Dueling burnout

Abstract

Dueling burnout:The dual-role nurse T hroughout history, the nursing profession has experienced fluctuations in turnover and retention and has experienced cycles of significant nurse shortages. 1 Before the COVID-19 pandemic, nursing turnover related to burnout, moral distress, compassion fatigue, and a desire to pursue advanced degrees and travel opportunities was a concern. 2,3 The COVID-19 pandemic has intensified these factors. 4 According to the 2022 NSI National Health Care Retention & RN Staffing Report, turnover has increased by 8.5% with a national average of 27.1%. 5 In addition, hospitals have had a 95.7% RN turnover rate in the past 5 years. 5 The United States Registered Nurse Workforce Report Card and Shortage Forecast projected that in 2020 there would be a shortage of clinical nurses totaling 154,018 and an additional shortage of 510,394 by 2030. 6 The US Bureau of Labor Statistics estimates the job outlook for nursing will average 194,500 openings per year over the next decade; many to fill the spots of team members leaving the workforce for other occupations or retirement. 7 The average turnover cost for an RN is estimated to be $46,100 (with a range from $33,900 to $58,300), and the average hospital could lose up to $7.1 million per year in turnover costs. 5 The report breaks this down further and describes that each percentage point lost in nursing turnover equals $262,300 lost from the organization per year. 5 The national data are telling, and illustrate what the Cardiothoracic ICU at the author's facility in 2018 was dealing with: an all-time high level of burnout.Colbenson and colleagues describe the definition of burnout by the World Health Organization as a syndrome that develops when chronic stress isn't successfully managed. 8 Nurses in the Cardiothoracic ICU were describing sentiments in which their core values and integrity were being dishonored, causing feelings of moral distress. 9 The nurses also described compassion fatigue or a feeling of hopelessness when caring for critically ill patients. 10,11 With these compounding factors, nursing KATERYNA KOVARZH/ISTOCK

Strategies to Stay

“…Similar to the steps mentioned in the case study earlier, the standard work for the dual role includes initiative of the employee, engagement and support of the employee's current leader, and engagement and support of the destination department leader 19Figure 2 depicts the process steps of Dorsey's19 standard work for the dual role.…”

“…Strong structures and processes are imperative to guide the implementation of flexible staffing models including blended roles or shared staffing. One health system that has created a reliable model to support “dual roles” recently shared its experience at a national conference 19. This health system has created a form for standard work and process steps.…”

“…This health system has created a form for standard work and process steps. The form provides guidance for leaders and staff, while providing the structure and processes required to ensure sustainability 19. When developing the standard work practices, Dorsey19 recognized the importance of clear expectations, strong communication processes, and engagement of all key stakeholders.…”

“…The form provides guidance for leaders and staff, while providing the structure and processes required to ensure sustainability 19. When developing the standard work practices, Dorsey19 recognized the importance of clear expectations, strong communication processes, and engagement of all key stakeholders. Similar to the steps mentioned in the case study earlier, the standard work for the dual role includes initiative of the employee, engagement and support of the employee's current leader, and engagement and support of the destination department leader 19…”

“…When developing the standard work practices, Dorsey19 recognized the importance of clear expectations, strong communication processes, and engagement of all key stakeholders. Similar to the steps mentioned in the case study earlier, the standard work for the dual role includes initiative of the employee, engagement and support of the employee's current leader, and engagement and support of the destination department leader 19Figure 2 depicts the process steps of Dorsey's19 standard work for the dual role.…”