At the start of my nursing career, I worked 12:00 a.m. to 12:00 p.m. shifts for low pay. I stayed late every day to chart or pass meds. On top of all that, I endured verbal abuse from patients and other staff members. I pushed myself to the brink of what my mind and body could take because I thought that was what nursing was. I accepted it for a while.
After experiencing a panic attack at work, I realized I needed to make a change. That change included therapy, recognizing my worth, and establishing clear boundaries.
Why Nurses Matter
Nurses make up the largest segment of the healthcare workforce. Nurses are essential in health promotion, disease prevention, and direct treatment. Nurses are consistently overworked and undervalued.
A nationwide study found that 55% of nurses suffer from burnout. During the COVID pandemic, 100,000 nurses left the workforce. By 2027, almost 900,000 registered nurses intend to leave the workforce. This will have a massive impact on the national healthcare system. COVID made it clear nurses are essential.
Nurse Burnout
Burnout is a state of mental, physical, and emotional exhaustion. Burnout is chronic workplace stress that has not been successfully managed. Any professional can experience workplace burnout, but nurses are at higher risk of burnout due to long shifts, constant pressure, and lack of support from leadership.
Nursing is a demanding profession, and there's no denying that it can be stressful, especially when lives are on the line. Certain stress factors, such as the constant pressure to make decisions, prioritize tasks, and act quickly, are often beyond our control. However, there are effective strategies to help minimize these stressors.
Steps nurses can take to prevent workplace burnout go beyond basic self-care, like sleeping, eating well, and exercising. It's hard to reach these basic needs when you don't have the time or room for them.
Setting Boundaries as a Nurse
We set boundaries to protect our time or mental and physical well-being. Setting healthy boundaries is essential in any relationship and is no different in the relationship between nurses and their employers. It can be challenging to set a personal boundary because it involves feelings of guilt and fear of disappointing others.
I've attended several workplace meetings centered on self-care and managing nurse burnout. The one thing they never discussed or mentioned was boundary-setting as a form of self-care.
Boundary setting is not endorsed or encouraged in the workplace because it doesn't benefit the employer; it benefits the worker. Only the worker can set boundaries, and no one will permit them.
Here are steps I have learned and taken in my nursing career to set clear boundaries that improved my mental well-being and made it possible to continue being a nurse.
Speak Up and Say No
To set boundaries as a nurse, you must say them out loud. Venting to family and friends can help relieve some stress, but it doesn't change anything. Talk to your manager or supervisor if you feel you're being asked to take on too much as a nurse. Say no to extra shifts when you have nothing left to give.
I've had good and bad nursing supervisors. Some listened, and some dismissed my concerns completely. Some dismissed me initially and then returned to apologize and validate my concerns. Give them a chance to support you better; you might be surprised.
If you have a supervisor or manager who completely dismisses you and other staff members about staffing and safety concerns, it's time to move up the chain of command.
Change your schedule
The variety of schedules available is one of the benefits of being a nurse. In the hospital setting, nurses are often expected to work 12-hour shifts three days per week, sometimes consecutively. For some nurses, this works well. Working three days a week sounds good, but think about what three 12-hour shifts can do to your mind and body.
You may not be able to see your family during that time, will lack sleep, and by the end of those three days, there's not much left. It also takes at least a day of rest and recovery. So yes, three days on four days off sounds good, but it's not always conducive to a good work-life balance.
Hospitals allowing staff to organize their work schedules can increase staff retention. For me, it was one day on to warm up, one day off, and then two days on and three days off. It's different for everyone, depending on their situation.
Hospitals generally work within a 12-hour schedule, but there are options to work PRN or as needed, and choose which days or nights you want to work. Having a sense of control and clarifying what schedule works best for you is a boundary-setting must in nursing.
Get Support
Support can be obtained in various ways. Therapy is one great way to get support and help develop personal boundaries. Prioritizing your mental health and getting help is one of the best ways to prevent nurse burnout. Many employers offer mental health services. Use them. If they are not provided at your place of employment, look into other options your insurance company offers.
Joining a nurse union is another way to get support in setting boundaries. Depending on your state or company, there are nurse unions you can join to help set and enforce boundaries. Change happens in numbers. Nursing unions give nurses the right to advocate as a collective.
Knowing your rights as a nurse and acting if they are being violated is necessary. If a nursing union is unavailable in your area, support is also available from the Emergency Workplace Organizing Committee (EWOC). They help support workers in organizing their own unions.
Change Your Specialty or Setting
Setting boundaries as a nurse can include leaving a job where your boundaries are not respected. I have moved on from several jobs that I considered to be unsafe and disrespectful of my boundaries.
Changing your specialty or setting can also affect your schedule. Hospitals generally work within a 12-hour-per-day schedule. Changing your specialty to outpatient care or home care would allow you to work a more traditional nine-to-five, eight-hour-per-day work schedule.
I moved from working in hospitals on medical surgical floors to home care and then to hospice registered nurse case manager. In my current role, I can set my own schedule that works around my life instead of working my life around my job.
Advocate for yourself
As nurses, we're taught to advocate for our patients, but we must also advocate for ourselves. It's important to set your boundaries early and often and make them clear to your employer. Nurses are essential to the healthcare system and should be treated as such. It can be difficult to set boundaries, especially for new nurses, but if you don't do it, no one will.
About the Author:
Jessica Benson is a registered nurse and freelance writer with over 10 years of experience in the medical field. She's interested in health policy and aims to raise awareness and discussions in the community surrounding public health and human rights.
Jessica is an independent contributor to CEUfast's Nursing Blog Program. Please note that the views, thoughts, and opinions expressed in this blog post are solely of the independent contributor and do not necessarily represent those of CEUfast. This blog post is not medical advice. Always consult with your personal healthcare provider for any health-related questions or concerns.
If you want to learn more about CEUfasts Nursing Blog Program or would like to submit a blog post for consideration, please visit https://ceufast.com/blog/submissions.
