EPS 133: Daniel Diaz

02/14/18 • 24 min

Your Next Shift: A Nursing Career Podcast

Nurses, ready for a supportive, fun, and innovative episode? You’re in the right place! This next podcast will leave you with thoughts to contemplate and actions to take. And trust me- hearing a story about how this guest overcame his tremendous public speaking fear on a stage in front of executives- you’ll definitely be motivated to make that shift happen!

Daniel Diaz RN, BSN is a former operating room nurse, that became Director of Operations at Clipboard Health, a venture-backed tech startup company.

A few take aways from our interview with Daniel Diaz RN, BSN include:

How sitting around alone at the ICU nurses station influenced a nursing career;
What assessing and managing your fear can do for your nursing success;
And why leveraging one opportunity can ripple out to multiple nursing achievements!

Daniel Diaz RN, BSN is a former operating room nurse, that became Director of Operations at Clipboard Health, a venture-backed tech startup company.

A few take aways from our interview with Daniel Diaz RN, BSN include:

How sitting around alone at the ICU nurses station influenced a nursing career;
What assessing and managing your fear can do for your nursing success;
And why leveraging one opportunity can ripple out to multiple nursing achievements!

Previous Episode

What’s the Definition of Nurse Burnout?

WHAT IS THE DIFFERENCE BETWEEN BURNOUT AND NORMAL STRESS?

Stress is common. It’s a normal aspect of modern life. It’s nearly constant for a nurse on the job. With stress an ever-present condition for every practicing nurse, how can you tell the difference between the “normal” stress of practicing nursing and burnout?

Before we get to that simple answer, let’s remember that stress is not always a bad thing. Without an appropriate amount of stress and challenge, the average human lapses into boredom and inactivity. The stress and responsibility of caring for patients is part of the motivation to do your best in every case. The perfectionism it inspires is a good thing for the patient. However, too much of that good thing is bad for the nurse.

So, what is the difference between the normal stresses of the healthcare workplace and the syndrome of burnout? It’s really important that you and I get on the same page here in regards to this critical distinction.

Burnout is not about what is happening to you.

The difference between burnout and normal stress is not the nature of the external events that you find stressful. What one person finds to be stressful, a different person would experience as stimulating, exciting, and even fun. Everyone’s situation is unique.

Burnout is about whether or not you can cope with the things you find stressful.

The difference between simple stress and burnout is your ability to respond to and recover from the energy drain caused by the things that stress you out. Here’s a simple definition of nurse burnout.

With normal stress . . .

. . . You are able to recover with time off. You are able to maintain “energetic homeostasis.” You can recover your energy, enthusiasm, and drive with adequate rest. Your energy may be higher some days and lower on others. You notice the day-to-day fluctuation in your energy levels; however, you don’t feel overwhelmed or incapable of recovery from week-to-week.

With burnout . . .

. . . You are unable to recover. Your energy enters the pattern of a relentless downward spiral. There comes a time when you notice you are not bouncing back, and you dread heading back into work. In most cases, a person suffering from burnout will eventually say something like, “I’m not sure how much longer I can go on like this.”

The only reason burnout rates can hover in the 30 percent range for decades and not destroy the profession of nursing is because we’ve been work-hardened to tolerate this energetic drain. Let’s face it: our training is a gladiator-style survival contest. We are conditioned to be able to cope with burnout better than all but a handful of other service-oriented professions—law enforcement and active duty military come immediately to mind. We will talk much more about this below when we discuss the pathophysiology of burnout.

This high-level overview will make one thing obvious. If you are burned out or headed in that direction, there is something about the stress of your job and the things you do now to recover that are not working. You are leaking energy and not replenishing it, like a boat with a hole so large that bailing as fast as you can does not keep you from sinking.

This is why a vacation, sabbatical or retreat will never cure burnout. Simple time away from work will only provide temporary relief. If you don’t fundamentally change how you are working by taking different actions, when you return to the workplace after your break, the excess drain begins anew. There is still a hole in your boat.

For more... check out Stop Nurse Burnout by clicking here.

So nurse beware. Watch what you are labeling stress. Next time you hear yourself stating that you just need a break. Pause and ask yourself.

Get your copy of Stop Nurse Burnout: https://elizabethscala.com/stop-nurse-burnout.

Check out the blog post that accompanies this episode here: elizabethscala.com/the-definition-of-nurse-burnout/

Next Episode

Nurse Burnout Statistics: Can We Measure and Evaluate It?

The State of the Science

While there is a lot of evidence related to physician burnout (e.g. the prevalence, rates, and consequences of), this is not the case in the nursing literature. Not that there are no articles related to nursing burnout. Trust me, there are many. But the issue relates more to the fact that the science does not tell us one story.

In fact, the numbers are all over the place!

Don’t believe me? Head over to PubMed or your favorite scholarly search engine and type in the term “nurse burnout prevalence” and see what you find. In one of my recent keynote talks, here are the studies I have on my prevalence slide:

Oncology Nurses 21.5 % (Clinical Journal of Oncology Nursing, 2010)
Nurses in England 42% (BMC Nursing, 2011)
ICU Nurses in Portugal 31% (BMC Anesthesiology, 2013)
NICU Nurses 25.9% (BMJ Quality & Safety, 2014)
Nurses in Mainland China 34.9% (Nursing & Health Sciences, 2015)
Emergency Nurses 26% (International Journal of Nursing Studies, 2015)
Nursing Homes in France 40% (Journal of Clinical Nursing, 2017)

And then there is this recent systematic review on the prevalence of burnout which outlines that burnout does exist in various roles of healthcare professionals. But again, this is just one subset (palliative care). So yes. Nurse burnout statistics are all over the place, however maybe one thing that the literature can agree upon is that it does exist.

Evidence Requires Measurable Outcome Data

The nursing studies that are published related to nurse burnout have limitations such as low sample sizes and weak study designs. If we do not have the literature to support nurse burnout, then we will not get the support from decision makers in power.

Poor studies- do data. Without the outcome measures, there are little interventions that can be put into place. Healthcare decision makers need to see the data. They are all about the numbers. Whether we like it or not, healthcare has become likened to a business. Without money, new interventions that can help alleviate nurse burnout, will not be adopted.

I do think that we can agree that nurse burnout does exist. Again, if you go to your favorite search engine and type in the term, you will receive lots of articles related to the topic of burnout in nursing.

What I also think is that we do not need any more of these smaller, specialty specific studies. The ones where the team uses the Maslach Burnout Inventory to measure burnout in nurses pre- and post- some intervention. We get it. Nurses are burned out. In all jobs, all locations, and all over the world!

Meaningful Research Across Practice Settings

While I cannot start to give advice or suggestions related to specific study design (that is not the point of this blog or the Nursing from WithinTM work), I do want to put a charge out there to anyone reading who is involved in world of scholarly work to look at nursing burnout.

We need robust evidence that nurse burnout is linked to patient safety and outcomes. Yes, process measures such as these are harder to measure and difficult to link in a one-to-one causation. For example, it is difficult to say that nurse burnout and burnout alone is what causes patients to fall (as an example), however we need study designs that do their best to look at burnout and the impact it has on patient safety and quality.

Nurse and researcher, Linda Aiken, PhD, FAAN, FRCN, RN, has published extensively on nurse and patient outcomes related to job dissatisfaction and burnout. In fact, in a 2012 article in the American Journal of Infection Control, study findings reported that “In a multivariate model controlling for patient severity and nurse and hospital characteristics, only nurse burnout remained significantly associated with urinary tract infection (0.82; P = .03) and surgical site infection (1.56; P < .01) infection.”

So, it can be done. And needs to be done more often, linking nurse burnout statistics to outcomes that healthcare administrators are interested in. Then, taken a step further.

Burnout is real. It exists and impacts nurses and patients we care about. Once we realize this, then we can start to measure the impact that we can have on nursing burnout. But again, we need to focus on implementation projects that study the barriers and facilitators to why interventions impact and relieve nurse burnout across the spectrum.

Work is to be done, but there is hope. Nurses across the world are doing great things to move the nurse burnout needle. Will you be one of them?

Get your copy of Stop Nurse Burnout: https://elizabethscala.com/stop-nur...