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SIU researchers studied 'nurse burnout' — here's what they found

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Drew Williams, a registered nurse in the intensive care unit at SIH Herrin Hospital, pauses outside of one of the ICU rooms at the end of his 12-hour shift on Wednesday in Herrin.

Drew Williams admits he's tired.

Like many in his chosen field of nursing, the RN who works nights caring for intensive care patients at SIH Herrin Hospital, Williams has worked a lot of hours during the past 15 months and he has seen a lot of suffering.

He's not alone.

All across Southern Illinois and the U.S., nurses have carried an enormous burden and they are tired – physically, mentally and emotionally – leading to widespread “nurse burnout.”

Researchers at Southern Illinois University Carbondale set out to study nursing burnout more than a year ago and what they discovered not only showed nurse burnout to be significant even before COVID-19, but even more relevant since the beginning of the pandemic.

The interdisciplinary study, called “Emotional Exhaustion as a Predictor for Burnout among Nurses,” looked at what causes burnout and offered suggestions to prevent it.

Kelli Whittington, who led the research team and is director of SIU’s nursing program, said the study showed several factors contribute to the burnout.

“First, there’s a really strong relationship between workload and emotional exhaustion,” she explained. “It’s not that nurses don’t handle a heavy workload, it’s how they are able to handle it and feel as though they can manage their time, interact with each other, how they can take a break and that the workload is equitably distributed. It’s about having the flexibility to handle that workload in the way that they feel is best.”

Additionally, she said nurses can become emotionally exhausted when they don’t have a sense of control and that nurses need a sense of community within the workplace.

She said emotional exhaustion may not be apparent within the nursing unit, but can manifest itself in a variety of ways.

“There are emotional aspects, such as not wanting to do anything with our friends and family. We just want to go home, stay home and not interact with people and our tempers become short. We also can see it with things like depression or stomach aches,” she explained.

'We make connections'

Williams said it is the very nature of nursing – the call to care for others – that makes the job challenging, especially when patients suffer or pass.

“In this job you take things personally,” Williams said. “We get to know these patients and their families and we make connections. It can be really difficult.”

Steve Marlow, administrator of The Voyage, an assisted living facility in Murphysboro, said more has been asked of nurses during the pandemic.

“With all of the extra hours, all of the extra precautions in all environments, it’s really been a strain on the nursing staffs,” he said. “Burnout is the real deal.”

Like many colleagues, Marlow said his organization is working to combat or prevent emotional exhaustion in nurses.

“We try to make sure that they get an appropriate amount of time off – at least two days in a row, maybe three,” he said. “We also try to make sure to make sure our facility is somewhere they want to be.”

He said leaders also must show compassion – such as assisting nurses with duties and picking up nursing or housekeeping rounds themselves.

“Rolling up their sleeves and showing that they care,” he called it.

The SIU study used the widely accepted Maslach Burnout Inventory (MBI) to measure the prevalence of burnout among nurses across the nation. An MBI score of 27 indicates burnout. Nearly half of the study participants reported a total score of 27 or higher.

Whittington said length of nursing career, ages and area of nursing did not seem to impact the level of burnout.

“We saw it all over the place, which tells me that if nurses are working as nurses, they are experiencing emotional exhaustion,” she said.

She said the study also offered suggestions to combat or prevent burnout.

“First of all, there is acknowledging it and finding ways to care for ourselves,” she offered. “Additionally, as nurse managers and leaders, we have to be equitable in assigning workload and in fostering ways to develop a sense of community, not only among nurses, but within the whole medical community.”

For leaders such as Johnna Smith, nurse executive at SIH St. Joseph Memorial Hospital in Murphysboro, caring for those who care for patients is a top priority especially because burnout can ultimately impact patient care.

“I think historically, we have always talked about nurse burnout, but I think the pandemic really brought it to light because it wasn’t just affecting one hospital or one unit. It is nationwide,” she said. “There are things we can do to help our staff and then it is a matter of convincing ourselves to take care of ourselves so we can continue to give ourselves.”

One example is a “relaxation room” on the hospital’s second floor. It’s a place where medical personnel can “take a breather.” Staff can use a massage chair, envelope themselves in environmental sounds or simply rest for a while.

“It’s a place that they can use to have a moment to get their mind off of something or if they just need a moment to themselves,” Smith said.

Heartland Regional Medical Center in Marion, like many other providers, offers an employee assistance plan to help battle job fatigue.

“We work to ensure our nurses have the resources they need to avoid burnout and that starts with mental, physical and emotional support,” said Heartland Chief Nursing Officer Barrie Questelle.

Questelle stressed the role of communication in avoiding burnout as well.

“Staff-to-staff communication is also key. Our nurse leaders hold daily safety huddles. We share information on work hour needs, work processes, and more. That helps make certain that nurses have input about important hospital decisions,” she said.

For many in nursing, simply talking about things – especially among peers – is a huge help. Williams said “debriefing” with his co-workers after a shift is beneficial in helping him deal with the challenges of nursing.

“Privacy laws prevent us from going home and talking with our families about these situations, so we really only have our coworkers and leadership to talk with. There’s a lot of leaning on each other. We’re like a family,” he said.

For Whittington, a nurse herself, battling burnout is something she said those who train nurses must teach.

“Nursing students and providers must become mindful of the things that impact their emotional health and set up a plan for success from the very beginning so that we don’t get to the point where we are exhausted and where we have a positive place and culture,” she said.

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