Burnout is undeniable and, in nursing, endemic. Defined as the “physical or mental collapse caused by overwork or stress,” many elements of nursing are responsible: long hours, emotional exhaustion, trauma, and many say Covid. However, nursing burnout has been a factor long before Covid. Understaffing, under-appreciation, inadequate remuneration, compassion fatigue, and poor work-life balance have been the standard work environment for nurses long before Florence. What makes today different is the stress and chaos that came with Covid brought us all to burnout at the same time.

Burnout roots in and grows without a person even realizing it. It festers, and with nurses, symptoms can be masked as ordinary daily life occurrences. Multiple 12-hour shifts? Naturally, a nurse is going to be tired, low energy, and maybe have a headache, but the nurse perseveres as being just the nature of the job and not burnout. A code, relief was late, charting needed to be caught up on, or there was a particularly needy patient or family member. These events always take time and more time to unwind. Sleep patterns become disrupted, and more exhaustion sets in. Burnout is growing, yet the nurse still perceives the symptoms as normal. Factor in inadequate diet, hydration, and the physical demands of nursing, burnout can take hold, and the nurse may not even be aware until it becomes debilitating.

The best method to be proactive with burnout is to be aware. Unfortunately, because burnout manifests differently in different people, it can be hard to identify. It can display physically, emotionally, cognitively, and or behaviorally; it can afflict multiple signs or as just one symptom. The important factor is to identify it and address it before it becomes burdensome.

Symptoms to be conscious of:

Physically

Chronic fatigue and low energy
Frequent headaches, muscle aches, irritable stomach
Changes in appetite (over and under-eating) or sleep patterns (insomnia or oversleeping)
Increase in illness, both real and perceived
Insomnia

Emotionally

Easily irritated or impatient
Low or limited motivation in interests and hobbies
Feelings of helplessness, hopelessness, or being overwhelmed
Emotional detachment, feelings of isolation and loneliness
Unable to cope with daily responsibilities
Sense of failure and self-doubt
Depression

Cognitive

Difficulty concentrating, making decisions
Forgetfulness
Decreased creativity or problem-solving

Behavioral

Avoid social commitments, withdraw from social interaction
Decreased tolerance of others, easily irritated and confrontational
Decreased productivity in responsibilities
Procrastination and neglecting responsibilities
Escapist behavior (drugs, alcohol, sleep)
Neglecting self-care
Increased absenteeism

If you or someone you know is experiencing burnout, seek help. Don’t attribute it to the normal nursing day. Look to your friends, your family, and your co-workers, and speak to a counselor. Most hospitals have anonymous counseling available, and most have the number or URL listed on their employee boards in the break room. Use it. Set boundaries. Say no to that extra shift, that double. Understaffing is not the nurse’s problem. Take care of yourself. Eat well, take your full lunch break, and eat in a place with windows and sunshine. Hydrate. Hydrate. Hydrate.

Start something at your hospital that helps you. In one hospital in Idaho, for the first 15-minute break, everyone went outside and walked around the hospital. This generally took longer than 15 minutes, but it was approved because we were practicing self-care. In another hospital, every weekend, the ED planned a potluck. It started because the staff meals were horrible on weekends, but it became a lot of fun. Camaraderie, self-care and companionship. Burnout will take over if you don’t address it. Seek help. You will find it.

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