Sample Student Prof. Lourdes Heuer COMP 2000 DateNursing Burnout: What's to Blame? When many people end up in the hospital, the first person they call out for is their nurse – not a doctor. Nurses have a hands-on relationship with their patients, doing everything from administering medicine to more personal clean ups and emotional care. They are usually the ones running from patient to patient trying to squeeze in as much care as possible in one shift. Consequentially, this often leads to an unfortunate burnout situation. Nursing burnout is known as the loss of motivation, compassion, and ability to deal with the stresses of work, though all nurses deal with it differently. But nurse burnout could be prevented if nursing programs amended their training, hospitals reconsidered staff operations, and nurses themselves made changes to their own personal life management. After all, without nurses who love their jobs, the hospital experience wouldn’t be the same. Nurses need to be able to (almost) always put their patients first. That's what they've learned to do from the start of their education. But nurses often forget that there is a balance needed to maintain their own sanity and health, and nurses are people who must also remember to tend to their own mental and physical needs, too. Otherwise, there are mental and physical tolls that will plague nurses over time, even though they are often kept out of plain sight. Kelli Dunham, an RN since the age of 19, says in her book How to Survive and Maybe Even Love Your Life as a Nurse, that "with a constant sense of urgency that's in the hospital, many nurses don't stop to consider their needs, often skipping a sit-down lunch to tend to their patients.” Often, the pressures of having patients leave the hospital on their own two feet get nurses to trump their own care. Forgetting not to just eat lunches, but often also to take regular bathroom breaks, nurses may be forgetting that when they cut corners for themselves, the hospital is taking a toll not just on their patients, but on them, too. There’s also the toll of patient trauma coming through the hospital doors. Many nurses leave with traumatic images in their heads from things they've had to deal with during their work day. Deaths and other things that can tug at the hearts of nurses often stay with them and can be severely damaging over time. According to Robert Wicks, psychologist and author of Overcoming Secondary Stress in Medical and Nursing Practice, "...as well as unrealistic expectations on the part of patients and health systems, the stakes are now so high for health care professionals that the potential for developing such psychological problems as emotional blunting on the one hand or extreme affectivity on the other is quite great." Often, coping mechanisms involve suppressing their emotions. Many people refer to this as "bottling," and when a bottle of soda is shaken enough, the top comes flying off and everything comes spilling out, .

1. Sample Student
Prof. Lourdes Heuer
COMP 2000
DateNursing Burnout: What's to Blame?
When many people end up in the hospital, the first person they
call out for is their nurse – not a doctor. Nurses have a hands-on
relationship with their patients, doing everything from
administering medicine to more personal clean ups and
emotional care. They are usually the ones running from patient
to patient trying to squeeze in as much care as possible in one
shift. Consequentially, this often leads to an unfortunate
burnout situation. Nursing burnout is known as the loss of
motivation, compassion, and ability to deal with the stresses of
work, though all nurses deal with it differently. But nurse
burnout could be prevented if nursing programs amended their
training, hospitals reconsidered staff operations, and nurses
themselves made changes to their own personal life
management. After all, without nurses who love their jobs, the
hospital experience wouldn’t be the same.
Nurses need to be able to (almost) always put their patients
first. That's what they've learned to do from the start of their
education. But nurses often forget that there is a balance needed
to maintain their own sanity and health, and nurses are people
who must also remember to tend to their own mental and
physical needs, too. Otherwise, there are mental and physical
tolls that will plague nurses over time, even though they are
often kept out of plain sight. Kelli Dunham, an RN since the
age of 19, says in her book How to Survive and Maybe Even
Love Your Life as a Nurse, that "with a constant sense of
urgency that's in the hospital, many nurses don't stop to
consider their needs, often skipping a sit-down lunch to tend to
their patients.” Often, the pressures of having patients leave the

2. hospital on their own two feet get nurses to trump their own
care. Forgetting not to just eat lunches, but often also to take
regular bathroom breaks, nurses may be forgetting that when
they cut corners for themselves, the hospital is taking a toll not
just on their patients, but on them, too.
There’s also the toll of patient trauma coming through the
hospital doors. Many nurses leave with traumatic images in
their heads from things they've had to deal with during their
work day. Deaths and other things that can tug at the hearts of
nurses often stay with them and can be severely damaging over
time. According to Robert Wicks, psychologist and author of
Overcoming Secondary Stress in Medical and Nursing Practice,
"...as well as unrealistic expectations on the part of patients and
health systems, the stakes are now so high for health care
professionals that the potential for developing such
psychological problems as emotional blunting on the one hand
or extreme affectivity on the other is quite great." Often, coping
mechanisms involve suppressing their emotions. Many people
refer to this as "bottling," and when a bottle of soda is shaken
enough, the top comes flying off and everything comes spilling
out, creating a mess that is very difficult to clean up. Nurses are
shaken so often that their tops come flying out when they enter
burnout, and many of them can no longer be the same person
they were before they experienced this burnout. Naturally,
people like to feel like they have some sort of control over the
situation that they're in. But in nursing, that control is often
wavering, and many nurses beat themselves up long after the
situation is over about things that they could have or should
have done, when in reality, it was out of their control.
Families are another stressor that keep nurses strung high. With
many patients, especially those with chronic and terminal
illness, family emotions often run high. They take these
emotions and frustrations out on nurses often because they are
seen as the primary care providers that are working directly
with their loved ones. When something goes awry that is out of
the nurse's control, nurses are still often the ones to get the

3. blame because they are the ones always around. According to
Dunham, "Nursing school curriculum addresses relationships
with patients, but most nurses we talked with said they got little
instruction about dealing with families." With tension running
high, fights are bound to break out. Many people are often
worried about family members and are quick to attack at any
sign of doubt. Dunham says, "We all have the same needs for
respect and recognition of our humanity as do our patients and
their families." Constant blame and emotionally charged
atmospheres would have ill effect on any person regardless of
profession. Nurses are often the first point of contact, but not
the last – they don’t have to make themselves responsible for
handling family complaints or for fixing family disputes. This is
hard to remember in the heat of the moment – but it’s up to
hospital administrators, particularly nursing at the management
level, to step in and intervene for nurses caught in the
crosshairs of family battles during sensitive times.
Problems are further compounded by nurses working off the
clock. Whether it be a family member asking for help with
athlete's foot or a friend asking for stitches to avoid hospital
fees, there is always someone calling upon a nurse’s skills. In
Dunham's book, boundaries are also mentioned. She stresses
that, "...a very important boundary a nurse should maintain is
the discipline of leaving work at work." In addition to patient
and co-worker related boundaries, nurses must be taught to
separate work and personal life. Otherwise, nurses’ personal
lives can become work. The trauma and the physical issues may
go home with them but should not be dwelled on. Nurses should
have counseling available to them by their employers if needed
or be taught early on in their training how develop a space of
their own to decompress from the day's work.
Perhaps more seriously, when people hear the word nursing,
they often bring up the nursing shortage. Many of today's nurses
are older in age and like any profession, older workers intend to
retire. With less and less nurses and hospitals also cutting
corners, the ones that do have jobs face making up for the work

4. not being done. In Dunham's How to Survive and Maybe Even
Love Your Life as a Nurse, she says, "Studies have consistently
shown that nurses leave nursing when they are forced to work
mandatory overtimes, float to where they are not trained, and
take care of a ‘nigh unto ridiculous’ number of patients."
Overwork of nurses can cause stress on the nurse and degrade
patient care quality. There is a difference between nurses doing
their job and nurses treating patients. Nurses doing their job
will push medicine and run to the next patient to make sure
rounds are done in time. Nurses treating patient will stop to
consider the patient's condition and assess pain levels and
answer questions. Patients have the right to be treated properly
and thoroughly, especially with the amount they are actually
paying for their medical care. Allowing a nurse an acceptable
amount of time to go through these routines without having
them feel rushed is necessary for their best performance. When
nurses don’t feel like they’re treating – when they feel that they
are just doing, they’re bound to feel stress. This very stress is
likely the cause of why nurses leave their jobs, if not the
profession altogether, as studies seem to show. Only hospitals
themselves can lead in this area. It’s up to them to
simultaneously put patients and nurses first by hiring enough
qualified caring nurses.
Finally, there seems to be a serious problem with feelings being
acknowledged. When a life is lost while in a nurse's hands, the
nurse often takes it to heart. But, with the previously mentioned
fast pace of a hospital, time to come to terms with the fact that
the loss of life was not a nurse’s fault or unavoidable just
doesn’t seem to there. A nurse often has to get over it within
seconds and move on to the next patient that is in need of care.
According to Wicks, "We [healthcare professionals] learn that
no matter how professionally prepared we are, we are not
immune to the psychological and spiritual dangers that arise in
living a full life of involvement with others." That has been my
own experience working as a nurse myself. Even outside the
hospital, stories of patient lives and losses are often shared with

5. nurses. Death and sadness is regularly shared with nurses,
usually not by choice. Nurses must be trained to be able to
recognize the fact that it is okay to be upset over the loss of a
patient, but it must not have a grip on their own lives and their
capacity to perform. Unfortunately, these things are not
regularly or thoughtfully taught in nursing school. Hospitals,
short on staff, don’t provide their staff the appropriate time or
space to grieve.
Nurses deal with a lot of things that most people couldn't dream
of dealing with at their place of work. The life of a nurse does
look stressful on the outside, and it is, in fact, as unimaginably
difficult on the inside. Nursing students are not sufficiently
taught how to deal with their personal feelings and the feelings
of others beyond their own patients, but those two sources are
the ones that can affect a nurse personally and performance-
wise the most. Few people go to work expecting someone to die
or walk in to work prepared to see blood on a regularly basis,
but that is all a part of a nurse's life. This may be a career, but
the people working are still humans, and many employers and
employees themselves forget this. Physical issues can arise from
the overwork and stress that a nurse goes through and can lead
to long term illness or suffering. In order to deal with the
burnout of nurses, the shortage should be stopped by advertising
more aggressively about the importance of nurses and pushing it
to be seen as a rewarding career, one that will pay accordingly.
Burnout from a more personal standpoint can be avoided by a
thoughtful modification of nursing curriculum. Nursing students
should be taught that feelings are an inevitable part of the
healthcare field. Although they not be allowed to rule
performance, they should be acknowledged, and schools should
spend more time throughout the curriculum preparing nurses for
experiencing the grieving process from the viewpoint of a
healthcare provider. Personal management is also important.
Nurses should be taught that they must find the balance between
taking care of themselves to avoid issues and taking care of
patients effectively. Overseeing staff must ensure that nurses on

6. shift take appropriate lunch and bathroom breaks, even if they
themselves forget to, and work orientations should cover
professional development subjects such as coping mechanisms
for leaving work at work and setting professional/personal
boundaries. Nurses are important, and they work extremely
difficult and long shifts to provide the in-depth care that save
the lives of many. They should be prepared for their careers and
treated well for taking on such an important role in society.
Works Cited
Dunham, Kelli S., and Staci J. Smith. How to Survive and
Maybe Even Love Your Life as a Nurse. Philadelphia, PA: F.A.
Davis, 2005. Print.
Wicks, Robert J. Overcoming Secondary Stress in Medical and
Nursing Practice: A Guide to Professional Resilience and
Personal Well-Being. Oxford: Oxford UP, 2006. Print.