6 Tips for Reducing Nurse and Physician Burnout

As COVID-19 tears through the country, physicians and nurses are already experiencing extreme stress and healthcare burnout. It's bad enough that this pandemic is a marathon at the pace of a sprint. It's even worse that it has taken away most of our coping mechanisms. Spending time with loved ones is impossible for many. So are hobbies, work/life balance, a healthy diet, and other well-meaning suggestions. But it's more critical than ever for you to practice self-care. Under these extraordinary circumstances, lives depend on it. What can you do to lessen the chance of burnout in healthcare during the height of COVID-19?

What is Physician/Nurse Burnout?

Nurse burnout (or physician burnout) is a long-term reaction to job stress. Healthcare workers are always at high risk for burnout. Roughly half of physicians and nurses experience symptoms of burnout under normal conditions. That's twice the burnout rate of other professions.

Signs of Burnout in the Healthcare Industry

Healthcare burnout can include physical, mental, and emotional symptoms. Symptoms include:

• Chronic emotional, mental, and physical fatigue
• Hypersensitivity or insensitivity
• Lack of sympathy or empathy
• Persistent irritability and lack of patience
• Forgetfulness and inattention
• Pessimism or cynicism
• Hopelessness, helplessness, or a persistent feeling you aren't making a difference
• Depersonalization (feeling numb, unreal, or detached from yourself)
• Changes in sleep patterns
• A weakened immune system
• Physical malaise, including aches and pains, flu-like symptoms, or gastroenteritis

The Dangers of Burnout in Healthcare

Healthcare burnout is problematic by itself. The well-being of nurses, physicians, and their loved ones matters deeply. But burnout in healthcare also has a domino effect on the well-being of everyone they treat. Research has shown that healthcare burnout:

• Increases the likelihood of medical errors and malpractice suits
• Increases patient mortality rates
• Increases the rate of hospital-associated infections
• Increases the probability of unprofessional conduct in-patient care
• Decreases altruistic views of their responsibility to society
• Decreases workforce efficiency and productivity
• Leads to higher turnover and staffing shortages

Just as COVID-19 is increasing the likelihood of burnout, it is expanding the consequences. Inherently, the COVID-19 crisis is causing staff shortages, logistical nightmares, high patient mortality, and professionals operating outside their area of expertise. Burnout can magnify all these problems. That's why healthcare workers must practice self-care as best they can under these trying conditions

How to Avoid Burnout in Healthcare During COVID-19

Many standard coping strategies for healthcare burnout aren't practical right now. COVID-19 calls for a triage approach to self-care as much as it does for patient care.

Tip #1: Get Calories In

Healthy eating is usually an essential part of stress management. But the fact is, you're working long hours on your feet and burning more calories due to stress. You have less time and opportunity to take breaks or sneak a quick bite. The healthiest options not only require preparation but are also light on calories. And you need calories. You're going to be exhausted, no matter what you do. But if you're also running a caloric deficit, you're making everything worse. This is a situation that calls for calorically dense foods. You can return to your normal eating practices after the dust settles. Even if you've been able to maintain your regular diet, you might need to increase portion sizes. It's still better to aim for the healthiest options you can – you don't want your blood sugar to spike and then crash. But right now, your main dietary concern should be that you have enough.

Tip #2: Hydrate a Little More

Due to infection control protocols, it's harder than usual to stay hydrated as a healthcare worker. Likely, you'll only have access to fluids wherever you take your meals. Just like getting enough calories, staying hydrated will help keep your energy and mental function up – or at the very least, not make your fatigue worse than it has to be. There's no need to guzzle to meet "8 glasses a day." While your body does need roughly 64 ounces, you're getting most of that water through your food. However, to make up for the lack of opportunities between breaks, you may want to put a little extra effort into adding a beverage to meals or snacks.

Tip #3: Stretch When You Can

You're probably experiencing a lot of back and neck pain due to stress and the physical demands of your job. Your workout routine (and the endorphins that go with it) may have also disappeared. Two birds with one stone: stretch whenever and wherever you can. You can find standing stretches and wall stretches to help relieve back pain, as well as stretching or self-massage techniques for your neck. Don't count out a full-body stretching routine, either. Your feet are probably also killing you. Before you sleep, elevate them above your heart for at least 20 minutes to relieve swelling and aid circulation.

Tip #4: Breathe Deep

You're carrying a lot of anxiety right now. You can use deep breathing exercises both to relieve acute anxiety and prevent more of it. Remember, healthcare burnout is an accumulation of stress. You want to minimize the build-up. The great thing about deep breathing is you can do it anytime, anywhere. There are a few different breathing techniques you can try, but it's important to breathe from your belly, not your chest. It may help to use readily available apps, videos, or gifs to visualize and time your breathing exercise. If you're ambitious and/or having trouble getting to sleep, you can also try meditation or mindfulness exercises before bed. There are a ton of apps for that, and many are free or discounted right now.

Tip #5: Practice Burnout-Busting Self-Talk

One of the most significant and most damaging aspects of healthcare burnout is the building feeling that nothing you're doing matters. Or on the flip side, that the responsibility you hold is so great, you can't stop working long enough to care for yourself. Both extremes are natural and understandable but ultimately harmful. To counteract those thoughts and feelings, you need to remind yourself of a few truths regularly. (Yeah, this is going to get a little Stuart Smalley. Go with it). Examples of helpful self-talk include:

• It helps my patients when I take time to rest and recharge.
• Taking care of my health serves the common good.
• This will pass. Things will get better.
• I am making a difference for this patient by giving them my care and attention.
• I can only treat one patient at a time. My teammates will do what they can for others.
• I'm doing my best under extraordinary circumstances.

You can and should come up with unique personal affirmations to counter specific negative thoughts. Try to make them constructive and positive, rather than just a denial of the negative. It may help you to write these down somewhere and carry them with you (or leave them with your meal to look at during breaks). Under acute stress, you forget everything that isn't the problem in front of you. You may want to keep a list of coping mechanisms to try for the same reason.

Tip #6: Use the Buddy System

Team up with someone you work with and support one another in self-care and stress management. No one understands what you're going through except for other nurses and physicians experiencing healthcare burnout. Admitting painful thoughts and feelings to someone who understands helps you feel connected and part of something bigger. That's a huge step towards avoiding burnout in healthcare. Buddies can also monitor one another's stress levels and coping mechanisms to encourage healthy practices. Remind one another to eat, stretch, breathe, rest, and think more positively. Point out ways that your buddy made a difference, even if it's small. It's easier to see warning signs in someone else than yourself, and just the act of helping one another will improve your well-being.

Safety and Well-Being, for COVID-19 and Beyond

Right now, we're all focused on the threat of COVID-19 and the mental or emotional toll of the crisis. But safety and well-being in the workplace should always be a priority. You can learn more about workplace safety in healthcare with our OSHA 10-Hour General Industry course.