Worker burnout is a perennial obstacle to providing effective and uninterrupted service in any industry—no less so in nursing.
Using Marion Conti-O'Hare’s model of the Nurse as Wounded Healer, we have constructed a series of organizational strategies to address nurse burnout. These strategies will be hospital-wide initiatives that serve as a support structure to nurses struggling with burnout through: 1. Access to counseling by trauma counselors. 2. Bi-weekly visits by trauma counselors to the floor. 3. Self-care programs. 4. Team-building activities. |
By acknowledging the severity of burnout in the nursing profession, we validate the nurse’s experience; this is the first step in treating the problem.
1. Access to trauma counselors
These counselors will be full time staff at the hospital and will be trained in common causes of nurse burnout, trauma, recovery, and the NWHT.
These counselors will guide the nurse through Conti-O’Hare’s QUEST tool. QUEST stands for Question, Uncover, Experience, Search for meaning, Transform, and Transcend (Conti-O’Hare, 2002a).
QUEST is a guide to self-reflection. It asks first the question: “How has trauma affected my life?” It then seeks to uncover patterns by asking, “What can I remember about the major instances or patterns of my personal or professional trauma?” Once the trauma has been identified, the nurse can fully experience it by asking the question “What are my feelings about these events or patterns?” Honestly admitting, addressing, and owning these emotions, no matter how furious or mournful, is a painful but invaluable part of the process. It leads us next to the search for meaning: “what do these feelings and experiences mean to me?” The search for meaning is the key step that leads to Transformation and Transcendence, and is where the healing occurs. Oftentimes, trauma seems senseless and meaningless, which increases the pain it inflicts on the soul. Facing that pain, surviving through it, and searching for the meaningful role that trauma has played in the narrative of life will help the nurse transcend their wounds and change his or her worldview. Once this step has been reached, transcendence to the Wounded Healer has occurred! |
Question
Uncover Experience Search for meaning Transformation and Transcendence |
2. Biweekly visits by trauma counselors
to the floor
During these biweekly visits, the counselors can can meet with nurses who might otherwise not be able to visit the counseling office. The nurse manager will provide the visiting counselor with a private space in which to conduct these meetings and will also excuse nurses from their duties for 30 minutes at a time to allow them the opportunity to speak with the counselor.
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This is not a journey one should take on their own. Nurses need social support to be successful in this process. The charge nurse, nurse manager, and hospital administration will need offer their full support to this initiative by giving struggling nurses the time and space to see a counselor at the hospital.
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3. Self-care programs
Self-care programs are another key aspect to this initiative. They will be created in partnership with the floor and tailored to each floor's unique needs. During each quarterly staff meeting, the nurses will not only discuss issues on the floor that cause stress, but they will also design a self-care program with the help of their nurse manager. Funds for these programs will need to be worked into the yearly budget.
The programs can focus on different aspects of care. For example, one program can focus on healthy snacking and remaining hydrated during the 12 hour shift. Other programs can focus on mental wellness through meditation, spirituality, and self-reflection (using the QUEST model as a guide). Exercise is an essential part of self-care and these programs can educate nurses on the importance of staying active, building core strength, and improving flexibility through activities like yoga, weight training, jogging, sports, and dance. The “healthy body” self care program should integrate technology like fitbits and apps, and motivational techniques such as floor-wide competitions with incentives.
The programs can focus on different aspects of care. For example, one program can focus on healthy snacking and remaining hydrated during the 12 hour shift. Other programs can focus on mental wellness through meditation, spirituality, and self-reflection (using the QUEST model as a guide). Exercise is an essential part of self-care and these programs can educate nurses on the importance of staying active, building core strength, and improving flexibility through activities like yoga, weight training, jogging, sports, and dance. The “healthy body” self care program should integrate technology like fitbits and apps, and motivational techniques such as floor-wide competitions with incentives.
4. Team Building Activities
Team-building activities will be led in-part by nurses who have undergone QUEST counseling and are functioning as wounded healers on the floor.
As a wounded healer, the nurse is now able to help others. If we assume that some nurses will overcome burnout, we may regard, echoing Conti-O'Hare’s assumptions, that some of the same nurses will have an enhanced ability to therapeutically address burnout and wounds in other sufferers. These nurses can be given leadership roles in team-building activities on the floor, so that they can influence and encourage their fellow nurses.
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