Pandemic-era burnout: Nurses in the trenches say technology hurts and helps

Beyond the stress of increasing patient volumes and emotionally draining hospital shifts, RNs are grappling with alert and alarm fatigue, burdensome documentation, and EHR usability. But they’re finding ways to cope – and AI and automation are helping.

To see all of the feature stories in the Burnout in the Age of COVID-19 series, click here.

Nurses, the backbone of healthcare, typically have to deal with serious levels of burnout – the COVID-19 pandemic has made the problem that much worse: 61% of nurses have emotional and physical fatigue, according to a new survey of 226 nurses titled “Leading in Times of Crisis” by Inspire Nurse Leaders, a nursing education organization.

Meanwhile, 53% cite challenges with inadequate staffing; 35% say it’s difficult to meet work and family demands; 28% wish for more adequate support programs for emotional needs and wellbeing; and 25% say they’ve suffered compassion fatigue in dealing with traumatic events, the survey found.

In this, Healthcare IT News’ fifth feature story on Burnout in the Age of COVID-19, six nurses talk about dealing with the myriad stresses in the trenches, offer tips on how best to cope – and describe how healthcare information technology can contribute to burnout, but also help nurses fight it.

How IT can hurt a nurse’s ability to cope

Information technology typically is intended to make processes and tasks more efficient. But different types of health IT can actually throw a monkey wrench into the works. Electronic health records, for example, might not be user friendly and can cause problems for nurses and others. Health IT is not always the savior it is meant to be.

“Unfortunately, IT has been cited multiple times as a reason for nurse burnout,” said Suong Nguyen, RN, a critical care nurse at Virtua Health, a large health system in New Jersey. She’s a bedside ICU nurse at an acute-care hospital. “‘Click fatigue’ is something I’ve experienced myself, especially when it seems like policies are ever-changing, and these changes seem to result in more and more required charting. EHR charting is such an important part of a nurse’s daily workload, and it is dynamic, not completed once at the beginning of the shift and done.”

As the patient progresses, more charting is revealed. If a patient declines, more charting is required to document the decline. If the patient is getting better, nurses have to chart a discharge and complete all required discharge education.

“It is an ever-growing list of things that need to be done,” she said. “Something that is very discouraging to hear as a nurse is someone saying we spend too much time on the computer, whether it is a fellow staff member or worse, a patient or a patient’s family member. From the outside, it often looks like we are sitting at a computer and pressing keys. In actuality, we are trying to document as efficiently as possible, as quickly as possible.”

Nurses are aware that if they are not thorough, they face the possibility of being called to come in on a day off to correct charting, or face the fear that if they miss something, they could face disciplinary action.

“Even worse, if we make an error, the biggest fear is that our error could result in any harm to the patient,” she said. “But again, from the outside, the perception is often that we are sitting at our computers. It is disheartening when I feel like I have to allot as much time and care to my computer as I do for my patient.”

"The stress that I have had to manage through the COVID-19 pandemic had my ‘good system’ turned upside-down."

Suong Nguyen, RN, Virtua Health

The narrative role of nursing notes also do not seem to carry as much weight when the majority of required charting consists of discrete data entry, she added.

“When it feels like there is a place for everything and everything has a place, writing a narrative nurse’s note feels obsolete,” she observed. “It is clear that this type of documentation helps with data collection and organization; however, I feel like oftentimes my experiences at the bedside are not able to be captured completely through clicks in boxes.”

This leads to burnout because the role of a narrative note is now seen as extra work, another step on top of everything else a nurse is expected to do, she said. It makes Nguyen question how fulfilled she can be if her subjective assessment of the patient does not carry as much weight.

“Sometimes I want to write a narrative nurse’s note to describe the lengthy discussion I had with a patient about code status and the emotional support I provided,” she explained. “However, in the documentation environment we are in, I get discouraged with feelings that no one will read what I have to say in that regard, but the attention is more geared toward whether or not I charted my required every-two-hour restraint documentation correctly.”

Alarm fatigue

Chris Caulfield, RN, chief nursing officer at IntelyCare, a vendor of a workforce management solution for post-acute facilities, said the ability of a nurse to cope with burnout is hampered by alarm fatigue.

“Imagine working a 12-hour shift, and on that shift, you continuously hear patient alarms coming from different directions,” he said. “You continue to ask yourself: Do I have to go running to make sure my patient is safe, or is it a false alarm?”

Many of these alarms use technology built well over a decade ago and are unreliable in detecting what’s an actual emergency versus what’s not, he contended. There has been advancing technology for heart monitors, but many times the basic alarms used to tell if a patient is unsteady on their feet, often called chair or bed alarms, take an all-or-nothing approach, he added.

“Depending on the unit the nurse is located on, it isn’t uncommon for those taking care of geriatric patients to have half of their patients on these alarms,” he explained. “With an advanced capability of monitoring, nurses can distinguish between real emergencies versus false alarms. Unfortunately, in today’s setting, the stress and burnout continue to be exacerbated due to these constant false alarms throughout our shifts.”

Treating the patient or treating the computer?

Long gone are the days of paper charts, where there were fewer criteria required in the documentation, said Sophia L. Thomas, NP, president of the American Association of Nurse Practitioners and a practicing nurse practitioner based in New Orleans.

“Sometimes it does feel like we’ve gone from treating the patient to treating the computer, and, for providers and nurse practitioners in particular, our main focus is always the patient,” she said. “When the EHR and other systems require so many boxes to be checked and screens to be confirmed, it can undermine our time and focus on patient care.”

"The unpredictability and seemingly endless timetable of the pandemic heightened stress for many healthcare workers."

Michelle Schuster, RN, Boston Children’s Hospital

This is not a new phenomenon. Various studies have explored provider burnout as a result of technology and have shown that poor EHR usability can be a significant, contributing factor to provider stress and burnout, she said.

“Compounding that stress [are] changes and/or upgrades to companies’ systems that result in failed chart conversions, and system-to-system integration issues,” she noted. “When new patients join our practices, we may also experience billing and reimbursement issues if all the quality indicators aren’t checked off in the EHR. The measure of the quality of care provided to patients should not be determined by the number of boxes checked or data entered into a computer system.”

At the same time, the EHR and other systems used in practices across the country can be invaluable in allowing providers to collect and share data, review patient histories, and get to know new patients. They can also enable nurses to access patient records quickly and efficiently in order to avoid duplication and improve care, she added.

“Technology breakdowns can be particularly stressful for lead clinicians since they are charged with ensuring repairs and/or replacements are made, so that their teams can continue to keep up with daily patient demand,” she said. “For example, at my practice, one of our otoscope/ophthalmoscope wall unit combinations doesn’t work, preventing me from using the exam room for all of my patients. The more sophisticated our equipment becomes, the harder it is to fix in a timely manner.”

Even when a practice experiences an Internet or power outage, the practice goes into what’s called “downtime,” meaning nurses have to resort to backup paper-based systems until services are restored, Thomas said. When that happens, teams must retroactively input the necessary data in order to keep the EHR up to date.

More and more data entry

Paul Coyne, RN, chief nursing informatics officer at the Hospital for Special Surgery and cofounder of Inspiren, a vendor of nurse-led technology that uses computer vision and AI, observed that there is a growing cyclical paradox in healthcare that lies within the relationship of data and patient care.

“Healthcare leadership seeks metrics to determine how to best provide patient care, and turns to IT,” he said. “IT seeks more data to feed algorithms and dashboards, and turns to frontline clinicians to input the data into the EHR. Frontline clinicians manually enter this data, and turn to leadership and say they are burned out. And the cycle repeats.”

Healthcare is the only remaining industry of the 21st century whose primary source of data generation relies on additional manual input by a human being, he contended. This human being most often is the nurse, he said.

“This technology could be in the form of a new mobile application, software enabling quality to calculate the number of falls, software for IT tickets if something breaks, new AI software designed to create predictive algorithms and the EHR itself,” Coyne explained. “Every solution, workflow or company that adds to the burden of documentation to a frontline clinician has its priorities in the wrong place.”

As an industry, healthcare must be better, and not settle until technology is created that does not oppose but aids caregivers in their efforts to achieve the goal of allowing frontline clinicians to spend time caring instead of charting, he said.

How IT helps nurses avoid burnout

Those were some of the ways health IT can actually lead to nurse burnout. But health IT can really help nurses fight burnout. IT can be a great ally.

One example of how information technology has helped Nguyen of Virtua Health avoid nurse burnout is the use of speech-recognition technology to complete her daily charting.

"This hardest barrier to overcome is to fight the tendency to seek to eradicate stress, but rather seek to have stress wane into other positive emotions."

Paul Coyne, RN, Hospital for Special Surgery

“My organization expanded the use of speech-recognition technology beyond the provider role and began to implement it in nursing documentation – not only for narrative notes, but also by building step-by-step commands used for documentation,” she explained. “Dictation has been used for years for providers to complete their documentation in EHRs. My organization finally challenged the bounds of these technologies and opened up the doors to a new way for nurses to document.”

The role of informatics in nursing is growing day by day. The changes that come from it can directly help combat burnout, she added. Prior to the COVID-19 pandemic, use of speech-recognition technology for nurses at Nguyen’s organization was granted after a two-hour instructional class was taken. However, to help lessen nursing-documentation burden during the pandemic, this access was given to all nurses.

“The use of speech-recognition technology in nursing documentation has helped me greatly in reducing the time I spent documenting and, in turn, being able to give back that time directly to patient care,” she said. “The step-by-step commands that were created saved on average 25 clicks for the user. My organization gathered the data and found that nurses who use speech-recognition technology to chart spend around 9% less time charting a body-system shift assessment compared to users who do not use speech recognition.”

Ever since she started using speech recognition for her charting, she has completed her daily charting more quickly, and no longer feels like she is charting the same thing multiple times throughout her shift. With step-by-step commands, she is able to say into the microphone of her device, “Chart IV assessment normal,” and her IV assessment is complete.

Free resources for healthcare workers

Information technology in the form of freely available resources for healthcare workers has been extremely helpful for avoiding burnout by acknowledging the stressful situations nurses face daily, said Michelle Schuster, RN, who works on the inpatient hematology/oncology unit at Boston Children’s Hospital and serves as a high reliability instructor for new hospital hires.

“I’ve been using the free full version for healthcare professionals of the Headspace phone application,” she said. “Through this, I have been able to incorporate mindfulness activities more seamlessly into my day. Mindfulness is about the frequency, not the length, so having the opportunity to do 10-minute meditations was a great coping tool for me.”

She sought out other free resources.

“For example, on the American Nurses Association website, there is a COVID-19 resource center,” she noted. “Here, there are opportunities to learn more about mental health support, self-care and COVID-19 in general. Being aware of what was already available for nurses allowed me to share these resources with colleagues, as well.”

Disaster-documentation charting

An example of how information technology has helped Nguyen of Virtua Health avoid nurse burnout, especially during the COVID-19 pandemic, is her organization’s use of disaster documentation charting.

“Protocols were placed that made our required shift and admission documentation more condensed and abbreviated,” she explained. “Using this disaster documentation allowed us to document our core data, but do so in a more concise way. Instead of having multiple different sections to tab through to complete our required charting, our entire shift requirements were in one seamless section that could be completed at once.”

"We spend more time with our coworkers than we do with our family, and it’s important for us to support each other, function well as a team, and ultimately create a positive environment for us and our patients."

Sophia L. Thomas, NP, American Association of Nurse Practitioners

Prior to the use of disaster documentation, she had to fill out information on at least six different sections of the EHR to fulfill her requirements. With more complex patients, that number could increase to more than 10 different sections, depending on the patient. With disaster documentation, everything was organized into one section.

“Using an abridged version of documentation alleviated feelings of redundant documentation; this helped combat burnout and documentation burden,” she said. “The wonderful thing about disaster documentation is that it did not change our practice. We were still caring for patients the same and assessing them the same.”

The difference was relying on the principle of charting by exception. For instance, instead of charting routine IV assessments every shift, the nurses were only required to chart if there was a change outside of defined limits for the IVs. What this looked like in practice was the nurses were still flushing IVs routinely every shift and doing a site and dressing assessment. However, instead of charting this every shift, they only charted if an exception was assessed.

“The time we saved in implementing disaster documentation is invaluable,” she stated. “I do not believe there is a way to adequately quantify how the time we saved from charting has helped improve the health of our patients and ourselves. That time we saved could’ve been spent holding a patient’s hand as they passed away.”

The time she was able to save could have meant the difference between her being able to sit down for lunch as opposed to going 12 hours with no break. That time saved could have been spent helping a family member video chat with a patient who they have not seen in a week due to visitation restrictions.

“That time is priceless, and the true value of it is seen in the lives that we have helped throughout this pandemic,” she stated.

Electronic scheduling and paperwork reduction

On another front, patient scheduling has always been a challenge, but electronic scheduling platforms have made it easier and more convenient for patients while allowing providers greater flexibility to organize their schedules and maximize practice efficiency, said Thomas of the American Association of Nurse Practitioners.

“Many of these systems also allow patients to update or upload their own medical and insurance information before they arrive at their nurse practitioner’s office or participate in a telehealth visit,” she said. “Being able to make proactive decisions that a patient needs a telehealth visit or must come into the office to be seen means we can organize our staff to be where they need to be when they are needed most. This reduces burnout for providers and makes the most of our patients’ time with us.”

Additionally, decreasing the time patients spend filling out paperwork at the office is becoming increasingly important in reducing wait times and potential contact with other patients amid COVID-19, she said.

“As part of the return to in-person primary care, we want to limit the time patients spend sitting in the waiting room, and moving them to an exam room quickly and efficiently lowers stress for both providers and patients,” she noted.

The work of improving the patient experience and the provider experience needs to operate on both sides, and it takes a team to make it work, Thomas said.

“We have focused on making sure the right inputs and infrastructure are in place (like accurate patient contact information and text, e-mail, and notification technologies) to ensure the system works for all of us, whether we are conducting a tele-visit or in-person care,” she said.

“When these systems are quality-assured and properly utilized, it means we as providers are spending more time with patients, and patients are safely and efficiently triaged from the waiting room to the exam room, to the lab or pharmacy, to their home again. Knowing our patients are getting the very best, most efficient care is a stress reliever for all of us.”

A unified platform

Using multiple systems for a nurse’s different roles and responsibilities is a real headache, especially when these tools lack integrations, or when one part of the system is down, observed Caulfield of IntelyCare. Whether it be medication administration, ancillary documentation, internal communication or looking up educational resources, having these important tools built into a unified platform is essential for nurses’ wellbeing, he said.

“There are easy first steps organizations can take to help nurses out tremendously, including implementing basic functionalities like single-sign-on or upgrading their current tools to be run under a suite of tools rather than isolated silos of technology,” he said. “If it isn’t easy for the nursing staff to access these tools, many times the adoption across teams is minimal, resulting in a feature or tool that, in theory, can produce better patient outcomes, but in reality, is a wasted resource.”

Using tech to spread stress reduction

Through technology, Schuster of Boston Children’s Hospital has been able to take chances and advance her career in ways she did not previously see as possible. Working to improve the wellbeing of the workforce and to acknowledge the emotional toll of caring was something that helped reinvigorate her passion. It also helped her avoid burnout.

“To address a need during the early weeks of the pandemic, I codeveloped a Promoting Resilience series that was offered in an online platform for staff of all disciplines,” she explained. “This Promoting Resilience series explored strategies to reduce stress and anxiety through mindfulness practice and self-reflection to promote connection, sharing of experiences and building resilience. By having the capability of running online sessions, outreach ability for teaching others about resiliency, mindfulness, and the importance of prioritizing self-care was increased.”

"First and foremost, I think pre-planning is crucial to your wellbeing. Pre-planning means mentally preparing yourself for your shift."

Kashina Whitmore, per diem licensed practical nurse

Technology helped acknowledge burnout and promote self-care, not only for herself, but for many others, as well. Being able to virtually gather with others also allowed for a feeling of connection among individuals, she said.

Furthermore, by connecting with SHIFT Talk, a podcast by nurses connecting with other nurses, she was able to be a podcast guest and spread awareness about the research she has been doing about post-traumatic stress disorder in nurses.

“This podcast also addresses issues such as nurse burnout, health inequity and COVID-19,” she said. “Also, I’ve had the opportunity to create online micro-learning sessions with Sigma, an international nursing organization. Through this collaboration, I was able to create content related to PTSD in nurses and Resiliency and Mindfulness in nurses for Sigma’s Advocacy and Resilience Resources site.”

COVID-19 has changed the way nurses operate as healthcare professionals and as individuals, she said.

“One positive thing that has come from this pandemic is the conversation around the importance of recognizing and prioritizing individual mental health and wellbeing,” she said. “Technology is adjusting to support the new needs of our patients and healthcare staff. By supporting one another, learning from each other, and continuing to find ways to be inspired in our fields, we will continue to grow as a nursing profession and meet any challenge put before us.”

Dealing with stress of patient workload during the pandemic

For Nguyen of Virtua Health, stress of patient workload is not a completely strange topic.

“If I were asked in February 2020, I would say that I have developed a good system for handling stress: time with my family or getting a massage,” she said. “However, the stress that I have had to manage through the COVID-19 pandemic had my ‘good system’ turned upside-down. The pandemic itself limited me from both spending time with my family and getting massages, my two great joys. I had to become resourceful in new ways to de-stress in a changing world and relying on other people for comfort.”

In the beginning months of the pandemic, her coping mechanisms for stress were very poor. They were mainly internalized, and she often felt very isolated.

“Was I the only one this afraid?” she asked. “Were other nurses not seeing their families, too? Did other nurses draft an advanced directive at the age of 26 just in case?”

Fortunately, the leadership team on her unit was very supportive during this time. They stressed the importance of stress management daily, in their words as well as their actions. They took time out of monthly meetings to discuss topics such as burnout and compassion fatigue, giving nurses time to share their feelings with their peers.

Further, Nguyen felt great support from her organization.

“Organizational emails were sent weekly via a coronavirus update newsletter to update us on cases in our organization, new policies and protocols that were taking place, and uplifting stories of gratitude and recognition from throughout our health system,” she noted.

“The transparency was very helpful because it gave me something solid to rely on; it was a way to stay informed without feeling the pressure of mainstream news outlets. In a time surrounded by fear and uncertainty, the transparency eliminated the sense of the unknown.”

Nguyen relied on her peers to help deal with patient workload during the pandemic. She completely isolated herself away from her parents, siblings, nieces and nephews. Depending on her work family while she stayed away from her biological family, she reminded herself constantly that they were a team, and they all needed to help each other get through this trying time.

“We ensured we took our breaks, and when we did take breaks we did not talk about our work,” she explained. “That was a time dedicated to eating and resting. We ensured that no one was ever in a quarantine room for too long by switching out and always having a buddy. We avoided burnout further by organizing a monthly themed lunch at the beginning of the month. While staying socially distanced, we were able to share homemade meals together and feel like ‘normal people’ amidst the chaos.”

Though Nguyen and her colleagues worked side-by-side every day, they also found a need to spend time decompressing together outside of work. They found a way to be socially distanced, but together, and focus on their mental wellbeing at the same time – socially distanced outdoor yoga.

“This was a fantastic way to avoid burnout because we were surrounded by people who understood the stress we were constantly under but in a more relaxing environment, an environment that reminded us we are more than nurses – we are humans going through a very unprecedented time,” she said.

“This was especially important because it was able to make me feel a connection with my ‘old’ way of coping. Doing this made me feel the therapeutic relaxation of a massage and also feeling like I was spending time with my family. The term ‘work family’ had transformed into a therapeutic relationship for us throughout the pandemic.

“It was important for us to acknowledge the traumatic experiences we were witnessing first-hand,” she continued. “My biggest advice to any peer who is struggling with the stress of the pandemic and experiencing symptoms of burnout is to acknowledge the experiences you are going through. Do not tuck them away and hold those feelings in. I venture to say, to a peer struggling, that you are not alone in your worries and your anxieties. Doing this helps to separate work life with home life, and doing so will greatly decrease feelings of burnout.”

Endless timetable, infecting loved ones

Beyond the heavy workload, the reason for exacerbated stress is multifactorial, said Schuster of Boston Children’s Hospital.

“For example, the unpredictability and seemingly endless timetable of the pandemic-heightened stress for many healthcare workers,” she noted. “The fear of potentially infecting loved ones was an invisible burden many healthcare workers carried, and continue carrying to this day. Also, not being able to use typical coping strategies, such as going to gyms, meeting up with coworkers or friends on days off, and banned traveling disrupted individuals’ routines and measures of previously used self-care.”

Schuster says she’s had many ups and downs during this past year dealing with the pandemic and the stress. She realized she was at her best when she would take the time to care for herself.

“For example, I used my home gym to focus on building physical strength, I used walks around my neighborhood in a mask to build an appreciation of nature, I used music and adult coloring books to find new hobbies and create inner joy on my days off, and I used phone apps to incorporate mindfulness into my daily routine,” she explained.

It may sound as if following this new routine would be simple, but it wasn’t. Some days, Schustert lacked the willpower to work out at home, or she would binge a ton of TV episodes and feel guilty for not doing more on her days off. She realized that prioritizing her mental, physical and emotional wellbeing was something she would have to actively work at each day.

“The advice I have for peers would be to assess where the stress is for you,” she advised. “Is watching the news or seeing posts on social media triggering? If so, choosing to not watch the news or deleting social media apps are ways to take care of you and avoid burnout. Also, another tip is to give yourself dedicated time off on your days off from work. On many occasions, I found myself checking work emails while working out at home.”

Her husband even pointed out that she was not being fully present in the moment. By not “leaving work at work,” she was continuing to bring the stress home. Learning that she can (and should) prioritize herself and her health was one of the best things she ever did, she said.

Framing the situation for nurses

When any stressful situation arises working in healthcare, it is essential to remember why nurses are there and why nurses choose to be there, said Coyne of the Hospital for Special Surgery.

“We are there to take care of patients,” he stated. “No matter how stressful it becomes for us, it is, without question, more stressful for the patient. Unlike the patient in the bed, we made a choice to become qualified and obtain employment in healthcare. Each day, we again make the choice to wake up, get dressed and be there. Nowhere in the unspoken, but universally understood, contract of working in healthcare does it state that we get to dictate the circumstances of our environment, decree the level of risk that is tolerable, or proclaim the amount of stress that is optimal.”

In fact, the role of working in healthcare is quite simple, he added, to make the choice to do what is needed to care for those patients who have no choice but to need nurses.

“If this is the framework by which one perceives a stressful situation, the stress will inevitably be reduced for three reasons,” he said. “First, the recognition that another human being, the patient, is ‘more stressed’ will lead to feeling a sense of gratitude for your current state of being. Second, the reminder that there was an autonomous choice to seek this profession, and to show up each day, will lead to feeling a sense of control.”

And third, recognizing that a nurse’s role is to help others in need will lead to a sense of purpose, he added. The human mind can only process so many emotions consciously at the same time. The perception of stress wanes if it is overcome with feelings of gratitude, control and purpose, he contended.

“Conversely, the self-state of gratitude, control and purpose wanes if confronted with extreme stress, as has been the case with COVID-19,” Coyne noted. “When stress reaches this level, it becomes a threat to our wellbeing. When presented with a threat, human beings have two primitive responses, fight or flight. Fleeing a pandemic is not an option, leaving no choice but to fight. But stress is not an enemy that can be eradicated unilaterally. Attempting to fight stress, inherently, by nature, leads to more stress.”

The appropriate way to combat stress is to find ways for it to coexist with other desirable emotional states, leaving stress in an appropriate and tolerable place in the overall state of being, he said.

“This hardest barrier to overcome is to fight the tendency to seek to eradicate stress, but rather seek to have stress wane into other positive emotions,” he said. “Yet, if successful, there will be a balanced self that is able to do your job and care for patients, even during a pandemic.”

Self-care and personal–professional networks

There is no doubt that providers, just like their patients, have endured a tremendous amount of stress as a result of the COVID-19 pandemic. The loss of patients, colleagues and loved ones; increased patient workloads; financial hardship; and the impacts of limiting social contact with friends and family have taken their toll on many nurses, said Thomas of the American Association of Nurse Practitioners.

“When demand for nurse practitioner care is at an all-time high, pandemic or not, it’s easy to get in the habit of working at an unsustainable pace, without time off, a short break during the day, or even the time to process the impact of seeing a patient we care for struggling to breathe or helping a family member say goodbye to a loved one,” she said. “All of this, of course, leads to burnout.”

Self-care is incredibly important for healthcare providers, as is leaning into their personal and professional networks for support and, frankly, recognizing when professional therapy is needed, Thomas added.

“In terms of self-care, there are several methods that I use that can help NPs and other providers manage stress and stave off burnout,” she advised. “Begin by setting boundaries, so that you can spend a few hours focusing each day on yourself and your family. This allows you to separate from the clinic or hospital, decompress, and give yourself what you feel you most need, whether that’s the solitude of a quiet room, or a social boost via a Zoom call with friends, or dinner with family.”

As nurses advise their patients, quality sleep, proper nutrition and exercise are all important in helping to maintain balance and to lower stress levels. If one can get out from behind the computer screen and into the sunshine and fresh air, all the better, she said.

“Like many Americans, providers suffer from vitamin D deficiency, which can create symptoms of fatigue and impact our mental health,” she noted. “It’s sometimes a challenge to get enough vitamin D through direct sunlight, so choosing vitamin D-rich foods and incorporating a dietary supplement into your day can help.”

At Thomas’ practice, each day a member of the team will bring in a nutritious – sometimes less so if it’s a holiday or special occasion – treat for everyone to enjoy, she said. It’s a small but effective way to show appreciation for one another and have some nonwork interactions, she added.

“Like many of our patients, we spend more time with our coworkers than we do with our family, and it’s important for us to support each other, function well as a team, and ultimately create a positive environment for us and our patients,” she said.

Preplanning, allotted breaks and hobbies

While reflecting on how she has dealt with the stress of patient workload and avoiding burnout during the pandemic, Kashina Whitmore, a per diem licensed practical nurse, came up with a few tips: preplanning, taking quality allotted breaks, changing your working environment (if possible) and making time for hobbies one enjoys outside of work.

“First and foremost, I think preplanning is crucial to your wellbeing,” she said. “Preplanning means mentally preparing yourself for your shift. I review my assignment and prepare and organize my nursing cart with supplies that I may need. I always prepare my nursing bag with sanitation wipes and essential nursing equipment required if the facility’s equipment or supplies are limited. I have learned to train my way of thinking by expecting to have a successful shift, and if challenges arise, I will be able to handle or use my resources when needed confidently.”

Next, she takes her allotted breaks.

“It is essential as a nurse to take your breaks and ensure they are quality breaks,” she advised. “That means leaving the floor. I take my lunch off the floor and listen to soothing music to relieve stress and tension. When I return, I feel rejuvenated and ready to finish my shift.”

Occasionally, Whitmore works at different places to change it up and avoid the monotony of working at one location. While it’s not possible for everyone, she can do this because she works at a staffing agency that allows her to work anywhere, rather than a full-time job with one facility.

“Finally, I continue to set aside time outside of work for me,” she suggested. “I enjoy reading a book by the fireplace with a cup of coffee and taking early morning runs or walks through my neighborhood. With businesses beginning to open up, I now utilize my gym membership or get the occasional massage. I enjoy moments of solitude. Taking time to relax is imperative for preventing burnout, now, more than ever.”

Twitter: @SiwickiHealthIT
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