Nurse Burnout Causes: Two More from Stop Nurse Burnout

by | Feb 5, 2018 | 0 comments

Nurse Burnout Causes_ Two More from the Stop Nurse Burnout Book

Two More Nurse Burnout Causes from The Stop Nurse Burnout Book

In last week’s post, we highlighted the fact that there are five nurse burnout causes, sharing the first one with you. Feel free to check out this post (What Are the Causes of Nursing Burnout?) for the introduction to this topic and first cause that was shared from the Stop Nurse Burnout book.

In today’s post, we will review two additional nurse burnout causes.

Nurse Burnout Causes #2: Your Specific Job

The second root cause of burnout is the stress associated with your specific job position. These stresses are deposited in an additional layer on top of the level one stresses of the practice of clinical medicine outlined above.

A very incomplete list of job-specific nurse burnout causes includes:

  • Your rotating schedule and on-call shifts
  • The Electronic Medical Record (EMR) in your institution, the IT capabilities that support the EMR, and your specific documentation requirements—including the regulations governing how you document, such as medication orders, pain protocols, and others
  • Your support staff and your relationships and delegation abilities in leading your team
  • Your holiday schedule and weekend hours
  • Your relationships with nurse colleagues and administrative leadership
  • The expectation for you to participate in activities viewed as professional development, such as committee work, evidence-based research and specialty certifications which you are typically not compensated for
  • Your confidence in your team’s abilities to adequately care for your patients when you leave your shift

And on and on and on it goes. These additional job-associated stresses can make pulling the curtain shut—and having your seven-and-a-half minutes with the patient—an island of sanity in what feels like a crazy career choice.

These stresses hit below the belt as well. The only way to deal with them effectively is to use skill sets you were never taught.

Your Missing Skill Sets

Nursing school trains you to be a competent clinician. Within your specialty, you are experienced in assessing a patient, creating and implementing a plan, and then evaluating progress towards goals. Unfortunately that is not enough to build your ideal career.

Now that you are a working nurse, your job responsibilities could really use several additional skill sets. There was no room in nursing school to teach you these, and they would really come in handy now. Here is a partial list:

  • Leadership
  • Project management
  • Business development
  • Business finance
  • Team communication

(To name a few.)

When you add these job specific stresses to the stress of just caring for patients, your workday can quickly force you into survival mode.

Job-related stresses differ by specialty and location.

The stresses you experience from your job are often determined by the where and how of your specific nursing job choice. Job-related stress is universal; the “flavor” of the nurse burnout causes is different depending on whether your nursing career is:

  • Hospital-Based
    • Clinical Staff
    • Advanced Practice Role
    • Director/Executive Level Leadership
  • Long-Term Care Facility
    • Adult Day Services
    • Assisted Living
    • Rehabilitation Centers
    • Hospice Care
    • Nursing Homes
  • Academic
    • Nursing Research
    • Joint Faculty
    • Professor of Nursing

The list goes on and on. You can see this is not a comprehensive list of all of the different roles nurses fill by any means.

Then there’s the stress of working inside a bureaucracy. The more people you interact with on a daily basis, the more your stress levels can increase as you navigate the chain of command and different silos that inevitably form.

Beware of Magical Thinking

You may be tempted to think changing your job or your nursing specialty will eliminate all your stress. You hear this when a nurse says something like, “If I left the hospital setting . . .” or, “If I just become a nurse educator, everything will be so much easier.”

This is a form of magical thinking. Every job position and each nursing specialty have their own unique set of nurse burnout causes.

If you do change jobs or nursing specialties, the change rarely brings the stress relief you seek. You simply trade one flavor of stress for another.

Often, I meet nurses at the point where they have done exactly this: jumped from the frying pan into the fire. This happens because you changed jobs or specialties because you were running away from your last job. To create your ideal career, you must know what you would run towards.

Burnout Cause #3: Having a Life

For most nurses, your larger life is the place where you recharge. You rest and recuperate and make deposits in your energy accounts when you are off the job.

There is a huge assumption here though. We all assume you know how to recharge when you are not at work. We both know it is not a skill you were ever actually taught. Sure, you would come home from a long shift as a nursing student, grab whatever you could to eat, and crash until the next day. But that is not true recharge or authentic life balance.

The 800-Pound Gorilla

Left to its own devices, your career is very much like living with a wild 800-pound silverback gorilla.

Imagine you live with a wild gorilla in your house right now. How much room would that gorilla leave you … in your own house? Where would he poop?

Imagine now that the gorilla is your career choice to be a nurse and the house is your life. Left to its own devices, your career can take up all the room in your life and make a mess whenever and wherever it wants.

The gorilla-that-is-your-career can completely dominate your personal time and all your major relationships. It can feel like you only get the cold leftovers to yourself. If it feels that way to you, I wonder how it feels to your spouse or significant other?

You have never been taught the skills to create and maintain life balance. You have to learn them on your own, by trial and error, all while simultaneously balancing the stresses of a nursing career and your specific job.

And life has a tendency to get more complicated as we get older.

Occasionally, nursing students will marry and start a family before they graduate. However, most of us begin that phase in our lives after taking our first job position. This is usually a huge time and energy demand we never needed to add into the mix and cope with until now.

Whether you are single, married, in relationship or not, have one child or six or none, your larger life has many ways to add additional stress to the stresses of your nursing career and your job.

More examples:

  • Your relationship with your spouse or significant other
  • Children and raising and caring for a family
  • Your own physical health and fitness
  • Finances (saving money, paying off debt, investments, etc.)
  • Your wider family responsibilities, including caring for aging parents, etc.
  • Hobbies, friendships, and interests outside of nursing

Most of us are able to grow a life and find some balance by trial and error. We learn to get some exercise and sleep and deal with the additional time commitments of our life outside of healthcare. Our skill in this balancing act varies from week-to-week, and everyone is on their own to figure it out.

What if things don’t go well?

If anything happening outside of work begins to block your ability to recharge your energy accounts, you are in trouble. These blocks to recharge at home can actually be a cause of burnout at work.

If you are a nurse leader, it is important to understand this. High stress levels at home can prevent recharge. This will show up as burnout on the job, even when the problem is not on the job site at all.

Let me emphasize this point. If someone looks for all the world like they are entering the downward spiral of burnout at work … it may have nothing to do with work.

If you are a manager checking in with a colleague who seems to be struggling, make sure you ask, “How are things going at home?”

You won’t uncover these life based issues unless you ask. Here is a partial list of nurse burnout causes that are not work-related:

  • Conflict in the nurse’s primary relationship, including separation and divorce
  • Birth of a child, third child, twins
  • Problems with children—from special needs to behavior issues and more
  • Financial hardships
  • Personal health issues
  • Wider family issues such as the failing health of a parent

If you have these additional stressors in your life, it is vitally important to continue to take good care of yourself, despite the extra stress and responsibility at home. The first law of burnout applies here too. When it comes to successfully navigating these life stresses, “You can’t give what you ain’t got.”

In some cases, you will need to cut back on work responsibilities to have the time and energy to deal with these issues in your life outside of nursing.

Let’s hear from you! What other causes of nursing burnout could you come up with? And be sure to check back for the last two causes!! Or, cannot wait for the next post to come out… Check out the Stop Nurse Burnout book for all five causes of nursing burnout.

p1050390About the Author: Keynote speaker and virtual conference host, Elizabeth Scala MSN/MBA, RN, partners with hospitals, nursing schools, and nurse associations to transform the field of nursing from the inside out. As the host of the Nurse’s Week program, The Art of Nursing, Elizabeth supports nursing organizations in celebrating and recognizing their staff in a meaningful way. Elizabeth received her dual master’s degree from Johns Hopkins University. She is also a certified coach and Reiki Master Teacher. Elizabeth lives in Maryland with her supportive husband and playful pit bull.


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