Nursing has always been a demanding career, but it has become more challenging in recent years. Between a growing population with rising rates of chronic comorbidities and staffing shortages worsened by a once-in-a-century pandemic, the potential for burnout is at an all-time high. Within six months of the emergence of COVID-19, the number of nurses reporting very high levels of burnout jumped 350% compared to pre-pandemic levels, according to the Medscape Nurse Career Satisfaction Report 2020.
Besides burnout, the ongoing stressors that nurses experience on a daily basis can lead to compassion fatigue, depression, lowered quality of care and possibly an exit from the field entirely. To cope, nurses must use targeted strategies to avoid the deleterious effects of stress and build resilience.
What Are the Main Challenges Nurses Face in the Field?
Nearly two decades into her nursing career and with experience in hospital, hospice and home health settings, Jami Carder, BSN, RN, understands the uphill battles nurses face. “Nursing burnout is nothing new, but with the pandemic, constantly evolving technology and insurance requirements, nurses are under more pressure than ever before,” she said. Combined with shift work, overtime work due to staffing shortages and attempts at maintaining a fulfilling personal life, the competing priorities make it tricky to strike a balance.
There is also the mental and emotional strain of caring for patients who may, at times, be noncompliant, violent, angry, critically ill or nearing death. Providing support to patients’ families and friends compounds the daily stress, as does walking the fine line of coworker disagreements and personality clashes. “There are so many challenges nurses face every day,” explained Shawn Ellis, a heart-centered resilience coach and keynote speaker who works with healthcare organizations. “Perhaps the greatest challenge of all is that these circumstances are out of your control. When you add it all up, it can be emotionally draining.”
How Can Nurses Build Resilience?
Although the range of variables impacting nurses may seem overwhelming and insurmountable, one way to minimize the negative effects of these stressors is to develop resilience. Many nurses already have well-established basic coping skills, simply born out of their years of experience, but the pandemic has forced them to become more intentional in how they manage stress.
Self-care is absolutely critical. Journaling, streaming your favorite show or taking a walk in nature are healthy emotional outlets. Meditation and exercise are other options. Carder, who is also a certified Nama Shivaya Meditation instructor, creates personalized guided meditations designed to enhance stress relief and prevent burnout.
Ellis is a proponent of “heart-focused breathing” to calm the mind and body and stay present in the moment. He says as little as 30 seconds of focused breathing can be helpful. Nurses can then increase the length and number of daily breathing sessions to fit their needs. “Resilience is a moment-by-moment proposition,” added Ellis. “We all get knocked down. This is the human experience. I encourage you to carry a mantra with you throughout the day: ‘All that matters right now is right now.'”
Employers should have a prominent role in promoting resiliency, too. Besides ensuring adequate staffing and break times, empathy and communication are key. “Nurses are less likely to feel burnout if they feel they are part of the team and listened to, as opposed to working under conditions dictated by management personnel,” explained Carder.
Simply recognizing the difficulty of the situation, even when you cannot offer complete solutions, is beneficial. “Rather than assuming or pretending that ‘you should be able to face this with no problem,’ acknowledge the feelings of your team members,” said Ellis. “Being in an environment where you know you’re cared for automatically boosts morale and strengthens resilience.”
Nurses are exposed to a multitude of stressors each day. If they do not have the ability to work through the emotions of those events, it will severely impact their health and the quality of care they provide. Building resiliency helps nurses handle difficult situations and ensures they have mental, emotional and physical fortitude.
Carder, J. (February 2021). Email interview.
Ellis, S. (February 2021). Email interview.