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Caring for the caregivers: combating nurse burnout and fatigue

Is anyone’s life on the line when you’re having a bad day at work?

When nurses, doctors and other health care providers aren’t well, they aren’t able to provide optimal care to patients — an issue with serious implications.

It’s why Ohio State researchers are taking action to make clinician self-care and wellness a more inherent part of the work and learning culture.

When nurses suffer, so do their patients

More than half of nurses who took part in a national survey reported sub-optimal physical and mental health, according to a recent study led by Bernadette Melnyk, dean of Ohio State’s College of Nursing and the university’s chief wellness officer. Nurses in poorer health had a 26 to 71 percent higher likelihood of reporting medical errors than their healthier peers. 

“Nurses do a great job of caring for other people, but they often don’t prioritize their own self-care,” Melnyk said. “And their work lives are increasingly stressful: Patients are sicker. Hospitals are crunched financially, and nurses are having to find ways to juggle patient care with all of their other assigned tasks, such as tending to the electronic medical record.”

Melnyk, also a member of the National Academy of Medicine’s Action Collaborative on Clinician Well-being and Resilience, said health care providers are experiencing burnout — described as exhaustion, a low sense of personal accomplishment and cynicism — at epidemic levels nationally.

“Clinician burnout, depression and compassion fatigue,” she said, “decrease the quality of life in those affected as well as negatively impacting the quality and safety of health care.”

Helping nurses manage stress

Nurse and researcher Christa Newtz developed a program to help nursing students manage stress but found it had useful applications for self-care that could be shared with nurses and broader populations.

“The stress I was seeing in students and the knowledge of what was happening in my profession tell us that nurses are not healthy. I wanted to do something,” Newtz said. “A program where self-care was part of the norm from the beginning that would change wellness in the end.”

Clinician burnout, depression and compassion fatigue decrease the quality of life in those affected as well as negatively impacting the quality and safety of health care.

Bernadette Melnyk, College of Nursing dean

Banding Together for Wellness is an online, self-paced program centered on the nine dimensions of wellness embraced at Ohio State. Participants set personal wellness goals — everything from setting up the financial wellness goal of creating a budget to connecting with friends to satisfy their emotional wellness — and, in some cases, are provided resources on campus to achieve them.

The program started in 2016. Faculty expected about 50 students to participate; more than 100 did. Among that group, 64 percent participated fully and completed the program. Newtz is looking at ways to study the cohort further, as these nurses move forward in their profession.

Banding Together for Wellness has been expanded to the university’s employee health and wellness program and could be applied across the university in coming years.

“Evidence shows that for every dollar invested in worksite wellness, there is typically a return of $4 in reduced health care costs, higher engagement, improved productivity and lower absenteeism,” said Melnyk, the university’s chief wellness officer. “Ohio State is reaping the benefits of (its) wellness (programs) in multiple ways. … There have been improvements in population health outcomes.”

Finding solutions for caregiver burnout

Meanwhile, Melnyk continues to work with health care leaders on a national level to find solutions for clinician burnout.

In 2018, Ohio State’s seven health science colleges and College of Social Work hosted the Inaugural National Summit on Promoting Well-being and Resilience in Healthcare Providers, where national health care leaders presented evidence-based practices along with research and innovations to improve outcomes and create cultures of well-being.

The two-day summit was a success, bringing together health care professionals and students to talk about why their mental and physical well-being matters. The next summit takes place in 2020.