Nursing is dynamic, impactful and above all, essential work. There is currently a shortage of nurses in the United States. Some researchers estimate that shortages in registered nurses will range from 154,018 in 2020 to 510,394 in 2030. Therefore, when you consider nursing as a profession, it is important to understand how the current nursing shortage is impacting this rapidly changing workforce. According to the U.S. Bureau of Labor Statistics, there will be about 176,000 new job openings annually until 2029 —certainly good news for those entering the profession. With this job security, however, comes a hidden consequence: burnout. Therefore, self-care to avoid burnout must become a priority for both current and future nurses.
The nursing workforce is diverse in all ways, particularly by age, and the intersection of perspectives that happens when multiple generations work together can sometimes create friction. Expectations, approaches and priorities between generations can differ dramatically, and these differences also have an impact on the nursing shortage.
The most experienced nurses come from the baby boomer generation. Born between 1946 and 1964, many nurses of this generation are approaching retirement with the majority due to retire by 2029. The effect of this mass exodus on the existing nursing shortage is a major concern and nursing education programs are struggling to successfully graduate new nurses to take their place.
Baby boomers grew up in a time where frequent job changes were frowned upon.
Baby boomers grew up in a time where frequent job changes were frowned upon. One recently retired nurse of 40 years recalled “you worked where you were hired until you retired and changing jobs frequently indicated that you were either prone to personal issues or were unprofessional.” Seniority earned time advantages, such as longer vacations and not having to work weekends, which are important to this generation. These benefits are seen as earned due to the years they endured working holidays and weekends as new nurses. When asked about working weekends and holidays one senior nurse said, “that’s for the younger nurses—I’ve done my time.”
This dedication to one healthcare facility and the focus on seniority is starting to change as Gen X nurses, born 1965-1980, occupy positions of authority. Nurses of this generation are tech-savvy and more easily adapt to technological changes like transitioning from paper to electronic medical records.
Gen X nurses change jobs and seek out new opportunities if they feel their work needs are not being met or if they are not able to change specialties, often to the dismay of their older counterparts. This willingness to change jobs can cause significant staffing issues. Fortunately, the next generation is stepping in.
Meeting the expectations of a younger workforce
What are the expectations of the younger workforce? A millennial nurse commented that younger nurses are not willing to accept working all the weekend and holiday shifts based on their lack of seniority: “Time has to be respected and valued. Then, people are more likely to be flexible and it decreases burnout if you feel your own needs are being met.”
It is important that nursing management understand that these younger generations enter the workforce with certain expectations and will not hesitate to change jobs if they feel their needs are not honored.
It is important that nursing management understand that these younger generations enter the workforce with certain expectations and will not hesitate to change jobs if they feel their needs are not honored. Turnover, whether due to burnout or dissatisfaction, is costly and strains the healthcare facility and by proxy the patients themselves.
The importance of self-care to prevent burnout
As a helping profession, nurses are at particularly high risk for burnout. While some stressors are outside our control like COVID19, we can work to minimize nurses’ overall stress to be better prepared for the unexpected. Here are a few simple daily changes that as a nurse you can introduce to destress and avoid burnout.
Strategies for nursing students
If you ask a nursing student what causes them the most stress, they will undoubtedly tell you nursing school. Fortunately, there are strategies that reduce the risk for burnout from the first day.
Begin by getting organized. Having a clear plan for classes and assignments helps you to prevent becoming overwhelmed. This might look like prioritizing work by assignment dates, length and how much time tasks take. If you have an exam coming up, think about how much time you can devote to each topic on the test and plan accordingly. Having a practical, flexible plan will help you stay on track and keep your stress levels under control.
Although many nursing students work while studying, it can be hard to balance work and school. It seems logical that with the addition of personal and family obligations, nursing students who are also working are at higher risk of becoming overstressed and at a greater risk of burn out. If you do work, there are some things you can do to help mitigate the stress. Minimizing your hours when possible and empowering yourself to say no to shifts that are outside of your regular schedule are good strategies. If you start to feel overwhelmed, streamlining your budget by cutting back on spending can make working fewer hours possible. Remember that any steps you take to consciously take care of yourself during your studies will pay back dividends not only in well-being but in good grades and better future job prospects.
Passing your boards is a major milestone on your journey to becoming a nurse. This is not only a time to celebrate, but to consider your well-being as you evaluate job offers. Consider the following as you begin interviewing at healthcare facilities:
- Do you have a young family at home or family members you care for?
- Do you have the flexibility to work any shift?
- Do you mind working weekends?
- What do you value more: time or money?
Don’t forget that it’s okay to be proactive and ask perspective employers questions about seniority, unions, their scheduling system and how they assign work on holidays. If you have certain needs such as a vacation scheduled in the future, make sure to mention it. Being up front about your needs and expectations sets a strong foundation between you and the facility.
Strategies for nurses
Stress is an accepted part of working in medicine, but did you know that stress comes in more than one form? Eustress, or good stress, comes from things like overcoming a challenging situation, for example when a team is able to help a patient with complex problems recover. Distress, which is bad stress, can lead to feelings of sadness or overwhelm. Recent studies indicate that over a third of nurses have symptoms indicative of burnout. Here are a few simple daily changes you can make that can be helpful in destressing and avoiding burnout.
Take time for yourself daily. Even 15 to 30 minutes a day can be effective in avoiding burn out. There is no right or wrong way to practice self-care. Any activity that helps you to feel calm, happy and content is great. For some, it might mean a long hot shower, meditation, or prayer. For others it can be a walk or yoga. Music, journaling, or simply sitting outside and enjoying nature can all serve as self-care. There are some activities that have even been clinically proven to improve your mood including journaling, meditation, exercise, good sleep hygiene and therapy.
Journaling can be a very productive way for a nurse to process their feelings about what happened at work. Many consider the act of journaling to be cathartic and report feelings of well-being after completing an entry. Be sure to consider patient confidentiality when writing about stressful events at work.
There are great meditation apps that are available for smart phones and tablets online, many of which are free. Meditation has been used for thousands of years to achieve a calm, peaceful state. The use of relaxation techniques such as meditation have been clinically proven to decrease burnout and improve job satisfaction.
Multiple studies have shown that exercising releases endorphins and helps stimulate the production of serotonin. Serotonin is one of the main neurotransmitters involved in depression. Low serotonin puts a person at higher risk for developing depression. Therefore steps to increase serotonin can help lift depressed feelings that may accompany burnout. Exercising at least 30 minutes 5 times a week can have positive effects on our state of mind. What’s more, research demonstrates that anything that elevates your heart rate such as walking can be enough to foster better mental health.
Good sleep hygiene
Sleep hygiene refers to our habits and strategies for sleep. When our schedules become chaotic, we often deprive ourselves of sleep to stay on top of the things. However, sacrificing sleep also sacrifices mental wellness, which increases your chances of burnout.
Good sleep hygiene includes sticking to a fixed sleep schedule. As nursing students and nurses have fixed schedules, deciding on an ideal time to go to bed and wake up and sticking to it will help your body maintain its natural rhythms.
Making sure that phones, tablets or other devices are put away an hour before bedtime is essential. These items emit blue light that stimulate the brain, so shutting them down ahead of sleep is another way to get better quality rest.
One nurse told a story of putting a band-aid over the digital read out on her air conditioning unit, saying “I just couldn’t believe how much light it was throwing.” Lights, such as those on a phone charger or modem tower, can stimulate the brain even while sleeping and should be covered or removed from the bedroom.
Having a television or radio running while sleeping can also interrupt sleep patterns. If you are unable to quiet your room, heavy room darkening curtains can help buffer noise. If you must have sound, use a fan or other source of white noise.
When asked about nurses and burnout, a psychotherapist who specializes in medical professionals stated, “nurses, like other high stress jobs, have a shelf life.” Processing feelings and getting support can help nurses reconnect with their love of the profession. There are many therapists who can assist nurses in skills such as cognitive behavior therapy (CBT) or stress reduction techniques. To find a therapist, contact your health insurance provider for a list of local therapists. You can also use online resources to help connect with a therapist in your area who specializes in treating medical professionals.
As a final strategy, it is important to consider that a job change in nursing is always possible. Evaluating your needs and goals should be an ongoing priority throughout your career. Nursing is a veritable buffet of different job opportunities. From education to management and floor to office nursing, the ability to reinvent oneself is possible. Taking time to evaluate your wants and needs may be a way to preserve your career. A nurse works hard to get through nursing school, pass boards and maintain credentials. Nurses will always be necessary, and it is okay to prioritize finding happiness at work by continually assessing your progress and accepting that your own needs are important.