Top Sources of Stress for Registered Nurses in 2019
By Mary McWilliams
With an aging population that is living longer than ever before, registered nurses (RNs) continue to be one of the fastest-growing occupations.
It’s not slowing down in 2019. The field is poised for upward trajectory at a 15% growth rate until 2026, according to the Bureau of Labor Statistics. The demand is mounting, and the hours and expectations have followed suit. Nurses are stressed, with many experiencing burnout.
What Does Burnout Look Like in the Nursing Community?
Nurses experiencing burnout may:
- be emotionally exhausted
- find they have less compassion toward patients than before
- feel hopeless or unable to accomplish goals
- have physical symptoms from severe sleep deprivation
- plan to leave their role in the near future
There are a few unique sources of stress for nurses.
Registered Nurses & Compassion Fatigue
Day after day, registered nurses are on the front lines of distressing experiences, gruesome injuries and other traumatic patient outcomes. This can certainly weigh heavily on the minds of even the toughest care providers. However, there’s often little time to take mental breaks during hectic shifts and little opportunity to help RNs and other healthcare providers truly process these events and maintain mental balance. Patient care (appropriately) comes first, but the link between RN mental state and outcomes cannot be overlooked.
Compassion fatigue is ubiquitous within nursing, and it can be detrimental to patient care.
Registered Nurses & Moral Distress
Nurses working in emergency room (ER) settings, in particular, have distinct challenges. The environment can bring extremes: limited resources for severe conditions, time-sensitive life or death situations, long shifts that test attentiveness, the balance of admin duties with patient care, and more. Emergency situations often place nurses in a position of determining difficult priorities within seconds; it can sometimes mean nurses are unable to do what they deem “right,” or moral, in the moment.
This is called “moral distress,” according to a 2015 report by the Emergency Nurses Association (ENA). And it’s a top reason for registered nurse burnout.
Registered Nurses & Increasing Workloads
Registered nurses work in fast-paced environments. And while there is growing demand, they are also often short-staffed. Compounding the issue, workloads have changed over the years with the introduction of new technology and changing processes. Nurses have had to learn and incorporate new documentation and electronic medical records, adding to already-heavy demands on their shoulders.
Like other stressors, studies have shown the adverse impacts of a mounting workload on patient care, safety and patient experience. In fact, reports have found a link between understaffed nursing teams and high rates of pneumonia. Heavy workloads are also directly correlated with high turnover, which further fuels the nursing staff shortage.
Registered Nurses & Shift Work
Shift work is common for nurses. The goal is often well-intentioned: providing longer shifts to offer nurses more days off to recover in between and work-life balance. These shifts are also intended to provide continuity of care to patients. However, National Institutes of Health studies show that nurses are often working twelve-hour shifts. In one study, 65% often worked 12-hour shifts or longer, and it was most common in teaching hospital or “high-technology” facilities. It also found burnout was 2.5 times higher for those working longer shifts than those working 8–9 hours.
Shift work can impact care providers in a number of ways. Perhaps the most obvious, it is disruptive to sleep cycles. Some nurses may even develop shift work sleep disorder, which can lead to:
- Poor performance
- Difficulties staying awake or on task
- Irritable mood
The mission of registered nurses is to treat patients with the utmost attentiveness and compassion. However, self-care and self-compassion often fall to the wayside. With a direct connection to patient outcomes and more, it’s critical for healthcare organizations to take stress and sleep management within their workforce seriously. Making employee self-care a priority is making patient care a priority.