1. Section Editor(s): Raso, Rosanne MS, RN, NEA-BC, FAAN

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Are you reading about burnout and its opposite, professional well-being, lately? There seems to be a plethora of information in the literature, going back to 2014 when the Quadruple Aim was introduced. Last year we had The Joint Commission's Quick Safety publication on "Developing Resilience to Combat Nurse Burnout" and, most recently, the National Academy of Medicine's (NAM) "Systems Approaches to Improve Patient Care by Supporting Clinician Well-Being." Are we doing enough to promote nurse well-being in our workplaces?

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For me, burnout conjures up negative visual images such as wildfires and burnt toast. It's harmful and destructive. On the burnout spectrum and in its definition are high stress, compassion fatigue, emotional exhaustion, and lack of joy at work. The presence of these states of mind is a threat to patient care. As leaders, we must work to avert their occurrence. And as much as I believe in boosting resilience to feed the soul and tamp down stress, it doesn't get to burnout's roots. We need resilience and we need to provide the leadership that creates environments for professional well-being.


Burnout occurs for many reasons, some specific to a person's own dynamics. The work burden of our electronic health records is frequently cited as a factor. The Joint Commission identifies factors such as work overload, lack of support at work, sleep deprivation, exposure to work-related violence, and more, advising us to make improving working conditions a priority. The NAM recognizes system pressures, job demands, lack of a sense of accomplishment, administrative burdens, and moral distress, among other factors, recommending a systems approach to creating positive work environments.


Is professional well-being burnout's opposite? How do we contribute to well-being? To start, without a healthy work environment (HWE), you most likely can't have professional well-being. Nursing has several evidence-based models that provide a blueprint for HWEs. The American Nurses Credentialing Center's Pathway to Excellence(R) and Magnet(R) paradigms are well-known. Another model is the American Association of Critical-Care Nurses' HWE standards. Common to all of these is leadership.


As leaders, we can't escape our role in and responsibility for the work environment. And we can't have positive work environments without caring and authentic leadership, combined with adequate resources, communication, collaboration, shared decision-making, and recognition. Whatever model you use, leadership is central and critical. Professional well-being is possible, nurtured by a supportive and respectful work environment to curb burnout.


Resilience is intertwined with our work environment. It's difficult to be resilient in the absence of organizational and team support, feeling valued, and professional autonomy-all of which require positive leadership. Self-care helps too, wrapped around healthy habits to include good eating and sleep. Healthy Nurse, Healthy Nation began a couple of years ago as a social movement to improve the health of our nation's 4 million nurses through self-care. We can certainly encourage healthy behaviors at the very least.


Nursing Management conducted a Wellness Survey a few years ago to help us understand what drives wellness and workplace stress. We're repeating it this year and results will be published in a future issue. Please take a few minutes to complete the survey at to help us understand the state of nurse leader well-being.



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