CalmWave Blog

Authored by: Peggy Pilon, RN, BSN, MS, VP of Clinical Success

 

Nurse burnout is a hot topic today, and not only in healthcare settings. In 2019, only 15.6% of nurses reported feeling burnt out. However, over the past three years, 95% of nurses have reported burnout. It is well documented that 30% of all U.S. nurses quit their jobs in 2021, and 27% of those nurses who quit reported burnout as their main reason for leaving. As of 2023, the annual rate of nurse turnover is 27.1%. It is estimated that by 2024, we will need another 1 million nurses globally. In addition, it is projected that we will need 13 million nurses by 2030. So it is imperative that we deal with nurse burnout quickly and effectively.

The Dalai Lama states that “If you feel burnout settling in, if you feel demoralized and exhausted, it is best for the sake of everyone, to withdraw and restore yourself.” His advice seems like the logical thing to do when experiencing burnout. However, with patients requiring 24/7 care and nurses needing to provide for their own families, we need to look to other solutions to solve nursing burnout.

 

There have been many Nurse Leaders who have recently weighed in on the nurse burnout issue. For example, the American Nursing Informatics Assoc (ANIA) issued the enclosed letter in time for Nurses’ Week 2023, reminding us about the importance of self-care:

 

Happy Nurses Month! As nurses, we have dedicated our professions to caring for patients and their families. Although the core of nursing has not changed since the days of Florence Nightingale, the way we care for patients has. Nurses no longer simply care for patients, they ensure that regulatory, quality, and safety initiatives are being achieved and met. As stakeholders in our patient’s care we ensure our organization meets patient experience goals, and care management along with documentation has become the responsibility of more than just case management. Our responsibilities to our patient’s often requires us to give 100 percent of ourselves including our physical and emotional well-being. Today more than ever, we need to take a moment for ourselves and make “self-care” a priority.

According to the World Health Organization (WHO), self-care is defined as “what people do for themselves to establish and maintain health, and to prevent and deal with illness” Self-care reduces stress and helps replenish our capacity to provide compassion and empathy when caring for patients. Self-care can improve the quality of care being provided and has been recommended by the ANA in the Nursing Code of Ethics. Hence, why the first week of Nurses month is dedicated to cultivating and maintaining optimal mental health and physical well-being.
Self-Care can be divided up into eight areas that include mental, physical, emotional, spiritual, social, personal, professional, and medically. Here are a few ideas on things you can do to help improve your own self-care.

Mental

• Engage in a committee within or outside of your organization
• Read a journal article
• Try a new hobby
• Listen to audiobooks or podcasts

Physical

• Park far away from the building and enjoy the outdoors
• Bring Healthy lunches and snacks
• Find Exercises you enjoy
• Have a dance party with yourself, your kids, friends, or family!

Emotional

• Praise others for their accomplishments
• Praise yourself
• Smile at everyone you walk past
• Be creative, build something, make something, or write something

Spiritual

• Become mindful with meditation
• G outside on your break
• Try Yoga- There is all kinds of variations like Hot Yoga or Goat Yoga
• Keep a gratitude Journal

Social

• Ask co-workers about their day
• Celebrate with your work family- Birthdays, bridal/baby showers, or just because
• Go out with a friend
  Plan a date night or a road trip

Personal

• Add adventure like hiking, canoeing, or flower picking
• Go get your hair and/or nails done
• Only commit your family to activities and social engagements that you can manage. Don’t overextend!
• Make a manageable daily to-do list

Professional

• Declutter your work bag
  Create career goals
• Create a monthly wellness Calendar for the team
• When you clock out, make sure you truly clock out.

Medical

• Daily physical activity outside of work
• Healthy food and drink choices
• Routine preventive Care
• Quality Sleep

Resources and Technology- Not sure how to get started? There are some great apps out that can help!

• Emergency Self-Care Worksheet- Allows you to create a plan of what to do for yourself when things get tough.
• Joyages- Delivers a customized experience designed to empower users to become happier in less than three minutes each day. The app encourages positive habit formation and mindset shifting
• Implementation guide for Gratitude Practice for Nurses Took Kit From the ANA
• Headspace- Is an app that can help anyone start meditating
• Getting Started with Mindfulness- A website answering questions about mindfulness and meditation
• National Suicide Prevention lifeline or call 988- It’s ok to not be ok. If you are having thoughts of suicide or are in distress please reach out for help. Help is available 24/7 via phone or chat.

What does Self-Care look like to you? ANIA Midwest wants you to show us and your colleagues what self-care looks like. Celebrate nurses month by posting a selfie of you doing a self-care activity to our Linkedin with the hashtag #ANIAselfcare and/or our Facebook page.

 

What is stated in the letter is true: self-care can be a therapeutic measure to destress, maintain positive mental health, and increase resilience. However, suggesting to “go get your hair and/or nails done” can appear insensitive to an already burnt out, struggling nurse. I am wondering if a predominantly male dominated occupation has ever been encouraged “to get their hair/nails done” to feel better? Encouraging nurses to “smile at everyone you walk past” seems to be well intended, but falls short when we remember the stress nurses are under everyday. Perhaps this letter is reflective of how society sees nurses…as heroes. Yet the suggestions are more targeted at the surface manifestations of stress, as opposed to tackling the root cause of the stress that leads to burnout. Nurses do not need a bandaid-type approach to stress reduction with a list of self-care activities. They need validation of what they are experiencing and specific actions to resolve the root causes of their burnout.

 

In March 2023, the 2023 President of the American Organization of Nursing Leadership (AONL), in his “The Voice of the President” letter, states:

 

“For at least two decades, we have heard the labor predictions and are now feeling the implications of an international nursing shortage. Researchers who study workforce trends forecasted many years ago that we would experience a significant deficit in the supply versus the demand of health care workers, more
specifically nurses. In 2020, the COVID-19 pandemic was a shock to the system and threw us curve balls. Suddenly the predictions related to the number of nurses graduating, going part time, retiring or leaving the profession were no longer as reliable – and neither were the strategies to address these trends. 

As a result of examining new workforce shortage prediction models, many nurse leaders are exploring various strategies to sustain and expand their ability to care for their communities. The solutions to workforce challenges are complex and require silos to be broken and interprofessional partnerships to occur. Health care leaders need to take a hard look, examining why we are in this current state.

Moreover, highlighting the joy that exists within our profession remains a priority. Keeping (or in some cases, restoring) joy in a clinician’s day must be at the heart of everything we do. The programs, initiatives and strategies we are developing and implementing across health care are about more than improving efficiencies, building a robust pipeline and slowing turnover. The goal and expected outcome of these efforts is to restore enough time and space for individuals on our teams to practice mindfulness and self-care on a consistent basis and (re)identify the joy in what we do.”

 

Although AONL makes some good points about the gravity of the nursing situation, the main focus is on putting “joy” in the hearts of nurses. Again, this seems more like a surface approach to a much deeper problem of burnout. I believe it would be difficult to approach a burnt out nurse, who is having trouble even conceptualizing returning to work, and remind him/her to find the joy in their work. Perhaps nurses are already resilient enough and “joy” is a building block for the future. Perhaps it is more about the environment than the tips that Nursing Leadership have stated.

 

Laurie Smith MSN, RN, NEA-BC, ACC, is a former CNO and Nurse Healthcare Executive. She writes that most frontline nurses do not trust their Nursing Leadership, and this is at the heart of non-functional teams and nurse burnout. Laurie stresses the importance of:

 

• Empowering nursing teams to work outside of their comfort zone 
• Breaking down silos between interprofessional cohorts 
• Inspiring teams to improve metrics 
• Fostering ownership with direct care nurses through a thriving shared governance model  
• Inspiring teams to improve metrics and take their leadership to the next level

 

Again, these are all important points to foster healthy teams. But will these initiatives deliver any real-time solutions to the nurse burnout crisis? Are they part of the building blocks for the future of nursing teams?

 

Timon Kaple and  Elizabeth Clark, FNP, MSN, RN, MSSW, of the Nurse Journal write about the “Top Tips“ for dealing with nurse burnout:

 

• Noticing Nurse Burnout
• Developing Strong Interpersonal Relationships
• Setting Boundaries Between Work and Personal Life
• Caring for Your Physical and Mental Health
• Seeking Out Regular Therapy or Assistant Programs

 

These tips are valuable….but are we still assigning the nurse with practicing more self-care and becoming more resilient? Isn’t it time to look past what nurses can do for themselves and look elsewhere for solutions that can be deployed in real time to combat burnout?

 

De-Stress Study: The “Lavender Lounge”

 

A group of Critical Care Nurses from a large teaching institution launched a study in their ICU to see if they could remediate burnout. The goal was to give nurses a way to renew themselves after stressful situations. They identified that nurses caring for critically ill patients experience additional and unique stressors. They hypothesized that if nurses were given a safe place within the hospital, where only they could go, after experiencing a stressful situation or when they feel mounting stress, that may help combat burnout. Hence, the birth of the “Lavender Lounge,” where nurses could find a break from stress and enjoy a “serenity” oasis. Even though the nurses who used the “Lavender Lounge” reported liking it, most were unable to utilize this new oasis. Many of the reasons were around the nurses being too busy to get to the lounge and not having enough staff to cover their patient assignments when in the lounge. The results are disappointing at best because the clinical group noted, “Repeated exposure to similar stress can lead to lasting emotional, cognitive, behavioral, and spiritual injuries among some caregivers.” I applaud this group of Critical Care Nurses for addressing the stress and burnout issue by changing the actual nursing environment, as this is an important step. But it’s time we employ technology to help us change the stressful, chaotic ICU environment.

 

Combatting Nurse Burnout With Technology

 

Managing the stressful and noisy ICU environment remains one of the biggest, most concrete opportunities to decrease burnout and stress in ICU nurses. It is important to recognize that no other industry or work environment puts up with this level of noise along with this amount of false alarms. As vital sign monitoring devices continue to beep with non-actionable alarms that have ICU RNs and patients constantly hearing and attending to “just noise,” we need to look to AI technologies, such as CalmWave, to manage this “noise pollution” that permeates every aspect of the ICU environment.  

CalmWave improves alarm management by guiding nurses with informed decisions and actions. We at CalmWave use AI technology to make every alarm an actionable alarm for the bedside caregivers. Fewer alarms means a less stressful environment. Less stress means less burnout and more ICU nurses wanting to stay in the nursing profession. In addition, this technology is already here today, so not one more nurse needs to suffer. It is important to implement the other self-care techniques identified in this article…but those will take time. Let’s act now and implement AI technology and partner together with the nursing community to make the ICU environment manageable. Increasing one’s resiliency is good future “life advice,” but AI technology is the answer to the nurse burnout problem today.

 Contact us to learn how we can help you turn your ICU into a more optimal place for healing and recovery.