When Tessa found the ShiftKey app, she had been working 13- to 16-hour shifts, five days per week. Regularly, she’d need to work the whole weekend, and as a mother of five, that meant missing out on a lot of things. It also meant burnout.
“Primarily what we experience in healthcare is burnout and fatigue, which doesn't come from our patient care at all,” Tessa says. “It comes from the corporate environment, the management environment, the staff environment.”
Tessa’s not alone in having experienced nurse burnout.
In 2019, 35% to 54% of nurses and doctors reported symptoms of it. In 2022, a study conducted by the American Nurses Foundation found that 60% of acute care nurses felt burned out, and 75% were “stressed, frustrated and exhausted.”
Even though the burnout problem is systemic (change is needed at the organizational and policy levels), it's important that nurses are able to recognize its early signs so they can make career choices that support their mental health.
What is nurse burnout?
The term “burnout” was coined in the 1970s by healthcare professional Herbert J. Freudenberger in the paper “Staff Burn-Out.” He wrote it after noticing physical and behavioral changes in himself and other overworked colleagues. At the same time, researcher Christina Maslach was seeing similar symptoms among social service workers. Her Maslach Burnout Inventory (MBI) is now considered the gold standard for measuring burnout.
Burnout in nursing is no different from burnout in other industries, although a BioMed Central study found that healthcare worker burnout is caused by industry-specific factors, such as a high workload, low healthcare professional to patient levels, long shifts (greater than 12 hours) and low control.
The consequences of nurse burnout
Many nurses are drawn to healthcare because they love being of service, like Tessa. “I see people mostly on the worst day of their life, so if you can bring a light to that person, that individual, that family for that time, that's something that I do like to be a part of,” she says.
The mental and physical health consequences of burnout can rob nurses of the joy they feel in helping others. It also affects their physical and mental health, as well as the kind of care patients and residents receive.
Emotional exhaustion and depersonalization
Emotional exhaustion is a telltale sign of nurse burnout — it’s a feeling of being worn out and can include a host of other symptoms, including trouble sleeping and a change in appetite. Depersonalization is a type of detachment that makes people feel robotic or like life isn’t real.
Poor physical and mental health
Emotional exhaustion can result in clinical depression and physical symptoms such as headaches and fatigue. But even without a clinical diagnosis, people who experience emotional exhaustion may feel that they have no control over their lives.
Depersonalization causes people to feel as if they’re not in control of their bodies or emotions. It can be diagnosed as a mental health disorder, but even if it isn’t, it can lead to a lack of empathy and numbness.
Lower quality of care
Burnout can affect patient safety by making licensed professionals less attentive and collaborative. It’s also been linked to cognitive issues such as attention deficits, which can lead to errors. Errors can lead to poor patient outcomes, and poor patient outcomes can lead to more nurse burnout.
High turnover in the nursing profession
The nurse burnout cycle has been directly linked to healthcare’s high turnover rate, which is only getting higher. (And more costly: According to The National Academies of Medicine, the cost of replacing one nurse is estimated to be between $11,000 and $90,000.)
To meet demand between 2020 and 2030, the U.S. Department of Labor has said that 275,000 additional nurses will be needed. With more nurses leaving the industry than entering it, it’s unclear how that demand will be met.
How to prevent burnout in nursing
There’s no easy answer. Since nurse burnout is a systemic issue, individuals cannot resolve it without organizational support. But they can take action to help keep it at bay.
First, it must be stated that practicing self-care alone is not enough to overcome the symptoms of burnout. But there’s no risk in starting a meditation practice, eating healthier food or getting more sleep, so that’s a great place to start.
Advocate for yourself
Beating nurse burnout also requires taking action at work. One study found that healthcare professionals either feel that there is no use in speaking up or fear the consequences of speaking up.
But staying silent doesn’t resolve the issue. If you’re hesitant to speak up for yourself, think about how much value your work brings to your organization. Speaking up for yourself at work may help you speak up for your patients, too, which is crucial in avoiding errors and adverse patient outcomes.
Choose a flexible work environment
Flexible work is a potential antidote to nurse burnout. If you’re working full- or part-time, see what kind of flexibility your community can offer you. Or consider working PRN shifts. Facilities post PRN shifts as needed, making them the most flexible option when it comes to nursing.
When you pick up PRN shifts via the ShiftKey app, you choose the rate you prefer, and you choose your hours. You can use the ShiftKey app to easily connect with over 6,000 facilities in more than 120 markets, wherever you're licensed.
Tessa appreciates the flexibility she has with ShiftKey:
“My life is mine now,” she says. “I get to actually do what I want to do versus being kind of chained to the system of a career.”
If you’re feeling the effects of nurse burnout, you may choose to seek professional help. In addition to the therapists in your local area, there are online options such as Better Help, Alma, Talkspace and more. Therapy Aid Coalition offers low-cost counseling for healthcare workers and first responders.
The role of healthcare organizations in addressing nurse burnout
It might sound like nurse burnout solely affects individuals, but Dr. Vivek Murthy, the U.S. Surgeon General, says that it will “place our nation’s health at increasing risk.”
To retain nurses like Tessa and keep them from burning out, organizations can implement the approach outlined in the 2022 U.S. Health and Human Services advisory. Here are a few of the strategies they recommend:
Create a healthy and supportive culture
Organizations can promote work-life balance by encouraging people to take time off and increasing access to mental health resources. They can organize events that help build connection among healthcare workers, and they can implement zero-tolerance policies for racism and violence while actively combating bias.
Recognize and reward
McKinsey reported that 75% of nurses who left their organization within an 18-month period said not being valued was a factor in their decision.
Organizations can show appreciation by recognizing accomplishments publicly, creating a culture of gratitude, providing bonuses and financial incentives, and even just ensuring food is on hand in the break room.
Address staffing and scheduling issues
When a facility is understaffed, nurses are often required to work additional hours or care for more patients than they can handle. When that happens, patients may not get the care they need, which can lead to poor health outcomes. When patients have poor outcomes, nurses may experience moral injury, which can contribute to burnout.
“I was already burned out pre-pandemic,” Tessa says. “And again, it doesn't come from the patient care — it's everything else around it.”
Facilities can solve for varying occupancy rates, callouts and vacations without burning out their nurses by posting PRN or “as needed” shifts. When independent professionals fill these shifts, staff well-being and patient outcomes may improve.
How nurses are beating burnout and taking more control of their careers with the ShiftKey app
Nurses who work PRN shifts choose their own hours. They manage their own schedules. And when they use the ShiftKey app, they also get to choose their rate.
“I have said to my nurse friends that the freedom you get when you use an app like ShiftKey, you just can't compare to anything else,” Tessa says.
“If you have kids, you can be home with them more. If there's other things you want to do in life, you can schedule it around what you're doing, and you don't have to ask permission from anybody to take time off.”
Create a flexible career by scheduling your work around your life
When you use the ShiftKey app to book PRN shifts, long shifts, weekend shifts and back-to-back-to-back shifts are no longer required — you work on your own terms.
Since starting to use the ShiftKey app, Tessa has had more time for her family and her hobbies.
“We have five children and homeschool the younger two, so we spend a lot of our time at home homeschooling. And the rest of that is jujitsu. We own a jujitsu academy, and that is where our passion and our focus and our goals go — between our children and our hobbies.”
Creating a future that centers on health for all
As Dr. Murthy says, beating nurse burnout is a community effort. On their own, tech companies like ShiftKey, facilities, nurses, doctors and policymakers can move the needle a little. But if nurse burnout continues at the current rate or increases as projected, nursing shortages will continue, and that will affect everyone.
Ultimately, nurses must make the choices that are best for them. If you’re concerned about nurse burnout — for yourself, your organization or someone you love — visit the U.S. Surgeon General’s burnout index to access more resources on how to mitigate it.
If you’re seeking more flexibility in how you work, consider the ShiftKey app.