Nurse burnout is a bellwether for all of us and needs to be taken very seriously.
It's the canary in the coal mine, telling us that our healthcare system is crumbling and we better act fast to rebuild it.
1.
Lack of control Unlike other health professionals, such as chiropractors, physical therapists, or doctors in private practice, nurses generally work within a larger bureaucracy.
Hospitals are, of course, the most obvious example of this.
In these settings, nurses - although performing the majority of the direct patient care - are not in charge of how the care is given or the ways in which the patients are treated by the hospital as a whole.
Even the nurses who work for private practice clinics do not generally call the shots within their office.
They work for the doctors and the doctors make the decisions.
This creates a situation in which nurses may feel powerless.
If they feel the way patients are processed or the way their unit is staffed is a poor way of doing things, nurses may find they have no ability to change the situation.
2.
Lack of voice The inability to change the situation is directly related to a lack of voice within the healthcare system.
While nurses are encouraged to speak up if they see a mistake about to happen and even just to make suggestions, they must do so uphill.
When you are in charge of your own practice and you want to make a change, you simply make the change.
If, however, you work for someone else - let alone in a bureaucracy as large as a hospital - all you can do is mention the problem and try to draw attention to it, often with no hope that anyone will take notice.
That means it take a lot more effort and a lot more dedication to make the suggestion - or, worse, the complaint - than it otherwise would.
Add to that the fact that, since very little response may be forthcoming, the end result may be just of setting yourself up to be seen as a complainer or trouble-maker, even when your suggestion is brilliant and directly affects patient care.
Moreover, the lack of voice often stems from clear intent among supervisors, doctors, or others higher up in the hierarchy to not give credence to the needs of nurses.
This leads to our third reason why nurse burnout is different...
3.
Lack of respect This is the fundamental issue regarding nurse burnout, one that has to be given more than lip-service.
The nurse/doctor paradigm was created from a sexist, egotistical model that has never been overcome.
Doctors are still considered better and more important than nurses.
That both make valid and different contributions is acknowledged, but not sufficiently to play out in most medical settings, especially within large bureaucracies.
There is also the idea of unthinking obedience that has been built in to the job of nursing.
This went along with Victorian ideas of the workplace (not to mention male/female interactions), but does not integrate at all with the current belief that teamwork is essential for the medical system to run smoothly.
Obviously, teamwork requires a belief in the value of each team member, including their ideas and suggestions.
This environment makes it all too easy to create supervisors who lord it over their nursing staff and let their own dysfunctions run wild.
So, what can a nurse do about all this? There are really two ways to approach burnout, individually or systemically, and each nurse has to decide for herself what works best for her.
Nurses taking an individual approach focus on their own immediate needs.
Is their supervisor verbally abusive? Is the nurse/patient ratio in their unit unsafe? Are they sick of having suggestions that could easily be implemented be, instead, overlooked? Has their schedule gotten so unpredictable that it's getting in the way of their being able to plan for daycare for their kids? Once the triggers are identified, it's then necessary to explore deeper in order to figure out not only what would be the most desirable outcome, but what are the steps necessary to get there.
Nurses opting for a systemic approach, on the other hand, are going to focus more on how to change the way things are done in their workplace.
This may involve creating action groups, speaking at board meetings, circulating petitions, joining unions, or lobbying in Washington.
Systemic approaches take longer to bear fruit, but give the joy of knowing you are working for a common good.
In many cases, nurses dealing with burnout will want a mix of these two approaches.
First and foremost, they want to address their individual needs, but they would also like to change things in the healthcare system so that the problems they are experiencing don't recur.
Are you a nurse who has ever felt burned out? What happened in your situation - were you able to correct the situation where you worked, or did you wind up working elsewhere?