As frontline nurses continue to care for the growing number of COVID-19 patients, enact strategies to reduce their risk of burning out.
Prior to the COVID-19 pandemic, nurses were already facing a high burnout rate—with nearly four out of 10 nurses reporting they felt burned out—possibly due to long hours, increased workloads, weak work cultures, fragmented communication from leadership, and the emotional toll from caring for significantly ill patients.
Then nurses stepped up when the pandemic hit, putting their own fears and exhaustion aside, as well as the needs of their families, to prioritize the needs of their patients, which is an approach that is not sustainable for the long-term, says Renee Cecil, DNP, RN, CEN, TCRN, SANE, NREMT, senior consultant for Philips Healthcare Transformation Services.
"Faced with the overwhelming emotional and physical turmoil of the pandemic, these feelings of burnout are compounded among our frontline nurses and those in nurse leadership roles to the point of trauma," says Cecil.
Staffing issues also intensify nurse burnout, she adds. Before the pandemic, departments were already struggling with staff shortages. In fact, according to an article published in 2018 in the American Journal of Medical Quality, the country is forecasted to have a shortage of more than half a million registered nurses by 2030. Now, as the pandemic stretches on, a growing number of nurses are being exposed to the virus, requiring time away from work to quarantine.
"This can be a huge loss to the department and adds to the burden of working staff. The pandemic has also encouraged many nurses to retire early, shifting to work away from the bedside, or taking more time off to spend at home with their children who are engaging in remote learning. While understandable, this puts more pressure on short-staffed nurses in the hospital," says Cecil.
Cecil shares three strategies to address the growing problem of nurse burnout.
1. Create Coaching and Mentoring Programs to Develop Leaders
To proactively combat nurse burnout, Cecil says health systems should identify good nurse leaders and support them. "Now more than ever, we need leaders capable of offering the emotional support needed to empathize, look after each nurse's personal well-being, and ensure everyone feels valued and heard."
Developing nurse leaders and others with sufficient leadership skills will help inspire their teams, put staff needs first, and position them as trustworthy mentors who can provide guidance for reducing the symptoms of burnout, she says. "Today's pandemic has the power to make or break a department and good leaders have potential to ensure their team comes out of this stronger than ever."
To provide leaders with the proper coaching and mentoring to be effective and meet the needs of their staff, Cecil suggests using independent consultants or designated leaders within your organization to provide coaching and mentoring to new leaders. The coaches and mentors should be experienced in leadership through various disciplines of nursing and should have a certification in their specialty and/or leadership. The coaching and mentoring should include bolstering communication skills, executive presence, leader rounding, delegation skills, and the ability to focus on the strengths of the staff to drive empowerment.
She also suggests that leaders have succession plans in place early on by identifying potential candidates and then providing them with consistent coaching and mentoring. A succession plan would include identifying individuals who have goals to be leaders and the necessary skills and education. Leadership courses would be used to educate them on the essential skills of leaders. As they progress, more duties to grow them as leaders would be added, while the mentors observe and provide feedback.
2. Increase Communications With Staff
Strong leaders take the time to have one-on-one conversations with each staff member, as well as facilitate group conversations, says Cecil. "An exceptional leader has strong communication skills, and connects with staff in a transparent, empathetic manner. Particularly when COVID-19 first hit and there were so many unknown factors and unpredictable patient volumes, direction was always changing. While it is OK to not have all the answers, strong leaders are up-front with nurses about what information is available, what remains unknown, and what they can expect every day to the best of their knowledge, helping to build trust."
She suggests setting up recurring 10–15-minute check-in meetings with individuals or teams at the start or end of their shifts every month or every other month to discuss how they're feeling. Doing this will make a world of difference. To make these check-ins more manageable and to ensure the responsibility doesn't fall to a single person, consider spreading them among the leadership team.
If scheduling does not allow for a team to meet regularly, Cecil suggests ensuring impromptu conversations happen regularly.
"While it is easy for these check-ins to fall to the wayside with the chaotic work environment and schedule common among nurses, leaders cannot afford to not make time for it," she says.
3. Incorporate Frontline Nurses in Decision-Making
Nurses are on the frontlines and know what the barriers are to care and can provide innovative solutions, so their input in real decision-making conversations is important, says Cecil. "Particularly during the pandemic, involving frontline nurses will not only improve an understanding of their lived experience but will also help with engagement and adoption of new processes, as well as give them the sense that they are involved in decision-making and not just being told what to do. This will ultimately keep nurses engaged in their roles and improve retention."
She says leaders should talk with staff and ask pointed questions about what's going well and what can be improved. These discussions can be guided by asking questions like, "How are you doing?" Asking how things outside of work are going, such as family and school, is especially important than ever in light of COVID-19's impact on families and homelife.
Other simple yet specific questions to ask include:
- What is going well? What should we keep doing more of?
- What is not going so well? What can be improved? Do you have suggestions for a solution?
- Is there a peer that you want to recognize?
Identify and support nurse leaders who, in turn, will proactively address the contributing factors to nurse burnout.
Involve frontline nurses in decision-making to help with engagement and adoption of new processes.