Joint Commission Tackles Nurse Burnout In New Report

By: Kathleen Gaines BSN, BA, RN, CBC

In July, the Joint Commission released Quick Safety, Issue 50 that emphasizes developing resilience to combat nurse burnout. The safety issue was released as a result of numerous surveys indicating that nurse burnout remains an ongoing issue amongst nurses.

According to a national nursing engagement survey released in April 2019, 15.6% of nurses reported feelings of burnout. Emergency room nurses were identified at being at a higher risk for burnout and 20% of ER nurses reported feeling unengaged. Interestingly, 50% of nurses who reported feeling burnout in their current position also reported no immediate plans to leave their organization. Another 41% of nurses reported as being “unengaged”.

The report explained that unengaged nurses are nurses who:

• May not be part of a team with their colleagues
• Have diminished morale
• Feel emotionally checked out from their work

All of these can ultimately affect the quality of patient care.

Another 2019 survey found that nurse burnout was among the leading patient safety and quality concerns in healthcare systems. Unfortunately, only 5% indicated their healthcare organizations were highly effective at helping address nurse burnout. 39% said their organization was slightly effective and 56% were either slightly ineffective or highly ineffective at helping staff address burnout.

Patient satisfaction, patient outcomes, patient safety, and even patient mortality can all be severely impacted by nurse burnout. The Joint Commission found ways to reduce nurse burnout and potential consequences by supporting nurses through administrator supported interventions including resilience training.

First identified in 1960, work stress in nursing was broken into four sources of anxiety among nurses. These included patient care, decision making, taking responsibility, and change. Some of the identified stressors for nurses include,

• Physical labor
• Long working hours
• Short staffing
• Interpersonal relationships
• Human suffering
• Increase in the use in technology
• Rises in health care costs
• Heavy patient assignments

Symptoms Of Nurse Burnout

Nurse burnout is a physical, mental, and emotional state caused by chronic overwork, job dissatisfaction, short staffing, and lack of administrative support.  

How do you know if you are experiencing nurse burnout? Professionals identified the following warning signs:

• Always tired
• Overwhelming anxiety
• Physical illness
• Insensitivity
• Lack of appropriate emotions
• Calling out of work when not physically ill
• Dreading going into work
• Lack of personal accomplishment
• Depression
• Depersonalization
• Emotional exhaustion

Nurse burnout has led to adverse health outcomes for nurses, increased turnover thus furthering the current nursing shortage, and decreased patient satisfaction.

Nurses working in high-stress areas such as critical care, oncology, pediatrics, and emergency room report the highest levels of nurse burnout.  One study found that 13% of critical care nurses left their positions due to nurse burnout while 5% left the nursing profession altogether. A different study identified 25% of nurses in high-intensity work environments such as the ER and ICU left staff positions due to nurse burnout.

Combating Nurse Burnout

It is important for nurses to have an outlet to combat stress. Reducing stress benefits not only the nurse but also their patients. These outlets can be listening to music, yoga, going to the park, or watching a movie. It is important that a stress outlet is one that is productive. Many professionals recommend the following coping strategies for nurse burnout:

• Take deep breaths
• Identify your stressors
• Say no to overtime
• Learn to say no to coworkers for switches
• Delegate when possible
• Unplug and recharge
• Set boundaries
• Ask for help from professionals
• Practice self-care
• Engage in healthy attitudes regarding physical exercise and eating habits
• Strong coworker relationships
• Create a support network
• Slow down

Nurse Resilience

Resilience helps mitigate moral distress and burnout. It involves utilizing different coping strategies to minimize distress.

A study in 2010 by Cameron and Brownie identified eight themes that impact nurse resilience:

• Experience
• Amount of satisfaction attained
• Positive attitude or sense of faith
• The feeling of making a difference
• Leadership strategies, such as debriefing, validating and self-reflection
• Support from colleagues, mentors, and teams
• Insight in the ability to recognize stressors
• Maintaining work-life balancE

Developing Resilience

The Joint Commission recognized that administrators in health care organizations have a responsibility to take an active role in developing and fostering resilient environments, which can reduce nurse burnout. Leaders should consider the following to help prevent nurse burnout:

• Feeling valued professionally
• Colleague support
• Use of mentors/role models
• The feeling of making a difference
• Team support
• Organizational support
• Use of debriefings
• Feeling competent to meet the needs of the job
• Positive reappraisal
• Empowerment
• Sense of accomplishment

One of the first steps in reducing nurse burnout is acknowledging nurse burnout. A resilient work environment is only possible when nurses have the ability to discuss concerns to hospital administrators to listen, acknowledge, and act on the concerns.

Nurse burnout has long been a hot topic in the healthcare community as it directly affects staff and patients. Through the most recent Joint Commission report, hospital administrators are encouraged to engage and support their nurses through open communication and empowerment.

The ongoing nursing shortage will continue to affect nurse burnout. It’s important to remember to be kind to your co-workers, work together to provide the best patient care, and remember to slow down and take a few deep breaths during long shifts.