New research has linked nurses' long work shifts with job dissatisfaction and a greater risk of quitting.
Annette Tersigni decided at the age of 48 that she wanted to make a difference. She attended nursing school and became a registered nurse three years later. “Having that precious pair of letters — RN — at the end of my name gave me everything I wanted,” she writes on her website. Before long, Tersigni discovered the rewards — as well as the physical and emotional challenges — that come with nursing.
“I was always stressed when I worked, afraid to get sued for making a mistake or medical error,” says Tersigni, who was working in the heart transplant unit of a North Carolina hospital. “Plus, working the night shift caused me to gain weight and stop working out.” Tersigni moved to another hospital, but the long shifts continued. Three years later, she left her job.
Tersigni’s experience isn’t unusual. Three out of four nurses cited the effects of stress and overwork as a top health concern in a 2011 survey by the American Nurses Association. The ANA attributed problems of fatigue and burnout to “a chronic nursing shortage.”
The good news is that enrollment in bachelor’s, master’s, and doctoral nursing programs is up, according to data released last year by the American Association of Colleges of Nursing (AACN). In a 2015 Gallup poll asking Americans to rate the honesty and ethics of various professions, nurses ranked highest — for the 14th straight year. Still, the American Journal of Medical Quality has projected a shortage of registered nurses to spread across the country by 2030.
Work schedules and insufficient staffing are among the factors driving many nurses to leave the profession. While 12-hour shifts are increasingly common among hospital nurses, a 2015 study found that such long shifts can have adverse effects.
According to the research published online in BMJ Open, shifts lasting 12 hours or longer were associated with a 40 percent greater level of job dissatisfaction and a 31 percent higher risk of planning to quit. "Job satisfaction and burnout in the nursing workforce are global concerns, both due to their potential impact on quality and safety of patient care and because low job satisfaction is a contributing factor associated with nurses leaving their job and the profession," the study reads.
Deborah Burger, RN, co-president of the union and professional association National Nurses United, doesn’t believe that long work shifts tell the whole story. “Most people can work a 10- or 12-hour shift if they’ve got the right support and right level of staffing,” Burger says.
“In order for nurses to feel satisfied and fulfilled with their work, the staffing issues must be seriously addressed from a very high level,” says Eva Francis, a former nursing administrator. “Nurses also need to be able to express themselves professionally about the workload, and be heard without the fear of threat to their jobs or the fear of being singled out.”
A 2014 study suggests that nurses’ burnout risk may be related to what drew them to the profession in the first place. Researchers at the University of Akron in Ohio surveyed more than 700 RNs and found that nurses who are motivated primarily by the desire to help others, rather than by enjoyment of the work, were more likely to burn out.
“We assume that people that go into nursing because they are highly motivated by helping others are the best nurses,” says study author Janette Dill, PhD, assistant professor of sociology at the University of Akron. “But our findings suggest these nurses may be prone to burnout and other negative physical symptoms.”
That finding doesn’t surprise Jill O’Hara, a former nurse from Hamburg, New York, who left nursing more than a decade ago.
“When a person goes into nursing as a profession, it’s either because it’s a career path or a calling,” says O’Hara. “The career nurse can leave work at the end of the day and let it go, but the nurse who enters the field because she is called to it takes those emotionally charged encounters home with her. They are empathetic, literally connecting emotionally with their patients, and it becomes a part of them energetically.”
Besides driving many nurses out of the profession, burnout can compromise the quality of patient care. A survey of Pennsylvania hospitals found a “significant association” between nurse burnout and increased infections among patients. The authors’ conclusion: A reduction in burnout is good for nurses as well as patients.
So what can be done? O’Hara thinks the burnout issue should be addressed early on, when future nurses are still in school. “I honestly believe the way to truly help nurses avoid burnout is to begin with a foundation of teaching while in school that stresses the importance of knowing yourself,” she says. “By that I mean your strengths and weaknesses. It should be taught that self-care must come first.”
Burger stresses the importance of taking regular breaks on the job. “If you’re not getting those breaks or they’re interrupted, then you don’t have the ability to refresh your spirit,” she says. “It sounds hokey, but it is true that you do need some brain downtime so that you could actually process the information you’ve been given.”
Tersigni went on to work part-time at a local hospital, specializing in the health and well-being of other nurses. She founded Yoga Nursing, a stress-management program combining deep breathing, quick stretches, affirmations, and relaxation and meditation techniques. “All of these can be done anytime throughout the day,” Tersigni says. “I even teach nurses to teach these to their patients. So the nurse breathes, stretches, and relaxes, while also teaching it to the patient.”