3 Ways leaders are burning out nurses (and how to prevent it)

Staff burnout is a little like carbon monoxide. You can't smell it. You can't see it. But, if it's present it's likely causing major problems for your organization that will be detected too late.

There are ways to get a "feeling" about the level of burnout in an organization through surveys, word of mouth, and astute and aware managers. Unfortunately, the realization that staff burnout is a painful issue for an organization often does not occur until the burnout has resulted in turnover.

By the time burnout becomes turnover, the effects have often permeated the workforce. That staff member's burnout has had a negative impact on the morale of those around her at the hospital, her loved ones away from work, and the patients she has been caring for.

Diagnosing Burnout
While there are human factors that can cause burnout, including poor managers or personal problems, the most common work-related causes of staff burnout can be detected through analytics and mitigated through sound staffing practices. There are typically three staffing practices that are the root cause:

• Excess Core Floating
• Cancellations
• Overtime

Research conducted by Avantas on the causes of turnover can be used as a guide to gauge the possible severity of burnout.1 In this study, a number of key staffing metrics from 38 hospitals across six health systems were analyzed to determine at what point they affected turnover.

Excess Core Floating
Core staff with a floating pay period average greater than 14.2% of their worked hours for the year were 32.5% more likely to terminate than staff floating less.

Staff with a cancellation pay period average greater than 3.2% of their worked hours for the year were 39.2% more likely to terminate than staff who were cancelled less.

Staff with an overtime pay period average greater than 3.1% of their worked hours for the year were 22.3% more likely to terminate than staff with lower overtime worked hours.

Acting on Analytics
Access to staffing metrics and knowing what to do with them are two different things. Data becomes actionable when it is backed by strategies developed to improve performance. Effectively taking action on analytics requires new behaviors derived from workforce management best practices.

With core staff floating and cancellations, the cause is typically the same, and can be reduced significantly with a mix of workforce analytics and predictive analytics. While being cancelled is not necessarily a cause of burnout, the effects of having to use PTO or not getting paid for a shift can be stressful. Establishing the correct number of core staff on a unit-to-unit basis relative to that unit's forecasted demand, and scheduling staff in correlation with that demand will reduce instances of over or under staffing. The ability to build core staff schedules to meet demand requires the utilization of a forecasting tool that provides an accurate projection of needs/volumes at the time core staff schedules are built, at least four or six weeks in advance of the shift.

To reduce overtime, in addition to right-sizing core staff, organizations can establish properly sized and layered sources of flexible resources, e.g., float pools. This layering of staff enables an organization to expand and contract resources to adjust to changes in volume. The right contingency layering, including what external sources of staff your organization needs, in what numbers and areas, is determined in much the same way as core staff sizing.

An often overlooked strategy to reduce overtime is to ensure all core staff members are scheduled to their FTE at the time schedules are built. This prevents the burnout caused by a self-inflicted "nursing shortage" stemming from under utilizing resources.

Caring for Caregivers
A staff member experiencing burnout can be helped. Leveraging analytics can help your organization be vigilant of the indicators of stressful work conditions. Predictive analytics can provide a better roadmap so schedules can be made in accordance with demand. Best practices can be implemented to further minimize staff dissatisfiers.

We all know that caregivers are resilient, and we need to put more effort into ensuring that caregivers are cared for. AMN Healthcare's 2015 Survey of Registered Nurses2 clearly showed the affect burnout is having on nearly 9,000 RNs. While there was strong indication that nurses loved their profession, they had mixed feelings about their jobs. In fact, half of those surveyed worry that their job was affecting their health.

The same study revealed that 62% of RNs over the age of 54 were thinking about retiring, with most planning to retire within three years. With this in mind, the onus is on provider organizations to ensure they take strides in preventing additional turnover by reducing the causes of burnout. Taking action to leverage analytics provides a measure to ensure progress is being made toward developing a better, less stressful work environments for care staff.

1 (Avantas) Understanding Turnover: A study of staffing metrics and the correlation to turnover. avantas.com/whitepapers
2 (AMN Healthcare) 2015 Survey of Registered Nurses: Viewpoints on Retirement, Education and Emerging Roles. amnhealthcare.com/2015-RNSurvey

Jackie Larson is a healthcare industry veteran and recognized thought leader. She has been the driving force in building out the company's client management, analytics, and consulting groups into world-class teams providing guidance and support to clients on a wide range of issues including workforce optimization, productivity, labor pool and incentives, system integration, resource management, and business analytics.

The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker's Hospital Review/Becker's Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.​

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