13 November 2015

Beating the burden of burnout

It’s amazing to me that, not long after the start of a new academic year, many nursing faculty members are overwhelmed by stress with some nearing a state of burnout. During a lunch break at a recent nursing conference, I chatted with nurse educators from around the country. The conversation centered on their myriad work responsibilities and heightened levels of stress. Seated around the table, they described how each minute of every day seems to be filled with an endless list of family, life, and work responsibilities. They lamented the long work hours invested in preparing for classes, grading assignments and exams, meeting with students, engaging in committee work, working on scholarly activities, providing service, teaching—both classroom and clinical—and fulfilling a number of other responsibilities.

Manuel Faba Ortega
One professor commented: “It’s only the first month of classes, and I am completely exhausted. I’m teaching two 12-hour clinical days and an extra class as an overload assignment because we have unfilled faculty positions, and there is no one else to teach the class. I’m also enrolled in a DNP program, because our university requires all faculty members to obtain a doctoral degree. We have a new director, and she has asked me to take on some of the school’s administrative responsibilities, which I have agreed to do. On top of everything, our current cohort of students is more challenging than ever, and I am completely drained.”

Too busy for self-nurturing
Concerned for her, I asked: “What are you doing for yourself? How are you nurturing your body and spirit?” She looked at me with a perplexed expression and said, “To be perfectly honest, I am doing very little, if anything, to nurture myself. I’m just too busy.”

Unfortunately, this story is not uncommon. I often ask nurses, nurse faculty members, and nursing students the same question, “What are you doing to nurture yourself?” Sadly, the vast majority of respondents say they are working so hard and moving in so many directions that self care has taken a back seat to responsibilities that often overwhelm them.

This is deeply concerning, because lack of self care takes a significant toll on personal, physical, emotional, and spiritual well-being, and it can have a potentially negative impact on our ability to care for others, including patients. The pressure created by competing demands from family, work, and life responsibilities can cause stress and maybe even burnout.

Obviously, stress will always be a part of our lives, and mild stress levels can actually give us an edge and help us mobilize for action and achievement. However, too much stress, especially if prolonged and coupled with poor coping habits, can cause physical, emotional, and spiritual fatigue as well as ill health. Common signs and symptoms of stress overload include accumulation of belly fat, interrupted sleep, fatigue, irritability and anger, and lack of interest. Mental health problems, such as increased anxiety and depression, may result, and it’s not uncommon for stomachaches, headaches, intestinal problems, and cardiac changes to manifest when stress levels are heightened and prolonged.

A few questions to ask
For some, burnout may also occur. Burnout is a state of emotional, mental, and physical exhaustion caused by excessive and prolonged stress. When we are burned out, we feel overwhelmed, depleted, unproductive, unhappy, unappreciated, and too tired to function. To determine if you might be experiencing burnout, ask yourself a few questions:
  • Do you have difficulty getting out of bed and feeling excited about your day?
  • Do you become irritable or impatient with students, coworkers, or patients?
  • Do you lack energy and feel disillusioned about your work?
  • Are you using unhealthy coping strategies, such as spending hours watching TV or browsing the Internet, or using drugs, food, or alcohol to feel better?
If so, you may be experiencing or approaching a state of burnout.

While eliminating stress is impossible, minimizing it and engaging in self-care techniques can be extremely helpful and ultimately important in achieving an overall state of wellness. So, take a minute to jot down your favorite stress busters and most effective stress-reducing techniques. Some of us benefit from physical exercise and activities, such as yoga, meditation, progressive relaxation, deep breathing, and enjoying music or the outdoors. Spending time with family, friends, and pets, eating nutritious foods, and getting enough rest also help reduce stress.

While these stress-management techniques can be helpful—and I certainly recommend them—real and lasting change comes from identifying the sources of our stress and creating an intentional plan to deal with them. It may be helpful to carry a small notebook or make a note using your smartphone to record events or situations that cause you stress. After a week or two, you will likely gain a clear picture of where your stress is coming from and how you might address it.

Putting yourself first essential
After reviewing your personal list of stressors, identify those that you can do something about and those that are out of your control. For example, you may be stressed by your work commute. Is there a way to change the method, timing, or route of your commute to reduce your stress? If so, this is something within your control. If you identify a stressor that you cannot effectively eliminate—caring for a child with a disability, for example—perhaps there are ways to reduce the stress involved. In the case of a child with a disability, are there other people or community resources available that can share your care responsibilities and thereby lessen your stress?

Regardless of the sources of your stress—whether you can change them or not change them—putting yourself first is essential. This is not a selfish endeavor. By taking care of yourself, you can better attend to the needs of others. Enter “me time” into your calendar and regard that time as important as any other work meeting or event. Resist the urge to cancel “me time,” because the healthiest way to cope with stress and burnout is to take excellent care of yourself.

Managing your time well and staying organized can also be stress-reducing. Start each day with a “to-do” list and arrange them by priority—from high to low. Consider dropping low priority tasks altogether by rescheduling them for completion sometime in the future, or better yet, when possible, delegate those tasks to someone else. Resist multitasking and the urge to immediately respond to every text or email message you receive. Prioritize the messages, and, if possible, save them to a folder to be addressed when you have more time.

“Unplug” from your phone, television, computer, and other distractions to enjoy a moment of peace and quiet. Take a deep breath, and clear your mind. When life is busy, we often get distracted and lose connection with those we care about most. Schedule a date night with your partner, enjoy lunch or a power walk with a friend, or spend time with your furry friends. Avoid negative people as much as possible, and surround yourself with those who bring fun and laughter into your life. Take time off, or schedule a mini-vacation. Whatever you decide to do to de-stress, remember, you deserve it!

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International. Comments are moderated. Those that promote products or services will not b posted.