Nursing in stressful work environments
Health care needs to change. It’s time to improve work environments for nurses and ultimately improve the patient experience. A systems approach to reduce burnout and unnecessary systems challenges can result in greater well-being, engagement, safety, and career satisfaction.
Stressed Healthcare in the U.S.
What do you think – is U.S. healthcare perfect just the way it is? I don’t think so! Neither does the Massachusetts Health and Hospital Association (MHA). In an easy to read bullet format, a the newly released Caring for the Caregiver Task Force Report presents challenges and recommendations regarding workplace violence and worker injury, workplace culture, workplace wellness, caregiver preparation, lack of available job applicants, and staffing shortages. All of these challenges negatively impact not only healthcare staff, but also patient care.
In my research about stress and nursing, I’ve read about all of the challenges cited before. None of them are new to me, and if you work in healthcare, they won’t be new to you either. The difference, for me, is that this is the first report I’ve read that compiles all of these challenges in one place. Frankly, I was overwhelmed, and began to wonder how any of us healthcare workers make it through the day.
I don’t want to overwhelm you, my reader, but I do want to bring to your attention that reducing the stress of working in healthcare is not only a personal issue, but also a systems issue. I want you to feel supported by knowing that others see the problems and want to improve the healthcare system. I hope you will accept that you are likely stressed, and something needs to give, even though a common response of healthcare professionals is to accept all the challenges thrown at them as “all in a days work.” I want you to care for your self by managing your personal stress and become an advocate for a healthier safer healthcare system for all workers and patients. Don’t worry – I’ll help!
If you work in healthcare, do you acknowledge or ignore the stressful challenges of your work? The number and nature of challenges varies among organizations, and sometimes among departments within the same organization. One of the accomplishments of the MHA task force is to name, in one document, the many challenges interfering in doing what we entered healthcare for in the first place – to compassionately care for patients.
Here are some of the challenges they identified in “Caring for the Caregiver Task Force Report.” I invite you to read through this list of challenges addressed by the task force as if it’s a check list. Check how many you experience in your work setting. How many do you think you might check? One, five, ten, or more?
Challenges to safety from workplace violence and workplace injury
- Organizations that discourage or make it challenging to report violence or injury
- Inaccuracy of systemic data collection about workplace violence
- Lack of support for staff affected by violence or injury
- Lack of training for staff in violence prevention
- Lack of effective injury prevention in the workplace
- Insufficient specialty beds for patients with mental health, forensic, or substance abuse issues
Challenges to engagement in positive work environments
- Rapid changes with information technology
- A trend of high turnover among younger generations
- Different generations of staff have different skill sets, communication styles and motivations.
- A shift from smaller to larger organizations, created by mergers and consolidations
- Varying levels of contentment and discontent within an organization, often related to leadership within micro-cultures
- Compassion fatigue
Challenges to well-being, including physical, emotional, mental, financial and social health
- Disruptive financial, technological, political, and workforce challenges
- Overall, a decreased well-being of staff members
- Increased rates of burnout
- Ineffective wellness programs
- Reactive stress management approaches, rather than proactive mitigation of stressors
- Insufficient opportunities for growth and development
- Lack of respect and supervisory support
Challenges to a healthcare workforce
- Shortages of job applicants, depending on location and specialty
- Not enough effort given to staff retention resulting in high turnover rates
- Negative perceptions of some care settings, such as home care and long-term nursing care
- Reimbursement rates in many settings too low to compensate staff sufficiently
- Sense of isolation specifically among home care staff
- Shortages of mental health staff
- Lack of safe and effective staffing measures
How many of these challenges do you experience in your workplace?
How many did you check? 50%, 75%, 100%? With that information you are ready to
- Acknowledge and accept your own stress levels
- Care for yourself with stress management interventions
- Advocate for what needs to change in your work setting
Solutions for a systems approach to resilience
Thankfully, this task force’s report does more than identify problems, which most of us are quite capable of doing. In each of the four focus areas, both recommendations for the future as well as specific recommendations during the Covid-19 pandemic are offered. In addition to recommendations, there is an extensive list of resources for each of the focus areas and for the Covid-19 pandemic. Additionally, the MHA has created a website to which additional curated resources will be added.
What nurses and patients can do
The health care system needs to improve work environments for nurses and ultimately the patient experience. Reducing clinical caregiver stress and increasing resilience will take a systems approach. Best practices improve work environments for nurses by reducing burnout and unnecessary challenges, resulting in greater well-being, engagement, safety, and career satisfaction. And those accomplishments will result in better patient care and patient satisfaction.
What can we do to be sure the challenges of either working in healthcare or being a patient in healthcare are resolved? Changing the healthcare system not only begins at the top of the administrative ladder, but it also begins with front line transformational leaders on the bottom rungs of the administrative healthcare ladder. Two places to start are by raising awareness to both challenges and solutions, and by advocating for change in whatever circles of influence you have. Each healthcare leader, department, site, facility, and organization must choose to act – and you can encourage them to do so.
- Alert your employer to the Caring for the Caregiver Task Force Report.
- Discuss issues you see in your workplace with healthcare administrators.
- Bring hope to your unit director, team leader, or C-suite that change is possible and that resources to create change, such as this task force report, are available.
- If you don’t work in healthcare, you are likely a patient consumer. Ask your provider if they know about this report, and what positive changes they plan to support their staff.
What will I be doing? In upcoming newsletters and on TLC’s Facebook page, I’ll continue to offer information about how you can join healthcare advocacy organizations and how you can support legislation that solves challenges in ways you know to be effective. Until effective system changes take place and stress on healthcare providers is greatly reduced, I’ll be here to help you with stress.
Together we can raise awareness of the challenges and advocate for healthcare change!
In peace, Gale
Related blogs/TLC links
Photo credits: photos of nurse from Pixabay