Self-Care for Nurses: 6 Tips to Avoid Burnout

Putting yourself first might sound like a contradiction to someone who has a passion for helping others and is called to the nursing field; however, for a nursing professional, focusing on your own well-being is one way to ensure you remain fully present for your patients – and avoid burnout.

We spoke with Marilou D. Shreve, associate professor of nursing at the University of Arkansas, about self-care techniques for coping with nurse burnout.

 

What is Professional Burnout?

To understand professional burnout and how it impacts nurses and other health care practitioners, it is helpful to reflect upon the definition of burnout.

The first documented use of the term "burnout" in relation to the workplace goes back to 1974 when clinical psychologist Herbert Freudenberger was volunteering at a free clinic in New York City. He'd coined the term to give a name to the "emotional depletion" he'd observed among the clinic's volunteer team. Freudenberger described burnout as "exhaustion stemming from excessive demands on energy, strength and resources in the workplace." Its symptoms, he noted, included malaise, fatigue, frustration, cynicism, and inefficacy.

The World Health Organization (WHO) recognizes burnout as an "occupational phenomenon." In its 11th Revision of the International Classification of Diseases (ICD-11), it defines burnout as "a syndrome classified as resulting from chronic workplace stress that has not been successfully managed."

In his observations, Freudenberger discovered that burnout was often prevalent in professional environments that required large amounts of empathy and personal involvement. In other words, people in health care careers are naturally susceptible to burnout. It's not surprising that nurses, who work perhaps most directly with patients and families – and often in highly stressful or traumatic situations that require a great deal of patience and empathy – are particularly vulnerable to burnout.

 

Nursing Stress: Why Do Nurses Burn Out?

Nurse burnout is nothing new. However, the COVID-19 pandemic has certainly contributed to its rise. According to the International Council of Nurses, pre-pandemic burnout rates among nurses was 40%; in January 2021, that number jumped to 70%. Longer hours, staff shortages and higher-risk patients – as well as exposure to greater occupational hazards – all contribute to increased stress.

"We make the assumption that everybody has fast internet access, and that's not always true," says Samuels. "Where I am in Northwest Arkansas, you've got four major cities, but go ten miles out to the east or west, and there may not be a stable internet signal. If people in remote areas do have internet access, it's not always high speed. That makes it difficult for them – and their employers – to function."

The pandemic also forced many HR directors to re-think how they can develop an increasingly physically remote workforce.

"You can run a lot of employee development programs and talent development strategies online to improve organizational efficiency," says Samuels. "But connecting with people on a personal level is also important. You've got to reach out and understand where people want to go in their careers and encourage them. We talk to our students about how to assess the needs of employees and build plans to support them."

 

How to Prevent Nurse Burnout

Burnout in the health professions can lead many away from the field, and it also can lead to costly mistakes. Burnout prevention – by way of promoting the physical and mental health of service providers – has become a priority within many health care organizations. Examples of intervention and education programs hosted by hospitals include:

• Communication skills training
• Mental attention training
• Resilience training
• Web-based stress management programs
• Psychological empowerment programs
• Professional identity development programs
• Employee wellness incentive plans
• Yoga or bodywork (reiki, therapeutic massage, etc.)

There might not be an easy answer or clear way to completely prevent burnout in the nursing profession; however, self-care can go a long way.

 

Self-Care for Nurses: 6 Tips for Coping with Burnout

Aside from organization-led programs and resources, nurses themselves can implement their own self-care practices. Shreve identifies six effective ways to prevent (or cope with) nurse burnout:

1. Regular exercise
2. Adequate sleep
3. Healthy eating
4. Mindfulness
5. Social connection
6. Access to support

Let's take a closer look at each one.

1. Regular Exercise

Getting enough physical activity has long been seen as a preventative health measure. However, the Centers for Disease Control and Prevention reports that most Americans aren't getting the recommended 150 minutes of physical activity each week.

Shreve says making time for exercise is an important part of her own self-care regimen, and she encourages her students to do the same. Research shows that, along with the physical benefits, exercise can also improve mood and concentration, reduce anxiety and increase immunity. Getting enough movement during the day also can boost sleep quality, which is next on the list of self-care tips for nurses.

2. Adequate Sleep

Fatigue can be detrimental to work performance in any occupation. The emotional exhaustion and the physical demands of nursing can often lead to sleeping difficulties, so it's extra important to establish positive bedtime habits.

"You have to sleep for eight – at least seven – hours a night, and it has to be good, quality sleep," advises Shreve.

3. Healthy Eating

Proper nutrition is also a big part of stress management for nurses. It's not even just healthy eating, explains Shreve. It's also sometimes simply remembering to eat during the rush of the workday.

"As nurses, we tend to eat really quickly," she explains, with nurses often grabbing a quick snack or scarfing down lunch in record time in order to get back to the floor. "We need to find a way to stop and slow down."

Shreve believes that eating – when we take some time to savor a meal – can also be an exercise in mindfulness. And that leads to another stress management tip for nurses.

4. Mindfulness

Sleeping and eating well are important, but relaxation and being in the moment also have positive benefits for mind and body. For this reason, Shreve routinely meditates, but she knows the practice is not for everyone.

"A lot of eyes glaze over at the mention of meditation," she says. "But it's really about focusing on mindfulness."

And meditation is definitely not the only effective way to practice mindfulness. Walking or just being in nature – while paying extra attention to your movement and surroundings – can be restorative.

5. Social Connection

Spending time with people you care about is important to your mental health. Busy work schedules often make it difficult to set aside time for social engagements or even quick check-in phone calls with friends and family members. During the COVID-19 pandemic, especially, it was a challenge to maintain friendships. But Shreve says, pandemic or not, "It's so important to work at keeping your connections strong."

6. Access to Support

Having a good support network is helpful in preventing or coping with professional burnout. That's why, Shreve says, "Another thing we stress to nursing students is to make sure you have access to resources."

This can be as informal as feeling supported by friends and family members. It can also be more formal, such as taking advantage of mental health services offered by an Employee Assistance Program.

 

Addressing Professional Burnout Through Education

Professional development and continuing education for nurses not only expand career opportunities in the field, but they also can offer strategies for coping with burnout.

Developing skills to recognize and cope with nurse burnout can be introduced and reinforced throughout various levels of nurse training.

Shreve says addressing nurse burnout is built into the curriculum and mentoring process at the Eleanor Mann School of Nursing at the University of Arkansas.

For example, to help students build self-awareness and get a handle on stress management, she asks first-year students to keep a journal. This practice also helps her better advise her students.

"The journals also serve as a kind of touchpoint of ‘How are you doing?'" she explains, adding that reading these weekly entries helps her and her colleagues spot obstacles early. "If we see something concerning, we can reach out individually."

Later in the program, an advanced health professions course has students complete a personal improvement project on the topic of their choice.

"It could be to eat better or sleep more," explains Shreve. "And then they can watch their progress throughout the semester. Maybe they started getting four hours of sleep per night, but now they are getting seven."

Shreve says throughout coursework and in advising sessions, she and her fellow nurse educators constantly share how important good physical and emotional health is for the profession. On the more formal side, the program also hosts various stress management workshops and programs for nursing students of all levels.

"We will have an event in the fall that focuses on therapies shown to release stress," she explains. "It will cover mindfulness and being in nature, art therapy, music therapy and even drum therapy."

Nursing students are known to be high achievers. But at U of A ONLINE, Shreve says she and her colleagues want students to be healthy at the end of the program.

"We try to emphasize that it's not about the grade, it's about the learning," says Shreve. "And you never stop learning. Learning is a lifelong process."

Sometimes that learning means discovering a new direction.

 

Shifting Gears in Your Nursing Career

A 2021 Nursing Central burnout study found that 47.9% of nurses who reported they felt burnt out were actively looking for a less stressful nursing position or to leave the field entirely. With that in mind, returning to school to earn a doctor of nursing practice degree is often an appealing option for nurses looking to change specialties or who might want to stay in the field but transition from direct bedside care.

The master's in nursing really focuses on patient care, explains Shreve. Many nurse practitioners already have an MSN, so when nursing professionals are ready to move into leadership or education, they often pursue the DNP.

"The DNP shows you how to impact health care beyond patient care. It gives you the ability to see the big picture," she says. "Even if you decide you want to stay in direct patient care, the DNP deepens your ability to provide care to your patients – and that's why we're in this profession."

 

The Rewards of a Challenging Career

Most professions can and do come with challenges. A bedside nursing career, for one, can come with the physical and emotional toll of caring for patients. Still, the threat of burnout is not enough to deter would-be nurses from entering the field.

"The big thing that keeps nurse practitioners, and all health care professionals for that matter, going is just our passion to be there and help our clients in any way possible," Shreve explains. "As nurses, we tend to put others first. I haven't really seen that change over the years."

Visit our program page to learn more about the online DNP program at University of Arkansas ONLINE.

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