Despite the fact that nurses fill the trenches of the healthcare system, prevention of burnout and compassion fatigue is a subject rarely--- if ever---addressed in nursing school. This truly needs to change if we want to continue to recruit and retain healthy, competent and satisfied nursing students at a time of a global nursing shortage. 

 

 

Burnout is a common condition among nurses, whose work often involves caring for those who are unable---or sometimes even unwilling---to care for themselves. Nurses provide front-line care to individuals across the lifespan, often bearing the brunt of patients' anger, frustration, loneliness, isolation, and dis-ease. Nurses provide the moment to moment skilled clinical evaluation which provides the raw data and anecdotal information which informs the work of the doctor. This contribution to patient care is invaluable and often fraught with stress, and nurse burnout is something we all equally understand, dread, and are often too slow to recognize in its nascency.

However, despite the fact that nurses fill the trenches of the healthcare system, prevention of burnout and compassion fatigue is a subject rarely--- if ever---addressed in nursing school. From the moment a newly minted nursing student walks through the doors of the classroom, "Passing The Boards" begins to be a mantra which students and professors recite like a liturgy. Nursing students are, of course, taught to give a bed bath, take a blood pressure and administer injections, yet self-care is a subject sorely missing from nursing school curricula. It is here---among other places---that nursing schools simply fall down on the job.

Why isn't the prevention of burnout a higher priority for nursing school faculty and administrators? Since we are aware that the newest generation of nurses entering our schools may be the very ones to care for us when we are in need of care later in life, isn't it (at least selfishly) in our best interest to make sure that our fresh-faced students are prepared for the emotional and physical maelstrom ahead? Do we want our current students to become just more cannon fodder, thrown to the lions of the system and leaving the profession after a decade of skill development and overwork? There is an old saying that nurses "eat their young". If we don't urgently choose to nurture our fledgling students' ability to care for themselves from the very onset of their careers, how do we expect them to survive in the harsh and unforgiving world of healthcare?

Nurses are by nature giving individuals, and it is just this tendency towards giving which is at once nurses' collective strength and Achilles Heel. From the very start of nursing school, issues such as co-dependence, transference, counter transference and projection should be reviewed, not simply as convenient and esoteric psychological terms, but as often unavoidable manifestations of therapeutic relationship which nurses are bound to experience in the course of their careers.

Quantitative research published in Nurse Education in 1995 demonstrates that nursing students experience burnout levels comparable to that of working nurses. During the course of the study, research further demonstrated that "nine theme clusters emerged: engulfing demands, time pressure, no outlet, physically debilitating, emotionally overwhelming, lack of concentration, decreased motivation, impeding relationships, and coping attempts."

In terms of coping skills, a study published in the International Journal of Nursing Education Scholarship (vol 1, issue 1, 2004) showed that recreational music-making can demonstrably decrease the effects of burnout in nursing students, decrease attrition, and potentially save schools and hospitals millions of dollars in lost revenue and training expenses. "Based upon the study’s findings, an independent research firm projected that the average nursing school could retain two more students per year by employing the Recreational Music-making protocol. This translates to a $16,800 annual savings for the typical 105-student program and $29.1 million a year for all U.S. nursing schools, resulting in more than $29 saved for every dollar invested."

Taking into consideration the fact that original research exists corroborating the existence of nursing student burnout---as well as potential interventions to mitigate its effects on attendance and attrition rates---it would behoove nursing programs across the country---and around the world---to consider burnout and compassion fatigue as potential contributing factors to the worldwide nursing shortage, and thus to take positive and constructive steps towards stemming the tide of nurses who burn out before they are released into the stressful workaday world.

 

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NurseKeith is a blogger, nurse, consultant, and writer. Please feel free to visit his blog, Digital Doorway .  

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