Reality shock redux.

Flickr / Harshit Sekhon

It seems to me that we’ve been talking about burnout about as long as I’ve been in nursing, and that’s over 40 years. In 1974, Marlene Kramer’s book Reality Shock: Why Nurses Leave Nursing reported on how nurses’ dissatisfaction with their inability to practice as they were taught was a major factor in their leaving the profession. (Here’s AJN’s 1975 review of the book.) In the 1980s, it was the downsizing of staff that caused many to leave (see the February editorial for my own experience). In the last decade, as health system changes and staffing (again) engendered moral distress and burnout among members, nursing organizations sought ways to mitigate distress among nurses.

Burnout’s persistence as an issue.

But the issue persists and arguably has gotten worse, with increasingly alarming reports of high levels of burnout—between 34% and 54% physicians and nurses report symptoms—and suicides.

To address the problem, the National Academies of Science, Engineering, and Medicine (NAM) established a 17-member committee to review the research on the causes and effects of clinician burnout and to develop “recommendations on designing systems to reduce clinician burnout and foster professional well-being.”

The resulting report, Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being, notes:

“Clinician burnout is bad for both clinicians and patients. Emotional exhaustion, depersonalization, and loss of sense of professional efficacy—the three dimensions of burnout—are detrimental to quality of care.”

The report calls for immediate action. We summarize the finding of the reports in our February issue—see “Restoring a Burned Out Workforce,” which is free to read.

Free March 25 webinar on burnout.

Two nurses were on the NAM burnout committee: Cynda Hylton Rushton, PhD, RN, FAAN, the Anne and George L. Bunting Professor of Clinical Ethics in the Berman Institute of Bioethics and the School of Nursing at Johns Hopkins University in Baltimore, and Sharon Pappas, PhD, RN, NEA-BC, FAAN, is the chief nurse executive for Emory Healthcare. Both will discuss the report and its implications for nursing in a free webinar on Wednesday, March 25, from 3pm to 4pm (Eastern). Click here to register.

For additional information on moral distress, burnout, and promoting resilience, see the following:

Moral Distress: A Catalyst to Building Moral Resilience (July 2016)

State of the Science Initiative: Transforming Moral Distress into Moral Resilience in Nursing (Special report, February 2017)