Workplace distress and nurse burnout don't develop overnight. Instead, they're the result of a variety of ongoing factors that build over time. A culture that lacks the proper support and policies to prioritize well-being can significantly impact the health of providers and the overall quality of care.
A proactive approach can mitigate many of the cultural and systemic factors that lead to nurse burnout. The organization has a critically-important role in creating a positive culture and providing the necessary resources to prevent nurse burnout and overall distress. Here are just a few ways that organizations can go beyond burnout and foster nurse well-being.
1. Create Holistic Support
Nurses share a "thirst for holistic support," according to a 2015 study published in the Journal of Qualitative Studies in Health and Well-Being. Both internal support systems (comprised of family, colleagues, and the organization) and external (society and media) play an important role in a nurse's sense of recognition and value at work and home.
According to the study, just 10.7% of responding nurses thought that their holistic support systems were good. Employers have an obvious role within the internal support category to create a positive culture. However, employers can also foster peer-to-peer support and successful work-life integration as well as yield some influence over external support systems by contributing to positive media coverage or professional organizations for nursing.
Research has discovered that "authentic leadership" plays a critically-important role in nursing staff perceptions of employer support. Nurse managers and other clinical supervisory support are responsible for creating a day-to-day workplace experience which prevents burnout. The lowest rates of nurse burnout are associated with leadership who are balanced, transparent, and ethical. Data-driven decision making practices can contribute to perceptions of unbiased, transparent behavior among nursing management staff. In addition, leaders who can recognize their own weaknesses and mistakes can make more balanced decisions and support an ethical work environment.
2. Improve Work-Life Integration
Fluctuations in workload, shift changes, and staff shortages can all contribute to workplace stress among nurses. Nurses can easily finish a shift with a mental stress load which impacts their ability to rest and enjoy their home-life.
Providing nurses with the greatest flexibility possible could strengthen work-life integration and improve well-being. A study originally published in the Journal of Nursing Management found that designing shift schedules based on staff input had the greatest positive impact on work-life integration. In addition, shorter shifts are linked to a perception of balance among nurses and can reduce other harmful dimensions of distress such as sever fatigue.
Finally, there's evidence that distress caused by poor work-life integration is a "shared experience" in clinical settings which can harm individuals and other clinicians. According to a BMJ Quality & Safety study, "dissatisfaction with work-life integration in healthcare workers continues to increase" and it "appears to operate as a climate." Nurses who work among highly-stressed colleagues may have a much harder time feeling refreshed at home after a shift.
3. Foster Positive Relationships
A strong system of peer support can prevent burnout from disengagement or a culture of poor teamwork. Peer support can be especially critical to avoid 'second victim syndrome,' or lasting psychological and physical symptoms after medical errors, complications, or adverse patient outcomes. A formal system for peer-to-peer support is crucial to increase workplace wellness and resilience, according to Joanne Chapman, Director of Professional Practice at Maine Medical Center.
Nurses and other healthcare workers can experience feelings of shame or failure after a stressful workplace experience. Many nurses experiencing second victim syndrome are unlikely to seek out peer support by themselves, which is why many healthcare organizations can benefit from formalized programs.
Among other well-being initiatives, John Hopkins Medical Center created a Resilience in Stressful Events (RISE) program in 2010. Thirty-nine members of the clinical staff completed extensive training in peer response through role-playing scenarios to provide effective support and referrals to employee resources. Employees can call the RISE hotline which is staffed 24/7 and can meet face-to-face with colleagues. From when the program launched to 2017, over 700 employees utilized the call service. In addition to providing much needed support, RISE has had a measurable impact on Johns Hopkin's nursing staff retention rates and has been estimated to save the hospital over $1.8 million annually.
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4. Provide Recognition
Nursing is a demanding career in any environment, which is why formalized systems for reward and recognition can be extremely beneficial for staff engagement. According to a 2017 study among ICU nursing staff, it was found that imbalance between effort and rewards perceived by workers is tied to increased emotional exhaustion and burnout. When staff feel that they are valued or recognized for their effort, they're less likely to experience burnout.
Compensation plays a significant part in reward. Under-compensated nursing staff are more likely to leave the organization, especially in high-effort environments such as the ICU. However, leadership can also prevent burnout with non-financial systems for recognition to consistently ensure that nursing staff feel valued.
5. Develop a Wellness-Focused Experience
Healthy lifestyle habits can combat the effects of stress and mitigate burnout among nursing staff. Nurses and other clinical professionals may adopt unhealthy lifestyle habits to cope with workplace stress, unpredictable scheduling, or fast-paced shifts. The effects of stress are far more serious when they're coupled with stress-related lifestyle choices such as being sedentary, substance abuse, or eating an unhealthy diet.
"A culture of wellness will make health a part of your organization's mission," writes Forbes' Alan Kohll. The culture should "empower employees to get healthier, happier, and more productive by creating healthy habits." Initiatives to provide better access to healthy food, exercise, and other lifestyle resources can promote wellness among nursing staff.
Go Beyond Burnout at Your Organization
Creating an environment which offers holistic support, strengthens work-life integration, fosters positive relationships, provides recognition, and promotes healthy habits will improve the lives of all involved. A proactive approach to combating nurse burnout and distress is necessary, and creating initiatives in these specific areas can help improve well-being and lead to happier and healthier nurses and patients.
Actively measuring nurse well-being with a clinically-validated tool can also help organizations identify risks and measure the success of their wellness initiatives. If it's time to Go Beyond Burnout at your organization, check out the Nurse Well-Being Index and see how hundreds of institutions, academic medical centers, associations, and medical schools have reduced distress and improved well-being with the data and resources offered in the tool. Together, we can improve the lives of nurses and combat the adverse consequences of distress.