Archive | January, 2020


18 Jan

It’s Saturday morning. It’s raining in Brisbane. I mean, really raining. At home we’ve had 70mm, but I’m aware of places within an hour’s drive that are sitting on totals of 253mm since midnight (that’s about 8 hours ago). Normally my Saturday morning starts with parkrun if I’m not at work – but today I didn’t go because of the rain (many were cancelled). It’s a grey day, perfect night shift sleeping weather – hopefully it will help me nap this afternoon before I start my night shifts. The grey day and weather though is a bit reflective of how I’ve been lately.

At the end of last year, after being told I was “burnt out”, I started reading up on burn out in nursing, and I was a little shocked at what I started to find. As those who work at the coal face of health care, nurses manage traumatic events, are placed in compromising situations, witness critical incidents, and are increasingly exposed to occupational violence (a recent report in Queensland showed that violence had increased in QLD hospitals by 40% since 2016/17!!).  Unfortunately, the qualities that motivate you to do nursing in the first place can be the very ones that lead to burnout.  Those driven to care, solve, fix and heal can find that when resources do not allow them to do that, or when support is lacking, the cumulative effect can lead to dissatisfaction, disillusionment and burnout (or “physical and emotional depletion after a period of chronic, unrelieved, job related stress”).

I think if someone had told me that I was a case of “burnout waiting to happen” (statistically), maybe I could have been a little more aware of what to watch out for. So if this is you, here are some of the factors that have been found to affect burn out, and the symptoms to be aware of – taken from Danielle LeVeck’s article found here:

  1. Women are at a higher risk of burnout. Women tend to have higher levels of anxiety and more responsibilities at home and at work, thus burnout is a possibility.
  2. Working in the ICU or in another high-stress environment like ED, you are at a higher risk of burning out due to long hours and the intense emotional burden amongst other factors.
  3. Being single or divorced, 
  4. Lacking spirituality of any kind, 
  5. Holding an Undergraduate/Postgraduate degree, you are at a higher risk of burning out.
  6. Working full-time at the bedside, you are at a higher risk of burning out. In other words, the closer you are to the patient, the closer you may be to burning out.
  7. If you are a nurse, especially a new grad, you are at a higher risk of burning out than any other position in healthcare.

3 Key Symptoms of Burnout

  1. Emotional exhaustion is the single highest predictor of burnout and depersonalization is a coping mechanism we develop to deal with burnout.
  2. Depersonalization – we become so emotionally exhausted, that we have to “depersonalize,” or become numb to emotion to protect ourselves.
  3. Lack of personal accomplishment is frequently found in ICU settings where nurses often experience death, trauma, and arguably futile care.

Interestingly, I also discovered in my reading some other facts – the fatigue from changing shift schedules and working nights, weekends, overtime and long shifts are all major contributors to stress. In fact, those who work 12 hour shifts as standard (yes, this is me too) are two and a half times more likely to experience burnout symptoms than those who work shorter shifts. Inappropriate skill mix, inadequate staff levels and excessive administrative tasks can all lead to ongoing stress, which when continual and unrelenting can lead to burn out. Interestingly, LeVeck also said that “surprisingly, many ICU nurses still say they love their jobs, making sustaining or leaving a very difficult choice” – and this is where you find me right now! If you ask me, I will tell you that I love working in ICU. I enjoy the complexity of the patient care, the way you can holistically manage a patient, the technical aspects of the job and the equipment we use, and of course seeing recovery after critical illness. Of course, with any job, there are aspects that I do not enjoy. I cannot see myself working in any other area, and yet, at the same time, I wonder how much longer I can continue as I am.

So… as I work out where to from here there are a few resources that I want to share with my nursing friends, that I have been finding useful, in the hope of helping anyone who hasn’t been in this situation from getting there in the first place.

When you are experiencing signs of burnout:

  • Take some entitlements – a mental health day or a holiday
  • Create some “me” time and stick to it
  • Reduce sugar and refined foods if you are feeling lethargic
  • Exercise = endorphins – go for a walk or do some physical activity that you enjoy
  • Review your job – Are you performing well? Do you enjoy it? Are you getting positive feedback?
  • Develop a career plan. Where are you going? What do you need to get there?
  • Do more of what you love when you’re away from work
  • Tell someone how you are feeling
  • Be realistic – reduce your goals to manageable plans

The main thing I keep hearing time and time again from my reading and research, is make sure that you prioritise sleep wherever you can. First comes sleep, then everything else.  Secondly, self-care. For years I’ve thought that self-care meant that I was being really selfish and for this reason I think I didn’t prioritise what I needed when I needed it. I said yes when I should have said no. I’ve had to say “no” a little bit lately, and while sometimes I feel guilty about doing this, I am needing to put some boundaries in at the moment to get myself back to a position of health. So please, bear with me.

If you are struggling with burn out at the moment, or you recognise that you may have some of the “risk factors” then please have a look at some of these articles/resources and look at some of their prevention strategies.

  • The Healthy Shiftworker – Audra has a book, podcasts and regular information offering tips on everything from sleep to nutrition and beyond. Use the link to access all that information.
  • Nurse and Midwife Support – This is an Australian support network for nurses and midwives 24/7. Loads of articles, where to go for some help if you need it. In particular the information and articles on burnout 
  • I mentioned the article during my blog earlier, but LeVeck has information on how to help prevent burn-out in her article here.

There are loads of resources out there, have a look around if you need to. It is really hard to put up your hand and say “I’m struggling” but it is also really imperative that if you are struggling you do say so. Talk to your GP. Talk to a coworker, friend, boss… whoever you need to to get the ball rolling. It’s important. Trust me.

Anyway, that’s all from me. I’m only a few weeks away from some annual leave, and I’m hoping I can take some time to pause, reflect, recharge and return to the area I love. I’m hopeful that by putting some new strategies in place, I will be better able to manage this in future, to ensure that I can continue nursing for many years to come. ox