Monday, 20 November 2017

On Nursing Burnout, Staff Shortages and Travel Nurses

Kaitlyn Williams, RN

I am writing with regards to the journal article titled “Factors influencing new graduate nurse burnout development, job satisfaction and patient care quality: a time lagged study” (2016) by Sheila Boamah PhD(c) RN MN, Emily Read PhD RN, and Heather Laschinger PhD RN FAAN FCAHS. Burnout in the nursing field is a national issue. Healthcare is such a demanding field to be in. Boamah draws specific attention to the fact that short staffing and the lack of structural empowerment in the work environment are some of the most common reasons nurses experience dissatisfaction among their job. I was once one of the ones on the verge of nursing burnout within a year of my nursing career, and this author describes all of the emotions and frustrations that I experienced during a time when I thought I was the only one experiencing it.

It is so very unfortunate that some nurses feel unappreciated for the extra work that they offer. I cannot honestly say that our clinical supervisors and manager have ever made it feel like doing extra was an expectation. They are always so grateful for the help and understand that we are giving up our time off. The clinical supervisors are always checking in with the nurses to see if they need anything, assess the status of new admission, and are willing to help in any way that they can.

While most facilities are experiencing staffing shortages, the nurses are experiencing a higher workload and an increased patient to nurse ratio. We welcomed a new nurse to our night shift family and after talking to her for a while about why she left her old facility she explained that it was because of staffing. While they were losing staff members, the people higher in administration felt it was appropriate to increase their patient to nurse ratios from 6:1 on night shift to 8:1. She felt that it was not safe for her or the patients and was not willing to take the chance.

Facilities are experiencing high turnover rates within their departments. On my unit especially there are many nurses that plan to continue to get their nurse practitioner license. I think that is a wonderful thing for them to continue and applaud their decisions. However, after speaking to some about why they chose that pathway it was alarming to hear how many were “just tired” of bedside nursing. Our night shift staff experienced the effects of short staffing almost every night. We were offered monetary incentives as well as gift certificates if we were willing to pick up an extra shift to help. The majority of the night shift staff picked up extra shifts for weeks until we were approved to bring in travel nurses. One of our more experienced clinical supervisors made the comment that she has only seen travelers brought in to the unit one other time in her 19 years there.

Travel nurses are a wonderful resource to have and provide a sense of relief to the ones that have been working extra to help staffing needs. Jan Cottingham, in the Arkansas Business article “Health Care Demands Push Growth of NLR’s Travel Nurse”, explains that the concept of travel nursing came about as a “short-term solution” for staffing shortages in the 1980s. The effects of staffing shortages are being felt nationwide still today. If the hospital’s budget permits it, travel nursing contracts should be initiated more often instead of allowing the staff to work beyond mental and physical fatigue each week.

This article made me reflect on the past year in my nursing career. As I was reading each section I found myself relating to the situations and circumstances described. It is so common for nursing staff to experience these frustrations. I never thought it would happen to me so soon in my career. Through this article I realized that I am lucky to be a part of the team that I have. We are being reminded that we have to take care of ourselves, too. We cannot allow our patients to be the ones to deal with the repercussions of our fatigue.
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Boamah S.A., Read E.A. & Spence Laschinger H.K. (2017) Factors influencing new graduate nurse burnout development, job satisfaction and patient care quality: a time-lagged study. Journal of Advanced Nursing 73(5), 11821195.

Cottingham, J. (2017) Health Care Demands Push Growth of NLR's Travel Nurse. Arkansas Business. [Online]. Available from: http://www.arkansasbusiness.com/article/117025/health-care-demands-push-growth-of-nlrs-travel-nurse

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