Burnout is on the rise with Mental Health First Aid Australia reporting that 61 per cent of Australians have experienced burnout, significantly higher than the global average of 48 per cent.
Defined as a state of mental, physical and emotional exhaustion caused by prolonged- unmanaged job-related stress, burnout not only has significant impacts on wellbeing and productivity, but can also put individuals at a higher risk of developing mental health problems.
In today’s healthcare environment, nurses and midwives are particularly impacted by burnout. As the backbone of the healthcare system, they face unrelenting pressures from workforce shortages to the lingering effects of the pandemic.
This article will explore nurse burnout in detail, from recognising its signs and symptoms to strategies for recovery and practical tips for prevention.
Causes of burnout in nursing
A survey conducted by the Australian Primary Health Care Nurses Association (APNA) revealed that over 75 per cent of nurse respondents have felt burnt out.
While the longer-term consequences of the COVID-19 pandemic have been cited as a reason for burnout, some other causes include staff shortages and overwhelming workloads.
Lingering effects of the pandemic
The COVID-19 pandemic has had a significant impact on the psychological wellbeing, work and personal lives of Australian nurses.
Madeline Kessler, an experienced registered nurse and life coach, reflects on the pandemic’s emotional toll, “During the pandemic, it felt like we were treading water while holding people above the waterline. We were in the thick of it – grappling with our own fear, our own uncertainty, all while trying to keep others afloat.”
Though it has been a couple of years since the pandemic, its effects still persist throughout the healthcare system.
Perception of nurses
In society, nurses have been perceived as tireless caregivers that never falter and are always dependable and caring.
“Being seen as strong, resilient and almost superhuman has historically and traditionally been seen as the main qualities of a nurse. But with the current pace and intensity of the profession, it’s unsustainable,” says Madeline.
This perception, however, isn’t just external as nurses themselves also often feel the weight of these expectations.
Madeline recalls a conversation she had with a group of nurses about what they believed a good nurse looked like.
“I asked them, ‘what does a good nurse look like?’ and some of the things that they said were that they don’t take breaks, they always put their patients first and they take on extra shifts even when they’re exhausted. At that moment, I thought, no wonder they’re all burning out.”
Staff shortages
The Australian Nursing and Midwifery Journal states that Australia will face a shortage of more than 70,000 nurses by 2035.
“With staff shortages, it can lead you to continue to work when you really should be organising to have some time off," states Madeline.
Staff shortages not only mean that there’s less team members to cover shifts and provide patient care but it also leads to heavier workloads.
Due to the lack of available staff and workload, nurses often don’t feel comfortable taking a break even though they’ve worked long hours as they feel a sense of responsibility towards their colleagues.
Madeline stated that some thoughts that nurses have include, “I can’t let my colleagues down. If I don’t go to work tomorrow because I just feel so exhausted, drained, there will be no one else to fill that position and therefore my colleagues will have to work twice as hard to get through that day.”
Signs and symptoms of nurse burnout
Recognising the early signs of burnout is crucial to addressing it before it worsens.
Madeline experienced her first burnout in her 20s while working in oncology where she cared for many patients with terminal illnesses. Some of the burnout symptoms she had included:
Becoming more isolated and withdrawn
During her days off, Madeline stayed in bed instead of socialising with family and friends.
Trouble sleeping
One of the first symptoms that Madeline had was difficulty sleeping. She was often awake till one or two o’clock in the morning even though she had to wake up early for work.
Disinterest in life or spending time with others
Madeline lost interest in spending time with friends and family. “Even when I’m around friends and family that would normally recharge me and lift me up, I just didn’t feel like engaging.”
Feelings of detachment including isolation, loneliness and anxiety
Madeline mentioned that she felt depleted both physically and emotionally and was constantly thinking about work and worrying, even in quiet moments when she was going for a walk or lying in bed at night.
Feeling discouraged
Madeline felt a sense of shame that she wasn’t coping and had thoughts such as, “I’m weak, I’m not cut out to be a nurse. I can’t do this. I’m a failure.”
Short quiz: Am I burnt out?
This short quiz may help you identify if you are experiencing or at risk of experiencing burnout.
-
How often do you feel a sense of dread or anxiety about going to work?
A) Rarely or neverB) Occasionally, but I manage to push through
C) Frequently and it’s hard to motivate myself to go
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How often do you feel physically and emotionally drained from work?
A) Rarely or never
B) Sometimes
C) Frequently -
How often do you feel irritable, frustrated or unusually agitated?
A) Rarely or never
B) Occasionally
C) Frequently or almost daily -
Do you find yourself isolating from family, friends or colleagues?
A) No, I enjoy being around people
B) Sometimes I prefer to be alone
C) Yes, I actively avoid interactions and feel disconnected -
Do you often feel a sense of detachment or lack of purpose in your work?
A) No, I feel connected and fulfilled in my role
B) Occasionally, I question my purpose but still find meaning in my work
C) Yes, I often feel detached and wonder why I’m doing this
Results
Mostly A’s: You’re likely not experiencing burnout. Continue to prioritise self-care and check in with yourself regularly.
Mostly B’s: You may be showing early signs of burnout. Pay attention to your stress levels and consider implementing stress-management strategies to prevent it from worsening.
Mostly C’s: You may be experiencing burnout. It’s important to seek support, reassess your workload and prioritise self-care.
How to recover from burnout
If you’re experiencing burnout, here are some ways to help with recovery.
Recognition
While it can be difficult, Madeline emphasises that being vulnerable and sharing your feelings is a powerful step towards recovery.
“Your colleagues are sometimes the best people to share your feelings with because not only are you admitting it to yourself but you’re normalising it for every single person in the room”, she explains.
Madeline also elaborates on how being vulnerable with someone you trust can help dispel the fear and shame of feeling alone in your struggles.
“It just expands and opens up the whole network of normalising what we’re experiencing and smashes the need to feel like you’re carrying the burden entirely yourself."
Seek help
If you are experiencing burnout, it could be helpful to seek help from a professional who can provide guidance and support. In Madeline’s case, her nurse unit manager referred her to a social worker, which proved to be incredibly helpful in her recovery.
You can also contact Nurse and Midwife Support, a 24/7 national support service for nurses and midwives in Australia that offers free peer support counselling via telephone or email.
Set boundaries
Recovery often requires taking a step back to evaluate what needs to change. For some, it may mean setting boundaries at work, taking some time off or transitioning to a different role.
In Madeline’s case, this meant stepping away from oncology after six years and working in a different field. She did, however, still continue working at the hospital every second weekend to maintain her registration before eventually returning to nursing full-time.
Create a self-care plan
Finding activities that bring you joy and help you recharge is vital for recovery. Everyone’s outlet will differ. For Madeline, it was riding horses.
“I’m a very outdoorsy, earthy kind of person so I just got back into my riding and immersed myself into working with my horses, which really helped my recovery.”
Some other self-care ideas include exercising, spending time in nature, connecting with others or journaling your thoughts and feelings.
Speak with your leader
If you feel comfortable, consider opening up to your manager or nurse leader and seeking their support. A good nurse leader should be empathetic to your needs and take active steps to help prevent or alleviate burnout.
“A good manager will make sure that if you’re showing signs of running out of gas, they’ll make sure you get time off”, says Madeline.
Pivoting to a different healthcare career
In some instances, recovering from burnout might mean stepping away from nursing and exploring a new path within the healthcare industry.
Nurses possess a valuable set of skills including clinical expertise, strong communication abilities, empathy and adaptability which are transferable into roles such as case manager, counsellor, social worker, public health officer and healthcare researcher.
To develop the skills needed to transition into these roles, consider enrolling in a postgraduate course such as the Graduate Certificate in Health Research at the University of Canberra, Graduate Diploma in Counselling at the University of Canberra, Master of Public Health at the University of Technology Sydney or the Master of Social Work (Qualifying) at the University of Canberra.
The courses below are listed by qualification level, from lowest to highest.
Most of these courses only require a bachelor's degree or equivalent in a health discipline and will provide you with the skills required to meet the demands of the field.
Tips for preventing burnout
Here are some ways that may assist with preventing burnout.
Tip one: Continuous learning
Continuous learning, such as leadership training or postgraduate studies may help with building resilience by equipping you with the skills to manage challenges effectively, adapt to changing environments and foster personal growth.
Postgraduate nursing programs often include units focused on personal development, resilience and leadership.
The Master of Advanced Nursing at University of Technology Sydney for example, includes a unit on Leading Health and Social Care where students will consider their own leadership capabilities and a development map for their career.
James Cook University’s Master of Nursing also has a unit on Professional Portfolios for Career Advancement where students will critically assess and reflect on professional experiences, identifying areas of strength and areas for growth.
The courses below are listed by qualification level, from lowest to highest.
Tip two: Understand and prioritise your needs
Simply knowing what you need to function at your best can help with preventing burnout. This could include things like recognising when it’s time to take a break or sharing your experiences or feelings with a trusted colleague, family member or friend. In Madeline’s case, she often asks herself, “Who have I got that I can talk to if I need to just vent at the end of the day and process some of the triggers that I’ve experienced?”
Tip three: Practise regular self-care
Madeline explains that challenging situations during the work day, such as dealing with upset or distressed patients, can lead to a buildup of stress that needs to be released.
“Those stress responses you accumulate throughout the day require some sort of physical act for you to release it.”, she says.
There isn’t a one-size-fits-all approach, however, when it comes to dealing with stress. Some may find yoga or meditation helpful while others may prefer a quiet night at home or engaging in outdoor activities.
“Sometimes, it’s just encouraging people to understand that they might need something different to manage their stress and complete their stress cycle at the end of every day.”
Tip four: Practise breathing exercises
Simple, intentional breathing is a powerful tool for stress management, not only does it assist with calming the nervous system, but it also lowers levels of stress and helps to calm and clear the mind.
Madeline recommends practising square breathing, a technique that involves inhaling, holding your breath, exhaling and holding your breath again – each for four seconds. She has taught this technique to nurses who have, in turn, also guided their patients through it.
Tip five: Understand your limitations
When Madeline left oncology, she was able to eventually return to nursing because she learned how to set boundaries and respect her own limitations.
Recognising when you’re reaching your limits and knowing when to step back is essential for avoiding burnout. This goes beyond managing your workload and includes being mindful of behaviours like staying at work longer than you should or tolerating situations that you shouldn’t.
Tip six: Focus on the meaningful aspects of your work
Taking time to reflect on the purpose and fulfillment your role brings can help protect your wellbeing and prevent burnout, allowing you to continue making a positive impact.
For Madeline, nursing is a profession that offers the opportunity to touch lives in meaningful ways. “What has nursing given me in my life? Meaning. You can see people at their most terrified, their most fearful state and just by holding space for them, you give them a sense of safety in that moment.”
Overcoming nurse burnout
While nurse burnout can be challenging, it is manageable with the right tools, strategies and support. Recognising symptoms early, implementing self-care strategies and seeking help when needed are essential steps toward recovery and building resilience.
At GlobalHealth Education, our university partners offer postgraduate nursing courses that can assist with building resilience and advancing your nursing career. They also offer a wide range of courses in mental health, health leadership, public health, psychology, counselling and social work.
Select a course and enquire to speak with a Student Enrolment Advisor who can guide you through the enrolment process and answer any queries you may have.
