The Nurses’ Health Study 3 Needs You

The Nurses’ Health Study 3 Needs You

The third round of the Nurses’ Health Study (NHS3) promises to reveal information as transformative as the first version of the study. But this time around the revolutionary study is looking to make a change that will resonate with minority nurses nationwide. To better reflect the nation’s increasingly diverse population, the study is especially interested in the participation of minority nurses—both ethnic and racial minorities and also male nurses.

We need nurses,” says Dr. Jorge Chavarro, the principal investigator of NHS3. Chavarro became involved in the third round of the study 15 years ago, with a special interest in infertility and reproductive health.

When the first Nurses’ Health Study launched in 1976 (and the second in 1989), the scientific focus was to follow women for clues to breast cancer. Specifically, the study wanted to find out if there was any correlation between birth control pills and breast cancer risk, but it also gave more general information about cardiovascular heath and diabetes as well. From there, the information gathered has revolutionized areas of healthcare.

Interestingly, the nurses’ study has always been defined by an occupation, but it has never been an occupation cohort,” Chavarro says, noting that NHS3 will now include occupational health issues such as heavy lifting, radiation exposure, or exposure to cleaning agents. Study investigators recruited nurses to participate because they were excellent responders who had a thorough understanding of specific medical terms and could participate with less margin of error.

What’s new in NHS3?

  • a targeted effort to recruit more minority nurses
  • a targeted effort to recruit more male nurses
  • a new participation option for Canadian nurses
  • a focus to capture occupational exposure concerns and understand how that impacts a nurse’s health
  • an entirely web-based participation

We want to involve as many minority nurses as possible,” says Chavarro, “and it’s the same for male nurses.” Canadian nurses are also welcome to participate, and many of them have already been long-term participants. Chavarro says the team realized it’s not difficult to continue collecting information from nurses who have moved to Canada, and so opening the study to all Canadian nurses is only going to be helpful for study results..

The Nurses’ Health Study collects vast amounts of data on lifestyle, nutrition, exposures, and health events. The study’s history is revealing in itself and shows the vast changes over the past decades. Nurses were the designated cohort after some trial and error in the first study. Initially, doctor’s wives were going to be the chosen cohort in the pilot study as birth control pills could only be prescribed to married women then and most physicians were men.

The second choice was nurses,” says Chavarro, “and it was the best decision ever. It changes the questions you can ask.” Nurses are going to be very clear about any medical events that happened to them and that makes all the difference in evaluating the data, he says. They can also do other tasks that are extremely valuable and that are primarily unavailable to the general population. For instance, collecting varied biological specimens is something nurses can, and do, perform with ease and accuracy.

Chavarro says nurses who participate are making a change in the health of future generations and that’s often why they get involved. The time commitment is fairly low and the benefits to humanity are significant.

To continue being impactful, we need all nurses, but especially those who give us a picture of how the US looks as a whole,” says Chavarro. “Nurses are amazing and are the best participants ever. This is a definite opportunity to join this study and make enormous contributions as they have done in the past and will continue to do for many decades to come.”

Find out more information about signing up for NHS3.

5 Methods for Improving Your Day When Caring for Difficult Patients

5 Methods for Improving Your Day When Caring for Difficult Patients

On most days nursing is extremely rewarding. At the end of our shift, we feel we’ve done a good job caring for the needs of grateful patients. But occasionally, we encounter patients who test our patience and make it challenging to effectively care for them. So how can we improve the situation when caring for difficult patients?

1. Lend an Ear

No one is at their best when they’re in the hospital, a rehab center, or receiving medical care at home. They may have pain or nausea, or maybe they are still struggling with a change to their ordinary lives as a result of an accident or illness.

Provide them with an opportunity to talk about their situation if they feel comfortable, and make the effort to actively listen. Nurses can get caught up in the endless to-do list on any given day and aren’t always able to take the time to connect adequately with their patients. While listening closely to them, a nurse can learn what a patient’s expectations for recovery are as well as any concerns they may have about their care or prognosis.

2. Body Language Barrier

During a day’s work, our patients are often in a hospital, home bed, or sitting in a chair.  When we are talking to them, we’re standing above them, which can make them feel uncomfortable. As often as possible, make the effort to put your body on the same plane as theirs. Avoid crossing your arms over your chest, putting your hands on your hips, or in your pockets, none of which communicates receptiveness and may further agitate someone who is already upset. Face them when speaking to them and modulate your voice appropriate to their hearing ability.

3. Culture Clash

Does your patient have a culture different from your own? Be respectful of any differences and try to learn what you can about their culture. You can learn either through resources available to you or by asking questions, but only if they’re receptive to educating you about their ways.

4. Build a Bridge to the Unknown

Alleviate any concerns they may have about what is unknown to them. Encourage discussion about their health condition, medications, or upcoming procedures. Welcome questions that will allow them to open up. Building a relationship with them can motivate the patient’s own investment in their care and help smooth a rough nurse-patient relationship.

5. Autonomy Can Be Helpful

Many patients express feelings of helplessness in the face of their illness, which can lead to difficult behaviors. Restoring some of their autonomy can go a long way to returning a sense of control within their lives when caring for difficult patients. Allow them control over that which can be allowed: bathing, medication times, meal times, and any other choice that can be accommodated without contradicting their physician’s orders.

Making the extra effort to reach out when caring for difficult patients can often smooth the path to a better nurse-patient relationship.

The Road to Resilience: Nurses Week Edition

The Road to Resilience: Nurses Week Edition

Overcoming adversity is a demanding task that requires a great deal of emotional resilience and mental toughness. While many people react to such circumstances with a flood of emotions and a sense of uncertainty, others may choose to adapt positively in response to their life-changing situations and stressful conditions. As a medical-surgical nurse, Jamie Davis, RN, understands the meaning of handling adversity both professionally and personally. In this Q&A interview, Davis discusses the importance of emotional resilience and how rising above adversity ultimately shaped her into the nurse that she is today.

Jamie Davis discussing her road to resilience

Jamie Davis, RN

How did you become a nurse?

In 2006, I attended college in Michigan with a major in cosmetology. I met someone who was working as an LVN at the time who asked if I needed a job. During that moment, I did not have any intention of working in the health care industry. But during the interview however, I was asked, “how would you feel if you were unable to help someone you were caring for?” Surprised by this question, I simply responded, “I would feel horrible, but in the end, I would do everything in my power to assist them and make them feel better as a person.” It was at this moment that ultimately began my journey as a future nurse.

Why did you choose the specialty you currently work in now?

In 2007, I received a distressing phone call from my parents informing me that my brother was admitted into the ICU. After hearing the news, I booked a flight to California and headed straight to the hospital where he was staying at. When I walked into the room, I saw my brother lying lifeless in bed with machines hooked up to him. At that moment, so many memories rushed through my head and I began to have all these endless questions – What am I going to do if he doesn’t come out of this bed? How are we going to move on? How are we going to make it through this? Luckily, my doubts and fears went away when he began to improve so I decided to fly back home.

A few months later around Christmas time however, I received another troubling phone call from my mother telling me that my brother got readmitted again to the ICU but this time with worsening complications. As I rushed to the hospital, I distinctly remember seeing all the tubes hooked up to my brother and the nurses working tirelessly to save him.

Unfortunately, the following morning, I received the phone call that nobody ever wants to hear – my brother has passed away. It was a life changing moment that my family and I will never forget, but ultimately inspired me to become the nurse that I am today.

Therefore, although I currently work on the medical surgical unit, my dream is to one day work in either the ER or ICU settings to one day help those patients who are also in critical need.

How has your brother’s passing impacted the care you give for your patients? 

Although my brother’s passing continues to affect me each and every day, I’ve learned to keep his memory with me every time I come to work and care for my patients. Despite his unexpected death, I’ve learned to understand that being resilient is learning how to not only live with those painful memories but also deal with it in a positive way.

What kind of advice would you give our readers on how to overcome tragedy as a nurse and develop resiliency? 

One piece of advice that I would like to give the readers on how to overcome tragedy as a nurse is understanding that overcoming adversity is a personal journey. It’s okay to grieve from time to time, but it’s also important to take your sadness and create something positive out of it. Because of this, I have learned to become a more vocal advocate for my patients and their loved ones in times of need. By doing this, I am able to honor my brother’s spirit through my work as a nurse.

Do you have any parting words of encouragement for those interested in pursuing a career in nursing? 

To anyone else who may be going through a difficult time, please don’t give up. Regardless of how difficult and emotionally challenging life can seem, personal success all depends on how you choose to deal with your given circumstances. Therefore, I am a living example that no matter what life puts you through, your dreams can become possible if you believe it.

Encouraging Activity for Minority Health Month

Encouraging Activity for Minority Health Month

Every April, the sponsors of National Minority Health Month call attention to the prevalent health conditions of minorities. But the month is also about spreading information to improve the health of these communities.

This year’s theme for Minority Health Month is “Active and Healthy,” and brings a focus on how an active lifestyle can reap true rewards in overall physical and mental health.

As a minority nurse, the information is personal. You can take a look at your own lifestyle and any inherited or existing risk factors you have in your own life to make changes. But you can also use that information and your own experiences to help your patients who might be struggling to have a healthier life.

Luckily, helpful information is plentiful and easy to find. You can work with your patients to find a plan that is achievable for them. Making small adjustments and changes that they are willing to implement is the first step.

Through the Centers for Disease Control and Prevention’s Office of Minority Health and Health Equity (OMHHE) or the Department of Health and Human Services’s Office of Minority Health, minority health disparities become clear. Minority populations disproportionately suffer from high blood pressure, diabetes, heart disease, and higher rates of obesity. Because of cultural taboos or attitudes in some minority communities and combined with a lack of nearby high-quality care, mental health struggles go untreated. All of these things can lead to a decline in health and contribute to lifelong, serious diseases.

An active lifestyle impacts both physical and mental health in all populations. After treating many patients, however, any nurse knows you can’t just tell someone to start jogging and enjoy the benefits. You have to fine-tune your approach, taking into account their existing health conditions, so they will be motivated and can do what you are suggesting. Remind them that any activity is good. A sustained and consistent active lifestyle is optimal, but even small changes can make a big difference.

Here are some ways to encourage your patients (and yourself) to get active:

  • Walk whenever you can
  • Take the stairs – if you can’t do three flights, just do one
  • Stretch when watching TV
  • Take a couple of laps around the mall when you go
  • Think of all the ways you move – cleaning, gardening, walking the dog – increase it
  • Walk in place when talking on the phone
  • Meet a friend for a walk instead of meeting for a coffee
  • Do activity that is fun—dancing, swimming, hiking, yoga
  • Think of “active” as just moving and move more whenever you can

Getting active feels good (maybe not at first!) and can prevent or help many health conditions. Encouraging your patients to get moving and finding a plan they can manage is a great start.

Sexual Harassment by Patients: What Every Nurse Needs to Know

Sexual Harassment by Patients: What Every Nurse Needs to Know

Especially since the #MeToo Movement began, sexual harassment has been in the spotlight. We spoke with nurses who have been harassed, legal experts, and nursing professionals to determine what you should and can do if this happens to you.

Celia,* RN, a longtime hospice nurse, remembers it like it was yesterday. A younger man, at least younger for hospice, had been admitted with terminal cancer. While Celia says she recalls other nurses talking about the patient having made “inappropriate comments,” she had never experienced it herself.

Until she did.

The patient had been angry and struggling with what he deemed the unfairness of dying young and leaving his wife and child—and knowing that he wouldn’t be able to take fun trips or do things with his daughter. Because he had a trach, which requires frequent suctioning and medication, he felt like the staff was treating him like a leper—when actually, they were simply following all safety precautions.

“Once trach care was completed, I sat down, took my gloves off, and offered him a hand to hold—this is standard practice between hospice staff and patients, and it’s not frowned upon,” says Celia. At the time, the patient held her hand, cried, and expressed gratitude for the time to talk. “I felt we had a nice, professional, and therapeutic rapport.”

A few weeks later, a couple of days after Christmas, Celia was caring for the patient, and he asked if she was married. When she responded that she was in a long-distance relationship, he asked how she took care of her sexual needs—and asked using inappropriate, graphic sexual language.

Celia replied, “One—that is none of your business. And two—It’s not appropriate conversation between a patient and a nurse!” Then, Celia calmly informed him that this was harassment and abuse. With one word to her managers, she told him, she would never have to be his nurse again. She says that the patient was contrite and apologized. Celia passed it off as a one-time thing and let it go.

Unfortunately, that wasn’t the end of the harassment. After a couple of weeks, Celia was the patient’s nurse again. While taking care of his trach, she talked with him. When he could speak, they discussed their favorite kinds of music. She recalls, “It was a nice interaction, as I grew up in a musical home, and discussing this was special to me.”

Near the end of the treatment, though, everything changed. The patient told her lots of things that he would like to do with her sexually, in graphic detail.

Celia recalls, “I was horrified. I was angry. I felt nauseated. I felt ashamed about my body, and I wanted to cry. I was shaking, inside and out.”

She told the patient that he was so far out of line. He was shocked that she was so rattled and tried to justify it by saying that it was a compliment. Celia left his room immediately.

The first thing she did was post on the staff’s white board that she would no longer care for this patient. When she calmed down, she emailed her managers and then communicated with them in person the next day.

Celia’s managers were supportive. She never saw the patient again, and he left the facility a few days later.

Harassment is Prevalent

A Medscape.com survey published last year revealed that the majority of nurses—71%—say that they had been sexually harassed by a patient. Of those responding, 90% were female nurses, 10% male.

But male nurses get harassed as well. They may, however, be even less inclined to report it. In the same survey results, it states, “By gender, female nurses…were much more likely to say they had been sexually harassed than their male counterparts (73% for female nurses vs 46% for male nurses).”

No matter the gender of the nurse who experiences it, sexual harassment is wrong. That said, how do you decide if what a patient is doing or saying is sexual harassment?

If it Looks Like a Duck and Quacks Like a Duck

According to Trista Long, RN, DNP, MBA, ON-C, a nurse manager for an inpatient med/surg unit with Blessing Health System, it is easy, most times, for nurses to differentiate between behavior that is appropriate or inappropriate. “The first sign of inappropriate behavior is when patient’s actions or conversation makes the nurse uncomfortable. Patients who are making inappropriate comments will first ‘test the waters’ by making inappropriate jokes or mild comments to gauge the nurse’s response. If the nurse dismisses the comment, the patient will likely continue with the inappropriate conversation or actions.”

If a patient exhibits inappropriate verbal behavior, it’s often easy to recognize, says Long. “Nurses know what crosses a line and what doesn’t,” she says. Because of the physical nature of nursing, however, Long says that inappropriate physical behavior can sometimes be more difficult to recognize.

“I often tell my staff that—again—inappropriate touch is anything that makes them uncomfortable…it’s no different than being in public and having someone touch you inappropriately. Just because you are in a hospital does not give another person the right to touch you,” explains Long. “Most patients will want to hold your hand or touch your arm, but they will not go any further than that. An action or remark could be considered harassment if the nurse directs the patients to stop, but that direction is ignored.”

“A ‘reasonable person standard’ is generally used to determine if conduct is motivated by prurient interests or for a person’s sexual gratification,” says Debra W. Levin, counsel in the health law group at Brach Eichler. She previously served as counsel to the New Jersey State Board of Medical Examiners and was the Assistant Section Chief responsible for legal services provided to more than 50 licensure boards, including the New Jersey Board of Nursing. “If a reasonable person would be offended, then it can be determined to be sexual harassment. Because the standard is subjective, it is often hard to determine.”

“Sexual harassment is generally any unwanted sexual direct or indirect physical contact or comments. Of course, some physical contact may be more overtly ‘sexual’ than other contact, but much of the time, the intent will be evident,” says Jessica T. Ornsby, LL.M., Esq, managing attorney with A+O Law Group. “A good rule of thumb is whether the contact is objectively appropriate under the circumstances. For example, if a nurse is taking a patient’s blood pressure, is it necessary for the patient to place his or her hand on the nurse’s thigh? Probably not. But if a nurse is helping a patient into bed, that patient may need assistance stabilizing himself/herself and may rest his or her hand on the nurse in a way that would otherwise not be necessary.”

She adds, “Sexual harassment is basically a step down from sexual assault. If the action/contact involves force or any kind of penetration, that is most likely assault and should be addressed accordingly.”

What to Do if It Happens to You

Suppose a patient sexually harasses you. What do you do?

“Experts believe that sexual harassment is significantly underreported in health care. For that reason, I believe the best defense for nurses starts with reporting these types of incidents,” says Jennifer Flynn, CPHRM, risk manager at Nurses Service Organization. “No matter who the harasser—whether it be a supervisor, coworker, or a patient—nurses can take steps to address harassment in their workplace.”

“While working in a hospital, the first step is for the nurse to address the behavior. The nurse should tell—not ask—the patient to refrain from the inappropriate comments or actions and to stop immediately. The nurse should then report the behavior to his/her manager so that the leader can be aware. If the behavior stops, it typically will not need to go further,” says Long. “It is imperative that the nurse set boundaries with the patient immediately once s/he recognizes the behavior. If the action is severe or violent, the nurse should report it immediately, and the leader should address it. If the nurse is uncomfortable caring for the patient, the patient can be reassigned to another nurse. There have been times when I have assigned only male nurses to a patient who was harassing the female nurses.”

There may be times in which a patient won’t stop. In this case, Long says that the leader should talk with the patient and stress that the behavior won’t be tolerated and must cease. “If the behavior continues or if the nurse is uncomfortable caring for the patient, the patient should be reassigned to another nurse, and the leader should engage the Risk Management Department and/or the Security Department to assist. Many times, a Security Officer will be asked to speak with the patient and direct them to stop the behavior. Since they are often in uniform, it can be a show of added authority and the behavior will stop. If it does not, the Risk Management Department can speak to the patient and explain any legal consequences to their continued inappropriate behavior,” says Long.

Ornsby says that each work environment, ideally, should have some kind of policy with regard to sexual harassment. “Nurses should make note of these policies and earmark them for future reference,” she says. “If the policy does not specify to whom to report the incidents—ask. If a patient’s behavior…is making you uncomfortable or causing you to feel unsafe, leave the situation immediately. Your personal safety and well-being are the most important. Federal laws on sexual harassment apply regardless of whether the harassment is taking place at a hospital or a doctor’s office.”

Levin agrees that health care organizations should have policies in place. “Larger or licensed facilities may have staff to counsel the patient regarding harassing behavior. Additionally, in regard to patients, the patient can be transferred to another’s care, a chaperone can be provided, and the patient can be counseled. In dramatic situations, the patient can be discharged/terminated from the practice or facility. State-specific laws apply that govern termination of the doctor/patient relationship/discharge so that the patient is not abandoned, and there is a transition of care,” she says.

The American Nurses Association has challenged nursing professionals to end sexual harassment in the workplace by adopting a zero-tolerance policy. “Much has been written lately about the importance of nurses engaging in self-care. Not tolerating sexual harassment is an integral component not only for self-care, but also for self-respect, vital for professional effectiveness. Speak up when sexual harassment occurs and facilitate a civil work environment,” Flynn says.

The Bottom Line

“If the organization is not responsive to the nurse’s claims, s/he should consult legal counsel or their union. No one should be subjected to sexual harassment in the work place,” says Levin.

Long says that harassment, whether physical or verbal, has been perceived in health care as “part of the job.” But it’s not and never should be seen as such. “It is never acceptable to be harassed by anyone at any time. Nurses are an integral part of the health care team and should command the same respect as every other profession,” says Long. “Unfortunately, nurses have been depicted in a sexual manner for ages and that has demeaned the profession. Being a nurse does not negate my rights as a human being to not be verbally or physically assaulted.”

“I took an oath to care for others, but that does not mean that I have to sacrifice my physical or mental well-being,” Long adds.


* not her real name

How to Combat Nurse Burnout

How to Combat Nurse Burnout

Many people feel called into nursing careers. Nurses get the unique opportunity to directly serve people in achieving better health. But while nursing offers many rewards, the stress of the job can also lead to burnout. Left unchecked, career burnout can drive even the most dedicated nurses to leave the profession altogether.

Anyone considering a nursing career should start by having realistic expectations of what day-to-day life is like as a nurse—especially in acute care settings.

Ingrid Flanders, RN, BSN, MN, FNP-C, a visiting assistant professor at the Linfield-Good Samaritan School of Nursing in Portland, Oregon, says sometimes the job is different from what a nurse might expect. “Maybe they don’t have a full understanding of the role and the responsibilities that go with it,” says Flanders. “Then they’re surprised at the level and intensity of the workload. Maybe they haven’t prepared themselves physically, mentally, and emotionally for the work involved; because a nursing role, regardless of what setting you’re in, is really demanding.”

Flanders notes that patients have high expectations of nurses’ proficiency, which can create pressure. There’s also the pressure that many nurses put on themselves. “Generally, the people who are drawn to be nurses have high expectations of ourselves and so we try to give it all away and we don’t always have enough left for ourselves,” explains Flanders.

What starts out as a passion for helping people can soon lead to chronic job stress or what Vicki S. Good, DNP, RN, CPHQ, CPPS, vice president of quality and safety at Mercy Hospital Springfield Communities in Springfield, Missouri, calls burnout syndrome (BOS)—work-related stress that remains unresolved. “BOS has three elements: exhaustion, depersonalization, and perception of decreased personal and professional accomplishment. BOS is directly related to stress at work and not related to stresses outside of work, although outside stresses may impact the stress at work,” explains Good.

Good says that nurses in high-risk, high-stress work environments (such as critical care nursing) are at especially high risk for developing BOS, where they are asked to care for patients during a vulnerable time in the patient’s life, and often at the end of life, with the accompanying ethical issues.

“Nurses are engaged in high-stakes decision making on a daily basis,” says Good. “The nurse is the clinician who is constantly at the bedside of the patient, giving their entire physical and emotional self to care for their patient and their family. Combine this with one of the most challenging workforce shortages in nursing and nurses have rates of BOS equal and often higher than their physician colleagues.”

One extreme consequence of nursing job burnout is nurses deciding to leave the profession—a choice that nurses are making in unprecedented numbers according to Good.

“By raising awareness and educating nurses on how to respond and mitigate symptoms of BOS we hope to prevent nurses from leaving the profession. BOS has been called a ‘silent epidemic’ because nurses and other clinicians have been afraid to speak up about their feelings, and instead the nurse ‘votes with their feet’ by leaving the unit and/or profession,” says Good.

Warning Signs of Impending Burnout

Because nurses invest vast amounts of time, education, and money into entering the field and growing their careers, it’s important that they practice good self-care and watch out for the warning signs of chronic stress and burnout.

Nursing career burnout can be sneaky, warns Anna Rodriguez, BSN, RN, CCRN, PCCN, a critical care nurse who launched TheBurnoutBook.com to help nurses combat burnout. “It comes on so gradually, one bad shift at a time, and before you know it, you dread clocking in to work,” says Rodriguez. “Early recognition is key. You need to pause and assess yourself frequently for signs of fatigue, depression, or feeling cynical or apathetic toward your work. You might go home feeling emotionally or physically drained more days than not. You might feel anxious and find your mind racing, thinking about work. These are all unhealthy signs that the work is getting to you and, if it continues, will lead to full-blown burnout.”

Good says that unfortunately, most nurses do not realize when they are developing the signs and symptoms of BOS. “This is one reason that raising awareness of this syndrome is so important to our profession. As a professional nurse, it is critical to be able to recognize the warning symptoms so that one can then take action to mitigate the potential outcomes of the syndrome,” says Good.

So, what do nurses need to watch out for as they go about their daily work?

“As a nurse, the first thing to become keenly aware of are any changes in energy levels related to work—both physical and emotional. Exhaustion is one of the key symptoms. If the thought of going to work makes you exhausted, pay attention, ask questions, and seek intervention,” Good advises.

Flanders agrees that nurses should watch out for fatigue. Another common symptom is a lack of resilience or tolerance for challenging situations where you feel more impatient or more irritable than usual.

This lack of resilience may cause nurses to become disengaged in their work and interactions with coworkers and patients. “If a nurse was previously highly engaged in social events and activities on the unit and stops participating, this may be a sign of BOS development,” says Good.

Finally, watch out for the general feeling that you’re not making a difference as a nurse for your patients/community. Good notes that this lack of a personal and professional sense of accomplishment is a warning that burnout has set in.

How to Avoid Burnout—or Nip it in the Bud

What can a nurse do if they are on the road to burnout or to prevent burnout from developing? Here are some expert tips from seasoned nurses.

Practice Self-Care. Flanders says it all starts with prioritizing self-care. This includes reading for pleasure for a few minutes every day, maintaining a healthy diet, getting regular exercise to reduce stress, and making sure you get adequate rest. “Even if you’re a nurse working on a night shift, it’s important to make sure your sleep pattern is one that’s sustainable,” says Flanders.

Develop Resiliency Skills. “Resiliency is the antidote to burnout,” says Rodriguez. “It’s the ability to bounce back after feeling that emotional, physical, and psychological exhaustion that burnout creates. It’s finding a way to balance the energy you give to others and recharging yourself so that you can continue to care for others effectively.”

Rodriguez suggests the following tips to build resiliency as a nurse:

  • Be intentional on your days off to regroup and rest so that you can come back a better nurse on your next shift. Don’t say yes to extra shifts if you need to rest.
  • Take breaks during your shifts (and practice self-care strategies during your break, such as eating a healthy meal or reading for pleasure).
  • Plan unit-bonding activities. Getting together with coworkers outside of work is a great way to fight off burnout.

Talk It Out. Having a support network is vital for nurses. Nurses need to ensure they have other nurses to turn to vent about a bad day, a troublesome patient, or frustrations. Having nursing friends at work and/or joining a professional nursing association dedicated to your specialty, such as the American Association of Critical-Care Nurses, can be an excellent outlet.

“We need a way to talk about the things we see every day,” says Rodriguez. “There’s a lot of doom and gloom. There are morally distressing moments. There are times when we’ve given so much of our energy to others that we develop compassion fatigue and go into survival mode, shutting down our empathetic side as a coping mechanism. The ability to vent in a healthy way with our peers is essential to dealing with all of that and maintaining our empathy. No one understands what you go through better than another nurse.”

Explore Your Options

If you feel that you are already in burnout mode, take some time to explore your career options. Some nurses who experience burnout leave the profession altogether. But that may not be necessary.

Start off by exploring ways you can remain in the field by taking some time off, changing units, or finding a new job in a less stressful environment.

“A sabbatical or some time off may help, but it’s generally not a long-term fix,” says Paula Davis-Laack, JD, MAPP, owner of Davis-Laack Stress & Resilience Institute.Remember that burnout is more about work systems, cultures, and values creating an environment that breeds burnout, so until the workplace changes, burnout will likely remain a possibility. You may just be in an environment that’s a disconnect for you. Can you switch teams, organizations, or practice settings?”

If a change in work environment or position doesn’t help, then it’s time to look at nontraditional career tracks such as becoming a health coach, nurse entrepreneur, or nurse educator.

“One of the things I’ve enjoyed about being a nurse now for almost 35 years is that there’s a variety of nursing roles within the profession, and it’s important for young nurses to know that if they’re getting to the point that they feel like they can’t do it anymore, there are other options and other roles that might be a better fit for them at that point in their lives,” says Flanders. “It’s important not to feel like you’re stuck in a corner and that you don’t have the power or ability to make it different if it needs to be different. Because when you’re in the role of taking care of other people, if you’re not doing well, then how can we possibly do our jobs as nurses?”