Emotional Exhaustion in Nursing and the need for Self Care

Roberta Heale, Associate Editor EBN,  @robertaheale @EBNursingBMJ

EBN has just published an interesting commentary “Personality and interpersonal behaviour may impact on burnout in nurses” found here: http://ebn.bmj.com/content/ebnurs/early/2017/11/18/eb-2017-102797.full.pdf

The study as the basis for this commentary used the Maslach Burnout Inventory as one of the research tools. The research tool incorporates three concepts two of which are depersonalization and personal accomplishment. However, the third concept from the article and this tool stood out for me and it was Emotional Exhaustion.

Emotional Exhaustion is defined by the MBI authors as “feelings of being emotionally overextended and exhausted by one’s work” http://www.mindgarden.com/314-mbi-human-services-survey

Burnout in nursing is not a new phenomenon. There has been awareness of burnout since I began my career…more years ago than I care to say! Burnout has been researched, measured and discussed at length…so why does it continue to be endemic within nursing? I’ve witnessed it in the practice of my colleagues and heard it in their voices when they spoke about work. It permeated their entire lives.

The concept of emotional exhaustion resonated most clearly with me. I know that emotional exhaustion was a factor in my decision to become a nurse practitioner and leave work in the acute care, hospital setting. I remember articulating at the time that I had to find something in nursing that I could tolerate, or I had to leave it and find a completely different career. Although other concepts of burnout played a role, it was emotional exhaustion…completely emotionally drained from the burden of caring, that was the primary issue for me.

Recommendations arising from the EBN commentary identify both individually-directed and organizationally-directed strategies. These are indeed necessary in addressing burnout, however, there is also the need for nurses to monitor themselves and put plans in place to mitigate the extent of emotional exhaustion.

The term ‘self care’ has been touted as one remedy for stress and burnout. Self care should be the foundation of all strategies directed at emotional exhaustion and burnout in general. Even if nurses aren’t able to impact organizational policy, for example, they are definitely able to impact their own responses to the stresses of their work life. Self care is part of nursing education programs and, hopefully, is a concept that is widely discussed among nurses.

However, just what is self care? Is it enough to schedule in distractions from the issues at work such as to start an exercise program or take a ‘mental health day’ once in a while? The following article points out that the ultimate goal of self care is to make the choice not to build a life you need to regularly escape from.

https://thoughtcatalog.com/brianna-wiest/2017/11/this-is-what-self-care-really-means-because-its-not-all-salt-baths-and-chocolate-cake/

How can this be achieved in the day-to-day work environment of nursing, in order to avoid burnout? The answer is different for every person. However, regardless of the approach, nurses who build in self-care that helps them avoid emotional exhaustion takes work. It’s not a passive exercise. The first step is to acknowledge the risk of burnout and then to actively seek out resources and strategies that help to avoid falling into the burnout trap.

Nurses need help with mitigating burnout. Just like campaigns for reducing the numbers of people who contract influenza, campaigns against nursing burnout are warranted. Just like the flu, these campaigns need to be updated and re-distributed annually. Part of this campaign should be to fortify individuals with the tools they need for effective self-care strategies to assist them in avoiding burnout, especially emotional exhaustion.

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