1. Donnelly, Gloria F. PhD, RN, FAAN, Editor-in-Chief

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You Can't Burnout Unless You've Been on Fire!

Kathleen moves swiftly and deliberately about the unit checking on her assigned patients, helping a nursing assistant who needs an extra hand, fielding questions from patients and families, and deftly handling a difficult and demanding colleague. Most days are pressured because acuity is high and staffing is tight, particularly when someone calls out sick. Staying late to complete her documentation is occurring more and more. Kathleen, however, is a perfectionist with high aspirations and expectations for herself, and so she stays the course until the work is done to her standard and satisfaction.


Marsha, on the other hand, appears less sure of herself in the staff nurse role although she will often tout her years of experience and level of expertise. She freely and openly complains and one of her favorite sayings to colleagues is, "You don't know what busy is!" On difficult days when extra "pitching in" is desperately needed, Marsha is the first to delegate and the last to volunteer. And, although at the end of the day, Marsha has completed her work and delivered good care, she appears stressed and frazzled.


Who is at the highest risk for burnout, Kathleen or Marsha?


Burnout is a psychological syndrome characterized by physical, emotional, or mental exhaustion preceded by a numbing or lack of awareness of stress-related symptoms. It most frequently occurs in those with unrealistically high aspirations who push themselves to do more and better on their road to achievement. Kathleen is the nurse who gives her all, takes on more, and believes that there are no limits if you work harder and smarter. Kathleen has a "fire in the belly" to reach the heights of her profession on her own drive and merit. Yet Marsha is the one who flails in the hallway, wringing her hands, touting her busyness, and predicting her own burnout when a little extra is required. Kathleen is at a much higher risk for "burnout" than Marsha, since you can't burnout unless you've been on fire-and Kathleen's work habits show all of the signs of risk.


We most often turn to nurses like Kathleen when the going gets rough. Nurse managers describe this tendency to load more work on the most industrious nurses as the path of least resistance. Why delegate to those who sigh, complain, and roll their eyes when the Kathleens of the workforce will quietly pitch in and get the work done no matter what it takes?


Preventing burnout is not just the individual nurse's responsibility. Although it would be ideal if Kathleen could create more balance in her life, focus on her own needs, and take responsibility for her physical and emotional well-being, it will always be her tendency to go the extra mile. Therefore, it is incumbent on nurse colleagues and managers to protect those nurses who are always sparring with their inner voice to do more, and to ask more of those nurses who have well-developed repertoires for avoiding work.