Michigan nurses’ burnout is a health emergency, study says

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Christopher Friese is with the University of Michigan School of Nursing.

University of Michigan

Christopher Friese is with the University of Michigan School of Nursing.

Capital News Service

LANSING — Michigan’s registered nurses overwhelmingly feel burnout from their work, according to a new study.

Researchers at the University of Michigan found that almost 94% of those surveyed reported feeling “significant exhaustion” in relation to their jobs.

“Deficits in registered nurses’ well-being constitute a public health emergency and warrant a comprehensive, multilevel response,” said the study which was based on responses from 13,687 nurses.

Nearly 10% of those who responded said they had experienced thoughts of self-harm. 

Nurses’ mental health is at risk due to heavy workloads, poor working conditions and long hours, the study said.

The study noted that the suicide rate for female nurses is “notably higher” than for female physicians and American women overall.

Christopher Friese, a nurse practitioner and one of the authors of the study, said he identified a need for the research after realizing health leaders’ messaging that the health industry was in recovery after the COVID-19 pandemic and would “get back to normal” didn’t reflect how nurses actually felt.

“There was this sort of disconnect from what I was hearing from my colleagues who were practicing nurses, and what I was reading from health care leaders,” he said. “I wanted to make sure that the voices of the nurses who are practicing were able to be heard.”

He also said he disagrees with the notion that burnout among nurses was entirely a result of the COVID-19 pandemic. 

“Our work has shown that nurses have been dissatisfied with their working conditions for about a decade before this,” he said. “COVID made things much worse, but it’s not the root cause of this burnout problem we’re facing.”

Friese said the root cause is the culture surrounding nursing and the notion that the patient should always come first. 

“It’s part of the culture to put your personal stuff aside to care for the patient in front of you, and, obviously, a professional needs to do that,” he said. “But we’re also saying, ‘Make sure nurses take time to take care of themselves as well.”

“It’s the old airplane analogy: You have to put your own mask on first before you help somebody else,” he said. 

Friese said while legislation aimed at improving staff-patient ratios and increasing benefits for nurses could help mitigate burnout, it’s largely the responsibility of health care administrators to listen to their employees and respond to their concerns. 

That was made clear by the comments that survey respondents left, Friese said. 

“We heard repeatedly that nurses do not feel like their employers are listening to them,” he said. 

Matthew Budd, the deputy health officer at the Jackson County Health Department, echoed that sentiment.

“I don’t think it’s very common for organizations, at least that I’m familiar with, to ask the nurses directly if they’re feeling burnt out,” he said. 

But he said he thinks health care administrators have started to recognize that the role of nurses has become more stressful, especially as scrutiny of the decisions by federal public health bodies like the Centers for Disease Control and Prevention trickles down to nurses themselves. 

“Nurses are thought to be experts in anything health care related and thought to be experts as soon as the breaking news comes out regarding updates,” he said. 

“They’re supposed to know and absorb it and be able to relay that to the public. 

That has been an additional stressor on nurses in the last few years,” Budd said.

Kathy Marble, the chief nursing officer at E.W. Sparrow Hospital in Lansing, said she oversees 2,000 nurses, and tries to listen to their concerns as much as possible. 

“I’ve had two separate conversations with nurses this week about things that they’re experiencing in their unit,” she said. “That’s what they’re looking for, someone to listen to them.”

She also said she’s working to involve nurses in conversations with administrators about best practices in the hospital.

“Having a voice in your practice matters,” she said. 

Another stressor, Marble said, is increasing hostility and violence from patients. 

“A lot more violence is happening within the walls of our hospital,” she said. “We did not used to have the threatening, bad behavior of patients that we’re seeing today, and we don’t want that to become commonplace like this is just part of the job.”

But she’s proud of the work Sparrow Hospital has done to protect nurses, she said. 

Nurses who feel threatened at the bedside can call a Code BERT, which stands for Behavioral Escalation Response Team. A security officer, nursing leader and physician are then called to the room to help de-escalate the situation, she said.

The U-M study also found that younger nurses reported higher rates of burnout than their older colleagues, a finding which Friese said is concerning for the future of the profession.

However, Deana Hays, the undergraduate director of Oakland University’s nursing program, said the unique educational opportunities for student nurses offer a reason to be hopeful.

One example, Hays said, is simulation training in which student nurses respond to situations and are evaluated on their decision-making, preparedness and overall competency. 

“​​We’re able to simulate those kinds of high-paced, high-stress situations for students,” she said. 

While Hays said she admires the fact that younger nurses are “not afraid to express if they have a work environment that’s stressful,” she wants them to understand that change in the profession will take time.

“We have a great generation that can improve health care, but we need them to stay in the profession to do that and to continue to try to drive those changes in a positive way,” she said. 

The U-M study appeared in the American Journal of Public Health.

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