Preventive Initiatives That Help Tackle Nurse Burnout and the Nursing Shortage Conundrum!

Updated | Published
by Lola Ravid Lola Ravid, BSN, RN (New)

Specializes in Pediatrics, Research and Freelance Writing. Has 13 years experience.

This article will cover the well-known facts of burnout, current research on its association with personality traits, and strategies educators could implement to support student nurses as an early intervention to minimize the risk of burnout. Doing so would give young new nurses confidence in their professional role and support their service for many more years. 

Strategies to Prepare Nursing Students for the Professional Nurse Role

Preventive Initiatives That Help Tackle Nurse Burnout and the Nursing Shortage Conundrum!

Nurse Burnout has been on the rise since the COVID-19 pandemic. Health Media has been on a streak covering its impact on nurses and its relationship with the nursing shortage. While attending the 2022 American Health Care Journalist (AHCJ) Conference in Austin, Texas, the number of discussions over burnout was nothing short of surprising. Burnout is a phenomenon that has reared its ugly head not only within the United States but globally, and despite it happening in all professional areas, no other profession has felt it more than nurses and health care workers. Over the years, the research has focused on the contributing factors. Still, not enough research suggests strategies that may help resolve the big issue at hand — burnout nurses leave the profession.

What if nursing programs could tackle this issue head-on from the start? Perhaps tackling it through an initiative to educate nursing students in nursing school to prepare for the professional role.

What is Burnout?

Burnout is overwhelming exhaustion and an emotional drain because of prolonged mental, emotional, and physical stress. It's attributions have been well-researched over the years. The University of St. Augustine of Health Sciences (USAHS) published an article on July 2020 entitled, “Nurse Burnout: Risk, Causes and Precautions for nurses,” which describes the most common extrinsic factors as lack of sleep, long hours of work, high-stress environments, lack of support and emotional strain from patient care. That directly correlates with the working environment of a professional nurse. It’s astounding that burnout similarly impacts our bodies as posttraumatic stress disorder (PTSD). Nurses are continuously hypervigilant while caring for high acuity patients. The level of alertness and heightened stimuli, in combination with extended hours in a stressful environment, is a recipe for burnout ... unless one has the resources and knowledge to combat this phenomenon. 

What Does Research Say about Personality and Burnout? 

Personality may put the professional nurse at a higher or lower risk of burnout. A 2020 article published on Very Well Mind, entitled “Traits and Attitudes that Increase Burnout Risk,” notes that personality characteristics may play a significant role in the susceptibility to burnout as a nurse. It claims that perfectionists, pessimists, excitable, and Type A personalities may be at a slightly higher risk. In 2020, The Journal of Nursing and Care published a cross-sectional quantitative study by Nathan Pacheco entitled “Nature or Nurture: The Relationship between Self-care, Personality traits, and Burnout in Critical Care Healthcare Professionals.” The study aims to answer the following question “Why, under the same working conditions, do some employees burn out and others do not?” It expands on the fact that all personality types may be at risk, but a single personality has a significantly higher risk. Like Very Well Mind, this research notes that agreeable or perfectionist personalities are more likely to be affected by burnout. This contributes to the high turnover rate among healthcare professionals and the nursing shortage conundrum. A 2021 study by Delana Galdino de Oliveira entitled “Exploring Global Research Trends in Burnout among Nursing Professionals: A Bibliometric Analysis” reviewed over 1406 articles to gather global statistics on burnout. The analysis showed that roughly 43% of nurses had high burnout scores. This research found that most studies covered prevalence, associated factors, predictors, etc. It also found that there was a lack of studies covering strategies for prevention.

How Strategic Initiatives Can Help Restore Balance and the Nursing Profession

How does this apply to nursing students? Nursing students should know the research and burnout phenomena. Although the nursing profession gives plenty of fulfillment, it also comes with responsibility and high-stress levels. Therefore, nursing students must understand themselves, their personalities, their character, and how they respond to stress before entering the professional role. 

What Can Educators Do? 

Through transparency and education in nursing school, educators can help regain balance in nurses and help slow down the rate at which the nursing shortage is happening. In his study, Pacheco referenced a 2009 study by Deborah McElligott, who wrote: “Health Promotion in nurses: is there a healthy nurse in the house?” She notes the importance of straightening stress management and self-care among nurses through health promotion strategies in nursing school before entering professional practice. The results showed that “… Guided, organization-led interventions aimed at bolstering health and self-care may improve intervention effectiveness.” There is an increase in recognition of the necessity for self-care training before entering practice; perhaps the innovation of courses that aim at self-care would serve nursing students and professionals alike. Pacheco hits the target with this statement: 

Quote

“The new interest to include self-care courses into the undergraduate nurse curriculum raises important questions: Just how prepared are healthcare professionals to practice self-care? And furthermore, what are the repercussions of self-care deficits? Examining the relationship between self-care practice and burnout is an important step in distinguishing the individual variables driving the condition.” 

Therefore, preventive initiatives can be effective. Consequently, I agree with Pacheco’s analysis that supports the idea that initiatives may combat nurse burnout. Strategies that may be useful as part of innovative programs such as these would include the following: 

  • Awareness of personality type and level of stress management. 
  • Awareness about burnout and steps on how to take action against it. 
  • Learning to cope with stress management. 
  • Learning self-advocacy. 
  • Learning ways to evaluate nursing specialties.
  • Evaluation of the environment, the team dynamics, and how it aligns or misaligns with one’s personality. 
  • Awareness of the resources available to nurses and where to find support.
  •  Awareness of the variety of nursing specialties.
  • Learning to find the best environment that brings fulfillment as a professional nurse.

Conclusion

The impact burnout is having on nursing professionals is clear. We recognize the importance of building a strategic approach aimed at nursing students before starting their professional careers. There is a need for research to create and evaluate practical, strategic approaches. American Nurses Association has taken the initiative. It has launched the “National Well-being Initiative for Nurses.” They designed this program for nurses in the U.S. to offer resources that aid in building resilience and offer tools to learn to manage stress and overcome trauma. Initially, it supported the trauma of the Covid-19 pandemic. Still, its effectiveness is a step toward other strategies that may balance the nursing shortage by handling one of the core problems. Since trauma is nearly the description of burnout, any nurse experiencing burnout may benefit from these programs. I have to say; that it is a beautiful start to an overdue needed strategic approach that may help combat burnout rates and the nursing shortage. 


References/Resources

Nurse Burnout: Risks, Causes, and Precautions for Nurses

Traits and Attitudes That Increase Burnout Risk

Nature or Nurture: The Relationship between Self-Care, Personality Traits, and Burnout in Critical Care Healthcare Professionals

Health promotion in nurses: is there a healthy nurse in the house?

Exploring Global Research Trends in Burnout among Nursing Professionals: A Bibliometric Analysis

American Nurses Foundation Launches National Well-being Initiative for Nurses

Lola Ravid is a Registered Nurse and freelance writer who is passionate about child advocacy, health, and parent education. She currently writes engaging content to educate and encourage lifelong learning in readers. Since 2016, Lola has volunteered at the Selective Mutism Association and became an accredited leader for La Leche League International in 2022. She is a polyglot, philomath, and self-proclaimed historian.

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4 Comment(s)

April Conner BSN RN

Specializes in Dialysis Nurse, Freelance Nurse Writer. Has 3 years experience. 1 Article; 3 Posts

You make a lot of great points here! I remember some mention of self-care tactics in nursing school, but it was just maybe one or two days out of the entire four years! We were taught about helping patients find healthy coping mechanisms, but not much was mentioned about helping ourselves find those same things. We were warned about "nurses eating their young" but not about just how verbally and physically abusive so many patients could be towards us. This topic should definitely be more of a focus in the nursing school curriculum and Continuing Education in the workplace.

Equipping nurses and nursing students with the knowledge of how to fight burnout is only half the battle, unfortunately. The other half is getting management and entire corporations to change how they view their employees and actually support self-care practices in their staff. To do that, we need more affordable healthcare in America so corporations don't have to worry so much about their bottom line and can focus more on the well-being of both their patients AND their staff!

Lola Ravid, BSN, RN

Specializes in Pediatrics, Research and Freelance Writing. Has 13 years experience. 1 Article; 7 Posts

I couldn't agree more with that fact. It's half the battle. It requires a multi-faceted approach to make long-lasting changes at the policy level. 

Thanks for sharing your thoughts on this critical matter. 

SunCityInsPhysical

SunCityInsPhysical, BSN, RN

Specializes in RN, BSN, MA, CLNC, HC/LC. Has 47 years experience. 15 Posts

No where did anyone mention the unrealistic, overbearing and abusive attitudes and practices of Hospital systems and administrators, chief nurses, unit directors or charge nurses and state board/ANA posturing and unions. 

Having studied and practiced Route cause analysis I can tell you It starts at the top. There are many who are more interested in promoting themselves and lateral/upward mobility. "Magnet" status is not all the promotion/propaganda professes them to be. 

I worked in a large system that became an AARP recognized Magnet hospital. Before that status, senior nurses did not have to pull night call in the OR after they turned 60. Afterwards, we were told if you can't do the job it may be time look for work somewhere else. After 40+ years of service and steadily more demanding acuity, frequency and safety risks of level one trauma in an large city several left which left remaining staff even more strained. Managers did NOT pick up any of the unstaffed shifts from no-shows. I was told I had to cover the 12 hour shift between my regularly scheduled shifts. I worked 36 straight hours. (Yes, illegal, I had 13 signatures of me stating I wanted to leave beginning at hour 23.) They moved the next patient into a room while I transported my patient to recovery. When I went to the desk to turn in paperwork they gave me report and threatened to report me for patient abandonment. At hour 36 I was finally allowed to clock out but was told I had better show up for my shift the next day. When I took off my scrubs,  my legs from knees down looked like pink water blisters. I went straight to the ER. I had greater than plus 4 pitting edema and peripheral neuropathy. The system, workers comp tried to deny culpability. 

Long story short. I transitioned from disability to early retirement at half of  Soc Sec than full retirement at 72. I had parent care expenses that ate up my savings. That was ten years ago and I still have pain, swelling and can't stand or bear weight for more than 15-30 minutes on a bad day. 

This whole system produces more than just burnout. It affects more than just the nurse. It ripples out into everything in the nurses orbit. It is life altering in all facets. Add career ending, retirement/ financial security disrupting. This is about more than just burnout. The ripple effects will be felt everywhere and it's just beginning. 

So, you may ask what happened to the management ladder? Very little. 

Again, I say this starts at the top, so add in boards of nursing and ANA and Federal. I lost confidence in and respect for them very early in my career. I've endured the added level of beaurocracy and corruption that the unions impose on minute by minute functioning, 15 minute turnover? good luck. 

Let's not forget the Florence Nightingale legacy of 'the patient comes first'. It was abusive from day one. 

I'm out. I don't and won't recommend it as a profession. I caution people I meet who are in school to be very cautious and put themselves and their family first. Nursing is a job, just like being a mechanic. Both hold lives and limbs in their hands.  

I use an analogy that every other business that is open 24-7-365 staffs for it.  Having people on call is a cheap shot. I've seen the numbers. I've dealt with cleaning up messy work, mistakes and catastrophies. Tired annoyed people are not happy staffers. Even McDonald's is struggling these days. No one wants the stress, responsibility or the risk. 

I get calls weekly from clueless recruiters working from a state registry list with offers upwards of 1-1.5 k a day. I laughed and commented the working conditions must be awful. I asked him if he actually knew what nurses do. He didn't. 

We need to educate everyone at all levels and encourage participation and accountability for self-care. OK, said my piece. The Ball is in play. I've got my feet up, I'm no longer viable or valuable, stopped looking for a desk job years ago. 

Will be curious to see how this plays out. Good luck to us all. 

Lola Ravid, BSN, RN

Specializes in Pediatrics, Research and Freelance Writing. Has 13 years experience. 1 Article; 7 Posts

Hi SunCityInsPhysical

Your story hits home to so many of us in many ways. It's a multifaceted issue that needs to be addressed. We all hope changes in all areas can be implemented to start seeing a positive difference. 

It's important to hear this and make experiences known to get enough attention to drive a change in the right direction. 

Like you, I was very disappointed on so many levels. Completely different from what I anticipated. I wanted freedom and found myself feeling like a slave. I was burnout. I left shortly and took small jobs here and there, never really feeling fulfilled until I found writing. Would I go back to an inpatient setting? I doubt it unless significant changes happen to prioritize the well-being of the entire nurse. Sadly, most nurses feel the same way. As a result, this is becoming a public health crisis. The helpers can't help anymore. Nurses have been taken for granted, and now we have a country in chaos. We all hope this can be turned upside down with research and implementation and bring back balance. 

Thank you for sharing your thoughts and your story. You are appreciated.