Nurses and nurse assistants get into the healthcare field because it is a calling. They hope to promote healing and comfort the sick. Part of being a caregiver is dealing with loss. This happens frequently, especially for those who work in senior care. Over time, senior care nurses and assistants develop a strong nurse-patient bond. They become almost like family. Therefore, following the loss of a patient, nurses need to deal with grief, loss, and burnout just as friends and family do.
What is Caregiver Burnout Like Among Nurses?
Nurses and nurse assistants, obviously, are caregivers. However, many don’t recognize that caring for patients can affect them mentally and emotionally. Some may assume that since it’s “part of the job”, nurses and nurse assistants are experts in dealing with burnout and grief. Unfortunately, this couldn’t be further from the truth.
Caregiver burnout is the emotional, mental, and physical exhaustion that occurs when caring for others. Basically, it’s like a battery that is running out of juice. Caregivers who are experiencing burnout may feel depression, anxiety, fatigue, and even physical ailments such as pain or illness. They may notice symptoms such as sleep disturbances, irritability, weight/appetite changes, and lack of interest in things that they usually enjoy.
There are a few different reasons why nurses experience burnout.
One reason is feeling that they have a lack of control in patients’ outcomes. It’s extremely upsetting when one gives all they have to care for others, and patients’ health still deteriorates and sometimes pass away. They try endlessly to foster their patients’ health and well-being, and unfortunately, it’s not always successful. For example, when caring for an older patient with dementia, especially for a long period of time, nurses witness the inevitable deterioration in memory. While a patient may have once recognized the nurse, it’s upsetting when this ceases to be the case. The nurse may feel that he/she invested so much time and emotion in caring for the patient, only to experience pain and sadness when the patient no longer remembers who they are.
Another reason burnout occurs is due to long-term stress in a high-demand job. Continuous interaction with others, balancing a multitude of tasks, being faced with constant decision-making, and the physical demands that nurses and nurse assistants experience lead to an almost chronic state of stress. This, in turn, leads to burnout. When providing caregiving responsibilities for their elderly patients, they need to sometimes physically mobilize, assist with feeding, and even toileting. This can take a toll on healthcare workers’ physical, emotional and mental health.
Prevalence of Caregiver Burnout Among Nurses
There are limited studies on caregiver burnout among nurses and other healthcare workers. However, in an article published by the Joint Commission, some surprising results led the Joint Commission to issue an advisory on combating nurse burnout with resilience. As reported by the Joint Commission, 15.6% of nurse respondents report burnout. Also, only 5% of respondents report that their organization was effective in addressing burnout. In other words, these healthcare workers who feel burned out are not getting the support they need to safely care for patients.
What does this mean for patients? Having nurses and nurse assistants who feel burned out (i.e., depressed, irritable, anxious, lack of interest, working on little sleep) may lead to medical errors and other safety concerns for the patients they care for.
Stages of Grief
Nurses and nurse assistants are human, and it’s human to form bonds and relationships with others. It’s also human to grieve for others when the relationship is severed, whether it’s from death or physical separation. While some may think death and dying is “part of the job” for nurses, grief is a primal emotion that one can’t simply turn off. Following a loss, healthcare providers can feel all the stages of grief that a family member does. The following is an example of the emotions a nurse or nurse assistant may experience following the loss of a senior patient:
Denial: “Mrs. Smith couldn’t have passed away – I just took care of her yesterday and she was fine!”
Anger: “It’s not fair that Mrs. Smith passed away! We were supposed to work on a craft project together!”
Bargaining: “If only I would have paid more attention to Mrs. Smith, I might have noticed something was wrong. From now on, I’m going to pay attention to every single detail, so I won’t lose another patient.”
Depression: This is an appropriate response to a loss of a patient and is completely normal for nurses and nurse assistants. Depression following a loss is NOT considered a mental illness. Rather, it’s a normal stage of grief. However, if the depression is prolonged and begins to interfere with one’s practice or home life, one should seek out professional help.
Acceptance: Acceptance does not mean everything is okay. It means the nurse has accepted the fact that he or she has lost a patient, and the nurse will always hold a spot in his or her heart for that patient. An example of acceptance might be: “I’ll really miss spending time with Mrs. Smith. But I know she lived a long, fulfilling life and I will always remember her.”
Tips To Manage Caregiver Burnout and Grief For Nurses
Burnout and grief can be incredibly difficult to get through. However, there are ways nurses, nurse assistants, and other caregivers can manage the emotions that come with caring for seniors. Some tips include:
1. Take a break.
Sometimes just being able to take a vacation day or two (or more) can help recharge the brain to be able to care for others. Keep an eye out for the warning signs of caregiving stress to avoid emotional and mental exhaustion. Giving oneself time to relax and reflect can do wonders. When a nurse loses a patient, he or she may need a day or two to come to terms with the loss. Many employers are sensitive to this and try to accommodate the need for a break after a loss.
2. Find an outlet.
Nurses and nurse assistants should find a hobby or something they enjoy and plan to spend time doing it. The key to this is to make sure it’s a healthy outlet. Exercise, meditation, reading, traveling, gardening, and crafting are examples of a healthy outlet. When feeling burned out, hobbies help recharge the mind.Exercise. While exercise is sometimes the last thing a caregiver wants to do when feeling stress, it’s actually a fantastic stress-reliever. Exercise releases hormones such as endorphins, serotonin, and dopamine, all which promote the feeling of happiness. It doesn’t need to be anything too vigorous, just getting moving will help relieve caregiver stress.
3. Find support.
Sometimes it helps to talk about stress and loss. Regular “venting” gets feelings and emotions out into the open. Doing so with a spouse, friends, or coworkers is a great stress reliever. Also, talking about stress with those who understand caregiver burnout and loss is extremely helpful. Finding a support group might help.
4. Do something relaxing.
Taking a bath, listening to music, getting a massage, and doing yoga or meditating is a great way to deal with burnout and grief. It helps one look within and come to terms with the feelings associated with caring for or losing a senior patient. Take a look at an example of a program a hospital hosts to give their healthcare staff ways to cope with emotional fatigue and stress:
5. Take care of the body as well as the mind.
Proper nutrition and sleep are also crucial. Lack of sleep, for example, may cause the mind to become unfocused, which can lead to errors and higher levels of stress and burnout. Doing something relaxing before going to bed can help facilitate sleep, as does meditation. Avoiding TV, computer work, and other screen time before going to bed is also important.
6. Seek professional help.
Sometimes, no matter what nurses or nurse assistants try, burnout and grief cannot be managed independently. One should always remember that it is absolutely okay to reach out for professional help. In fact, it is often encouraged by employers when self-care isn’t working. One needs to be open and honest with themselves as well as their employer when dealing with burnout and/or grief.
Caring for seniors can be challenging as well as physically and emotionally draining. However, it is also very rewarding. Senior patients have fantastic stories to tell about their lives and the past and are often extremely skilled in the art of conversation. Senior patients grew up in a time where less technology meant more human interaction, helping to facilitate strong interpersonal relationships. Nurses and other healthcare workers are lucky to have the chance to form these strong relationships with their patients!
Explore The Caring Blog for more resources for caregivers and seniors.
Written by: Amanda Bucceri Androus RN, BSN
