4 Strategies to Avoid Nursing Burnout During COVID-19

Sarah Villavicencio, BSN, RN

Covid-19 has significantly impacted healthcare in multiple ways. There are supply chain shortages and there are staffing shortages. Some facilities are over capacity and some areas are working under crisis standards of care. People are dying in record numbers and we have been forced to place bodies in freezer trucks. Healthcare workers are at the forefront of the pandemic providing care to patients while not only exposing themselves to the Covid-19 virus, but exposing themselves to increased levels of stress brought on by working conditions. According to a survey by the Kaiser Family Foundation¹, 56% of health care workers have experienced sleep disruption and 31% have experienced stomach aches or headaches. Additionally, this same survey found 62% of healthcare workers identifying that worry or stress related to COVID-19 has had a negative impact on their mental health. Burnout rates in nurses are rising with 33% of all nurses and 66% of ICU nurses² reporting consideration of leaving the nursing profession due to their experiences during the pandemic.

Let’s take a look at what exactly burnout is, what causes it, and identify strategies that you can use to combat burnout to take control of your own mental health.

What is Burnout and What Causes it?

Burnout is defined by the World Health Organization³ as a syndrome resulting from chronic workplace stress that has not been successfully managed. Prior to the pandemic, nursing professionals were at an increased risk of burnout due to demanding workloads and staffing shortages. In the midst of the COVID-19 pandemic, unprecedented challenges for healthcare workers have increased levels of stress and elevated rates of burnout. A Kaiser Family Foundation⁴ survey found 69% of healthcare workers aged 18-29 reported experiencing burnout compared to 59% of healthcare workers aged 30-49 and 43% of healthcare workers aged 50-64 identifying that the youngest individuals are at a higher risk of burnout. You may already be experiencing burnout if you are feeling fatigued, feeling underappreciated, feeling a loss of motivation, or feeling like you have a loss of empathy.

Causes of Burnout in Nurses

Long Hours - Many nurses routinely work over 8-hour shifts in high stress environments.
Lack of Sleep - Long hours and consecutive shifts coupled with chronic stress lead to a decreased amount of sleep.
Staffing Shortages - Population growth, an aging population, and a workforce that is aging are contributing factors for the nursing shortage.
Salary - 56% of nurses⁵ surveyed feel like their employer is “falling short” in providing hazard pay for those working in high risk situations.
Childcare Shortages - Nurses are exponentially affected by the childcare shortages, with 66% of survey respondents⁶ they do not have child care fully available.
Turnover of staff - Turnover increases training workload and can affect team dynamics.
Lack of PPE - Nurses are at increased risk of exposure to pathogens when PPE is unavailable.

Strategies to Avoid Burnout

Many elements of the systemic working conditions are outside of your control, but as a nurse, you are committed to caring for your patients. How can you help position yourself to give the best during your shifts and protect your own mental health? Avoiding burnout starts with acknowledging the stress in your life and consciously creating habits. Choosing routines that support self-care can help you to protect your own mental health. This takes a little planning and preparation, but the key is to be intentional. Here are four practices that you can start doing today to protect your mental health and reduce your risk of burnout.

Establish a routine

Establishing a routine provides you with an automatic process which decreases decision making. By limiting the number of decisions you are making each day, you automatically decrease the amount of stress in your life. You can choose anything that fits your lifestyle from sitting down with a hot beverage before you start your day to exercising to a bubble bath before bed. One thing that you will want to do when choosing your routine, is finding something that you enjoy and limit variables to ensure you can be as consistent as possible.

Mindfulness

Mindfulness is defined by the American Psychological Association as moment-to-moment awareness of one's experience without judgment. Some benefits of mindfulness⁷ include a decrease in negative thinking, stress reduction, and increased ability to focus. One simple way to start practicing mindfulness is by connecting to your breath. This can be done by focusing all of your attention on the act of inhalation and exhalation. Two activities that have a foundation of connecting with your breath include yoga and meditation. Other options for practicing mindfulness include slowing down during any activity to fully experience all of your 5 senses, and mindful journaling⁸.

Gratitude

Gratitude is the act of finding events in daily life in which you acknowledge being thankful. Individuals who consistently practice gratitude have been shown to have improved happiness and satisfaction, and are less likely to suffer from burnout. A few ways you can start to incorporate gratitude in your daily routine are by starting a gratitude journal, expressing feelings of gratitude with others, or by developing 1-2 questions that you can ask yourself each day causing you to reflect and identify events that elicit gratitude.

Build Connections with Others

Human beings thrive on connection, and connectedness is a crucial part of well-being. Feelings of connection have been shown to have benefits with overall health and a decrease in the risk for depression. What are some ways you can help build connections to impact not only yourself but others? Try asking a coworker a nonrelated work question to find out more about them. This could be something like finding out what they did over the weekend, what they had for dinner last night, or where they would travel to if they could go anywhere. Setting up an event outside of working hours like a happy hour or a seasonal activity can be a great way to connect a group of coworkers. Outside of work, consider joining a group, either virtual or in person, with individuals that share some of your interests.

In summary, burnout rates are at an all-time high amongst healthcare workers and our youngest workforce members are being significantly more affected by the Covid-19 pandemic. Given current staffing shortages and an aging nursing workforce, the medical system cannot withstand losing any nurse. You can learn to protect your own health with more than just PPE. You can learn to utilize strategies aimed specifically to take care of your own mental health thereby intentionally decreasing your risk of burnout. When you choose to share any of these new strategies with your colleagues, you’ve already made a connection. And, that connection just may be what saves the next nurse. So, what strategy resonates with you and when are you going to start?

References

^1,4,5KFF/The Washington Post Frontline Health Care Workers Survey

²Hear Us Out Campaign Reports Nurses' COVID-19 Reality

³Burn-out an "occupational phenomenon": International Classification of Diseases

⁶About 1 in 5 Clinicians Considers Quitting Due to Pandemic: Survey

⁷What are the benefits of mindfulness

⁸How to Start a Mindful Journaling Practice