CNA Burnout: Understanding, addressing and overcoming the challenge

A close up of a female CNA in scrubs laying a comforting hand on the hands of an elderly female patient in a long term care facility.

From bathing to mobility to cataloging changes in condition, CNAs (certified nursing assistants) provide essential services that help people meet their daily needs when they are unable to do so themselves. Like other healthcare professionals, CNAs are at a high risk for burnout due to the emotional and physical demands of the work. In addition, the workforce shortage, a wider, systemic issue, is a major contributing factor in burnout — one that will need to be addressed collaboratively by government agencies, facilities, professionals and technology.

Understanding CNA burnout

Burnout is a state of emotional, physical and mental exhaustion caused by prolonged and excessive stress. It occurs when individuals feel overwhelmed, emotionally drained and unable to meet constant demands, and it can lead to decreased motivation, reduced performance and a sense of helplessness. Over time, burnout can negatively affect one's health, relationships and well-being.

Burnout is common in many industries. A 2022 Future Forum study of more than 10,000 workers in the U.S., Australia, Japan and several European countries found it in 42% of those surveyed. In the nursing profession, of which CNAs are a part, burnout is even more common. In a 2023 nurse.org survey of 2,100 nurses, 81% said they’d felt burned out during the previous year.

Causes of CNA burnout

CNA burnout is similar to nurse burnout, but as a recent study concluded, additional and more methodologically sound research is needed before we can understand factors that are unique to CNA burnout.

Two causes of healthcare professional burnout are heavy workloads and demanding shifts. Heavy workloads occur when CNAs have more patients than they can reasonably handle or work too many shifts: 79% of nurses surveyed by nurse.org attributed burnout to the nursing shortage. A demanding shift occurs whenever stress levels increase, and stress can increase for many reasons, like dealing with a belligerent patient, a patient emergency or a difficult work environment (41% of nurses surveyed by nurse.org said they felt unsafe at work).

But a work environment doesn’t have to be difficult, unsafe or hostile to create excessive stress. Lack of support from colleagues and supervisors can also be an issue: 61% of nurses from the nurse.org survey said they felt unsupported at work.

A study focused on acute care CNAs during COVID-19 attributed burnout to staffing challenges, lack of respect and recognition, the physical and mental toll of the job, lack of facility leadership support and lack of pay or incentives.

Exposure to traumatic events and emotional strain from patient interactions are also risks, an increasingly common trend exacerbated by the pandemic.

Signs and symptoms of burnout

Christina Maslach, one of the foremost experts on burnout, measures burnout according to three scales (the Maslach Burnout Inventory or MBI):

  1. Emotional exhaustion
  2. Depersonalization
  3. Personal accomplishment

Emotional exhaustion may include physical symptoms such as fatigue and headaches and can lead to a loss of motivation or interest in work, along with increased irritability or cynicism. (Emotional exhaustion may also lead to medical errors. More on that soon.)

Depersonalization may make a person feel like a robot, begin to see patients as “impersonal objects” or feel as if in a dreamlike state.

While experiencing burnout, people also tend to have a reduced sense of accomplishment. Since poor performance can be a result of emotional or physical exhaustion, that may be warranted, although it isn’t always.

Impact of burnout on patient care

When nurses are burned out, patients can suffer. A meta-analysis of 82 studies on burnout identified that burnout negatively impacts quality of care and patient safety, both when self-reported and when correlated to medical records and observer ratings.

Cognitive issues associated with burnout, such as attention deficits, can lead to medical errors, which can lead to poor patient outcomes (a 2016 study found that medical errors caused 250,000 deaths annually in the U.S.). Depersonalization has been linked to poor patient satisfaction, and the burnout meta-analysis cited several studies that claim burnout leads to increased absenteeism and turnover.

Building resilience as a CNA

It’s important to note that burnout is more of a systemic issue than a personal one. Even so, CNAs can address burnout on a personal level by building resilience, a word that refers to how quickly a person is able to rebound from stress.

According to a Cornell study, building resilience requires effort in a few key areas:

  1. Cognitive: How one interprets events and copes with daily stressors.
  2. Behavioral: How one acts when faced with obstacles and failures.
  3. Motivational: How one is motivated in general.
  4. Existential/spiritual: How one makes meaning.
  5. Relational: One’s level of social connectedness and engagement.
  6. Emotional: One’s ability to tolerate negative emotions.

Taking inventory in each area can help you increase your self-awareness and uncover the areas that require your attention. If you need more guidance, head to the U.S. State Department’s comprehensive guide on building resilience. Released during the COVID-19 pandemic, it offers tips on how to cultivate a support network, examine thinking, reframe events, find meaning and purpose, and even take better care of yourself.

Strategies for preventing CNA burnout

Set realistic goals and expectations

Be real about what you can and can’t change about yourself or your work environment. Take action on what you can change, like carving out time for a 10-minute meditation break or regulating your breathing for a few minutes. Chunk larger goals down into smaller, more achievable action items.

Manage time and prioritize tasks

There’s only so much one person can do in a day, and sometimes there’s more to be done than time to do it. Recognize that, and prioritize to the best of your ability. Reach out for help if you need it — asking for help can even increase social connectedness.

Seek professional development opportunities

Building your skill set can increase your sense of personal achievement at work. There are many career paths CNAs can take, and working toward a self-defined goal can help improve work satisfaction levels.

Balance work and personal life

Work-life balance can be hard to manage for those in the healthcare profession. Making time for what really matters to you, taking time away from work and scheduling breaks while working can help.

Create a healthy work environment

A healthy work environment is one of teamwork, support and open communication. As a CNA, you don’t have control over much of what happens in a facility, but you can make an impact on those you work with. This nurse headed an initiative at her facility to encourage nurses to take breaks. These nurses changed history.

Using the ShiftKey app to address CNA burnout

You can reduce some of the effects of CNA burnout by introducing more flexibility into your schedule. Gloria, a CNA pursuing a bachelor’s degree in nursing, uses the ShiftKey app to pick up PRN shifts around her classes. Linkeitha, also a CNA, uses the ShiftKey app to be there for her five children. Gloria, Linkeitha and more than 140,000 independent professionals use the ShiftKey app to work on their terms, set rates they prefer and more.

CNA burnout and you

CNA burnout is a complex issue, and reducing it requires participation from facilities and policymakers as well as CNAs. In 2022, the U.S. Surgeon General put out a burnout advisory declaring burnout a national crisis and priority. If you’re feeling any of the early warning signs of burnout, such as anxiety, concentration issues, depression or fatigue, it’s important to take action. Head to the CDC’s website for resources. If you’re curious about how the ShiftKey app can help you create more flexibility in your schedule, head here.

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