Supporting Systems to Address Clinician Burnout

National Academy of Medicine calls for action to address a crisis among clinicians.

As a nurse and researcher who has worked in the area of clinician burnout for many years, I was pleased to see attention to this issue by the National Academy of Medicine (NAM) in a recent consensus study report, Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being.

Burnout, a syndrome of “emotional exhaustion, depersonalization, and lack of personal accomplishment” (Maslach et al. 2001. Job Burnout. Annu Rev Psychol. 52: 397-422), has far-reaching and troubling consequences for health care clinicians. The problem has grown to crisis levels: estimates indicate that 35%-45% of the nearly 4 million nurses in the U.S. are experiencing symptoms of burnout, and up to 54% of our physician colleagues experience it as well.

A ‘chronic imbalance’ of job demands with available resources.

Prominent among the factors contributing to burnout are the systemic patterns that erode professional fulfillment and well-being, many of which are beyond the control of individual clinicians.  Burnout represents a chronic imbalance of job demands with resources needed to meet them.

The National Academies of Science, Engineering and Medicine (NASEM), of which NAM is a part, convened a committee to examine the scientific evidence towards understanding the scope and consequences of burnout on the […]

2019-11-04T09:34:15-05:00November 4th, 2019|Nursing|0 Comments
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Dia De Los Muertos: Thoughts On Life, Death, Nursing, and Time With Our Families

I discovered she died the way I typically learn a patient I’d navigated for died: the tiny abbreviation “dcsd” appeared next to her name on my computer’s patient list. Although her passing was not unexpected, I felt a deep sadness at the loss of her beautiful soul. From my desk, I sent a silent prayer of remembrance, and then another asking comfort for her family.

She was about the same age as my daughter, and like her, married to a devoted husband, the mother of young children. She was also an only child like my daughter, and feeling this connection, I grieved for her mother too. I wondered if there were things she would have done differently if she’d known their time together would be cut short.

Nursing doesn’t stop for the holidays.

Dia de Los Muertos. Illustration by Julianna Paradisi

We are entering the holiday season, and nurses begin scheduling their holidays off, and on. Not everyone will get what they desire. Perhaps it’s not coincidental that ringing in this season is the Latino celebration, Dia De Los Muertos (Day of the Dead, Oct. 31-Nov. 2), which is not only […]

2019-10-30T09:58:35-04:00October 30th, 2019|Nursing, nursing career|0 Comments
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Informing Policy, Driving Change: No Longer Optional for Nurses

Nurses have the knowledge, skills, and obligation.

Rep. Lauren Underwood, left, with AAN president Karen Cox

The American Academy of Nursing (AAN) kicked off its annual policy conference last week by honoring Rep. Eddie Bernice Johnson, (D-TX), the first registered nurse elected to Congress, and hearing from the nurse most recently elected to the House, Rep. Lauren Underwood, (D-IL). Their presence underscored a viewpoint that is gaining traction in prominent circles, from the World Health Organization to the National Academy of Medicine: Nurses have the knowledge, skills, and obligation to inform policy and drive change.

During her talk, Underwood laid out her policy priorities and expressed her fervent belief that for nurses, “engaging in policy is not optional.”

Underwood serves on three House committees—Veterans’ Affairs, Homeland Security, and Education and Labor—and within those on subcommittees dealing with emergency preparedness, disability assistance, and other topics where she uses her health expertise to influence policy on a range of issues. These include gun violence prevention, black maternal health, infant mortality, drug pricing, and suicide among veterans.

A data-driven approach.

Underwood’s approach to policymaking is data driven. Prompted by research on medication adherence, she sponsored a bill to allow veterans to receive a full-year’s supply of contraceptives rather than having to refill their prescriptions every three months.

When asked about […]

2019-10-29T15:50:34-04:00October 29th, 2019|Nursing, nursing perspective, nursing roles, Public health|0 Comments
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November Issue: Chronic Pain and Opioids, CVDs in Pregnancy, Preventing Patient Self-Harm, More

“[S]eeing this patient, his return, his presence, his enduring love, was a gift. Because some days in health care, you don’t really know what hope you are fighting for or for whom.”—Hui-Wen (Alina) Sato, author of the November Reflections column, “Beholding the Returning Light”

The November issue of AJN is now live. Here’s what’s new:

CE: Implementing Guidelines for Treating Chronic Pain with Prescription Opioids

An overview of five tools outlined in the CDC’s 2016 opioid safety guideline—prescription opioid treatment agreements, urine drug screening, prescription drug monitoring program databases, calculation of morphine milligram equivalents, and naloxone kits—and their relevance to primary care nurses.

CE: Gestational Hypertension, Preeclampsia, and Peripartum Cardiomyopathy: A Clinical Review

The authors discuss three of the most common pregnancy-specific cardiovascular diseases and their risk factors, prevention, assessment, and management.
[…]

2019-10-28T10:00:42-04:00October 28th, 2019|Nursing|0 Comments
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Revising Protocols in the Midst of Disaster Response

Refining an unsuccessful triage process.

Health care moves at such a rapid pace these days that quality improvement (QI) seems to be never-ending. We know these projects can help us to better our care, but it sure does become tiring when yet another new protocol or data responsibility falls on our shoulders. What if you were tasked with an urgent QI project in the midst of responding to a disaster?

Considering our own repeated scrambles to squeeze QI into ordinary workdays, imagine what it would be like to manage QI in a setting of extremely limited resources, where many people were desperate for emergency services—and you had to “get it right,” ASAP.

In “Implementing a Fast-Track Team Triage Approach in Response to Hurricane Maria” (free until November 15), Brittany Parak and colleagues describe their efforts to improve emergency services after their mobile military hospital was deployed to Puerto Rico, just 16 days after Hurricane Maria devastated the island.

“We soon discovered it would be necessary to refine our triage process, as our initial strategy resulted in limited access to care, prolonged wait times, many people leaving without being seen, and patients with acute problems not being cared for in a timely manner.”

2019-10-24T10:04:30-04:00October 24th, 2019|Nursing, Public health|0 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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