inadequate or ineffective management and leadership
  • Longer shifts, or working more than 40 hours per week
  • Sleep deprivation
  • Value conflicts
  • Work overload
  • Working in a hospital setting or high-stress environment

These stressors likely describe what it was like to work as a nurse throughout the pandemic. Many hospitals and nursing units were already short-staffed, and then came under further strain as COVID-19 spread across units, requiring quarantines and treatment of the disease among HCPs.

The workload for nurses dramatically increased as more patients were required to be cared for above the standard nurse-to-patient ratios. Shortages of masks and appropriate personal protective equipment were additional stressors. Many nurses also felt like the public did not understand the situations they were working in, leading to feelings of isolation from the community.

Compassion fatigue plays into burnout

Compassion fatigue is one of the leading contributors of nurse burnout. It may seem the same as burnout and bear similar outcomes, but it’s defined differently. Compassion can be defined as “sympathetic consciousness of others’ distress, together with a desire to alleviate it.” It can turn into compassion fatigue, or CF, given “the physical and mental exhaustion and emotional withdrawal experienced by those that care for sick or traumatized people over an extended period of time.”

Such fatigue is not only detrimental to nurses, but also to patients and healthcare organizations due to the negative impacts on patient safety, the lower quality of care provided, reduced reimbursements, and financial pressure for the organization. The constant exposure to patients undergoing extreme trauma and tragedy makes it impossible for nurses to remove themselves from the situation causing the CF.

Factors contributing to CF include staffing shortages, enhanced workload, longer hours per shift, time constraints that limit high-quality patient care, and a lack of both personal and professional boundaries. The never-ending workload stressors combined with CF leads to nurses feeling like the only way out of the quagmire is to leave the nursing profession altogether.

What’s the burnout rate for nurses?

It is not surprising that burnout spurs nurses to consider exiting the field to break the painful cycle. An extensive survey completed in 2018 found that 9.5% of nurses reported leaving their most recent position, and of those who did leave, 31.5% of them listed burnout as a contributing factor. This survey was completed in 2018, before the global pandemic. There has not been enough time since for adequate research on the long-lasting effects of the pandemic on the nursing profession.

There are a variety of symptoms that indicate nurse burnout is taking place:

  • Depression
  • Emotional exhaustion leading to potential errors
  • Fatigue
  • Headache
  • Insomnia
  • Lack of motivation or increased frustration
  • Negative feelings associated toward oneself, to patients, or to working as a nurse
  • Reduced physical and psychological energy

Recovering from (and preventing) burning out

Chronic stress can have serious lifelong effects for nurses, and steps should be taken to reduce burnout. There aren’t any “quick fixes,” but multiple factors that can address it over time. Consider the following:

  1. Nurses must maintain both personal and professional boundaries. This includes learning to resist extra shifts, overtime, and extreme nurse-to-patient ratios when possible. Resources such as Employee Assistance Programs through work, seeing a therapist, or reading about how to implement limits are great steps to take. It’s important for nurses to take time to focus on self-care and relaxation outside of work to reduce feelings of burnout.
  2. Legislation should support adequate staffing ratios to eliminate nurses caring for too many patients at once. Feeling overwhelmed and not having enough time to provide quality care leads to feelings of CF and burnout. Organizations must understand that adequate staffing reduces nurse turnover rates and the risk of mistakes made from burnout.
  3. Management and leadership teams have a role to play. They should create positive work environments to reduce emotional exhaustion, increase team cohesion, improve work conditions, and empower nurses to take control of their work to reduce burnout. Further, research has demonstrated that managers who show concern over their teams lead by example, and provide up-to-date information to mitigate emotional exhaustion and build trust. Managers can take simple steps to support their teams and improve morale, even in the heightened phases of the pandemic.

While it may not be possible to totally eliminate burnout or compassion fatigue, there are a number of ways that nurses, managers, and organizations can prevent or mitigate its impact. It’s important for nurses to recognize when they are experiencing symptoms of burnout and to start taking additional steps to care for themselves.

As the nursing shortage continues to linger as a looming threat to healthcare, it is essential that we support nurses already in the profession and prevent them from leaving altogether.