This week Nursing Times reported on a trust identified by the Care Quality Commission as requiring improvement. The report authors described several ward teams at North Cumbria University Hospitals Trust as “burnt out”.
The CQC said staff managed to give good care and that they were kind and compassionate despite being under pressure. But at what cost to their health and wellbeing?
Burnout is a consequence of chronic stress that is often insidious. It creeps up and often goes unnoticed until a crisis occurs.
Anyone who has experienced it will know the signs of physical and emotional exhaustion, detachment and feeling like a failure.
Sometimes the pressure of nursing can result in all these emotions. One nurse recently described to me the unrelenting feeling that there is never enough time, and said she felt like she was working in a war zone.
How do you keep a smile on your face when you know that at the end of a 12-hour shift you may only manage to achieve half of what you planned, and will go home knowing that what you failed to do has consequences for your patients?
“I remember a ward sister explaining that we cannot always achieve perfection, but we should always aim for it”
How often do nurses have to compromise? We have all grabbed a commode because it is quicker than walking a patient to the toilet. We know that walking patients to the toilet is beneficial in promoting mobilisation and important for privacy and dignity, but sometimes there just isn’t time. How often is a cup of tea left to go cold by a patient who needs help to drink, not out of neglect, but because another patient had a more pressing need at that time?
From my first day as a student nurse I became aware that on a busy ward nurses often had to cut corners. I remember a ward sister explaining that we cannot always achieve perfection, but we should always aim for it.
The pressures are so much greater today and the danger is that nurses are expected to cut so many corners so frequently that this becomes the norm rather than the exception. These compromises have a negative effect on nurses’ wellbeing as well as that of their patients.
So how do we fix the problem?
The bottom line is that we need more nurses. This means we need to attract people into the profession and we need to keep the ones we already have. Alongside recruitment drives we have to develop and share strategies to prevent burnout and ensure that nurses retain the passion that brought them into the profession in the first place.
“Nobody comes into nursing to do a bad job”
All nurses need access to meaningful, regular clinical supervision, where they can discuss problems and challenges in their practice. They need support with revalidation and help to plan their career and educational needs. They need to know that when they are struggling, they can put their hand up, ask for help and it will be there – and that they will not be judged.
Until this support is factored in for every nurse in every trust, the churn of those leaving the profession will continue. Nobody comes into nursing to do a bad job, and if that seems like the only possibility then people will understandably burn out and be lost to the profession.