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MARK RADCLIFFE

'Burnout is not a moral failure so needs empathy, not blame'

  • 6 Comments

In nursing, we can be a tiny bit ambiguous in the way we describe each other, don’t you think? Take, for example: “She cares too much.”

On the one hand, that’s not the worst insult in the world, is it? Being too kind, too engaged? On the other hand, it implies a vulnerability or a lack of boundaries or maybe even something unprofessional.

How about “you’re very efficient”? That’s a good thing, right? You help get things done without fuss. When you are around, the service runs smoothly. But those thank-you cards rarely praise efficiency, do they? In a certain tone, being called efficient can perhaps suggest you are a little bloodless. Unemotional. Disengaged.

Even being described as “lovely” is a double-edged sword, depending in part on the tone. “Thank you nurse, you were lovely to my mum” can be “your decency stood out” or it might be “you tended to tilt your head and smile a lot but were otherwise pretty pointless”.

And this is before we get anywhere near the more loaded stuff like burnout.

Burnout is interesting. We may see it in the way people nurse - being irritable or slow to respond, or with reduced emotional congruence. Or the way people manage themselves, sometimes being late for work or taking more time off sick, more tutting and loud sighing, maybe some muttering. We may feel their burnout in our increased workload as we pick up the load they drop - we may even become infected in some small way by their mood or demeanour.

Burnout may be a bad thing but is it essentially a descriptive term? If you have met a nurse who appears worn down by the job, willing but not quite as able, with reduced emotional labour skills but still efficient, you might think they were a little burnt out. Would you tell them? Isn’t it likely to be received as an insult not just a describer?

You may just be pointing out the effect of nursing in difficult circumstances and not getting support in the same way that you might point out to someone who has a high temperature, is listless and weak, with a reduced appetite, that they have flu. Yet burnout is more loaded a term than flu. To call someone burnt out is to accuse them of nursing poorly, of failing in some fundamental way.

Being burnt out suggests something moral as well - a failure of not only professionalism but also your sense of good. It is, it seems, a label.

Yet burnout is available to all of us. We know it can happen, we see it, we understand it conceptually and we have seen the research.

Maybe it doesn’t matter. Perhaps we are dismissive of the burnt-out nurse because they make our working day harder. But, given we are trained to be non-judgmental in the face of our patients, is it too hard to retain some sort of empathy for our colleagues? Might it not be worth noticing that if burnout is inevitable, we need clear strategies to offer something more helpful than blaming?

Nursing needs, above everything, to invest in strategies that rejuvenate, support and genuinely attend to the energies and capacities of nurses to maintain their energy, engagement and emotional labour. Putting that into place properly would - and I hate to resort to economics to make a point - save money in terms of sick leave, staff retention and wellbeing and patient satisfaction. I remain very curious as to why that isn’t the primary response to the Francis report.

Mark Radcliffe is senior lecturer, and author of Stranger than Kindness. Follow him on twitter @markacradcliffe

  • 6 Comments

Readers' comments (6)

  • " Might it not be worth noticing that if burnout is inevitable, we need clear strategies to offer something more helpful than blaming?"

    Most people will succumb to "burn out" if subjected to constant stress.

    Mark should have addressed this article to the "nurse managers" who could care less about the well being of staff or patients !

    Elsewhere there is an article which refers to 2 nurses being expected to care for 28 acute surgical patients. Such abuse of both nurses and patients must be stopped.

    All such instances of managerial abuse should be reported to the CQC and the "nurse managers" involved must e referred to to NMC.

    Some should not remain on the register.




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  • Mark, I couldn't agree with you more. This article highlights what many of us have felt for a very long time. Nursing does need strategies and practical solutions that are compassionate & person centred approaches, that support individuals & team to maintain their resilience. The research is gathering pace to demonstrate that not taking the time or putting in the resources to care for the professionals in health care comes at a personal and organisational cost.
    Supporting the profession has to become a priority, because without a compassionate supported and resilient workforce, where will healthcare go?
    We need to start to show in our actions that we value the individuals who work so hard to support and care for so many in our society.
    We as nurses should seek and ask for CPD opportunities where we can reflect, gain peer coaching and develop mental strategies that help maintain our resilience, having gained these insights we can start to 'look after self', which naturally enables us to care for others.

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  • Judith Ryan

    Are you a "real Nurse" Judith ?

    Judging from the post made I doubt you have in the recent past experience a professional life working on an understaffed acute ward.

    I am not challenging anything you say but the reality is that clinical nurses are ignored by management and bullied into accepting unsafe practice.

    It is of course the patients and "junior" nurses who suffer the results of managerial incompetence.

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  • tinkerbell

    Having learnt through my own mistakes about burn out, I am certainly not going to hold my breath waiting for a manager to recognise it in me, by which time I would probably only be fit to be used as the floor mop.

    The fast and furious pace I use to adopt has been replaced by a pace that is kinder to myself. I no longer expect others to move at my pace either, as we all march to the beat of a different drum. If we can't look after ourselves how can we look after anyone else. None of us is indispensible we are a number on the rota. That is why we have to look after and out for each other.

    It took me years to gain insight into my own burnout and I am still reluctant on occasions to drop the wonder woman role but every so often I decide to give myself a second chance.

    There is so much talk about accepting responsibility for our own well being, but where we can have some control we should at least try and the more experienced nurses should share the knowledge with the less experienced of how burn out affects us all if we aren't taking some time for ourselves to recharge our batteries.

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  • Post traumatic nursing disorder/ shitepan shock/ burnout. Not surprising considering how terrible nursing has become in the last few years. Perhaps we need some confessor nurses that we can speak to in confidence instead of going home and committing suicide about what are really, in the great scheme of things, mainly trivialities. Trouble shared and all that, eh?

    Then again, perhaps we should all have a shot of medicinal whiskey before we start the shift for a bit of ' Dutch Courage', after all, the Royal Navy conquered the globe on a tot of rum. Saying that, wouldn't want to be sent down under the new ' willful neglect' rap, at least not without taking a few band 8's with me. YOU'LL NEVER TAKE ME ALIVE, NMC!

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  • Love it, redpaddys12! Seriously, that;s how we need to be thinking.

    I am planning to re-read your post in the manner of Capt Jack Sparrow.....this is a compliment, by the way ;-) X

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