212 unit 3 | Professional Issues
■Collaborative practice and shared governance
models
In 2002, Dr. Linda Aiken and her colleagues iden-
tified a relationship between staffing, mortality,
nurse burnout, and job dissatisfaction (Aiken et al.,
2002). With each additional patient assigned to a
nurse, the following occurred:
■A 30-day mortality increase of 7%
■Failure-to-rescue rate increase of 7%
■Nursing job dissatisfaction increase of 15%
■Burnout rate increase of 23%
■43% of nurses surveyed were suffering from
burnout
Conclusion
You already know that the work of nursing is not
easy and may sometimes be very stressful. Yet nurs-
ing is also a profession filled with a great deal of
personal and professional satisfaction. Periodically
ask yourself the questions designed to help you
assess your stress level and risk for burnout, and
review the stress management techniques described
in this chapter.
There is no one right way to manage stress and
avoid burnout. Rather, by managing small segments
of each day, you will learn to identify and manage
your stress. This chapter contains many reminders
to help you de-stress during the day (Box 13-9). You
can also help your colleagues do the same. If you
find yourself in danger of job burnout during your
career, you will have learned how to bring yourself
back to a healthy, balanced position.
Ultimately, you are in control. Every day you are
faced with choices. By gaining power over your
choices and the stress they cause, you empower
yourself. Instead of being preoccupied with the past
or the future, acknowledge the present moment,
and say to yourself (Davidson, 1999):
■I choose to relish my days.
■I choose to enjoy this moment.
■I choose to be fully present to others.
■I choose to fully engage in the activity at hand.
■I choose to proceed at a measured, effective
pace.
■I choose to acknowledge all I have achieved
so far.
■I choose to focus on where I am and what I am
doing.
■I choose to acknowledge that this is the only
moment in which I can take action.
People cannot live in a problem-free world, but they
can learn how to handle stress. Using the suggestions
in this chapter, you will be able to adopt a healthier
personal and professional lifestyle. The self-
assessment worksheet on DavisPlus, entitled
“Coping with Stress,” can help you manage stress and
help you understand your responses better. The work-
sheet on DavisPlus, entitled “Values Clarification,” will
help you identify how to begin to change taking into
account what is most important to you.Adapted from Bowers, R. (1993). Stress and your health. National Women’s
Health Report,15(3), 6.box 13-9
Ten Daily De-Stress Reminders
Express yourself! Communicate your feelings and emotions
to friends and colleagues to avoid isolation and share
perspectives. Sometimes, another opinion helps you see
the situation in a different light.
Take time off. Taking breaks, or doing something unrelated
to work, will help you feel refreshed as you begin work
again.
Understand your individual energy patterns. Are you a
morning or an afternoon person? Schedule stressful duties
during times when you are most energetic.
Do one stressful activity at a time. Although this may take
advanced planning, avoiding more than one stressful situa-
tion at a time will make you feel more in control and satis-
fied with your accomplishments.
Exercise! Physical exercise builds physical and emotional
resilience. Do not put physical activities “on the back
burner” as you become busy.
Tackle big projects one piece at a time. Having control of
one part of a project at a time will help you to avoid feeling
overwhelmed and out of control.
Delegate if possible. If you can delegate and share in
problem solving, do so. Not only will your load be lighter,
but others will be able to participate in decision making.
It’s okay to say no. Do not take on every extra assignment
or special project.
Be work-smart. Improve your work skills with new
technologies and ideas. Take advantage of additional
job training.
Relax. Find time each day to consciously relax and reflect
on the positive energies you need to cope with stressful
situations more readily.