The Making of a Leader

“A leader is someone who has a sense of what is right and has that at the heart of everything they do.”
All you have to tell me is that you are a nurse, and I already know you have leadership skills. Every nurse has leadership skills. You manage other members of the healthcare team, you cause others to act, and you facilitate positive outcomes.”
This is what I told a woman who approached me during a break while I was presenting a seminar for nurses several years ago. As she walked toward me, I noticed her head was down, her shoulders were slumped, and her facial expression, from what I could see of it, was strained. She began to speak, and her voice was barely audible. “I want to get into a particular specialty,” she started. “Someone told me I need leadership skills for that. I don’t have leadership skills,” she said emphatically, obviously distressed. “I don’t want to manage people,” she continued. “I just want to go in and do my job, solve my own problems, get the job done, and take care of business.”
I smiled as I listened to her and said, “What you just described to me are leadership skills.” With this realization, she began to slowly lift her head and straighten out her body. She looked me square in the eyes and said proudly, in a now audible voice, “You’re right. I do have leadership skills.”
In this example, it took only a few reassuring words on my part to remind this nurse of her own capabilities. But it also highlights how many of us have a tendency to underestimate our abilities and convince ourselves that we are somehow inadequate or insignificant in the scope of things. Every nurse has leadership potential that can be, and should be, fostered and developed.
What Makes a Good Leader?
Leadership is the ability to take charge of a situation, to assess problems, and to facilitate solutions. Effective leaders have high regard for others, see the best in those around them, and have a way of making others feel good about themselves. A good leader possesses certain knowledge and skills and feels confident in that knowledge. Leaders have a sense of what is right and keep that at the heart of everything they do.
Leadership is not about telling others what to do. Rather, it is about inspiring others to be their best. It is about giving those around you a sense of what needs to be done and the desire to do it. It is about supporting every member of the team and recognizing another’s efforts. An integral part of effective leadership involves the ability to listen and hear what others have to say and to allow an opportunity for those thoughts and ideas to be put into action.
Just because someone is a manager does not automatically make him or her a good leader. While “manager” is a title, “leader” is an attribute. Good leaders are not born; they are developed through experience, studying, mentoring, and a basic desire to be the best they can be.
How To Set Your Sights on a Leadership Role
Although every nurse has leadership capabilities, there are certain ways to hone those skills and work toward a formal position of leadership within an organization.
1. Look for role models and mentors. When you encounter people whose leadership style you admire, take some time to observe how they deal with others. What is it about them that you admire? What makes them stand out? Spend a little time talking with them, if possible. Ask them what they believe makes a good leader.
2. Seek out challenging assignments. Ask for projects that will give you the opportunity to develop your communication skills, negotiating skills, and managerial skills. Volunteer to work as a preceptor, to take occasional charge, or to manage a group project. Personal and professional growth comes, in part, by challenging yourself. It also builds confidence, keeps you interested and excited about your work, and helps you to become more self-aware. These are all leadership characteristics. Be sure to ask your supervisor for feedback and constructive criticism, too, so you can continue to grow.
3. Get active in professional associations. Get on committees and run for office. This is a great way to develop your leadership capabilities. Years ago, I volunteered to chair the education committee of an association I belonged to. I had to learn how to motivate a group of people, delegate tasks, and speak in a diplomatic and tactful manner — never one of my strong points. But as with anything else, the more you practice and the more experience you gain, the better, and more humble, you are likely to become.
Involvement in professional associations also gives you the opportunity to observe other leaders in action, find a mentor or be one, and take part in leadership training courses. It provides the professional support you need to be successful in the workplace. Professional associations are excellent breeding grounds for good leaders.
4. Do some reading. A while back, when I became president of a local association of women business owners, I dreaded running board meetings for a large group of very strong and opinionated women. I went to the library and looked for books on leadership and management. Even though I had been a manager in several healthcare settings, I felt I had a lot to learn and was determined to be a good leader. I made a study of how to run an effective meeting, principles of group decision-making, conflict management, and how to motivate people. I picked up some great tips and practices that proved to be invaluable to me.
You Are a Leader Where You Are Right Now
Whether you have a designated title of authority in an organization or not, each nurse has the ability to influence his or her surroundings. You can, and do, have a positive impact on those around you by exhibiting leadership qualities in everyday situations. Continue to develop these qualities by showing some initiative, treating others with the utmost respect and regard, challenging yourself, and making a commitment to continuously become a better leader and role model.
As I told the nurse who approached me at that seminar, you already have leadership capabilities and you already use them on a daily basis. Understand your circle of influence, nurture and develop those capabilities, and put it all to good use to make a brighter tomorrow for nursing.


About the Author: Donna Cardillo, RN, is the country's foremost authority on non-traditional career opportunities for nurses, and an inspiring example of how nurses can go beyond the conventional job. She has been referred to as the 'guru' of career development for nurses. Donna is a professional keynote speaker, author, consultant, and career coach. Her accomplished career combines over 20 years of clinical, managerial and business experience, not to mention her stint as a professional singer. Donna’s clinical experience includes emergency and psychiatric nursing.
Donna received a diploma in nursing from Holy Name Hospital School of Nursing and holds a BS in Health Care Management from St. Peter's College and an MA in Corporate and Public Communication from Monmouth University. For more information go to:http://www.dcardillo.com/donna.html
Copyright 2003. Nursing Spectrum Nurse Wire (www.nursingspectrum.com). All rights reserved. Used with permission.

The Tech Boom on Boomers: Older nurses feel the pressure

Baby boomers have been called the “sandwich generation,” as many carry out the duties of raising children while also caring for aging parents. It can be an emotional and financial tightrope, a balancing act with ample challenges.Many Boomers, particularly nurses and other healthcare specialists, are also experiencing increasing challenges in the workplace. Technology is escalating faster than ever before and has created an environment of continuous change. While technology and its skillful use is nothing new to nurses, it’s the pace of change that has some mature professionals feeling the pinch. While the generation before Boomers confronted technology advances in a much different way, the younger generations are getting regular exposure at a much early age, and are therefore developing a level of comfort with wireless systems, electronic data entry, computers on wheels (COWs) and a range of other tools that is the envy of some older peers.As the chief nursing officer at Huntington Hospital (HH), a 522-bed, nonprofit medical center in Pasadena, Calif., I know that technology is here to stay. But I also know that the nursing staff is aging (the average age nationally is 48), and mastering the latest gizmo, while meeting the demands of providing quality patient care, is not as easy as some might think.Technology and boomersHealth care has long represented the confluence of technology and medicine. From improving medical practice to enhancing business applications to assisting with customer service and communication, technological advances have provided tools for more accurate diagnosis and treatments, efficient triaging of patient records and greater coordination among all parts of the healthcare system.Through solid training, along with a willingness to embrace the unknown, Boomers like myself can continue to learn on the job and shed the intimidation and anxiety that change can create. While mastering 21st century technology, however, we must also not lose sight of the fact that we are there to take care of patients. To the extent that technology can help us achieve that goal, it is wonderful. When it becomes a distraction or takes us away from the bedside and diminishes attention to the fundamentals, it is misdirected.With the advent of intensive care units in the early sixties, many nurses became accustomed to complex technology in the provision of patient care. But at the same time, other important aspects of their daily responsibilities, such as documentation and communication, remained—as a general rule—tied to pen and paper, and either face-to-face or phone-to-phone encounters. Today, technology in nursing would impress even the most skilled IT professional. More and more nurses must use a host of complex electronic tools, including smart medical devices, tablet and wall-mounted computers, electronic health records, drug retrieval and delivery systems, mobile carts, personal digital assistants and much more. Additionally, the integration of wireless technology delivers data from disparate sources at such speed that nurses don’t even need to be tied to a specific workstation to find critical information. As a result, I have seen first hand how change has impacted the way nurses do their jobs The Huntington experienceOver the past four years, nurses at HH have witnessed a $15 million initiative to upgrade the hospital’s computerized systems. In April 2002, following two years of careful planning, HH introduced Meditech, a well-crafted suite of integrated applications. This state-of-the-art, Windows®-based system provides online patient charting, and enables doctors to review test results and (with future support) initiate treatment orders from their offices. The system’s ease of use and customizing options would revolutionize clinical efficiency and enhance the hospital’s ability to deliver timely, quality care to patients.Prior to Meditech, HH had been using the same mainframe system for 12 years. An upgrade of this scope meant that the nursing team had to be fully prepped to comfortably negotiate the new system, which was no minor feat. It required the collaboration of 11 different interdisciplinary teams, each comprised of approximately 100 Huntington employees. In some instances, implementation team members were taken away from their regular duties for as much as 20 hours a week, placing additional demands on colleagues during the transition period.In an effort to make training as convenient as possible for nursing staff, two mobile classrooms were built, each accommodating 24 students and 24 individual computers. Some nurses, particularly in the Boomer generation and older, required a review of the very basics, even down to using a computer mouse. At the time, we learned that nearly half of our nurses and patient care assistants had no computer at home. We identified nurses (and other employees) requiring beginner Windows® training before moving into the intricacies of the new system and how it would be change the execution of daily duties. These nurses attended a one-day class and were provided additional opportunity for practice before the new system went live.In June 2004 the hospital set loose its first herd of COWs, becoming one of the first hospitals to deploy such technology. It was a significant step toward the use of mobile wireless computing, and it required nursing and information technology teams to work closely together to make wireless computing a reality. Huntington’s technological revolution also included the implementation of Kronos (a timekeeping and payroll system), the acquisition of new medical equipment (including an ultra-short MRI and a multi-slice CT scanner), and the implementation of a digital imaging program (also known as PACS, picture archive and communication system), which makes X-ray film obsolete.Soon every nurse, physician and patient who came through the doors at HH was impacted by the arrival of new technology. From timekeeping and payroll programs for employees, to wireless, bedside computing for improving patient care, HH implemented a variety of new systems to increase efficiency and make everyone’s job just a little bit easier.At least those were our primary goals. But have we achieved Lessons learnedAs I consider the experience of the last four years, and having directly observed the introduction of many emerging technologies in the nursing profession, I have a few thoughts and comments.1. The healthcare industry needs to better assess the role of high technology in improving patient care. It is not clear to me if the movement toward technology has detracted from the humanistic aspect of patient care or has truly provided the anticipated benefits for patients and nurses. Hospitals need to listen when nurses express concern about losing the “sounds and touch” of nursing when dealing with computer screens and mouse clicks.2. Ongoing training is essential in the age of new technology. No single system is the “turnkey” the industry may be after, and continuing change is inevitable. To ensure training at HH had relevancy to bedside nurses, we put much of the responsibility for education into the hands of clinicians.3. New technology doesn’t always result in more time for patients. Barcode scanning technology, for example, can serve as part of a checks-and-balance system for reducing errors, but are not always convenient or practical. The same is true for automated medication systems. Through proper planning and execution, the right technology should streamline processes and provide more time for personalized care.4. More hospitals need to consider technical knowledge when recruiting nurses. This is especially true in the emerging field of nursing informatics, a specialty focusing on the input, distribution and management of nursing data and information. These specialists, with both clinical and IT experience, are an increasing necessity in medicine.5. I don’t believe that technology has impacted the practice of nursing as much as it has impacted its application. Computerized systems might not improve efficiency as much as they improve quality. Physician notes and patient records can be more accurate (and more legible), and methods for accessing information standardized.In the end, I believe that technology is about innovation. That is no more true anywhere than in medicine, where professionals of all ages constantly strive to provide better care to an increasingly complex patient population. As we continue to move through this age of technology, I am confident that Boomers will enrich the nursing profession with their knowledge and expertise, and that technology will be a tool to their continuing success.Bonnie Kass, RN, MBA, is vice president and chief nursing executive at Huntington Hospital in Pasadena, Calif.

Technology's important, but nursing's irreplaceable

In our technological implementation efforts, we tend to focus so much energy on learning new skills and processes that we put aside the foundational elements of what makes nursing an art. Nurses' attempts to complete new assessment forms or to process computer entries to validate the care they've provided can be tirne-consuming. At the beginning of the learning curve, the time involved can seem overwhelming to caregivers who feel their art of nursing is slipping away from the patient's bedside. They may view safety checks as "just more things to do and worry about."

Champion the cause
Help clarify the importance of new technology and processes. Accomplish this by cheerleading the implementation and ongoing success of these changes. This isn't a simple task for some managers; waving pom-poms around and shouting, "Go team," won't suffice for this type of effort. Some managers feel as challenged by technology as their staff members. Educate yourself about the technology and develop a working relationship with vendors and your facility's IT staff. They'll be your greatest resource for ongoing knowledge and support throughout the implementation process.

Focus on what you're great at by demonstrating to staff that hands-on care and hearty care still matter in nursing. If the focus completely revolves around technological changes and ignores the art of nursing, you might hear:

"Bring back the good old days, when I had time to actually talk with a patient. "
"Despite all of these fancy new gadgets, it still takes an act of Congress to get medsfor a new admission."
Take pointed steps to address these negative sentiments. Learn to blend new technology with the art of nursing by:

* clarifying the goals of the new technology
* verbally communicating ways to reach these goals
* appearing enthusiastic about the process
* consistently maintaining a positive and energetic attitude, despite obstacles
* demonstrating the implementation process's organization and systems checks to ensure the best scenarios for success
* identifying areas of patient care that have improved by the technology and systems
* relating improved efficiencies in nursing practice that have led to better patient outcomes
* sharing data that validate how these changes affect the perception of customer service
* providing examples of specific changes that have resulted in more nursing time at the bedside.

Tech and touch
Remind staff that hands-on care and hearty care still matter to the patient. Technology can never replace holding the hand of a frightened elderly patient. No machine exists that can tell a family, the way nurses can, how saddened they are by the death of a loved one. Recognizing staff's art of nursing is a constant reminder that no matter how much technology intertwines healthcare delivery, it's always nursing that touches the human spirit and soul.

By Shelley Cohen, RN, CEN, BS
About the author
Shelley Cohen is an educational consultant and coach for Health Resources Unlimited, Hohenwald, Tenn.

Real Men Choose Nursing

By Susan MeyersMay 2003

Four men from various walks of life are featured on the cover of a University of Iowa College of Nursing brochure. A middle-aged Hispanic male is the poster boy for the Oregon Center for Nursing promotions. Johnson & Johnson's "Dare to be a Nurse" campaign includes several males of various ethnic backgrounds. [bullet] These images are appearing on brochures, public service announcements and billboards across the country-all to pique men's interest in the nursing profession. Nursing is getting a facelift, and nurses hope a new identity will help pull the profession out of its six-year school enrollment slump. [bullet] "As the country becomes more diverse, we need to attract a more diverse workforce to nursing to mirror that trend," says Barbara Blakeney, president of the American Nurses Association (ANA). In addition to minorities, men-who represent just 5.4 percent of the nurse workforce-are among their primary targets.

Debunking the Image
Nursing organizations, schools and hospitals across the country are taking their public image campaign to the streets. They are visiting with students at junior highs, high schools and colleges. They're educating guidance counselors about the diverse field of nursing. They're starting clubs for nurses and other health care professionals, and they are appealing to the public through brochures, advertisements, billboards and public service announcements on TV and in movie theaters.

"We're trying to break down those old stereotypes about nursing that have been reinforced by the media for many years," says Blakeney. "When people think of nursing, they think of women in nurturing roles, as 'handmaidens' to doctors. But nursing is much more than that. Not only is it high-touch, but it can also be very high-tech. It requires a lot of intelligence and a lot of education in the sciences. And it's not just for women. There are many opportunities for men as well."

Why do men shun nursing? According to studies from the American Association of the Colleges of Nursing (AACN), the reasons include: role stereotypes, economic barriers, few mentors, gender biases, lack of direction from early authority figures, misunderstanding about the practice of nursing and increased opportunities in other fields.

Changing its image as a female-only career choice is one way the profession is addressing the nursing shortage, and judging by the numbers, the future of nursing is on the line: Hospitals around the country are averaging a 15 percent nurse vacancy rate, says Kathleen Ann Long, president of the AACN. According to a report released in July 2002 by the U.S. Department of Health and Human Services, if the nursing shortage goes unchecked, the deficit of R.N.s is expected to rise from 110,000, or 6 percent, as recorded in the year 2000, to 29 percent by the year 2020. The Bureau of Labor Statistics projects that with a continued growing need for nurses, coupled with current trends of nurse retirement and leaving the profession, as well as fewer people entering the field, there could be a shortage of more than one million nurses by the end of this decade.

What the Numbers Show
The good news is that although the percentage of male nurses remains small, their ranks are growing. In 1980, men comprised 2.7 percent of all R.N.s. Today, men account for 5.4 percent of the total R.N. population. The number of men entering nursing schools is also going up. According to the AACN, men enrolled in bachelor's programs in nursing in the fall of 2001 rose to 8.6 percent; in master's programs it grew by 9.6 percent; and in doctoral programs, 6.7 percent. For all three programs combined, those statistics represent a 10 percent increase in male R.N. enrollment since 1991.

And at health care facilities and colleges where marketing efforts have targeted men, they are lining up in record numbers. At the University of Texas Health Sciences Center at Houston School of Nursing, male enrollment is up 23 percent since the university adopted many of the recommendations provided by a male focus group. "They told us to get rid of the lavender brochures and the flowery, fluffy language and to replace it with more factual and objective information," says Pat Starck, dean of the nursing school. "They suggested we play up the macho aspects of nursing, such as trauma and emergency care, advertise in the sports section of the newspaper and provide more male role models."

Much of the recruiting at the University of Texas School of Nursing is directed toward college students to encourage them to go into the B.S.N. degree program. "We still reach out to the junior high and high schools," says Starck, "but that's more for visibility purposes. These students are still too young to think about nursing and real career choices."

Nursing schools are also succeeding at recruiting male college graduates and those considering second careers for master's programs. The University of Iowa College of Nursing has found this strategy works for them. Fifty percent of applicants for a newly-created master's program in nursing and health care practice were men, says Melanie Dreher, dean of the college. Enrollment in the nurse anesthetist program is 50 percent male as well. "You have to offer a product with lifelong career opportunities," says Dreher. "If we can show them opportunities for mobility, career advancement and financial incentives, they will come."

New Marketing Strategies
Nebraska Health System, which comprises two hospitals in Omaha, recently re-evaluated all its marketing strategies to ensure that gender and racial diversity were included in the mix. "We now make a very conscious effort to make sure that males are represented in a more equal fashion in all of our advertising and portrayals of nursing and health care opportunities," says Nancy Brack, NHS' personnel manager. Additionally, the health system has initiated a variety of programs and recruitment techniques to reach out to the community, including: a workshop for high school guidance counselors to update them about nursing profession opportunities; a "nurse explorer" program in which interested high school students are invited to spend one evening a week for five weeks touring different patient care areas in a hospital; a job-shadowing program that allows a student to follow a nurse or other health care practitioner on his or her shift; and an "adopt-a-school" program where students are invited to come to a hospital for a half-day tour and learning experience. NHS ensures that male nurses are represented in all of these programs. Brack says NHS also targets retiring military personnel from the local air force base, as well as spouses of relocated employees coming to Omaha to work for local companies.
The hospitals are raising the stakes even higher. They are offering their own employees and employees' family members tuition reimbursement based on the agreement that they will enroll in nursing school and work for NHS upon graduation.

Scott Miller, R.N., manager of the NHS preoperative recovery rooms and surgery center, believes these strategies are paying off. "I'm seeing more men in the profession all of the time," he says. "The old biases against males just don't exist anymore."

Miller has been a nurse for 15 years and says he has never felt threatened by the stereotypes, and, in fact, has found nursing to be very different from its traditional low-tech nurturing image. "Nursing is very challenging," he says. "You have to be very technical now. You need to know how to use different types of equipment, to be more autonomous and know when to bring in the doctor." Miller, who has also worked in the intensive care unit, as a flight nurse, and in the emergency department, says the advancement opportunities, as well as the ability to work in different areas within the profession without ever having to start over, are two reasons he has stayed in nursing.

"Although we're gaining some ground, we still have a long way to go," says AACN's Long. "Nursing is a remarkably challenging and rewarding career. We're going to need all aspects of the media in helping us get the message out about what nurses really do. As we get more attention as to how many opportunities there are in nursing at a time when many college graduates are finding it difficult to find employment-that coupled with opportunities for career advancement in nursing and rising salaries-those things will make it become a more viable career for men."

Retention
The AACN and ANA are also attacking the nursing shortage from another angle. A growing number of nurses are reporting increasing burnout and job dissatisfaction, says ANA's Blakeney. A study conducted by the University of Pennsylvania School of Nursing found that one out of every three nurses under age 30 is planning to leave his or her hospital within the next year. To slow the exodus, the ANA is working to improve hospital working conditions through a magnet program called the Accreditation and Magnet Recognition Program. "The program helps hospitals reassess the whole culture of their institution, specifically as it applies to nursing and then make improvements [see "AttractingNurses: Why Magnet Hospitals Succeed," in the April 2003 issue]," says Blakeney. The magnet program, started approximately 10 years ago, has shown that health care facilities that pass its rigorous accreditation process have an increased R.N. retention and recruitment rate, and keep their nurses an average of eight years, compared with the national retention average of three to four years.

"Nurses, whether they are men or women, do not want to enter a work environment that does not empower them and respect them," says Blakeney. "The more we improve the work environment, the more we will be able to attract qualified and competent people to the nursing profession. We're trying to break down those old stereotypes about nursing that have been reinforced by the media for many years."

Fired Up or Burnt Out?

By: Karla A. Knight, RN, MSN

Are you so burned out that you can hear yourself sizzle? Here’s how to recognize the symptoms before the flicker becomes a flame.

Burnout. It affects the retention rate of nearly every hospital in the country. It causes nurses to feel exhausted and unable to care for their patients. It prevents new people from seeking a career in nursing. Are you one of the many nurses experiencing burnout? Here’s how to recognize burnout, ways to treat it, and strategies to prevent it from happening to you.
How Big of a Problem Is Burnout?

“Burnout is a very big problem, and it’s widespread,” says E. Carol Polifroni, RN, EdD, CNAA, associate professor of nursing, University of Connecticut, Storrs, CT, and a recognized expert on workforce issues.

In a 2001 ANA staffing survey, nurses were asked how they felt when they left their jobs each day. The majority of nurses responded with the following: “I feel exhausted and discouraged”; “I feel saddened by what I couldn’t provide for my patients”; “I feel powerless to effect change necessary for safe, quality patient care.”1 “When you’re taking care of seven, eight, nine patients on a day shift, that’s an overwhelming amount of stress. Is it any wonder that nurses feel burned out?” asks Polifroni.

Warm, Warmer, Burned Out
Burnout is classically viewed in three phases, according to Polifroni. Phase one of burnout is the stress arousal phase. This happens when the nurse experiences anxiety, insomnia, forgetfulness, inability to concentrate, feelings of being overwhelmed, frustration, sadness, and new physical symptoms, such as headaches. If the nurse does not recognize that these symptoms require intervention, Polifroni says, the next phase of burnout takes hold.

The second phase is energy conservation. In this phase, the nurse starts to call in sick to work, or he or she may be chronically late getting to work. Deadlines are not met, a cynical or resentful attitude develops, and a persistent sense of fatigue pervades both the nurse’s personal and professional life.

If the signs of this phase are not addressed, the symptoms become chronic, leading to a sense of isolation and overwhelming exhaustion. According to Polifroni, this isolation and exhaustion are the last phase of burnout when nurses finally leave their jobs.

Causes and Remedies
What causes burnout in the first place? Burnout on the job can be a direct result of inadequate staffing, according to Polifroni. If hospital administrations don’t work with employees to ensure adequate staffing ratios, nurses need to speak with their feet, says Polifroni. “I’m not suggesting job-hopping. But a nurse does not have to stay in a job because it’s the only game in town,” she adds.

It isn’t just poor staffing that contributes to burnout. It can also be the nurse’s lack of autonomy at the bedside. “Some things as fundamental as respect for what a nurse knows and what a nurse does are at issue,” says Polifroni. When a nurse has to call in a resident or intern to the bedside to make a decision that the nurse is capable of making, the nurse’s knowledge and skills are ignored and diminished. “When this happens, the system loses, the nurse loses, and the patient loses.”

In addition to staffing and autonomy, lack of recognition of the professional nurse contributes to burnout. Instead of giving bonuses to attract new nurses, hospitals should use bonus money to help the nurses who choose to remain, according to Polifroni. She adds that spending money on evaluating a new model of care or providing more personnel who can help nurses stay at the bedside are ways of recognizing the value of the professional nurse and avoiding burnout.

Burning Out Nurses — or Empowering Them
Burnout happens in every profession because there simply might come a time when you don’t want to do what you do anymore. But burnout in nursing is happening early on, often within the first four years of practice.2 “Nursing is asking men and women to walk through the door and do the impossible every day,” says Polifroni. “Institutions should be saying, ‘We’re not going to ask you to do the impossible anymore. We’re asking you to engage in one of the most powerful experiences of your life, and we’re going to support you.’”

If institutions were to change the work environment through decreasing the nurse-patient ratio, increasing nurses’ pay commensurate with assigned responsibility, and valuing and recognizing the nurse’s skills and knowledge, we wouldn’t have to talk about burnout, according to Polifroni. “I don’t like talking about burnout. It’s negative. It’s reactive. I’d rather talk about empowerment, which is positive and proactive. If we empower nurses with appropriate staffing, autonomy at the bedside, and recognition of their value, we wouldn’t have to discuss burnout in the first place.”

Feeling Burned Out? Ten Things to Do About It
Decide if your feelings are related to your personal life or to your job.
If it’s the job, ask yourself, “What would make me feel better?”
Ask for help with the answer to #2. If it’s the number of patients you are assigned, speak to your nurse manager. If you’re unable to prioritize your workload, speak to the unit educator about developing better time management skills. Don’t be afraid to ask for help.
Learn to say “no” appropriately. You don’t have to say no to everything, but saying no selectively can help you feel less overwhelmed.
Meet with other nurses so that you feel less isolated and less like you are the only one experiencing symptoms of burnout.
Keep yourself in good physical condition by eating a good diet, developing an exercise routine, and getting enough sleep. Use relaxation techniques to reduce anxiety.
Learn to delegate. You don’t have to do everything yourself.
Dismiss the minutiae. Take things off the list. Decide what’s really important and what’s not.
Develop a more positive attitude. If you can’t change jobs right now, find some joy in what you’re doing. Write down those joyful and positive experiences so that when you are saddened by your work, you can look back on what’s great about it.
Get back to the basics of nursing. Feel empowered by the fact that every day, you might save a life, teach a patient how to save his own life, help a new mother with breastfeeding, or make a child less afraid.

Karla A. Knight, RN, MSN, is a contributing writer for Nursing Spectrum.
References
1. Analysis of American Nurses Association Staffing Survey. ANA. Available at: www.nursingworld.org/staffing/ana_pdf.pdf. Accessed May 14, 2002.
2. O’Sullivan A. Statement to the subcommittee on governmental affairs June 27, 2001. Nursing World. Available at: www.nursingworld.org/gova/federal/legis/testimon/ 2001/govaref.htm. Accessed May 14, 2002.