Burnout and stress impact healthcare workers at all levels, but for nurses it can lead to lapses in the quality of care they provide. Nurses can take steps to protect their well-being, and the safety of their patients, by educating themselves on the risks.
Mary Gullatte, Ph.D., R.N., corporate director of nursing innovation and research at Emory Healthcare, said in an interview with FierceHealthcare that exhaustion can prevent nurses from "firing on all synapses" when caring for patients, leading to an "opportunity or a risk of care concerns."
Gullatte called nurses' penchant for taking on too much "super nurse syndrome."
"You get this sense of, 'I've got to do it all. I've got to be the best,'" she said.
And that extends beyond clinical work. Jennifer Flynn, manager of healthcare risk management at Aon, told FierceHealthcare that nurses are particularly susceptible to exhaustion or burnout, as they not only deal with care but also often must provide emotional support to patients and families.
Gullatte said that can even reach what is considered "secondary traumatic stress," as nurses may struggle with thoughts related to conversations they have with patients, like a fear of death.
"You can end up with this overdose of life, of someone's life, when you're taking on those burdens," she said.
Gullatte said solving the problem starts with education. When nurses in units are trained to spot the signs of burnout or compassion fatigue in their colleagues, they're more likely to mention concerning behavior to their peers. Not speaking out and helping fellow nurses, she said, is "enabling an opportunity for an error to happen."
Signs that a colleague may be burnt out include making small medical or care errors or showing a lack of compassion to patients, she said. One way to potentially avoid a crucial conversation is to instead discuss ways to improve communication and ease the workload in a team setting, Flynn said.
Flynn said that self-assessments are available for nurses who worry they may be stretched too thin, and providers should offer assistance programs and resilience techniques to help nursing staff ease their stress. Many self-diagnostic tools are backed by major providers, like Mayo Clinic, which offers a Well-Being Index.
"If the first step is to be aware, the second step is to take action," Flynn said.
Communication breakdowns can have serious problems for patients and clinicians alike, both Flynn and Gullatte noted. They pointed to a 2015 report (PDF) from CNA Financial Corporation and the Nurses Service Organization, which found that allegations against nurses involving either assessment or monitoring represent, respectively, 15.7% and 13.8% of medical malpractice claims.
Flynn said that's another key portion of education around burnout, showing that data backs up the stated risks for patients.
Nurses who feel stressed must also not be afraid to ask for help when they need it, Gullatte said. Many clinicians are not fully attuned to the options that may be available to help them, such as spiritual support and mental health support, she said.
Make seeking help and reaching out to other team members who may be in need of assistance part of "who you are" as a healthcare practitioner, Gullatte recommended.