Effective Strategies To Combat Nurse Burnout and Moral Injury
Have you ever experienced an overwhelming amount of stress or exhaustion from work? You wouldn’t be the only one. These extreme feelings are often referred to as burnout, which is categorized by a decrease in emotional, physical, and psychological energy resulting from work-related stress. This is a problem employees face in all industries but is particularly trying for those in demanding professions such as healthcare.
How can you tell if an employee is suffering from burnout or moral injury instead of just normal levels of work-related stress? Researchers have indicated that there are three primary aspects of burnout in employees.
#1. Emotional Exhaustion
Emotional exhaustion results from the feelings of immense stress and pressure on employees that leave them feeling emotionally and physically spent by the time they’ve finished their shift.
Emotional exhaustion goes hand in hand with another aspect of burnout, depersonalization. This type of detachment reduces the amount of empathy an employee is able to expend toward the people they work with and for. In the healthcare industry, this can raise questions regarding the quality of care that nurses are able to provide when they’re experiencing burnout.
#3. Feelings Of Low Accomplishment
The final aspect of burnout is described as a feeling of low accomplishment. Employees may feel worthless despite their established skills and contribute less toward the responsibilities of their position. This can have some serious implications in the case of nurses and other healthcare professionals.
For as common as burnout and moral injury is in the healthcare industry, not many organizations feel they have a good grasp on programs to address these issues. Below are a few strategies that would serve as effective tools for combating nurse burnout.
Creation and Implementation of Wellness Programs: programs designed to educate nurses on stress reduction and wellness strategies are a great start. These programs would provide methods that can be incorporated in their days to maintain stress levels.
Healthy Work Environments: providing nurses with an environment where they’re respected and able to communicate about their issues openly has a positive effect on their performance and stress levels.
Incorporation of Scheduling Software: integrated scheduling tools that provide clear information for nurses allows for a higher quality of care for patients.
Establishing Healthy Habits: though it may seem cliché, the basics are often the most important. A nutritious diet, a full night’s sleep, and exercise go a long way in terms of positive mental health.
Management Involvement: for the management staff, allowing nurses to bring attention to workplace issues with confidence and establishing an open dialogue will allow for a greater understanding of the employees and how they respond to stress.
For more information on how burnout affects the healthcare industry and nurses, as well as strategies to combat this burnout, be sure to review the accompanying infographic courtesy of ScheduleAnywhere.
You can go back to school without sitting in a classroom, fighting traffic, or even finding a parking spot like you would at a brick-and-mortar university. Instead, you can go straight home after work, cook your family dinner, help your kids with homework, and then work on your studies when everyone is asleep.
Starting online nursing school is something to be proud of. But in the back of your mind, you may be thinking, “Should I have waited until the pandemic is over? Will I be too overwhelmed with online learning?”
Online nursing school is challenging no matter when you do it. But you can still be successful, even during the pandemic.
Before addressing these concerns, see if one of the following four scenarios below mirrors your current lifestyle.
Scenario 1: You come home from work after being exposed to the ongoing surge of COVID-19 patients. You have not eaten. You have not gone to the bathroom. You are going on zero sleep because your 6-month old was up all night long. You come home from work and immediately bombarded with the needs of your children. Your babysitter has left the house in disarray, and now your husband calls and says he has to work late. Your online program starts next week, and you think, how am I going to do this?
Scenario 2: You are home-schooling your children and have a one-year-old who just learned to walk. You decide to get up early to get a head start on your work. You managed to get a couple of hours of work done until your 12-year old announces he needs help with an e-learning project that is due at 9:00 a.m. – the same time you have an important meeting. You sign in to Zoom, forget to mute, and the camera is on. You can be seen running after your diaperless 1-year old screaming in delight, thinking it’s playtime. The day is long and hard, with chores needing to be done, and your online program started today.
Scenario 3: You are now in the 3rd week of your online course. The COVID surge has hit your hospital hard, and you are working 60+ hours a week. You are already behind in two assignments and lagging in the discussions. You want to stay in class, but you also need to pay the bills and put food on the table. You need your degree to keep your job but don’t know what to do.
Scenario 4: You are working from home and get a call from the nursing home that your mother has taken a turn for the worst. You get in your car and receive a call that your 16-year old is COVID-positive and is coming home to quarantine. You haven’t seen your friends in ages and abandoned your own health care needs months ago. This whole pandemic has been very hard for you emotionally, and you don’t know how much more you can take. Your degree program is the LAST on your mind right now.
I’m sure many of you can relate to all or parts of these scenarios as you continue to ponder if online education is for you. You are not alone.
Online Learning and Reflections on Your Experiences
Before you think that pursuing your online degree during the pandemic may not be a good option, consider this: Part of learning online is about reflecting upon your experiences as a professional nurseAND applying these experiences to assignments in your classes. If you wait until the pandemic is over, you might miss out on one of the best opportunities of your life for reflection, personal and professional growth.
In all universities, objectives and curricula are designed according to national standards, such as an online RN-BSN program. Curricula contain specific courses for the program and are further broken down into course content.
Course content is typically divided into two main sections: discussions and assignments. Students have an opportunity to reflect upon and apply their experiences to demonstrate how they have met the overall program and university objectives. Therefore, the experiences you have accumulated from working through this pandemic can help you succeed in meeting program and university objectives.
What Can I Do to Be Successful in the Online Setting?
Now that you’ve considered the scenarios outlined above, there are ways to overcome many of those hurdles. Whether you are thinking about going to school online or have already started your educational journey, here are online nursing school tips you can integrate into your lifestyle right now.
Don’t be afraid to ask for help from your professors, advisors, and loved ones. Your school has many resources to help you, from time management strategies to writing resources.
It is important to learn about these resources right away. Find out who your advisor is and discuss any concerns you have. Communicate with your professor often. A simple email indicating that you need help, or keeping them informed about ongoing circumstances in your life, keeps the lines of communication open. You and your professor can come up with a plan for you to complete your work. Remember that they are nurses, too. They will understand.
It is recommended you do not choose an online program that does not offer this type of comprehensive support.
Create an Action Plan
Creating an action plan is vital. Why? Because you can see a snap-shot of all your roles and responsibilities from child care, employment, your study schedule, and more.
Your action plan can be just a simple sheet of paper or an elaborate spreadsheet with time-tables and prospective future endeavors. The best part of this action plan is that it is a working document. You can add or delete from your list and find more time to do the things you need to do.
Start a Reflective Journal
Many have reflected upon how their nursing roles have changed during the pandemic and pondered about where they see their professions headed in the future.
Reflection is essential in any nursing program because it allows you to apply your course content and develop new critical thinking skills in real-time. The best thing about online learning at this time is that you can use your professional experiences to help you complete your class assignments and have insightful discussions in class.
Writing down your reflections can be as simple as jotting down your experiences on a notepad, phone, or computer. Some of my best reflections occurred while listening to relaxing music and admiring nature and photography. Perhaps this strategy can work for you as well. Even just 5 minutes a day can help you gather your thoughts during these uncertain times.
Many nurses have verbalized that they may not have enough engagement in an online program. Not so!
Many online programs have innovative ways for professors and students to be engaged with one another, such as Zoom, Skype, Voki, and real-time audio and video. Most online nursing schools have discussion boards. Aspen University, for example, has the Nurse Cafe — in which you engage with your peers and professors on a variety of topics.
Online courses often have their own unique ways to encourage discussion and engagement. One of the main benifits is that online discussions are mostly asynchronous, which means you can partake in discussions anytime during the week – 24/7!
The COVID-19 pandemic has led to a great deal of stress, anxiety, and burnout for many of us. Self-care activities — like proper sleep, healthy diet, stretching, and other small changes to your daily routine — are so important as you treat patients and work your way through your online degree program.
Don’t Ever Lose Sight of your Determination and Passion!
This is true not only in nursing but also in life. The nursing courses you will be taking may ask you to focus on a topic you are passionate about – perhaps you discover that you have a great interest in developing evidence-based policy/procedures for addressing future pandemics. Whatever your passion is, make sure that you hold it close to your heart and remain determined to reach all of your dreams and goals.
But most importantly, remember this as you continue to ponder your future in higher learning through an online setting:
Passion and determination make up the core of our aspirations, and higher learning sets the stage to help you showcase your dreams.
About The Author
Dr. Linda Marcuccilli is a professor of nursing at Aspen University and a registered nurse for 33 years. She developed a research program involving persons with implantable ventricular devices, published her research in several peer-reviewed nursing journals, and presented her research across the nation.
Nursing is always a solid career path for people who have compassion for others and a desire to make a difference in the world. For some, it is a calling, but others get into the field of nursing because it offers a stable and fulfilling career path with lots of interesting opportunities.
This is a fantastic time to begin training as a nurse, simply because the need has never been greater. Not only are people living longer than they used to and requiring more care, but many healthcare organizations are already having staffing issues. This is expanding an exciting opportunity for those interested in travel nursing.
There are many perks to becoming a travel nurse!
What Exactly is a Travel Nurse?
Most nurses work for a specific hospital, school, assisted living facility, or other organization. They are traditionally employed and typically know what to expect regarding the work environment and their colleagues.
On the other hand, travel nurses are temporary staff for hospitals and healthcare facilities all over the country. They take on new assignments every few months (typically in 13-week blocks) and work in hospitals experiencing temporary personnel shortages or a higher-than-expected influx of patients. With shifts occurring in the healthcare industry, the demand is only growing for travel nurses.
Besides traveling around the country and working in different hospitals, travel nurses have the same responsibilities as permanent nurses. They care for patients and take on miscellaneous tasks to help hospitals run. Travel nurses have to adapt to enter a new work environment every few months, but there are several significant perks to being a travel nurse.
One of the best perks of becoming a travel nurse is the pay. Travel nurses generally get new assignments through a nurse contracting firm. This means that they enjoy a great salary from their contracts while also receiving benefits from their contracting firm.
In general, traveling nurses can expect to make around $65,000-90,000 annually, depending on their work and assignment. In addition to this salary, travel nurses might get allowances for temporary housing and living expenses, retirement contributions, health insurance, and even travel reimbursements.
Although travel nursing might not sound as stable as traditional nursing jobs, the truth is that the work is usually plentiful enough for nurses to make a great living on the road. The benefits can be as good or better than those from a permanent post.
Expand Your Personal & Professional Experience
Perks of becoming a travel nurse include: expanding your skills, living in new cities, and learning more money!
Working in one geographic area can provide comfort and stability, but it might not offer you new challenges or the opportunity to expand your skillset and experience. Nurses who don’t have the opportunity to work in a diverse healthcare environment might miss out on fulfilling experiences and the ability to build a more impressive resume.
Travel nurses get the chance to experience different environments and meet people from all walks of life. Not only does this provide professional benefits, but it also helps nurses grow personally. Working in different types of hospitals is a great way to expand your perspective and develop your communication skills and cultural competency.
Looking for a Bit More Freedom? Travel Nursing Could be for You!
Nursing jobs are usually quite stable but can also be rigid when it comes to scheduling and time off. If you’re looking for a little more freedom and flexibility, then travel nursing could be a great solution. Although it would impact your paycheck to pass up a contract, travel nursing gives you the option of taking time off if you need to attend to personal business or just take a long vacation.
You have a lot more control over your schedule and your life as a traveling nurse. You’ll be living in new places and embarking on new adventures every few months, but you also have the freedom to say no to jobs that don’t suit you.
Travel nursing is rarely boring and can be deeply satisfying. If you get “itchy feet” and don’t like the idea of spending the next 40 years working in the same hospital in the same town, why not consider taking your career on the road?
If you dream of adventure and feel called to help others, then travel nursing could be the perfect career path. Right now, hospitals need people who are willing to drop everything, roll up their sleeves, and help patients get well.
Becoming a mother is a full-time job in itself. Depending on your work-life situation, you might want to consider working in a nursing field that is more flexible and offers you the balance that you need. Childcare can be a challenge for nurses, especially for moms who work 12-hour shifts.
In no particular order, here are 5 of the best nurse jobs for moms:
#1. Per diem nurse
#1. Best nurse jobs for moms: per diem nursing
To work “per diem” means to work “by the day.” Per diem nurses are essential to every hospital organization because they allow the administration to fill in gaps where they don’t have enough nurses scheduled to work. It also will enable nurses who don’t have a very flexible schedule, like new moms, to pick the exact hours and days that they can work.
Per diem nurses are often required to work a specific amount of shifts each month. As a per diem nurse myself, I am required to work a minimum of four shifts in a thirty day period. However, I can ask to work as many shifts as I want. It puts me in an excellent position to earn money- I work on all of the days that I have childcare scheduled, and I don’t have to worry about being scheduled on the days I don’t.
Also, per diem nurses are usually able to call off within a specific time frame before a shift starts. For example, if my child becomes sick 12 hours before the start of a nursing shift, and I know I will be unable to work the next day, then I can cancel myself. It leaves a lot of wiggle room for me to schedule or unschedule myself when I need to be at home with my children. Most working moms don’t have that kind of flexibility, and it helps relieve a lot of stress.
The one drawback to per diem nursing is that you are only paid on the days that you work – you don’t have an allotment of sick days. Also, if the facility does not need any additional staffing, then you might get canceled. Which might not be OK if you were depending on the money you were going to earn that day.
Why being a per diem nurse is one of the best nursing jobs for moms:
Total flexibility over work schedules
Ability to call-off at the last minute
Higher per hour pay then career nursing
#2. School Nurse
#2. Best nurse jobs for moms: school nurse
School nurses work in educational facilities, including public and private schools (K through 12). They support students and staff who become ill at work or need other kinds of medical attention.
Also, many school nurses are educators and teach various health topics to kids, such as healthy eating and the importance of physical exercise. School nurses address the physical and mental needs of students, which helps them succeed in school and sets them up for success in the future.
Becoming a school nurse is an excellent job for nurses who are mothers because you would work during regular school hours -the same hours that your children would be at school. It also means that you wouldn’t have to work weekends, night shifts, or holidays.
Many school nurses find the career rewarding because you are able to help start kids out on the right health track from their early years. Many studies show that long term health has a greater success rate when children are taught healthy habits from an early age. School-age kids are impressionable, and nurses can make a significant impact on how they take care of their health as they grow up.
Why being a school nurse is one of the best nursing jobs for moms:
Only work during regular school hours (no weekends, nights, or holidays)
A rewarding career helping children develop healthy habits from a young age
Case management is another great opportunity for working moms because you can help patients through planning, care coordination, facilitation, and advocacy of patient’s medical needs. Case managers collaborate with all outside aspects of patient care to make sure the patient stays safe and gets the care they need.
According to the Case Management Society of America, “Case Management is a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual’s and family’s comprehensive health needs through communication and available resources to promote patient safety, quality of care, and cost-effective outcomes.”
Telehealth nursing is when nurses can give nursing care, information, or advice to patients over the phone. It also helps to improve efficiency in the healthcare system and help to treat patients in remote areas who otherwise would not be able to receive care.
Telehealth nurses work in hospitals, doctors’ offices, and for corporations. It is becoming more widely used in recent years due to improvements in technology and an ncreasing need to help patients remotely.
Why telehealth is one of the best nursing jobs for moms:
Ability to work remotely from home
Able to help patients without having to work strenuous shifts in the hospital
#5. Advice Nurse
#5. Best jobs for nurses: advice nurse
When patients are not feeling well at home or have a question about a medical issue, advice nurses are used to help field questions via phone. One of the most significant benefits to patients is that it helps them determine what kind of medical care they need before they come into the hospital.
Why advice nursing is one of the best nursing jobs for moms:
Sometimes a work from home position
Less strenuous then 12-hour work shifts at the hospital
Ability to help patients remotely
There are so many alternative nurse careers for nurses who are moms. In fact, that is one of the best reasons to become a nurse – the nursing profession offers so many unique career opportunities that other professions simply do not.
Take care of your family first, and fit your nursing career in a way that serves your family best. Good luck!
Per diem is a Latin term that means “by the day.” A per diem nurse is a nurse who is employed “by the day,” or as needed by a medical facility.
What is a PRN nurse?
PRN is a Latin term for pro re nata, which translates in English to “as the situation demands.” Both “per diem nurse” and “PRN nurse” have essentially the same meaning and can be used interchangeably.
Whether your nursing job title is per diem nurse or PRN nurse, it means you only work when that institution has additional staffing needs that they cannot fill with their own “career” nursing staff. With the increasing demands of today’s healthcare environment – and the fact that patients are living longer (and are often sicker) than ever before – per diem, or PRN nurses are in high demand.
*Post contains affiliate links
About per diem/ PRN nursing
Most hospitals have their own unit of staffed per diem nurses. These nurses may be assigned to one particular unit in a hospital or can be resource nurses who cover many different specialties within the hospital setting (as long as they are trained to do so). Hospital staffing needs usually increase during holiday seasons or during times of high census in the hospital (such as during the COVID-19 pandemic).
In addition, there are nurse staffing agencies that set up outside nurses to work in hospitals that have additional staffing needs. These nurses work for “per diem nursing agencies” and may end up working in a variety of facilities. Often, these nurses might work a few shifts at one hospital, and then a shift in another facility, all in one week.
Per diem (or PRN) nurse vs. full-time nursing: what should I choose?
Most nurses work full time, at least for their first few years after graduating from nursing school. Novice nurses need to put the time in and develop their clinical and critical thinking skills. It takes many years to build up nursing expertise at the bedside, which is why I would never recommend that a new grad nurse work per diem. If you are considering per diem as a nursing avenue for your career, make sure that you are experienced enough to manage the stress of working in many different working environments.
As a per diem nurse myself, I have found many benefits to working per diem that I would not have had if I was working as a “staff” or “career” nurse. If you are teetering on making a change into the per diem nursing environment, these are benefits of working as a per diem, or PRN, nurse.
Benefits of being a per diem/PRN nurse:
#1. Higher pay then a career nurse
Per diem nurses are usually paid more money per hour than regular staff because they generally do not receive benefits, and do not have set hours.
Some states pay more per hour than others. California, for example, is known for having a higher hourly wage than many states with a lower cost-of-living, like South Dakota or Illinois. Per diem nurses in California have even been known to make over 15K or more in a single paycheck by working multiple days in a row, and taking advantage of overtime pay!
#2. You can make your own nursing schedule
One of the most significant benefits of working per diem is that you can choose precisely when you want to work. As a working mom, it makes it much less stressful to know that you won’t be scheduled during a time you don’t have child care.
#3. Per diem nurses can pick up seasonal work
There are times of the year when more nurses are needed to meet staffing needs, such as flu season or summer time. During the current COVID-19 global crisis, there are many hospitals with increased staffing needs in coronavirus “hot spots,” such as New York City and Seattle, where some of the first clusters were found. Per diem nurses who are willing to be flexible and work in new facilities have the opportunity to work more often.
Unlike career nurses, who often do not have complete control of their schedules, per diem nurses can choose to decline shifts if they don’t jive with your schedule. This means that if you don’t want to work nights, holidays, or weekends, you usually don’t have to.
#5. Have the possibility to add on a shift at the last minute
Some per diem nurses work for two different hospitals at the same time. Therefore, if they end up getting canceled to work at one hospital, they can call the staffing office at their other hospital to see if they have any nursing needs. Often, they do, and you can work that day and not lose income.
#6. Cancel a shift the last minute
Working parents understand the need for flexible scheduling. If your child (or yourself) become ill the day or two before a per diem shift, then you have an opportunity to cancel yourself ahead of time. You don’t need to worry about whether or not you have a vacation or sick time saved up.
#7. Opportunity to cross-train in different specialties
Per diem nurses, often have additional learning and educational opportunities because they get new opportunities to cover many specialties.
For example, a per diem emergency room nurse, who also floats to ICU units, might also be able to cross-train for a PACU unit they have staffing needs. Here is another example: a per diem NICU nurse, might be cross-trained for post-partum or antepartum units if they needed additional nursing support.
Nurses who can be flexible and open to additional learning opportunities may find that they have more opportunities than ever to work. When you have experience working in several different nursing specialties, then you have a decreased chance of being canceled and not making any money that day. Per diem nursing can provide nurses with increased job stability and add valuable work experience for your resume.
#8. Build vacation time right into your schedule without taking time off
For per diem nurses, there is no need to put in vacation time, because it is possible to build vacation time right into your schedule.
For example, full-time nurses often work three 12-hour shifts a week. You can schedule yourself to work on Sunday, Monday, and Tuesday one week, and then on Thursday, Friday, and Saturday of the next week. That leaves you with eight days off in-between your shifts to hop on a plane for a week’s vacation.
#9. Working per diem is a great way to keep your license active
Many nurses who only want to work part-time, appreciate the option to work as a per diem nurse. Whether you have small children at home or you have other side careers that you are persuing, per diem nursing allows you to have that flexibility without altogether leaving the bedside, or your profession, behind.
As nurses get closer to retirement, some may choose to work a little less and spend more quality time with grandchildren. If that is the case, then per diem, nursing is a great option. You can keep your foot in the nursing industry, keep your skills and knowledge sharp, continue to bring in some income, while also having time to dedicate to the other passions in your life.
I hope this article helped you clarify whether or not being a per diem or PRN nurse is right for you. There are many factors to consider, but it is wonderful to work in a profession where this type of work environment is possible. If you have any questions, feel free to leave a comment.
*This post about compassion fatigue in nursing may contain affiliate links. You can find our disclosure page here.
I first realized that I was experiencing compassion fatigue as a nurse after only two years in the profession.
That’s correct. After only TWO YEARS, I was already feeling overstressed, exhausted, and cynical about my career.
When my mind finally wrapped itself around this understanding, I thought I’ve barely graduated with my BSN, and I’m ALREADY burned out? How am I going to continue in the nursing profession for an entire career?
I was frustrated, confused, and, to be honest, a little heartbroken. I was passionate about helping others, and I did enjoy the mental stimulation that I got as a nurse. But I couldn’t figure out how there were nurses on our unit who had been doing the same thing for the last 5, 10 or even 20 years. Didn’t they feel the same way?
Lately, I have spoken with a lot of nurses about their experiences with compassion fatigue. The truth of the matter is that most, if not all, nurses feel spent and exhausted at some point throughout their careers.
What is compassion fatigue in nursing?
Simply put, compassion fatigue is the gradual lessening of compassion over time due to extreme caregiver stress and overwork. Compassion fatigue in nursing is also almost always tied to the chronic stress that comes with working 12-hour shifts, which can be very physically, mentally, and emotionally challenging, even on a good day.
Unfortunately, compassion fatigue is prevalent in the nursing profession. But with awareness and the willingness to make a change, it is possible to overcome this chronic, stressful state and learn to thrive within your nursing career again.
Here are seven tips to help deal with compassion fatigue in nursing:
1. Find a better work-life balance
Are you rotating days and nights? Constantly working overtime? Or maybe just working too many hours per week?
That may work for a while, but it is not a very good long term plan. Everyone needs a break, especially nurses.
Consider taking a vacation (or stay-cation) and plan a few solid days of “me” time. A little TLC can go a long way. You simply can’t continue to take good care of others before taking care of yourself first.
One of the best things a nurse can do to help prevent nurse burnout is to take good care of themselves. Often this notion is counter-intuitive to nurses because the nature of their job is to put others’ needs in front of their own continually. Ask yourself, what do I need to be healthy? Here are a few suggestions:
Compassion fatigue and nurse burnout are so common among nurses. Left unchecked, they can lead to mistakes, unhappiness, or even depression.
Share your nursing compassion fatigue struggles with a close comrade from work who can empathize with your effort. If that doesn’t help, consider talking to a trusted mentor, a therapist, or find a career coach that can help you work your way out of nurse burnout.
Nurses are self-giving creatures by nature, but we must give to our own needs as well. Crawl out of your shell and start talking it out.
6. Find an outlet
What do you do on your days off that may you happy? If you don’t have a stress-relieving outlet, then its time to find one.
Is your inner artist craving a creative outlet, such as painting, designing, or even scrapbooking? Does a day on the golf course or an afternoon on the tennis court bring you joy? Maybe you have been so busy that you have forgotten how wonderfully distracting it can be to become enveloped into an activity that you love to do.
Research has shown that finding a joyful outlet can enhance your mood, increase energy, lower stress levels, and even make your immune system stronger. Find out what makes you happy outside of the nursing profession.
7. Consider new options
Do don’t have to stay in the same place throughout your entire career. If fact, one of the greatest benefits of becoming a nurse is that there are so many types of nursing careers out there.
Have an honest discussion with yourself about your career. Are you a med/Surg nurse who has always dreamed of working in the ICU? Or maybe you are an ER nurse with interest in becoming a flight nurse. A change in specialty might be what you need to tackle your compassion fatigue as a nurse.
On another note, nurses don’t have to work in a hospital. Perhaps working in a dermatology office or as a home healthcare nurse would be a better fit. There are so many nursing careers to choose from. The sky is the limit. Find your passion!