Nursing burnout vs. happy nurse

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Specializes in Rehab, critical care.

Hello allnurses,

This isn't a post saying that I'm burnt out or venting. I love my job, and expect to love it for the duration. Yes, there's withdrawal patients at times trying to crawl out of bed, etc, but they need care, and someone to be compassionate toward them as odds are they've experienced a good bit of discrimination already (yes, still have to be firm with them; i'm not miss newbie allowing myself to be manipulated lol). I am an ICU nurse and love my job. I love the acuity, quick thinking/acting that's required, the great teamwork among the nursing team, the teamwork among physicians, as well, and how they work with us, and how my assessment/interventions end up for more positive outcomes for my patients. As we know it's not always a positive outcome, sometimes comfort care is required, but those times are rewarding, as well, since I'm making someone comfortable in their final hours, and providing emotional support to a family that is still in shock.

My question is: what is it about nursing that leads to burnout? I mean, the high rate of burnout. Other than the obvious: yes, we spend a great deal of emotional energy caring for our patients; healthcare is obviously very difficult work, but that's why the majority of nurses enter the profession anyway, so that doesn't answer the especially high rate of burn-out in nursing (yes, some do it for stable employment, etc, or other reasons). We became nurses so that we could care for other people. I work in what one would call a high burnout area because patients are very, very sick, and some don't make it. However, I am not burnt out (is it just because I'm newer?). No, because even on the tough days, I still love my job, and I know ICU nurses that have been ICU nurses for 10, 20 years and still love what they do. And not just ICU nurses: I know nurses in other areas that love what they do 10, 20 years later. I go to work knowing that I am providing high quality care and am making a tangible difference in someone else's life.

I know that it's probably a combination of factors for why nurses burn out, but if I had to guess, it's probably work environment. I work in a great environment, and that makes a huge difference. If I didn't work with a good team, my job would be that much more difficult and stressful, and I probably wouldn't even like my job. Doesn't matter if you are in the area that's a good fit for you if you're an island. I know that if I ask one of the nurses to call for a stat med for me while I'm stabilizing my patient, she'll do it and offer to help with something else. So, my guess is: lack of teamwork and poor staffing ratios in some areas (I know, not earth-shattering news, but those 2 things are very fixable). Nurses can't provide the kind of care they want to provide if nobody ever helps them or if they have 8 patients when they should have 5. Better patient care can be provided when there are realistic staffing ratios. Now I'm not saying that m/s nurses should have 2 patients like in the ICU, but ICU nurses should have no more than 2 patients, especially if they're doing total care, as well. I take care of my 2 patients, and I know I am providing high quality care. I'm not sure what a good number would be for m/s; they should staff based on acuity. One nurse could have an easier 6 and another should probably only have 4 if there's complex dressing changes or one that might need an ICU transfer, one that's looking to be heading south, etc. Staffing in those areas should be based on acuity, not just number. That's just common sense.

So, all nursing leaders out there: if you're a charge nurse, and you think you should assign Mary Sue 4 patients (not the usual 5) because she has a tough group, but you don't want to make Angry Jane mad b/c she'll have 6 that day. Make Angry Jane mad since she'll be mad anyway lol. No, seriously, though: assign her the 6 patients, and explain why. If she wants Mary Sue's tough 4 patients, I'm sure Mary Sue would oblige lol. Also: anyone who is an effective leader, take the step up, and become one b/c there are some places that clearly need good leaders or we wouldn't have the burn-out rate we do. Also, it will increase your job satisfaction/decrease your burn-out because if you're a natural leader, you'll enjoy your job more....become the charge nurse or nurse manager or DON :).

Also, interested in hearing from all nurses out there. Who loves their job? Who doesn't? Just say a line or 2 about why you love or hate your job. Those aspiring nurse managers need to know so they can fix it lol. Do you think you would love your job much more if staffing were based on acuity not number? Or do you feel that if you just had one more CNA on your unit, that would help and you wouldn't be looking to leave? Let's face it: one more CNA on a unit is much cheaper than replacing nurses every 6 months lol. Those that just hate being a nurse need not reply as that is just not helpful lol. Those that like being a nurse, but just feel they're not in the right nursing area for them, say that. Just interested in seeing if there's a trend in responses. Also interested to see if satisfaction is just higher in certain nursing areas, and why that is. I guess we could call this a randomized study? lol Not very high quality, but fun nonetheless. :)

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Specializes in Rehab, critical care.

Oh sorry...that ended up being super long. Should have made that more concise. My apologies lol

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Specializes in ED/ICU/TELEMETRY/LTC.

I don't think that nurses burn out from patients or even work. I think we burn out, and make no mistake I crispy around the edges, from dealing with bureaucratic BS. The same stuff that make us have to smile while being cursed, treated like waitresses by families, yada yada yada.

Raises dependent on satisfaction scores.............how about that CEO, can we see if her/his salary and bonus are dependent on the satisfaction scores pulled from staff?

Were we just allowed to do our jobs to the very best it can be done, I think we would be better satisfied a lot longer.

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Absolutely agree with Dixie...

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I am tired of the Big Wigs trying to tell us how to do our jobs. They either don't know, don't show or even care what goes on the floor/front lines of nursing care. They are money motivated and treat nurses like dime a dozen. The aquity and ratio's are higher and salaries could be improved due to the responsibilities we have. Everything is transparent now with technology and it takes more steps to get things done and of course more paperwork, double charting and mistreatment by family memebers and doctors. Nurses wear many hats and god forbid you can't be a PT, OT, case worker and Chaplain at the same time. No, times have changed and I am glad to be out of direct care, I have been an RN for 12 years and it seems more difficult now than when I started. The liabilities are also a concern as everyone is watching what mistakes will happen next and if someone is unlucky to make one. I see all the money going to new professional buildings built for the doctors as they cut back on nurse benefits/education. If you work for a magnet hospital, the extra work required for committees, volunteering and making posters will be an added burden, also call for Safe Harbor on a busy day with poor staffing and see what happens--there will be a peer review in a New York minute. If you have a license, you have a choice- you may lose your job for your prudent choices but you can keep your license intact. I burned out from all the above. I believe you must get out of the environment if it is toxic but the beauty of nursing is that there are so many options/choices you can do with it. I believe the future will get better but it will take some time and transition. Right now we are in a sticky situation and the morale is down for some. I have no regrets being an RN, but you must find your niche and keep educating yourself and not be afraid of education or learning new things because a part of burnout is being stuck in something too long and it makes you not want to learn anymore.

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Specializes in Certified Med/Surg tele, and other stuff.

Hmmm, interesting thread...

I would love to give a nurse 6 pt that are easy and another nurse only 4 difficult ones, or even three. However, many nurses only see numbers and our max is 5 anyway, so that point is mute. My boss sees anyone with less than 4 and he is ready to send a nurse home and have the other nurses pick up her pt's. The man does not see acuity. I can usually talk him out of it, lol, so thankfully he does see reason and potential lawsuits. What I find interesting are the latest HCAPS scores. We got our hands slapped because our numbers went down. I brought it to our managers attention that those drops also coincided with sending staff home....:idea::rolleyes:

Now,with that being said, I did burn out. I had been a nurse for approx 16 yrs if you count my LPN with my RN. I worked on a horrible floor with ZERO support. You could stand out in the hall and try to catch somebody to get help to turn a pt. Forget that. Everyone was busy with their 6 pts and the freaking revolving door. Management offered no education and they never even asked us to renew our CPR! I went years without renewing it and they did not care. There were no breaks or lunches. We were told no OT, but to clock out and to come back and chart and do some chart audits as well. One day I told them to seriously shove it and I left.

Now I'm with an organization that offers massive education and it's all free. We are tested on everything and are expected to be on top of our game. The organization even paid for a certification course for us so we can become certified. I get breaks, lunches and have a say on how our floor runs. It's a complete 360. I can see myself staying there until I retire. I love my job and the challenges it brings.

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