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Topics About 'Nurse Burnout'.

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  1. 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? 
  2. 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

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