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Found 37 results

  1. gratefultobeanurse16

    Should I stay or step out of my comfort zone?

    (Sorry in advance for long post) I’ve been trying to find out if I should step out of my comfort zone and leave my current unit or stay. I currently work on an ortho/general surgical med/surg floor for 2 years. I love the variety of surgical patients and the acuity of the patients. Some of our patients are on PCA pumps, tpn/lipids, chest tubes, jp drains etc. I love the early mobilization of patients, providing education, utilizing a variety of skills such from IV starts to NGT insertion. It is is a fast paced surgical floor with frequent admission and discharges. Some days I may have a team of 5 patients, discharge 3 patients, and can get 3 new admissions back to back which makes it extremely difficult to know fully what’s going on with my patients. Depending on staffing, it’s typically 1:5, 1:6. When fully staff it's 1:4, which is rare! While I love my job, I am tired of being pulled in so many directions every shift to the point I feel that I do not do enough for my patients. I find myself stressed and constantly thinking about work on my days off. I love my job and patients but honestly I do not want to work like this for another 6 months to a year. My manager is super supportive and I get along with staff pretty well. However, another reason I want to leave is because there are many times where the assignments are just not divided fairly. Sometimes 1 nurse is stuck with a heavy patient assignment while others are just sitting at the desk listening to music and gossiping. Sometimes the charge nurse allows the unit secretary to create the nurse’s assignments, which completely blows my mind. I've recently applied to a few ICU positions and have 3 interviews in ICU coming up (SICU, MSICU, and NEUROICU) A part of me is scared of change especially because I have rapport with much of the staff, MD’s, and I've learned so much about the flow of the unit itself. However, a part of me wants to step out of my comfort zone and explore a new area. I guess this is more of a vent than a question but my question is 1) should I stay or should I go? 2) Have you experienced a similar circumstance? 3) If so, what was your decision and were you glad /regret you made the change? Thanks in advance 🙂
  2. adelina207

    New Grad ICU Burnout from COVID

    Hi everyone! I'm a new graduate nurse that has been in the ICU since April. I'm experiencing alot of stress related to COVID. We're in our 2nd wave of COVID now and the amount of death I'm seeing is almost too much for me at this point. We are coding people everyday. On Thanksgiving, we had 4 COVID patients code during just my shift. Not to mention my hospital is also not allowing visitors anymore so all the communication with family is via the phone. I understand providing emotional support to the family and patient is part of my job, but I am just so overwhelmed with how powerless I feel in this situation. I love the ICU population in general and I love the critical nature of the care, the critical thinking, the independence, everything, but I do not know how to deal with this much death and suffering. I know this is largely due to the pandemic and in the normal ICU environment, deaths are not quite this frequent, but with no end to this pandemic in sight, I don't know how much longer I can deal with this. Nurses on my unit are burnt out. Some are leaving the bedside permanently to go into administration/case management, some are just out sick with COVID for weeks at a time. It's not even just caring for these critically sick COVID patients that bothers me, it's also the way my community is treating it. I am seeing patients die every day at work, but then I go onto social media and see that half of my friends and family are posting that this virus is fake, that we're faking death certificates for financial gain, that nurses should just keep quiet because we "signed up for this". I literally feel like I'm being gaslighted by my community about this pandemic. I'm just looking for advice. How are you guys dealing with it? How do you get back into the right headspace after a code? How are you staying healthy and keeping your stress down among all this craziness? How do you prep for a shift dealing with critically ill COVID patients? I would appreciate any advice. I
  3. GS ED RN

    COVID guilt/burnout

    hello - this is probably a popular topic - I finished my masters/FNP may 2020. I have been a nurse for 5 years - the last 3 years have been in the ED my one true love - I knew I wouldn't want to do bedside full-time for the next 40 years of my career - however I always planned on staying at bedside per-diem (so funny how managers/admin/faculty forget so quickly the bedside struggles- I NEVER wanted to be one of those) then COVID accelerated my burnout --- worked COVID ICU and two EDs at the same time and it was tough -- like COVID was the gasoline on a little baby flame that torched my joys/love for nursing ... I just feel SO GUILTY for it - . Yep in typical nursing fashion I feel guilty for something I have no control over. I accepted a part time faculty position which I really wanted I have other offers lined up - I am just SO TORN. I do not want to leave the bedside even if I went per-diem I would feel so guilty not being up at the frontlines with my peers - also feel like I may lose some "street cred" no one but nurses will understand this and I don't know how to discuss this with my co-workers without feeling so guilty. Appreciate any advice/input please and thanks! and also huge thank you to all my fellow nurses - all specialities - we have all taken the brunt of this pandemic and I am so proud to be one of you
  4. Stella_Blue

    Is calling off for burnout a thing?

    Okay so let me start out by saying when it comes to attendance I get an A+. I never call off. In 5 years I have called off maybe three of four times total. I have been starting to experience burnout like I never have in my life. I have been exhausted before, but this is on another level. I cried at work yesterday, and I simply don't do that. It took my patient almost coding before someone would come help me. Unfortunately, I also let my vulnerability show at work, which again, I don't do. Fast forward to today, I called off because I didn't sleep at all last night, I had a terrible migraine from all the stress at work yesterday, and yes I'm so burnt out that my mental health could not take another day. So here is where my problem gets worse. I caught wind from a friend at work that the charge nurse was telling my manager how incompetent I am at my job (which is not true guys) and how she had to do my job for me yesterday. This is also not true. I was left on my own yesterday in the fast track area of the ED with tanking patients all day, and my charge nurse did not come to help until my patient was unresponsive, and I broadcast overhead that I needed help. When I was done helping that patient, I come back to my desk and she said I called the family for you. I thanked her and mentioned I had to call another family member for another patient and she offered to call them, so I let her. Today, she tells my manager that she had to do my job for me because I was too stressed. I know she is just trying to cover her own butt for putting inappropriate patients in the fast track area, with one nurse, when I voiced my concern with how sick these patients were. Now, I'm just concerned with how I will be perceived by my peers, my manager, etc. I feel like I should have just bit the bullet and went to work, migraine/bad mental health and all. Today was supposed to help me reset, but now all I'm doing is stressing more.
  5. Bugaloo

    Nursing: Taking Back Our Power

    I am not a positive person by nature. Unlike naturally positive people, I have to work at it. I want to be positive. I feel better when I am positive, but sometimes the negative bug bites me and won't let go. I am a voracious reader of psychology and "self-help" books and articles. They give me insight into the human psyche and help me understand my trigger points. One of my trigger points is feeling a loss of control. I am no dummy. I know that a higher power is really in control of my life, but He sometimes lets me think that he is in control just so he can have a good laugh. Anyway...When I am feeling overwhelmed and under-appreciated at work, I feel a loss of control. I like the illusion that I have a handle on things. When I lose my grip, I tend to get morose and negative. A fellow Allnurser called me on some things I said in the aforementioned article (thanks, Interleukin) and I have been thinking of what he said ever since. I am glad he commented because it made me clear my head and regroup. I want to share with you the things I learned on this little journey of reflection. In nursing school, what we are lead to believe is that we will "practice nursing". I don't know about you, but I don't practice nursing...I do nursing, for 12 hours straight, often with no breaks. For some reason, doctors, patients, and administration seem to hold nurses to a higher standard than others. By this, I mean that they seem to think that nurses should tolerate the abuse dished out on a regular basis. They should gulp it down and say "Thank you, sir, can I have some more?". Well, guess what? This nurse has had enough. I am not going to take it anymore. From now on, I am standing my ground. I am taking back my power. According to Dictionary.com, the term "abuse" means to a. to use wrongly or improperly, b. to treat in a harmful, injurious or offensive way, c. to speak insultingly, harshly and unjustly to or about, and d. bad or improper treatment. Do any of these definitions describe your work environment? Nurses are feeling demoralized, frustrated, discouraged and repressed. Rules and policies put in place by administrators who have never set foot on a nursing floor are the norms. They have a very unrealistic view of the process of nursing as a whole. By their choice, they have put blinders on, plugging away for the almighty dollar, while their nursing staff, the CORE of the hospital, takes the brunt of patient dissatisfaction. Most nurses are compassionate, caring people. One reason they decided to be a nurse was to be on the front lines of patient care. Yet, every day, nurses leave the nursing profession citing overwhelming stress and emotional fatigue. We try to be patient advocates. We try to set limits with difficult patients and demanding families, but the administration does not back us up. Instead, when complaints arise, it is often the nurse that the blame falls back on. As nurses, our plates are full, but each week seems to bring more and more responsibility and paperwork. The more we do, the more we are expected to do. Co-workers and doctors often add to our stress level. As more nurses become disillusioned with nursing, it shows. We become disgruntled, short-tempered and discouraged. Once the morale of the unit starts to suffer, it is very difficult to correct. Dealing with doctors who are less than cordial often causes unrelenting stress. I have seen nurses cursed, backed in a corner, called names and screamed at in front of their peers. All in the name of health care. Not once, have I heard a physician called down for this type of behavior. Why do we tolerate this? One reason may be because we feel that, as professionals, it would rock the boat if we complain or stand our ground. We are afraid of being labeled "troublemakers". Well, I have decided that from now on, I will not allow myself to be talked to or treated in a rude or obnoxious manner. I will stand up to the person who is verbally abusing me. I deserve to be treated with dignity and respect. Administrators, doctors, and peers are not the only ones who can dish out abuse. The people we are paid to take care of, our patients, are often the worst offenders. For whatever reason, patients, and often times, their family members, can be verbally and physically abusive. Demented patients have an out. They are confused. But patients who are not confused should not be allowed to physically assault health care staff, nor should they use threatening language. Yet, again, it is tolerated. As nurses, we need to take back our power. We need to start saying "No" to abuse, "No" to unsafe nursing ratios. We need to document and fill out incident reports on every incident that makes us uncomfortable. That seems like a ton of extra paperwork, but it must be done. If you are a supervisor, you need to support your staff, plain and simple. Your staff will respect you for it. Do not allow patients and their families to mistreat you. Let them know that their behavior is unacceptable. If they take it to administration, deal with it by handing management a letter detailing your side of the story (keep a copy for yourself). There are two sides to every story. More often than not, nurses are not allowed to share their point of view. Same with doctors. Stand your ground. Nurses need to support their fellow nurses. Let them know that you've got their back. Encourage them. Lift them up. Acknowledge their positive attributes. In 2007, a bill was placed before Congress. It is called the Registered Nurses Safe Staffing Act of 2007. Basically, if it passes, it would make it a law that hospitals would have to have safe staffing ratios or face big fines. Other nursing issues are also discussed in this bill. The American Nurses Association (ANA) supports this bill. If you are concerned about the future of nursing, write your congressman and ask for their vote on this issue. One more thing: Stay Strong! 🙂
  6. jnemartin

    Staff Burnout

    My small, private school with two campuses prek-5 and 6-12, has been in-person since august. We've only had 2 confirmed positives, each time sending ~35 into quarantine for 2 wks. Although we've managed really well throughout this pandemic, I HATE being here - I think it's unfair to teachers and an incredible burden on me and the administration to keep this running. Teachers are now cleaning their own rooms several times per day, during lunch and breaks they are supervising kids to keep them compliant with all the rules, etc. Basically they are SO burned out. They have been asking me if it's possible to not come back after Thanksgiving break and go remote the rest of the year. I know it's a big ask but I feel compelled by my colleagues and obligated by my duty to keep everyone safe to at least float the idea to our Leadership Team. So I'm going to write an email asking to consider going remote. I'd also like to offer some morale boosters for staff - anyone have any ideas? PTO brought a coffee truck last week, which was nice... something like that?
  7. If you are finding it challenging to keep up with all the demands and responsibilities of your life amidst the madness of nursing school, you are not alone. Nursing students are known for their lack of extra time outside of school. If it is your first year in nursing school, you may be struggling with the notorious nursing student stress that everybody talks about. On top of the normal stress of nursing school, you are attempting to earn a degree during the pandemic. All of you reading this article are likely motivated to succeed, firstly because you took the time to seek out advice, and secondly, because your hard work will earn you a license for a profession you are passionate about. However, sometimes that focus on success can cause you to neglect the other responsibilities in your life. That motivation and drive can easily wane down when you are not taking the time to sit back, care for yourself, and refill your metaphorical cup. While our degree tends to take priority, it would benefit nursing students to create a balance between schoolwork and other social, work, and emotional responsibilities. Here are five effective tips to maintain some calm and balance in your life, despite the perpetual stress of nursing school: TIP 1 Have a workout routine. There are undeniable benefits to regular exercise, including decreased stress levels, improved focus, and higher energy levels. As future nurses, you are expected to be healthy role models, which includes having an active lifestyle. To get started, set a low expectation for yourself, such as five minutes of walking and stretching. If that is too much, do just one minute of your favorite exercise. You could even dance around in your room to your favorite song to get your heart pumping. Whatever you can do to get your body moving on a regular basis will be worth the benefits to your mental and physical health. TIP 2 Utilize a planner. A planner to keep all of your tasks and assignments in order is essential for nursing students. Many students find it helpful to use an online calendar to input all of your assignments and due dates at the beginning of the semester. That way, you can visualize when everything is due. Then, one day a week or every night, sit down at the end of the day and plan out your tasks for the next week or day. Particularly for exams, planning exactly what you will study and on which day helps to reduce stress and procrastination. TIP 3 Create time to do what you enjoy. When you’re not studying, utilize the time you do have to do something that satisfies you and fills your emotional cup. Watching TV, scrolling through Tiktok or Instagram, or watching movies can be great at times to unwind. However, sometimes these activities can leave you feeling lazier and unwilling to return to your work. Instead make time to do a mind-stimulating yet relaxing activity you like to do (such as reading, listening to music, dancing around, going to a favorite coffee shop). If you struggle to stop thinking about school even when you’re not studying, schedule time in your planner specifically for enjoyable activities. This will equip your brain to switch into relaxation mode and hopefully stop worrying about school. TIP 4 Take study breaks. Sometimes amongst long study sessions, you can feel suddenly burnt out and overwhelmed, despite knowing you need to keep studying. When this happens, give yourself permission to take a brief break to reset your mind. A little bit of self-compassion can go a long way in giving you the strength to keep going. Shift your perspective by doing something active for five minutes, such as playing with a pet, calling a friend, or taking a quick walk. Set the intention that for those five minutes, you will shift your perspective in order to be willing to study. When you do resume studying again, you will feel refreshed and ready to go. (Pro tip: keep a running list of the activities that successfully boost your mood so that when exhaustion happens again, you know exactly what to do). If that doesn’t work, don’t be too hard on yourself. It is OK to take a break for the rest of the night in order to restore your energy for the next day. TIP 5 The most important: create your own plan. You can read hundreds of articles filled with good advice, but it will only work if you actually put those tips into action. A quick way to get yourself started on the right track is to come up with some strategies yourself. Stop what you are doing and for the next 10 minutes, think about (or better yet, write down) your own list of strategies that help you maintain your cool in nursing school. If you’re having trouble, you could start by going down each point in this list and reflecting: “Do I already do this?”. If you do, “does it work for me?”, and if you don’t, “could this be something I could benefit from?”. Hopefully, this will get the cogs turning so you can immediately start implementing balance into your life as a nursing student.
  8. Nurse Beth

    Worry about making a career change

    Hi Nurse Beth! I am struggling with major burnout and have been thinking for a long time about making a career change. It was always my plan to get an advanced degree, but I've become less and less certain what degree I actually want to pursue. I am passionate about women's health and currently work in labor and delivery, but the high stress and working nights/weekends/holidays is killing me. I literally dread going to work most days, even though I do love being a part of labor and delivery. I have considered a clinic RN position but I can't afford the pay cut that comes with it. I would love to find something with better hours, lower stress, but still satisfying and offers some purpose. I've considered nursing education and nurse practitioner routes but also worry about the job market for both careers. Would love whatever insight and ideas you may have... Dear Struggling, Major burnout, high stress, the dread of going to work...weigh those against a cut in pay. You already know you can't continue indefinitely on your current path. There is a high personal cost to what you are doing now. An advanced degree will help you redesign your career. Overall, advanced practice nurse jobs including CRNA, midwives and nurse practitioners is projected to increase up to 45% until 2029, according to the U.S. Bureau of Statistics. Of course the projections vary regionally, but overall the outlook for APRNs is very good. NPs are providing primary care and preventative care. Nursing education and nurse practitioner are very different roles. One is clinical, one is not. Your first challenge is to narrow down your choice. Can you picture yourself in Staff Development, as an educator in acute care? Or perhaps as a professor in a local nursing program? Online education can provide a career as long as you need or wish. Or do you want that patient connection, such as working as an NP and seeing patients? Best wishes with your decision, Nurse Beth
  9. BButterfly1993

    Feeling lost in my nursing career

    Hello, I have been a nurse for 3 years with previous experience in ICU, cath lab, and Interventional radiology. I started in ICU straight out of nursing school and I have been doing critical care since then. I currently work 4 days /10hr shifts each week. Our cath lab is extremely short staffed and I have been forced to take 15-20 days of call each month. This obviously increases your chance of being called in for emergencies. Our patients have been extremely sick, requiring more nursing care on a skeleton crew. We have also been having really late cases, so I typically work 10-14hr shifts. Needless to say, I am completely burned out. I have a newborn at home which requires all my attention as soon as I walk through the door. I am exhausted, tired, and frustrated. Now that I have my son, a lot of my nursing career priorities have changed. I want to go back to 3 days /12hr shifts. I would like to cut back on call or eliminate it completely. Back in July I accepted a day surgery position but my current director will not release me to this unit until September due to how short our cath lab unit is. I am having a hard time managing my current nursing career since I am being pulled into many directions. My team members are giving me a hard time for changing units, my director is also acting different now, and my home life is also requesting so much of my energy. I am feeling lost within my nursing career because I feel like I want to step back from emergency medicine and having to react quickly...solo. Recently, I have become so bitter and angry at work. I have never EVER been like this before. It makes me wonder if it is my environment within my unit (It has a lot of issues) or just burnout. I have applied for a few other jobs including surgery and an oncology unit. I really miss 1 on 1 nursing and educating patients. I love talking to patients and feeling like I make a difference. I also want to be home with my growing boy. I love my son so much and I’ve wasted a lot of time at work. I am stressed all the time -wondering if I am making the right decision. I feel guilty to step away from critical care since I’ve done it my whole career. Is anyone else experiencing this or have experienced a clash between home life and nursing career?
  10. Nurse Beth

    Can We Talk About Nurse Suicide?

    Nurse SuicideReports of nurse suicide are largely anecdotal. Sometimes nurses die by suicide after they’ve made a fatal mistake. Kim Hiatt was one such nurse. Kim was a critical care RN who worked at Seattle Children’s Hospital for 24 years before the day her shift, career, and ultimately her life ended in horror. On September 14, 2010, Kim received a verbal order to administer 140 milligrams of calcium chloride IV. The concentration was 100 milligrams per mL. The correct dose was 1.4 mLs, but Kim miscalculated and gave 10 times the ordered dose. 14 mLs. 1400 milligrams. The fragile nine-month old baby died 5 days later. Seven months later, Kim hung herself in the basement of her Seattle home. No statisticsInterestingly, no one knows the actual rate of nurse suicide in the United States, as no one organization tracks and reports it. There are no standardized reporting mechanisms across the states. For example, the death report may say suicide, but the space for “occupation” may be blank, or filled in simply with “nurse”, and is often hand written. If it’s any indicator of nurse suicides stateside, the number of nurse suicides in the UK is tracked. The Office for National Statistics reported 300 nurse suicides from 2011 to 2017 with the highest number, 54, in 2014. Fifty-four nurse suicides in one year is one nurse suicide per week. Studies performed outside of the US found nurses have a higher rate of completed suicides than other occupations (National Academy of Medicine: Nurse Suicide: Breaking the Silence). According to the CDC, suicides in general are up. Not only up, but higher than they’ve ever been, making suicide a major national public health issue. Celebrity suicides in the last couple of years have shocked the nation, and the Joint Commission has made suicide prevention a focus of concern. StigmaEven in the medical field, there is pervasive stigma around mental illness. It’s one thing to get diagnosed and treated for sinusitis. It’s quite another to seek help for a psychiatric disorder. In the nurses’ lounge you may hear “Hey, who’s a good orthopod to see for my knee?" but less often “Anybody know a good counselor for being depressed? Is Prozac a good antidepressant?” Or when ordering out “Hold the cheese on my taco salad! Doesn’t go with the MAO inhibitor for my bipolar disorder!” As nurses, we see ourselves as helpers, not helpees. Being a person with mental health needs makes you less than, in many people’s view. It can mean you are weak, or just can’t cope. Other people may look at you differently, treat you differently. Whisper about you behind your back, but stop talking when you walk in the lounge. Even loving families are not always understanding or supportive when a family member is depressed, believing mental illness brings shame on the family. The family member who can barely get out of bed and shower may be told to “snap out of it”. Ironically, if that same person broke a leg they would never be told to “snap out of it” but would be treated and expected to stay off the leg for as long as it took to heal. BlameFriends and family often blame themselves when a loved one dies by suicide, but they also blame the loved one who ended their own life, leaving behind devastation and broken hearts. It’s not selfish. Selfish would be if someone knew the pain it would cause, and disregarded it. The person contemplating suicide believes they are a burden to others, and that everyone would be better off without them. Their thinking and ability to rationalize is impaired. It’s not that they don’t want to live so much as they don't want to suffer. Suicide is a solution. Language MattersLanguage matters and words have power to not only express but to shape our feelings and beliefs. Use the words “completed suicide” instead of “successful suicide”. Much as we would not say a pt died of a “successful MI”, “successful” is not the best way to describe death by suicide. Or just say "died by suicide".Likewise, instead of “unsuccessful attempt” say “attempted suicide”.Instead of “committed suicide” say “died from suicide”. The word “committed” has connotations of sin or crime.Nurse RiskNurses are subject to depression, mental illness and suicide like everyone else. But nurses are more likely to experience PTSD, second victim syndrome, nurse burnout, compassion fatigue, and moral distress than those in other occupations. While nurse suicide is not tracked, it’s not much of a leap to induce that significant occupational stressors and suicide risk could be connected. Suicide is shrouded in secrecy, but when it does occur, it should be openly talked about. Facilities should have debriefings after a staff suicide. Employee assistance programs are helpful, but colleagues need to talk among themselves to process what happened. If you are suicidal and need emergency help, call 911 immediately or 1-800-273-8255 if in the United States. Maybe Kim Hiatt's story would have ended differently if she'd gotten the help she needed. National Suicide Prevention LifelineWe can all help prevent suicide. The Lifeline provides 24/7, free and confidential support for people in distress, prevention and crisis resources for you or your loved ones, and best practices for professionals. If you are in another country, find a 24/7 hotline and location of Crisis Centers worldwide at International Association for Suicide Prevention - Resources: Crisis Centers.
  11. Previous articles have garnered comments regarding graduate nurse proclivity toward advanced degrees and not remaining at the patient bedside. Graduate nurses self-describe as wanting to be the best, excel, and achieve the greatest compensation. In addition, there are those encouragements left from the Magnet programs (A new model, 2010; Drenkard, 2013; Stimpfel, Rosen & McHugh, 2014; Wolf & Reid-Pointe, 2008) for graduates to achieve degrees. The patient bedside care is comparable to primary health care. Primary health care is described as essential health care much like bedside nursing. Calma, Halcomb, and Stephens (2019) discuss curriculum, nursing student attitude, and perceptions, preparing them for primary health care workers. They discovered a focus on acute care in curricula that color the nursing student perception. Acute care curricula content and the encouragement to pursue advanced degrees is that having a greater impact? Is it truly a lack of awareness of essential healthcare career possibilities, therefore desire and confidence are lacking as suggested by Calma, Halcomb, and Stephens (2019)? Or could it be the student nurse experience that affects a nurse? When I was a student driver in a car with my driver education instructor (yes it was a long time ago), he pointed out to myself and the two other bored high school student drivers in the car that watching pedestrian reaction at seeing the student driver sign on the top of the car was indicative of their student driver experience. A smile indicated a positive experience a frown a negative one. Interestingly I noticed a reaction was universal despite age and gender. It has me thinking is it the same for nurses? Does their student nursing experience color their nursing practice or just their reaction when reminded of it? Or is it burnout? Burnout is defined in the ICD-11 as “a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. It is characterized by three dimensions: 1) feelings of energy depletion or exhaustion; 2) increased mental distance from one’s job or feelings of negativism or cynicism related to one’s job; and 3) reduced professional efficacy” (WHO, 2019). As discussed in previous articles by this author, burnout was first researched and identified in educators and healthcare providers primarily nurses in the 1980s. Since burnout has been extensively researched and led to the identification of it in many work settings and roles. Additionally, the research has continued for those in education and healthcare. More recently, nursing students have been included. My own study is of nursing faculty burnout. The research survey will be available soon. I began this article with thoughts of nursing graduates, many of which who have expressed intentions of not remaining at the bedside but to continue their education. This author has previously posted articles on allnurses.com which have garnered anecdotal lamentation commentary of educating graduates to advanced degree levels taking them away from the bedside resulting in leaving future patient bedside unattended. Interestingly, research and data that established the advantageous use of bachelor prepared nurses at the bedside for the patient also gave impetus to the Magnet programs (A new model, 2010; Drenkard, 2013; Stimpfel, Rosen & McHugh, 2014; Wolf & Reid-Pointe, 2008). There is the research conducted by Calma, Halcomb, and Stephens (2019) that offers the possibility of nurse graduates simply unaware of primary health care or bedside nursing as a viable opportunity. Another thought offered is the student nurse experience affecting the nurse as a graduate and beyond. There is current research of the nursing student and burnout that begins during the nursing education experience. Also, research has linked burnout in nurses and nursing faculty to nursing shortages. Is burnout leading the graduates to seek further education to leave the bedside? Will future bedside nursing experience shortages to the extent that patients will go untended? Given we have experienced nursing shortages in the past and are currently experiencing nursing shortages, is this happening now? Your thoughts? 
  12. Preventative Measures Burnout has been a topic well researched starting with Maslach, Jackson, Leiter, Schaufeli, and Schwab (1986). As someone who has been reading literature and spending a tremendous amount of time over the past few years thinking about burnout, I have often been asked what is the cure or the preventative actions. The research is consistent in establishing the existence of burnout and the all too commonality of it. In my reading, I found articles reporting nursing student burnout. Recent research is attempting to pinpoint where it begins for nurses, before graduation during the educative process? Or as a graduate nurse? The article I wrote recently and published here in allnurses.com titled "Are Nursing Students Burned Out Before or After They Graduate?" (2020) does delve into the topic with much greater depth. Currently, there are many more questions about student nurses and burnout than answers. Change in Mindset? Another nurse posted a question in allnurses.com (Destin293, March 17, 2019) "Burnout...what to do about it" had a respondent that stated “There is nothing wrong with YOU or your very reasonable feelings about this. Burnout is not the appropriate label for it. Chin up. Put your confidence and self-worth back in order, as this weight is not yours to bear. You have no professional duty to imposed nonsense. Instead be impowered. Formulate plan B and put it into action” (JKL33, March 17, 2019). A response that is well-meaning but not helpful. If burnout is the perceived experience, it is the individual’s state of being. And the description of burnout as put forth by Maslach et al. (1986) is one the encompasses an individual incapable of self-directed action as described by the respondent above. However, the respondent that posted the above comment is not alone, many believe that burnout can be defeated with a positive attitude or thinking, pulling oneself up by bootstraps or change of outlook. Maslach et al.’s (1986) beginning and subsequent work along with a plethora of other researchers have established the construct of burnout as valid with many different mediating factors. Little research has found burnout to be mediated simply by a change in mindset. Self-Care and Mindfulness Some recent study, however, has explored the impact of preventative measures for nursing students e.g. self-care (Nevins et al., 2019) and mindfulness for nurses Montanari, Bowe, Chesak & Cutshall, 2019). Nevins et al. (2019) reported that an increase in exercise and hydration in baccalaureate nursing students did increase students’ described levels of wellness. Montantari et al. (2019) found that nurses’ use of mindfulness “positive implications for the well-being of nurses” to stress and burnout (p. 175). Increased resilience in nurses mediated burnout (Guo et al., 2019). All increase my hopefulness that research is on track to illuminate a burnout preventative pathway. Faculty Burnout Additionally, my literature reading has included the topic I plan to research, nursing faculty member burnout. Aquino, Young-Me, Spawn, and Bishop-Royse (2018) found in their descriptive survey study of doctorate nursing faculty members’ intent to leave their academic position that degree type, age, and burnout were significant predictors. Their recommendations in addressing the nursing faculty member shortage as “critical to creat[ing] supportive and positive work environments to promote the well-being of nursing faculty” (p. 35). I have found the reading and contemplating burnout and nursing faculty members’ possible experience of it as interesting. The plethora of burnout research mentioned previously consists primarily of educators and healthcare providers as subjects. Little burnout research is of nursing faculty members despite the “great demands placed on many nursing faculty” (Aquino, Young-Me, Spawn & Bishop-Royse, 2018, p. 35). My doctorate topic is nursing faculty member burnout. I plan to offer qualifying allnurse.com members access to a survey. The qualifications include current full-time employment and one year of experience as a nursing faculty member. Interested? It is coming soon.
  13. The burnout study of nursing is extensive and ongoing. Evidently, nurses are either burning out or burned out. However, when does the burning out begin, nursing school? Graduate nursing? Beginning practice? Or possibly later, after many years of practice? There is an ongoing study of nursing students’ burnout, however, without the extensive history that is found in nurse burnout study. The most recent research of nursing student burnout suggests that it may start in nursing school (Ching, Cheung & Rees, 2020; Rios-Risquez et al., 2016; Robins, Roberts & Sarris, 2018; Valero- Chillerón et al., 2019). If burnout does start in nursing school for nursing students, the questions of immediate thought are many, is burnout and the nursing student personality or some other personal factor of the nursing student need investigation (Majerníková, 2017)? Is it the environment either societal, home, or school (Njim et al., 2018)? Is the presentation or volume of information required? Or the teaching approach? Nursing student perception of instruction and/or supervision? And/or other nursing school factors such as clinical learning leading to burnout in nursing students (Babenko-Mould & Laschinger, 2014)? I discovered the articles reporting the study of nursing students’ burnout when conducting a literature search for my doctorate study topic: Nursing Faculty Burnout. The discovery caused another avalanche of thought, and the question: Is the nursing faculty burnout related to nursing student burnout? A literature search of nursing student burnout using CINAHL Complete, Academic Search Complete, and Gale Academic OneFile with peer review and 2017-2020 as limiters revealed 549 research articles. However, none were of nursing faculty burnout and nursing student burnout. Why? If nursing faculty are experiencing burnout symptoms of emotional exhaustion, depersonalization, and reduced personal accomplishment would that influence nursing student stress and present modeling of burnout behavior creating students at increased risk for burnout? Moreover, of greater prevalence particularly recently is the study of nursing student incivility, violence, bullying, and aggression (Hogan et al., 2018; Hostetier, 2019; Streiff, 2019). Is nursing burnout and/or nursing faculty burnout factors in this extreme behavior? Nursing faculty burnout has been linked to the nursing faculty shortage and further has been linked to the global nurse shortage (AACN, 2019; WHO, 2017; WHOA, 2018). The nurse shortage creates an environment that exacerbates the burnout factors with overwork and overburdening demands that lead to chronically incomplete tasks. That environment causes an increase in suffering and decreased safety for patients that are unacceptable to the caring nurse. The typical nursing faculty member has 20 years of experience before joining the ranks of academia. Burnout tends to stick like burrs. Nursing faculty burned out leads to less nursing faculty. Less nursing faculty causes fewer openings for nursing students to attend nursing school. Moreover, it results in nursing student exposure to burned-out nursing faculty (AACN, 2019). The nursing student after experiencing nursing faculty modeling burnout behavior, exposed to the nursing school environment graduates to hire into the selfsame situation that caused the nursing faculty members’ burnout some twenty years previous. Is that circular linkage a factor? Further, is resilience as the counterpoint to burnout a factor? There are a few, mostly recent, studies of resilience, nurses, and nursing students as a predictor of burnout experience with interesting results. Garcia-Izquierdo et al. (2018) in a study of 218 nursing students found a significant relationship between resilience, burnout, and psychological health. Brown (2018) conducted an integrative review of the impact of resiliency on nurse burnout that yielded yet more interesting and positive recommendations. What is happening in nursing schools? The nursing faculty burnout survey that I will be posting for allnurses.com members to complete will have some interesting outcomes? Will it not? There are many more questions I am sure that will occur to others. Previous articles regarding nursing students and nursing faculty have instigated comments and exchange of ideas here in allnurses.com, I hope for more.
  14. Every nurse has had one of those days. This cartoon may PERFECTLY depict how you feel after five minutes or five hours into your shift. Now comes the fun part... strap on your thinking cap and get creative for this National Nurses Week contest. Submit your caption in the comments below and you could score $100 from Carson Newman University! Sponsored by Carson-Newman University In the Year of the Nurse, advance your career as an FNP! Confidently transition into Primacy Care with an online MSN-FNP Degree or Post-Master's FNP Certificate from Carson-Newman, a university recognized for nursing excellence and unrivaled student support. With clinical placements provided, 100% online classes and no mandatory login times, our programs are designed for busy working nurses. CCNE-accredited and affordable, you can save up to $200 per credit hour compared to national competitors. Define your future as an autonomous Family Nurse Practitioner today. LEARN MORE ABOUT CARSON-NEWMAN
  15. Meetings A typical nursing faculty day starts an hour or more early to check emails and get organized for the first lecture or class. And bing! An email calendar reminder: a 30-minute countdown to the curriculum committee meeting. Frantic scrambling ensues – where are the previous meeting notes? A dreaded discovery – today’s report is a totally forgotten one. Off to the meeting with the embarrassment and self-torture brain tape running amuck. Not quite what the TV sitcom portrays. Teaching Two hours of teaching follows the meeting. A class break between class one and two brings student appointments. After class two is a quick lunch at the desk and phone calls. Student Appointments After lunch, three more student appointments, no break, term paper grading for the remainder of the afternoon. More Meetings Late in the day - bing! A phone alert reminder of a Nursing Department meeting and the research update presentation obligation as the (leadership requested) task force head. More frantic scrambling looking for the presentation that - sigh – was found. Following the task force meeting… oh no! today is the library trip – now closed, so much for working on the dissertation. Wearily locking the office door, juggling a tote bag full of nursing care plans to grade and leaving. Yet, until the care plans are graded for tomorrow’s 12-hour clinical day, the day is not done. There is More... A typical day? But wait there is more! In addition to teaching duties and responsibilities and serving on committees, there is completing license maintenance professional development hours. Advanced practice faculty have to complete extended hours of continuing education credits to keep working. As if that weren’t enough, common are requests for workshops or conference presentations, often outside of office hours. Peer mentoring can eat up precious time, as can additional classes due to faculty shortage. Active participation in research, self-credentialing, and community involvement are among the many other responsibilities. Northwestern University found that 60.9% of faculty at public universities and 56% at private ones find committee work stressful. Overlapping Roles Overlapping roles increases the demand for faculty time, which is already constrained with student needs and course requirements. Far from the capability of doing it all, and not being able to meet basic responsibilities causes stress. The inability to meet leadership expectations with committee or task force assignments that may impact one’s chances for promotion or tenure exponentially increases the stress. Northwestern University reported that three-quarters of their faculty suffered at least moderate to severe stress from multiple roles required for their position (Northwestern University, n.d.). So, What Can Be Done? Considerations for leadership when assigning additional roles to stressed faculty are the possible stress associated conditions: mental depression anxiety pessimism inability to concentrate Serious physiological ill that can occur: Alcohol abuse Substance abuse Chronic fatigue Sleep disorders Headache Muscle tension Gastrointestinal ailments (Better Health, 2012) Teachers who were surveyed listed several reasons for their job stress. Here are some common themes: Too little time Not being able to develop their class Not enough administrative support Changing responsibilities (Mulholland, R. et al, 2013) Consequences of nursing faculty stress on their performance include: Less efficiency Impaired student-faculty interaction Poor student outcomes Clinical errors especially medication errors Placing patients at risk due to poor supervision of clinical students Academic institutions should take advantage of opportunities to decrease the stress caused by overlapping responsibilities on nursing faculty: Provide mentoring for new faculty before assigning additional tasks Review whether current committees or task forces are necessary Offer paid time off for faculty pursuing advanced degrees Consider the course load of the instructor before recommending them to a committee Rotate responsibilities throughout the nursing faculty community Nursing Faculty can help themselves by: Speaking to the Dean or Department Head when the workload gets overwhelming Get help with prioritization and organization if necessary Reach out to a mentor or colleague for help Schedule some time for self to unwind and relax Don’t take unnecessary work home Take care of physical and mental health Consider whether the job is worth the stress Overlapping roles for the nursing faculty may never go away. It is possible, however, to prevent hating the job you used to love.
  16. I am ready to leave the nursing profession after 6 years. I have a bachelor's degree in biology and got my associate's in nursing. In high school, I decided that I wanted a career in nursing. By the time I entered college, I decided I wanted to become an OB/GYN. Halfway through college, I realized I didn't want to be a doctor. I wasn't sure what I wanted to do but I wasn't going to change my major and start over. Fast forward about 8 years, I considered nursing and applied to nursing school and here I am.....back at square one. I wish I had sacrificed and endured one or two more years of college by changing my major and pursued something else. I often-times cringe when I think of going to work. My attitude changes, my heart races, and anxiety sets in. My coworkers are nothing less than awesome. Most of my patients rock. Both have been unexpected blessings to me and I thank God for our paths crossing. But management, the physicians, and the facility at which I work have made nursing a profession that I wished I had not entered. I never have to wonder how devalued I am when I'm at work. Our voices are not heard, and as a matter of fact, our concerns are considered complaints. Not only am I a caregiver, but I am the business office, auditor, waitress, maid, logistics, IT, quality assurance, babysitter, personal assistant, and the list goes on. When doctors fall short, it is our job to clean the mess up.....and, no, I'm not speaking of mistakes that affect patient care. I speaking of simple documentation that they are supposed to take care of. I understand the importance of having all "I"s dotted and every "T" crossed, but when will the physicians be held accountable? I can't be chasing down physicians when they forget to check the correct box especially when it has little or nothing to do with a patient's outcome. That's not my job. We nurses are stressed, afraid, furious, and just plain depressed as a result of these added responsibilities. We already worry about our patients even after quitting time. After leaving work, many of us call back up to the floor or unit checking on our patients. We are genuinely concerned about them, but it is very obvious that management's agenda is not the patients. Whatever management's agenda is becoming our agenda, right? WRONG! I'm here to take care of patients, not physicians. There are so many nurses, YOUNG, fairly new nurses, that I know that started their nursing careers with a clean bill of health. They are now on antidepressants, benzos, blood pressure meds, and others due to the stress and unhappiness. Nursing has gotten away from patient care. It's about making money for the organization which is about making the physicians happy. If that means being stripped of our dignity, we are to do what it takes. I feel as though it is second nature to provide excellent care to our patients. WE have saved many lives anywhere from observing changes in our patients to discovering mistakes made by others (physicians) and correcting them or directing attention to the oversight. I wish they would let us do OUR jobs and provide care and management can run up behind THEIR "customers". If we can keep those two jobs separate, that would be great. We are a vital part in patient care, but yet, we are so underappreciated and taken for granted. We make a positive impact in many lives, but we are the first ones cursed out because someone is having a bad day. Not only are we unappreciated, but we are very disrespected, and in many occasions, we are unfairly belittled and we are just supposed to accept those words because "it's part of the job." I'm done accepting it. I'm reminded every day there are replacements waiting in line. I'm reminded that any fool can do my job. I don't want a pat on my back every time I do a great job, just acknowledge that I am a vital part of the team. I understand human resources has a stack of nursing applicants on their desks. I just don't have to be reminded of that everytime all my paperwork isn't on the chart (because I'm still working on it), or if I come back from lunch two minutes late. I am not cut out to take jabs and low-blows without throwing them back. I have so many responsibilities that I take on from the time I punch the clock to the time I punch out and I refuse to be disrespected by someone with a title because I happen to not move fast enough or I am having to clarify an unclear and, most of the time, an unfinished or incorrect order. I'm helping YOU out!! We genuinely worry and care about our patients that it often consumes us. When a patient codes or expires, we are crushed. I once had a patient who got stuck at least 15 times by various staff members, including physicians, to get IV access. The patient took those sticks like a champ, but I still went home and boo-hooed because I hated to see him go through that. We hurt when our patients hurt. On top of carrying out our responsibility as nurses, we are holding in so much emotion associated with our patients.....yet we get very little to no respect. Don't get me wrong, there are some physicians that I'm in contact with whom are polite and value my opinion and I do appreciate them. Of course, I'm not always right or may not make the most intelligent statements, but they acknowledged my voice. Again, I don't want a cookie. I just want to be acknowledged as a professional. I understand customer service includes dealing with angry, rude, and the dissatisfied. But when I have poured my heart, soul, and emotion into my job and my customers and I am still allowed to be mistreated and insulted, then that becomes a problem. I feel I have no rights as a nurse. Who is protecting me? Who is my voice? Who is standing in my defense? So at this point, it's time for me to bow out from the nursing profession gracefully and while in good standing with the organization, my family, and myself before I am forced out or OD on my meds(or somebody else's). My family, happiness, health, dignity, and peace of mind is worth leaving. They tell me Costco employees never leave. I'm-so-over-nursing-I-would-rather-work-at-costco.pdf
  17. You’ve probably felt the effects of workplace burnout at least once in your nursing career. As of this week, burnout has officially been recognized by the World Health Organization (WHO) as a formal occupational phenomenon. Clinicians of all types have been living with the effects of short staffing, stress, and other patient barriers that seem to zap their energy and ability to provide the best care. Burnout is now defined as a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. It’s characterized by reduced professional efficacy, feelings of exhaustion, and increased mental distance or negative feelings about your work environment. Nurses and BurnoutThe concept of burnout has been around since the 1970s when psychologist Herbert Freudenberger coined the term. When you’re under high levels of stress for an extended period, it’s common to start to feel tired and unhappy. However, the phenomenon doesn’t only make you want to sleep. It can create psychosomatic issues like anxiety, depression, and insomnia, too. Nurses in burns units, critical care, pediatrics, and emergency departments are at a greater risk of developing the condition. The high levels of care and increased uncertainty of outcomes in these areas can take their toll on the mental and physical faculties of any nurse. Other causes of burnout include inadequate staffing and caring for those who are nearing death or actively dying. You might also struggle with burnout if you’re a newer nurse or have continued conflicts at work that challenge your values. How Can You Prevent BurnoutMany people think that burnout is driven by the way each nurse deals with stress. However, some experts believe that burnout is a consequence of administrative processes. This means that preventative measures must be initiated on a global level if you want to see changes in the level of burnout nurses experience. Here are a few ways administrators can help to minimize the number of nurses affected by burnout. Improving Communication MethodsThe concept of interoperability isn’t limited to the patient’s medical record. If you must access multiple platforms to gather information and then manually synthesize the data to make care decisions, this could be adding to your level of burnout. Another factor in communication involves having to search for policies and procedures, rather than having these types of resources in one central location. Think About SchedulingWhether you work 3-12 hour shifts or 5-8 hours shifts, nursing is challenging. Many nursing units have rigid scheduling policies that make it challenging to take a day off at the last minute for “mental health” needs or family events. You might also not get your schedule more than a week or so in advance, so scheduling life outside of work can be difficult. Facilities need to learn ways to adopt flexible scheduling policies so that nurses get the time off they need. This might mean hiring more staff, so that weekend rotations are decreased or using “prn” staff to fill in during times of high acuity. Some units use self-scheduling as a way to increase satisfaction with schedules Consider Nurse-to-Patient RatiosA 2018 study conducted at Marshall University concluded that nurse-to-patient ratios are directly related to nurse productivity and overall health, including mental, emotional, and psychological factors. Not only did the researchers find that the health of the nurse was in jeopardy during times of inadequate staffing, but they also suffered from job dissatisfaction. In California, nurse-to-patient ratios are mandated, but the rest of the country is left to the individual policies of healthcare facilities. More nurses are advocating for set staffing ratios and working with lawmakers to initiate legislation. However, this can take years for it to become the norm across the nation. Does the New Recognition from WHO Help?Do you feel that recognizing burnout out as a workplace phenomenon will help support issues such as staffing ratios, long hours, and job stress? Will employers finally look for new methods to fix the problems that plague nursing units? What do you think? Share your thoughts in the comments below.
  18. I am a later in life RN (46 yo.) Nurse for 2 years. 1 yr hospice, 1 yr skilled/rehab unit in LTC. Hospice: too many HOURS so i switched to 3-12hrs on a rehab unit. I dont like what its doing to my PERSONALITY. Since its an ltc, a LOT of our pts are more "attention needy" than medically needy. Ex: call lights to "empty garbage" or "pick my lettuce off the floor" kinds of bs. Pts ringing like crazy for DUMB stuff or coming to nur station 30+ times a SHIFT. Not to mention the faaaamily members expecting 1 on 1 specialty treatment. Lots of pts are more hospice/LTC approp than "rehab"...Ive tried setting boundaries, pts acknowledge,apologize and then just REPEAT behaviors. Feel like im growing to HATE ppl and dont want to turn into that nasty burnt out nurse we all dread. Feel like Im dealing with a bunch of needy self absorbed, tantruming toddlers all screaming at the same time! Coworkers tell me "its just nursing, it does that to you". Thinking about switching to hospital setting but afraid of the unknown. Any advice?
  19. Going to work should not be dreadful. However, for many nurses, the stress, burnout, and culture can sometimes make it downright painful to get dressed and head to work. After days, weeks, months, or even years of these types of feelings, you might lose the love you once felt for the profession. If you’re going through this, you must remember that you are not alone and that these feelings are normal. If they hang around for a few days or a month, it’s probably not too concerning. But, any longer than that and you may need to start looking at strategies to help you bounce back and reignite the passion you once felt for your career. Here are a few of my favorite things you can do to get back on track. Take Time Off Americans let 768 million vacation days go unused in 2018. This equals billions of dollars in lost benefits and often means that workers aren’t getting the rest, relaxation, and restoration they need. Unfortunately feeling like you’ve lost your passion for your work can sometimes be a double-edged sword. You feel burnout, so you keep working with the hopes of finding something that will reignite the passion you once felt. Unfortunately, it often makes the situation worse. If you’re feeling disconnected from work, talk to your manager or supervisor about scheduling in a few “mental health” days. Don’t plan any major events on these days, instead book time doing something you love. Or, you may want to make an appointment to get a massage, pedicure, or other restorative treatment. Treat Symptoms of Burnout Burnout is a challenging condition. If you start feeling like every day is a bad day or you’re exhausted all the time, you might be dealing with burnout. Other symptoms to watch for include: Feeling worthless or hopeless Feeling bored or overwhelmed Feeling under-appreciated Exhaustion Frequent illness Headaches or muscle pain Change in sleep patterns Change in appetite If you are experiencing any of these symptoms of burnout, you need to get the treatment you need. Talk to those around you about how you are feeling. If you have a workplace mentor or a boss you trust, start there. They may have noticed these changes, too and can offer invaluable feedback. You should also try to increase your connection with your coworkers, but avoid interactions with negative individuals. You might also need to look for activities outside of work that can increase your feelings of meaningfulness and purpose. Look for a New Specialty Sometimes feeling overwhelmed and unhappy can be a sign that it’s time for a change. If you work in a specialty like hospice, oncology, or other high-acuity areas, you may need to consider looking for a new area of nursing to try. Not only can a change decrease your level of stress, but it can also help you find your passion through learning about new areas you never thought about before. Work With a Coach or Mentor Reaching out to another nurse who has maybe experienced these same feelings can be helpful. If you have a mentor, start there. If not, it might be a good idea to hire a career coach who is also a nurse. You can discuss your feelings with them and also ask them for ideas of other areas of nursing that could be a good fit with your background. Take Care of Yourself It seems that self-care, getting plenty of rest, and eating a well-balanced diet is a good answer to just about any problems we have in life. And, feeling burnout and drained at work isn’t any different. Carve out time to get at least 30 minutes of moderate-level activity each day. Find a diet that is low in carbohydrates, junk food, and sugary foods. You might want to consider one that is plant-based or at least has high amounts of fruits and vegetables. Finally, make sure you are getting eight hours of sleep every night. Getting Back on Track Remembering your passion for nursing can be challenging when you are in the midst of burnout and other feelings of disconnection from your work. You can use these ideas, but there are also many other ways to reconnect with your passion for the art of nursing, it just takes a little work and time. Have you ever experienced burnout or “fell out of love” with nursing? What helped you get back on track? Share your ideas with us by posting in the comments below. We would love to hear them.
  20. Dear Nurse Beth, I have been in Med/Surg for my entire nursing career, for the past five years. I recently sustained a lower back strain and have been on workman's comp. I am wrapping up my recovery. The thought of having to return to work with the neuro population of patients is overwhelming (physically and mentally very heavy, demanding work). I feel the need to find a job less physically demanding. I am considering working part time in my next role, I am so burnt out. I have become very jaded due to recent budget cuts, feel exhausted from the customer service aspect, and now, recognize this line of work has taken a huge toll on me emotionally and physically. I am an empath. (Just discovered this about a month ago, however). I have a creative, sensitive spirit. I love to write. As a nurse, I value being an educator. I want to feel like an expert in my field, and have a skill set I feel confident about. The hospital is so rushed. I realized as well, after working with medical patients, at the end of the day I enjoy helping make others happy not just healthy. This time on workman's comp has helped me recover; I am tired of having to sacrifice my needs for others. Do you have any recommendations for the next step in my career? My thoughts so far have been: injections/cosmetology would please my aesthetic/creative spirit; Dermatology to promote self care, prevention, education although working in a clinic isn't super appealing to me; or finding a job that includes writing - I was really good at working with NCLEX material? My neighbor had recommended working for insurance companies as well. Appreciate any inspiration, feeling frazzled and lost even after being a nurse for five years. Thank you! Dear Lost, Sometimes in life, you have to step back in order to gain some insight into your own needs. Like you have been forced to do with your injury. It's actually an exciting time for you because you are on the brink of moving on to something new, which will take care of your MedSurg-induced burnout. Working in cosmetics/plastics satisfies a lot of your requirements. It's less physical, and for the most part, you are making people happy. The pay will typically be less than acute care, at least to start with, but your salary will grow with your expertise. Training is on the job. Be sure and go with a reputable employer. Once you leave acute care, it is hard to get back in. Once 3-5 yrs have passed, you may need a refresher course to be competitive and there's still no guarantee. Be sure you are comfortable with leaving the hospital setting. Try a writing job part-time or on a freelance basis to develop your writing skills. You can search for "nurse writer jobs". HealthStream, GNOSIS, Prophecy, and many other companies use item writers to write test questions. Being an empath means you have a high degree of empathy and feel what others around you feel. You want to heal other's pain which makes you an excellent caregiver but can leave you exhausted. Your recovery time after these intense connections is key. Put out some feelers into the job market and see what the search brings you. Go on interviews and you will get a better idea of what appeals to you. Best wishes, Nurse Beth Author, Your-Last-Nursing-Class-how to land your first nursing job...and your next! Start your job search today!
  21. First, the World Health Organization has declared that 2020 is the Year of the Nurse and Midwife. The theme for 2020, Nurses: A Voice to Lead - Nursing the World to Health, demonstrates how nurses are central to addressing a wide range of health challenges. It will encourage nurses and the public to celebrate, but also provide information and resources that will help to raise the profile of the profession throughout the year and attract a new generation into the nursing family. 2020 is also Florence Nightingale's Bicentennial – celebrating her 200th birthday on May 12. Having the Year of the Nurse and Midwife coincide with Florence Nightingale’s bicentennial raises the exciting prospect of nurses finally being recognized for all the good they do. And the Nursing Now Nightingale Challenge will produce a new cohort of young nurse leaders who will take the profession forward over the next decade. National Nurses Week is May 6-12, 2020. Supported by the American Nurses Association, National Nurses Week celebrates nurses and their role in society. The week also helps to raise awareness about nursing as a possible career choice and also to educate the public about the kind of work nurses are involved in. And, finally, coinciding with that week is: National Student Nurses Day May 8 National School Nurse Day May 8 International Nurses Day May 12 So there is a lot happening for you to get involved in. But we also need to be aware of and address some of the challenges that might be jeopardizing the forward progress of our profession. Challenge #1 There is a NURSING SHORTAGE on the horizon due to these factors: Aging Population As the population ages, the need for health services increases. Aging Work Force One-third of the workforce could be at retirement age in the next 10 to 15 years. Nursing faculty is also experiencing a shortage, and this leads to enrollment limitations, limiting the number of nurses that a nursing school can generate. Nurse Burnout Some nurses graduate and start working and then determine the profession is not what they thought it would be. Others may work a while and experience burnout and leave the profession. Career and Family Often during childbearing years, nurses will cut back or leave the profession altogether Regions Some areas of the country struggle to fulfill the basic needs of the local population as a whole. Growth A higher need is seen in areas that have high retirement populations. Violence in the Healthcare Setting The ever-present threat of emotional or physical abuse adds to an already stressful environment. Emergency department and psychiatric nurses at a higher risk due to their patient population. Challenge #2 Unhealthy Lifestyles There is an abundance of nurses with unhealthy lifestyles. We need to give attention to the personal health of our nurses. After all, if we don’t have healthy nurses, everything else we try to do to increase our nurse population will be of no avail. So let’s look at the state of our health. A study of 2,730 hospital nurses from the American Nurses Association (ANA) Health Risk Appraisal (HRA), surveyed from October 2013 to December 2015, found serious deficits in diet, sleep, and physical activity that may jeopardize nurses’ health and negatively impact the healing strength of the profession. (And from my vantage point as a Wellness Practitioner, this data probably holds and in fact may even be worse in 2020.) For nearly every indicator, the health of America's nurses is worse than that of the average American. Nurses are more likely to be overweight, have higher levels of stress and get less than the recommended hours of sleep. Here are some key findings: (Notice how many are within your control) Nurses are Exhausted 56-57% reported often coming in early and/or staying late and working through their breaks to accomplish their work 33% said they had often been assigned a higher workload than that with which they were comfortable 59% of respondents reported that they worked 10 hours or longer daily 47% slept fewer than 7 hours per day. Nurses are Overweight 56% were overweight/obese with a body mass index > 25 kg/m2. Only 14% of the nurses were eating at least five servings of fruits and vegetables per day (2.5 cups). Just 45% of the respondents were engaged in aerobic activity of at least moderate intensity for 2.5 or more hours per week, while 47% performed muscle-strengthening activities twice a week. Nurses Do Not Prioritize Their Health Over Others 68% put their patients’ health, safety, and wellness before their own. Nurses are Stressed and Burned Out From a study by the Cleveland Clinic of their nurses, 63% suffer from burnout. If it is not addressed nurses can become disengaged and eventually leave the profession. And, severe levels of stress are not only unhealthy but can negatively affect patient care. As you know, if nurses don’t adopt and maintain healthy lifestyle behaviors they are at risk for chronic diseases and early mortality. On the other hand, nurses who make healthy lifestyle choices have a spill-over effect and will be more apt to discuss and recommend preventive behaviors such as smoking cessation, more physical activity, and eating a healthier diet to the people under their care. With personal health on top of their mind, they may be better able to prevent workplace injury and avoid errors related to fatigue. So nurses who adopt healthy lifestyles may even provide better patient care. So What Does All This Mean For You? YOU can contribute by taking action on whatever you think would work for you. After all, you are the key to everything that will make The Year of the Nurse a truly important opportunity to showcase what we do and who we are. In my opinion, your best option that could be a win-win for both you and your profession is to take action on adopting a plan to get healthier. You are, after all, being watched by those around you as the expert on health, and if you embrace wellness as a lifestyle choice, you will make an impact on other’s behaviors as well. Don’t overlook the fact that you are a role model for not only your expertise but how well you model the health practices you teach to others to manage and prevent the chronic diseases they experience. And because this is the beginning of a NEW YEAR this is the perfect time to get started. What Are You Waiting For? Please share your lifestyle enhancement ideas to give other nurses ideas to draw from.
  22. Today I remembered a 4 yr old... lifeless, so pale, except for the bruises which covered his body. I remember so vividly the parent who angrily confessed that "the boy just refused to walk right"...so he beat him to death. I thought about the terror that child must have felt just before he lost consciousness. I remembered the tiny little boys we (PICU RN's) referred to as 'the blues brothers' because of the constant cyanotic spells requiring resuscitation, who all ultimately succumbed to their respective disease states. So many infants born of addicted mothers....left...just left...in the PICU to be cared for by us. No family, ever. A beautiful, fat, porcelain-skinned six months old transferred to us from the NICU...a graduate they called her. She was physically perfect except for a trach which was, apparently, more than her birth mother could cope with. Her life void of any bonding, this child had developed an aversion to human interaction. Months of patient coaxing finally led to eye contact and then to an earth moving smile from her. In my first work-related nightmare I stole this baby...and then frantically tried to figure out how to return her before getting caught. People ask "how can you keep from getting attached?" We couldn't do our jobs without getting attached. How many mother's faces I looked into as I laid their already lifeless child in their arms after I took them away from the machines which made them seem alive for a while...sometimes very long whiles. How many times I hurt a child in the name of treatment which we all really knew was futile. Oh my God, that one hurt. I remember feeling guilty about the joy I felt as one family lost a perfectly healthy child to a GSW to the head because another child would live ...perhaps...even though it would mean a life-long regime of medications, physician visits, lab tests, fear of rejection. The broken hearts of family members over a brain-dead child due to shaken baby....the sorrow I felt because he really didn't know the consequences of his actions....the rage I felt because a mother lied while her baby was dying because she didn't want to get her boyfriend in trouble for his abuse of that child. I am thinking how there seems to be an invisible wall which surrounds the bedside of a dying child; all the cacophony of PICU noises dulled by broken hearts and pulled curtains. So many times I was so angry yet so helpless to make a difference. Burns, abuse, accidents, mistakes, every disease known to afflict adults, head trauma, heart trauma, multi-trauma, multi-system-organ-failure, limbs lost, lives changed, slow deaths, traumatic deaths, anticipated deaths, unexpected deaths, and deaths which didn't happen; all have taken a toll. There were miracles, yes. There were triumphs, many. But today I realize, I am traumatized. I will not return to substance abuse...which is how I suppose I lived through it all. But I am asking for your prayers as I learn how to begin to deal with this realization: We as caregivers must recognize the effects of our caring on ourselves! My husband knew, but couldn't tell me. He said he saw me hugging my own children too tight and too long for their ages. Thank you all.
  23. Carol Ebert

    Is It Possible to Burnout in Retirement?

    And as I check in with others my age, I find several different paths that people take with their newly found free time. Take care of grandkids Travel Start hobbies Start a new business Go back to school for a new career Relax and hang out with friends Your path might be different because there really is not one path to take since the freedom you now have allows you to explore whatever you want. My path continues to be wellness because that is what I have always loved to do in my career and my passion has not stopped. What is different is that there is not a boss telling me what to do so I am free to do what I choose. And that is the reason I am writing about Burnout During Retirement. Can that be possible? I thought burnout was for those left behind who are over-worked, stressed-out, worn-down, exhausted and often depressed. As it turns out, when you aren’t answering to a schedule and the directives of an organization, you are still at risk for burnout. In my case, I blame it on my entrepreneurial nature which always directs me to seek more to explore, learn and do. And the result is that I find myself experiencing all the same symptoms of burnout that caused me to leave my last job in the first place. Here are some classic signs that employers report from their employees: Chronic physical and emotional exhaustion Sense of cynicism – everyone is bugging you, you don’t feel empathy for others Sense of ineffectiveness – you can’t see a path for yourself Lack of downtime – always “on” Lack of enthusiasm – can’t summon energy for what you used to be excited about Physical problems – headaches, stomach ache, bouts of cold and flu – especially if you don’t normally get sick Overreacting to requests I’m sure you are familiar with these or have even experienced some of these symptoms yourself. But if you are in your third act and happen to be an entrepreneur like me, you are still subject to this happening to you. I know that for a fact because I find myself overworking even more than I did as an employee because there is no schedule or corporate directive to tell me to stop and go home. I’m already home! So if you are entering the retirement zone, this is a cautionary tale – especially if you are an entrepreneur. But it is not hopeless. First step is to be aware that you might still burn yourself out if you have that busy nature as I do. So here are some excellent strategies to prevent this from happening. Tackle what frustrates you the most What stresses you out and leads to that headache? Pick it apart and see what you can change and what you can’t. Make the changes that you can and accept the changes you can’t. Surround yourself with inspiration Start and end your day with gratitude. Create a pleasant environment to work and play in. Listen, watch or participate in inspirational offerings Heed red flags Pay attention to the signs of burnout. Catch frustration early before your body starts to give you a symptom. (mine is a headache) Network with others your age who are entrepreneurs There is strength and support in numbers Find out what strategies they use to avoid burnout Do switch off Power down all your electronics before 8 pm to force downtime for yourself Create relaxing evenings before bed Get enough sleep We still need 7-8 hours/night Your body needs time to repair, restore, relax and during sleep is when that happens Talk things through Find someone you can talk to – friend, coach, therapist Find entrepreneur groups with your same interests who may be experiencing the same thing Take a break You may need to force this upon yourself because it is against our nature Keep a schedule and write it on your calendar Spend time with yourself Schedule time when you can purposefully do nothing Practice by working your way up from 5 minutes to finally about 30+ minutes. This inspired me. Hopefully, these strategies will be useful and provide you with a roadmap for creating a Third Act Retirement Plan that gives you the peace and wellness you desire while still honoring your busy nature. Your thoughts?
  24. Have you ever seen a double-pan balance scale? It’s a scale that has two pans that are balanced against one another. As you put weights on one side, you must counter it with weight on the other to maintain balance. If you read about these scales, you will find that you must put weight on them in very small increments to maintain equilibrium. You must also take into account the weight of the container that you use to help balance the two sides. The idea of nurse work-life balance works the same. For everything you do at work, you need to offset it with something at home to keep balance. And if you take time for yourself at home, you would need to ramp up work to meet the weight of what you just did for yourself at home. This concept would keep work and home life equal in function, value, and amount. The more you think about this notion, the more you may consider that this is not a safe or healthy life for nurses. Maintaining a complete balance between work and home will likely lead to burnout, fatigue, and career unhappiness. Let’s take a look at the dangers of work-life balance in nursing. Work Doesn’t End When You Clock Out In today’s world of technological advancements, walking away from work is challenging. Even when you aren’t within the confines of the hospital or long-term care facility, you are probably connected. You may receive emails on your phone or text messages from coworkers letting you know that Mrs. Johnson took a turn for the worse. You might even carry a laptop home with you that seems to call your name each time you sit down to take some time for yourself. It’s easy to think, “I’ll just check on a few things. It will only take 10-15 minutes,” and before you know it, it’s been three hours and you are knee-deep in work that you shouldn’t be doing until tomorrow or the day after. This can further tip the scales of nurse work-life balance towards unbalance. Challenge of “Leaving Home at the Door” Have you ever had a supervisor tell you that you need to leave your home life and any problems at the door when you come to work? In theory, this is a good concept. However, it isn’t always practical. If you have an ill child, parent, partner, or another family member, you might have to answer questions or check in on them at work. And, sometimes life gets messy in ways that you just can’t “turn-off” because you are at work. Trying to block out home life when you’re working can tip the scales in a way that could lead to an unhealthy home life. Balance Can Be Dangerous Trying to keep balance in life could be dangerous. Think about it, your body is rarely in perfect balance. When you walk, you need a little imbalance to keep moving. When you are perfectly balanced, you are standing still, not moving forward or achieving any goals. The same could be true with the idea of work-life balance. If work and home are equal, you are likely not moving forward in either place. It’s important to allow the scale to shift from time to time. Maybe this month you are doing continuing education and a conference that requires work to be a little on the heavy side. But, next month you have plans to take a few days off and will be resting and having fun with friends and family. This is a healthy mix of imbalance that can help you move forward in both areas of your life. What Are a Few Strategies to Be a Healthy, Imbalanced Nurse? Call in When Needed Raise your hand if you’ve ever called in and felt extremely guilty about it. Okay, a sea of nurses' hands just went up! Nursing is a challenging career. If you or a loved one are sick, you may need to stay home. Heck, sometimes you just need to spend more time at home, even if no one is ill. You might need a “mental health” day or need to spend time with a child who is having a hard time at school. While it might feel that you are letting your coworkers down, it’s critical to remember that your sick days are “yours” and you get to use them as you see fit. Your employer provides these days to give you time to address family needs, so use them! Make Work Your Focus When you are at work, be present. We all need to check in on kids every now and then, but it’s essential to have a structure at home that can handle the nuances of life when you are at work. This means hiring a babysitter, putting a little more responsibility onto your partner on days you work or asking for help from family and friends. Plan Professional Development You became a nurse to help others. To do this, you have to invest in your continuous improvement and education. One of the best ways to do this is to join professional nursing organizations and get involved. Go to the annual conference and participate in education and self-improvement activities. Be sure to structure home life in a way that allows you to fully engage with your educational opportunities. Plan a Vacation Going on vacation might seem like a luxury that you can’t afford. However, it’s vitally important to give your family a good dose of imbalance at least once a year. Plan a trip or cruise and completely disconnect from work. Let coworkers know that you are off and need to not be contacted about work. This doesn’t mean your work-bestie can’t text you, it just means that they need to not tell you about the issues at work, but can check in to see how you and the family are doing. An imbalance is good. How do you keep a little imbalance in your life to stay healthy? Leave a comment below to get the conversation started.
  25. Destin293

    Burnout...what to do about it?

    Anyone here ever experience burnout? If so, what did you do about it? I have been a nurse for almost 5 years...which is really not long at all. But, I am heading closer and closer to burnout, if I’m not there already. I used to look forward to going to work...now I just get such a sick feeling in my stomach every time before I start my shift. I used to work med/surg before making the switch to ER. I just feel like new policies are constantly being passed which involve never ending “audits” of nurses. Everything we do from bedside report to blood administration is audited...it either involves someone physically standing there with a clipboard watching you do something and then checking off it you did it correct, or adding a bunch of different paperwork to fill out that gets placed in the managers mailbox for an additional audit. I would occasionally pick up on the floor and vitals now became a part of the RN’s responsibility, not the aides, because there was no help (VS are q4h). They started making nurses go to something called SNAP rounds which take 45 minutes...which comes after having to follow a huge checklist of (an audited!) bedside report that takes an hour. It’s also in the middle of med passes (that are at 8am, 10am, noon, 2pm, 4pm, 5pm, 6pm) that involve insulin...which, if it’s not given within 30 minutes, we’re audited and talked to! If we do blood administration and forget 1 VS (such as RR during 1 vital check, or are off on our time), we get audited and talked to. Add all this to patients becoming more demanding (and sicker!), census going higher, and wages staying lower, I just feel done...totally done. I have already cut back to 24 hours a week (my hospital started the Baylor program). I started counseling. I just don’t know what else to do...I feel like a giant bundle of nerves everyday, and I used to be so confident.