Susan E. Mazer, Ph.D. Blog

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Hi, and welcome to my blog! I'm Susan E. Mazer -- a knowledge expert and thought leader on how the environment of care impacts the patient experience. Topics I write about include safety, satisfaction, hospital noise, nursing, care at the bedside, and much more. Subscribe below to get email notices so you won't miss any great content.

Staff Burnout in Healthcare: Authenticity as the Antidote

April 17, 2015

Stressed Nurse So much discussion and concern about staff burnout in healthcare. So many definitions and descriptions. Actually, an entire symptomology of burnout has been written, rewritten, analyzed, and then written again.

And, yet, for someone who is actually burned out, reading all of the details does nothing but justify the burnout.

For nurses, especially, burnout is a kind of abandonment of mission. It expresses itself in being not only exhausted, but disinterested in the very details about each patient that make up a healing relationship, or at least unable to process and respond to them.

None of us, especially the nurse or physician who has reached this point, can afford to ignore or accept it. In fact, an aggressive intervention may be called for.

The word “authentic” is being tossed around right now in many ways related to the patient experience and in expressing compassion and empathy. And yet, tossing the term around does not make it real.

Authentic means that we are what we do and say. The integration of purpose and action is so complete that it merges into and is inseparable from how we breathe — into such deep and complete satisfaction in our person that it replaces exhaustion with justified weariness.

Being in a service industry like healthcare, the giving is always greater than the getting. Patients have nothing and should not be expected to give to those who care for them.

Even with the anxiety and fear that comes with starting to care for a patient, the desire to be a nurse trumps the stress of nursing.  The challenge comes up when it becomes routine.  And, when the challenges of running a hospital interfere with ideal nursing practice.

When nurses know that their patients are at risk because of nursing-patient ratios being too high, or other operational situations over which they have no control, learned-helplessness can take over.

Burnout is a kind of resignment that consumes individual motivation and identity.  The reason it is so dangerous is that on the other side of a nurse or physician is a patient.

Each day, renewing the reason behind why you chose to do the work you do, is critical to staying alive in it.  It is about vitality of mission, energized and empowered skills, and delivering every day, all the time.

The most effective interventions are those we do to ourselves.  What can you do to pull yourself out of the muck that will allow you to fully engage with patients again?

Here are some suggestions, in no particular order:

(1) Heartmath offers vital tools to help nursing staff stay focused and mindful to themselves and others.  These take little time and have been shown to be effective not only individually, but collectively to facilitate collaborative support among the care team.

Using well-researched technologies, you can learn an effective skill set to reduce stress, enhance performance, improve health and well-being and build effective relationships with colleagues, clients, and family.  The focus is resilience.  Heart-centered practice and relationships are a means to avoid abandoning meaningful caring.

(2) In her Caritas Principles, Dr. Jean Watson offers the opportunity to take a deep breath and center yourself before entering a patient’s room.  The Caritas Principals offer, together, a theoretical and practical framework that itself can prevent burnout.

The first Caritas step is to “Embrace altruistic values and practice loving kindness with self and others.”  Each step moves into the practice of Caring Science, which calls for mindful presence at the bedside and an authentic, caring relationship between patient and nurse.

(3) Notice your own nature.  If you are normally engaged and become disengaged, do not wait to deal with it. If you start feeling like “all patients complain alike,” do something about it.  Find a work buddy with whom you can share and check each other’s vitality factor.

Do not assume burnout to be a natural result of many years, stress, or anything else.  It is intolerable and makes for neither a career nor a life worth enduring.  Do something for yourself.  Be proactive.

Also, be aware that burnout has its stages and it is different for each person.  That is why it is critical to be self-aware.

Know what is normal for yourself, and note what normal is for those you work with.  If something changes, come to understand what the change is and whether you are moving in a healthy, vibrant direction, or your own fires of passion need kindling.

(4) Prepare yourself, each day with each patient, to know what you can do to create and sustain a healing caring environment.  For our hospital clients, The C.A.R.E. Channel provides a therapeutic and supportive environment to allow for the intimacy of the nurse-patient relationship.

Ensuring that that both nurse and patient can be focused when they are together requires that there is no competition from talk television or any kind of dominant distraction. Know that this is not about linear minutes (how much clock time you can spend with a patient); rather it is all about the quality of time and attention given in the moment.

Authenticity — being wholly integrated, as a person and caregiver — cannot thrive within the symptoms of burnout.

Remember, that you matter all the time. There is nothing natural about burnout.  And, there are many ways to avoid its trap.

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