According to a recent survey, burned out nurses are more likely to spread infections. Here’s all the gory details: Burned-out Nurses linked to more infections in patients.
Having been a burned out nurse, I can see where this might happen. You’re tired, you’re pushed daily to give care to sicker and sicker patients and there’s more of them. Those of us who have tread that road know that it is not an intentional thing. These are small mistakes made through inattention, missed attention, attention focused on too many other things, complications of being pulled 7 ways at once that being a bedside nurse in inherent to.
But according to many comments left on the article, nurses are lazy and sit around all the time, it is all a conspiracy by the Man to keep the proletariat down, that being abused is part of the job, that we should just get over it and do our job correctly or get out of the profession. Very few voices of reason rang out, but this is the Internet and trolls abound. No one really gets it.
There is little to discuss why burnout happens or what our employers can do to help with burn out except for a short superficial look at staffing ratios. Unfortunately, staffing ratios are not a panacea, they are a means to an end, but unless coupled to acuity it is meaningless. Too often the cause is that there is too fluid of a patient population with huge swings in census, that hospital profits and administrator salaries are put ahead of nursing staffing, that reimbursement for many stays is a joke and that our patients are sicker than before.
There is hope though as the article mentions that when burnout symptoms ease, rates of infection go down. This highlights the obvious: happy nurses are nurses who can deliver the best care. Simple really. Too bad the things that would make many happy are the things that hospitals themselves would never realize. Instead they will continue to bury nurses under a blizzard of pointless paperwork, poor staffing, sicker patients, poorer compensation and even poorer support from those above in the hierarchy. We need though to learn as nurses how to keep us from transforming into Typhoid Mary even though we might be burned out and understanding of what can happen is the first step.
Lost on the Floor 
ticking timebomb here, or maybe already in the land of burn-out. Multiple vents on the floor. Not the stable, chronic home vents in the hospital for procedures like we were sold either–noooo, these are long-term, heavy weans that require a great deal of time and attention. But what can you do when they look into your eyes and tell you that they love you? Resent them? Yes. But damn you feel guilty for it.
Add these patients to a wildly varying census, and the number of nurses available to care for these patients also varies wildly. On a recent charge shift I actually had a nurse refuse to take part of an assignment. Refuse. Yeah he had another really difficult patient, but that patient was going home. Everyone else had difficult patients who were staying. So I took the patient as charge.
So yeah, things like foaming in and out get missed. Hand washing and the practice of changing gloves between procedures suffers. But things get done. And infection rates increase.
By the way…..glad to see that you aren’t dead
I think one thing we should also address when we talk about burnout is, are hospitals using an effective acuity system to create balanced assignments? In the places I’ve worked, the nurses from the previous shift will regularly fill out an acuity for each of their patients that will be used to determine the assignments for the next shift. They’re not always 100% with being a strong tool in creating fair assignments but they should be a factor so that each nurse gets a fair workload as opposed to one nurse running around all day while others are sitting for hours during their shift.
Acuity is paramount as far as my extensive critical care experience has taught me. But to answer your question: NO, hospitals only care about ‘X’ number of patients= ‘Y’ number of nurses. Not even whether the Nurses are ICU qualified. I have been known on many occasions to choose to keep my ICU patient care tech (aka ‘nursing assistant’) instead of trading her for an unqualified RN from the floor because my tech knew the job and was Much more helpful!
Back in ‘The Day’ patient acuity actually Meant something. Today it is all about numbers.
Totally the WRONG way to staff a unit and be able to deliver what the hospital has promised.
Hi, my name is Riccardo and I have just started nursing school in UK. I found your blog very interesting and I was hoping to ask you some advice about the profession.
Good description of what it means to be a nurse at the bedside these days. In 38 years, I have practiced in many nursing roles and several different nursing specialties, but none are as important as working directly with patients. I love preventing complications, saving lives and helping other nurses do the same. I am now a manger so much of my day is devoted to supporting my nurses either by getting more staff, working on the floor myself or convincing upper management of what our bedside nurses really need. Keep writing. If you can, read some of my articles, I would love your input! You can find me at: http://www.nancybanfieldjohnson.com/wordpress/
Nurse Mentor Nancy, author of “Catching Critical Changes; Six Essential Steps to Effective Nursing Assessment”.
Good description of what it means to be a nurse at the bedside these days. In 38 years, I have practiced in many nursing roles and several different nursing specialties, but none are as important as working directly with patients. I love preventing complications, saving lives and helping other nurses do the same. I am now a manager so much of my day is devoted to supporting my nurses either by getting more staff, working on the floor myself or convincing upper management of what our bedside nurses really need.
If you can, read some of my articles, I would love your input! You can find me at: http://www.nancybanfieldjohnson.com/wordpress/
Nurse Mentor Nancy, author of “Catching Critical Changes; Six Essential Steps to Effective Nursing Assessment”.
This is a very interesting article with a very alarming relationship between burnout and patient safety. It’s as if hospital administrators are blinded to these studies and research findings. It seems to me that there’s an increasing lack of knowledge when it comes to nursing as a profession and the importance of nursing retention.
As others have mentioned, there are programs out there that are currently being used to assess patient acuity in order to staff appropriately. Unfortunately, many of these programs are not comprehensive or a true representation of the actual acuity that takes place. I can see how high patient acuity coupled by a high patient load in a medical-surgical floor can contribute to decrease in time disinfecting central line ports, disinfecting medical supplies between patients, etc.
It also extends to the decreased time that nurses have to assess certain factors that may increase infection in a patients, for instance, a simple example can be a patient has a foley catheter for longer than 7 days but nurses are too busy that they are not able to look back at when the catheter was first placed in order to communicate these concerns with the physician. Now, every hospital has different task teams or implemented protocols to prevent the spread of infection but when a nurse is burned out, their ability to abide by these protocols may be impaired.
YES!!! We are in the midst of developing an acuity system for our unit (oncology). I’ve only been in nursing a few years and feeling burned out some days at the crazy load we’re dumped on! Our hospital seems to only care about profit over safety for patients or staff! I love and am annoyed with my job at the same time….
Hi Wanderer, is that what I call you? 😉
I loved reading your Typhoid Mary article. As a nurse who burnt out herself I could really relate! Thank you.
I have a facebook community of 50k nurses (facebook.com/whatiwishiknewaboutnursing) and I’m about to publish a new magazine with a working title of ‘Nurses Self Care Plan’ exclusively on the Apple Newsstand. I think the readers of the magazine would love to read your article too. As I would love to help prevent other nurses suffering the pain of burnout, by doing some simple self care. As we all know nurses need to look after themselves before we can look after others!
So, I was wondering if you are open to it, if I could reprint your article in the magazine please? If you’d like me to promote something for you – maybe a book or a specific web page you’d like me to point people to I’d be more than happy to do it. As it is an interactive magazine, once people have read the article they can be directed straight to a web page of your choice.
I hope to hear back from you soon, thank you.
Allie x
Author: What I Wish I Knew about Nursing
It is nice to get nurses perspectives on topics like this, cause this can discourage people from joining this incredible field.
Prepare us with knowledge to build on to become successful nurses