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nurse burnout

National Nurses Week: Finding Balance

Posted on Mon, May 08, 2017
National Nurses Week: Finding Balance

By Ginger Wirth, RN

Nurses, like most healthcare professionals, struggle with work/life balance. This stems from the reason that most of us pursued a career in healthcare – an innate desire to care for others.

Your interest in the field may have developed from early exposure to some aspect of healthcare. A family member or personal experience with your own or someone else’s medical issues can ignite the passion for the art of caring for others.

That passion for making a difference in the lives of patients, families and those we work with takes center stage for most nurses in the industry. There are times when our personal needs are put aside, our schedules changed and, sadly, family milestones are missed to execute our craft to the best of our abilities. This apparent oversight is never intentional, but it often creates conflict in our home lives.

It’s a constant struggle to find that delicate balance. This was brought to my attention by my then-5-year-old son, who asked me at the dinner table one evening several years ago, “Mom, are you going to be a nurse forever?” It was a strange question, to be sure, but our dinner table was usually where I’d recount my day in the emergency department. I answered honestly, “Of course I’ll be a nurse forever.” He then bluntly retorted, “Well, then you will never see your grandkids!” and promptly went back to eating his macaroni and cheese. Out of the mouths of babes … I have thought about that question many times throughout the rest of my almost 30-year career. I use it as a barometer when whatever in my professional career seems to be consuming all of my time, or I have inadvertently missed something important in my “outside life.”

Those close to you – your family and friends – deserve your attention and time. A true balance of both only makes you stronger, and both parts of your life get better. And, I would be remiss if I didn’t mention that it’s also important to take time to care for yourself. We cannot effectively take care of others if we are not taking care of ourselves. I wrote a blog article with some tips you may find useful.

The impact that we are able to make on the world through a career in healthcare, and in nursing in particular, is immeasurable. That is undeniable, and truly makes the world a better place.

Ginger Wirth

Ginger Wirth, RN, joined Envision Physician Services in 2013 as a divisional director of clinical services. Her goal is to make positive changes in healthcare by helping others focus on quality, excellence, and the overall patient experience. Wirth regards her role as the ideal opportunity to partner with nursing, physicians and facility leaders to make positive changes to the entire patient care experience. Her nearly 30-year nursing career has been dedicated to quality and excellence, promoting overall positive outcomes and safety for patients.


Four Strategies for Reducing Emergency Clinician Burnout

Posted on Mon, Nov 30, 2015
Four Strategies for Reducing Emergency Clinician Burnout

It’s a busy Monday in the ER. Gastroenteritis has hit the local assisted living center, flooding your facility with patients, many of whom are lining the hallways in stretchers. You’re trying to clear the waiting room when you hear that patients from a multi-vehicle MVA are in route – and you still haven’t gone to the bathroom. How can emergency clinicians handle “typical” days that aren’t very typical without giving in to stress and compassion fatigue?

It’s no secret that the ED is a challenging work environment, but part of the reason that we’re attracted to it is the adrenalin rush of that challenging environment. Still, it’s important to recognize the signs of burnout in your staff – and yourself.

According to the Maslach Burnout Inventory (MBI), there are three classic symptoms of clinician burnout:

  • Emotional exhaustion – You’re completely worn out after work and can’t seem to recover at all in your time away.

  • Depersonalization – You’re having trouble connecting with patients, and find yourself constantly blaming others. Your general attitude has turned negative and cynical.

  • Reduced accomplishment – You’ve lost confidence in your skills as a doctor and start to believe your care won’t do any good.Tips for Preventing Clinician Burnout

Here’s my advice to leaders in the field:
  1. Whenever possible, use lean principles to develop more efficient systems in the ED to, hopefully, mitigate the chaos. Eliminate waste in processes and the supply system, and involve hospital leadership in the effort. This Lean ED Checklist can help pinpoint opportunities for improvement.

  2. Develop a shared governance practice model to put the decision-making ability in the hands of front-line staff. This gives the team a sense of ownership and empowerment, which can balance the chaotic nature of the work.

  3. After particularly trying days, develop a debriefing program for staff. Hold brainstorming “post mortem” sessions led by counselors to discuss difficult cases or difficult days. These sessions help staff cope with the stressful environment that they, at times, both love and loathe. 

  4. Lastly, check your own pulse. Take 10 minutes to breathe deeply and develop a plan of attack. To be an effective clinician – and leader – you have to be able to keep your cool. Lean on your personal and professional support systems and use “emotional intelligence” coping mechanisms when appropriate. For more information about emotional intelligence, read a recent blog post on the topic.

In times of chaos, project a calm demeanor to your staff. Lead by example to help staff adjust – and flourish – when high volumes lead to high stress.

Sabrina Griffin, RN, BSN, CEN, is the Divisional Director of Clinical Services in EmCare’s Alliance Group.


Nurses: Take Time to Care for Yourself

Posted on Thu, Oct 15, 2015
Nurses: Take Time to Care for Yourself

This year, the Emergency Nurses Association (ENA) is celebrating Emergency Nurses Week from Oct. 11 to Oct. 17. Emergency Nurses Day is Wednesday, Oct. 14. In a year when Ebola and the measles made international headlines, this year’s theme is “Celebrating the Courage of Nurses Worldwide,” recognizing that emergency nurses courageously stand at the front line of emergency care every day. Be sure to thank an emergency nurse today – and every day.
By Ginger Wirth, RN
I recently had the pleasure of being on a call that discussed provider burnout – from nurses to doctors to advanced practice providers and anyone else who “provides” care for patients and their families. The speaker, Dan Smith, MD, Studer Group® coach, national speaker, and practicing emergency department physician, talked about the importance of taking care of ourselves, which really resonated with me.
The delivery of healthcare is frequently a juggling act. As providers, we have to balance the clinical care we provide with the compassionate care we share, balanced with our internal beliefs and past experiences. At times these may be in conflict, but those truly dedicated to caring for the patients push much of that aside and do all they believe is right at the time to deliver the best possible care and outcomes for the ones we are caring for.
Clinicians have the “clinical” piece “down to a science” and are able to postulate a care plan or diagnosis easily, as most of us are “unconsciously skilled” when it comes to the medicine. It can frequently be the emotional side of caring for patients or even their families that throw us for a loop. Those in emergency medicine can attest that those feelings frequently get pushed to the side while we are in the thick of it and often are forgotten and never truly dealt with. We need to do better and take better care of ourselves.
3 Ways to Take Better Care of Yourself
Three areas where we can make a significant improvement in how we deal with these everyday stressors and take care of ourselves are fairly easy:
1. Sleep is Crucial - There are studies that show that those who are routinely sleep deprived, meaning getting less than 6 hours of sleep at night can have these physical effects:

  • Heart disease: Cardiovascular disease is the No. 1 killer in the United States. And to think that sleep deprivation plays some part in it boggles the mind.
  • Anger: Research has shown a correlation between hostility and increased sleep disturbance. So don't blow your stack; sleep on it instead!
  • Fatigue: Consider this—well over 100,000 car accidents in North America occur every year due to sleep deprivation. More than 6,000 fatalities. Sad, tragic, and unnecessary
  • Weight gain: Research shows a link between lack of sleep, weight gain, and obesity. Napping to lose weight? That works for me!
  • Anxiety: Recent research suggests that sleep deprivation can cause anxiety, fear and worry.
  • Blood sugar: Researchers have discovered a connection between sleep deprivation and diabetes, in particular, type 2 diabetes.
  • High blood pressure: Studies have shown that people who sleep less than six hours a night have a significantly higher risk for high blood pressure.
  • Illness: Infections and weaker immune system
  • Frustration with life: Perhaps this is why alcohol and drug abuse are signs of sleep deprivation.
  • Irritability
  • Memory issues, including reduced cognitive function, decreased mental sharpness, lack of focus and drive
  • Blurred vision
  • Increased pain
  • Shortened life expectancy
  • Inflammation (a factor in numerous diseases, including certain types of cancer) 

2. Exercise is so Important!
  • The American Heart Association recommends 30 minutes of moderate exercise a day, five days a week, 75 minutes of vigorous exercise a week.
    • Use some of the latest tools: Pedometers/trackers like Fitbit, Apple watch, Jawbone, Ped, Omron or Garmin. Most have apps that you can share with friends and challenge each other, which make the experience much more fun.
  • Decreases anxiety and stress
  • Helps control your weight
  • Reduces your risk of cardiovascular disease
  • Reduces your risk for type 2 diabetes and metabolic syndrome
  • Reduces your risk of some cancers
  • Strengthens your bones and muscles
  • Improves your mental health and mood
  • Improves your ability to do daily activities and prevent falls, if you're an older adult
  • Increases your chances of living longer 

3. Healthy eating - Remember we get out what we put in!
  • There is a balance to eating. Most days, eat from each food group: grains, protein, vegetables and fruits, and dairy. Listen to your body. Eat when you're hungry. Stop when you feel satisfied.
  • Variety is the spice of life (literally). Be adventurous. Choose different foods in each food group. Pick a recipe from that cookbook you bought on sale. You might find a new favorite. Eating a variety of foods each day will help you get all the nutrients you need. Use different spices to vary the taste of even your favorite foods.
  • Everything in moderation! We say that for most things in life, and food is no different. Don't choose too much or too little of one thing. All foods, if eaten in moderation, can be part of healthy eating. Even sweets can be okay. 

One of the most important takeaways from this is BALANCE. As healthcare professionals, it’s just as important that we balance our own lives and health just like we balance the care we provide each and every day. We deliver better care when we feel better ourselves. We make the difference in the lives we touch with every encounter, every day! Let’s give them and ourselves our very best! Next steps from here: Take a walk, eat a carrot and then take a good long nap!

Ginger Wirth, RN, joined EmCare in 2013 as a Divisional Director of Clinical Services for the Alliance Group. Her goal is to make positive changes in healthcare by helping others focus on quality, excellence, and the overall patient experience. Wirth regards her role as Director of Clinical Services as the ideal opportunity to partner with nursing, physician and facility leaders to make positive changes to the entire patient care experience. Her 20-plus year nursing career has been dedicated to quality and excellence, promoting overall positive outcomes and safety for patients.