Nurses identified the top contributing factors in their burnout. Have you been listening?
The KLAS Arch Collaborative recently released their 18-month study on "Understanding & Addressing Trends in Physician & Nurse Burnout 2024" with a focus on EHR impact. Gathering data from 32,782 nurses, the report determined the top contributing burnout factors for nurses were staffing shortages, chaotic work environment, too many bureaucratic tasks, lack of teamwork, and lack of shared values with leadership.
It’s no easy feat to alleviate stress in a profession that’s been feeling the strains of unprecedented burnout for years. However, for leadership looking to invest in the psychological safety of their frontline workers, the data outlines a game plan to work towards a promising future where joy can be brought back to nursing.
We asked MEDITECH customers how leaders have listened to their nurses and directly addressed burnout issues in their organization.
“We want a more balanced workload.”
Even before the pandemic, health systems were dealing with a nursing shortage that COVID-19 then exacerbated. Organizations should prioritize recruitment, retention, and innovative care models to better balance nursing workloads.
“We are actually doing virtual nursing at HCA. We have a smart TV in the room that can be turned on from a nurse that’s working at a remote location, which could be at home. All those things that the nurse doesn’t have to put their hands on the patient can be done from a virtual nurse. This is a great opportunity to recruit and retain nurses. I was talking to some of my academic partners recently and they said they’d come back and do some hours doing that.”
- Sherri Hess, MS-IS, BSN, RN-BC, Chief Nursing Informatics Officer, Nursing Informatics, HCA Healthcare
“In early 2022, we began to explore different care models. One being the world of virtual nursing, which now is very common. What I love about utilizing our virtual nurse for admissions tasks is it is uninterrupted time for them and the patient. Whereas the bedside nurse may have a million things going on at one given time, that virtual nurse is solely responsible for that patient's discharge teaching. It's focused and it's thorough and that patient has their undivided attention. We've been able to really transform our model of care here at Phoebe, partnering with our virtual nurse team to really shift those more administrative-type tasks. Now we can ensure our bedside nurses can focus on true patient care and being at the bedside with our patients.”
- Kelsey Reed, DNP, FNP-C, Director of Patient Care, Phoebe Putney Health System
"We have partnered with our local high schools and community colleges to offer intern/extern programs to students interested in a healthcare degree. For new nurses going to school, we have created a scholarship program that we will pay for school and in return they sign an agreement to work x amount of time or repay their loan. We continually assess the market to see where we stand in relation to nearby hospitals for their salaries/benefits and attempt to stay competitive. We also offer sign on and relocation bonus. It’s a challenge to put a price on culture, but we do see some people leave for a neighboring hospital because of higher pay only to come back within the year because the culture is different.”
- Kim Maples, MBA, RN, CIO/Vice President Support Services, Carteret Health Care
Supported by intuitive technology, virtual nursing has emerged as an win-win solution to offloading administrative tasks while also giving nurses new opportunities in their field. An organization open to pragmatic retention and recruitment efforts intertwined with innovative care models shows promise in alleviating their nurse’s workload stress.
“We want a voice in the decision making.”
KLAS’s report identified a lack of shared value with leadership and lack of teamwork as burnout factors, which point to a somewhat ambiguous solution: improve communication. But what does that really mean for nursing teams?
“We have a lot of goals for Thibodaux. Our team decided to have monthly meetings on specific topics, such as inpatient needs or evaluating existing workflows. Those meetings became a time to focus on a single topic to see what changes we can implement.”
- Ashley Becnel, RN, Senior Clinical Analyst, Thibodaux Regional Health System
“We have a team called the Nursing Based Evidence Council. They meet monthly and take many different things there from wanting to change a workflow with documentation to setting up trials for different initiatives. Anything new requested goes to the council to assess for need. We have several nursing based councils that encourage involvement, and it does give the nurse a voice in many initiatives across the organization.”
- Kim Maples, MBA, RN, CIO/Vice President Support Services, Carteret Health Care
“At this time we do not have a dedicated nurse optimization group. Instead, I meet bi-weekly with specific departments to review questions, concerns, workflow, etc. Additionally, I meet every other month with our Acute Nursing Unit Based Councils (UBCs) to discuss various questions, concerns, workflows, process improvement, etc. These meetings, especially with the FUBCs, provide an opportunity to engage in discussions regarding functionality and build, offering insight into the behind the scenes efforts and rationale behind decisions. During these meetings, the transparency fosters open discussions and validates the nurses as key stakeholders. It also increases their sense of support and promotes shared-ownership and decision making.”
- Amber Lusk, MSN, RN, CNOR, CSRN, EHR Data Analyst/Nurse Champion, Northfield Hospital + Clinics
Creating opportunities to routinely meet nurses with a set, problem-solving agenda encourages productive conversation. Nurses have much to offer as the liaison between patients and physicians, and giving them an opportunity to share their ideas adds an imperative voice to the table.
“We want to be included in EHR optimization efforts."
The success of usability depends on the end user, so it’s only natural to involve nurses when optimizing nursing EHR workflows. Saving time on documentation not only reduces the impact of bureaucratic tasks but reduces time taken away from patients, so nurses can enjoy more of the patient connections that likely inspired them to enter the field.
“In April 2021, Boone Health implemented MEDITECH Expanse. We saw quickly that we wanted to give more attention to clinical workflow issues, in particular nursing documentation. But rather than leave the decisions to IT and nurse managers, we took a different approach. We formed our Nursing Optimization group, which includes a member of staff from every specialty to ensure equal representation across the board and to give nurses a much deserved voice in decisions. We made it a priority in IS to empower nurses with more ownership over the system and give them the platform they needed to offer their expertise.”
- Alison Smith, BSN, RN, Manager of IS Operations, Boone Health
“It's our nursing PI (Program Increment) goal – a wildly important goal – to improve joy at work by increasing efficiency of the EMR for nurses. We sent a staff survey previously and will send another this fall to measure what nurses like and what they don't like in their day to day work. Our main focus now is improving assessment questions and workflows.”
- Holly Davis, MBA, BSN, RN, Chief Nursing Officer, Bingham Memorial Hospital
When King’s Daughters Medical Center implemented Expanse Patient Care, MEDITECH worked with KDMC to put together a usability group to improve the user experience aided by quantitative data. KDMC also encouraged collaboration between nurses and their physician colleagues who were already on MEDITECH Expanse. It resulted in an impressive 100+ hours given back to nurses. “Everything is at our fingertips in a more user-friendly layout. It is amazing having easy access to everything we need to know about our patient basically on one screen rather than clicking through several tabs and pages to find what we need.”
- Eric Rowland, RN, ED Nurse, King’s Daughter Medical Center
Additionally, providing robust training improves application navigation for more informed optimization conversations. For the end user, MEDITECH provides role-based curriculums via our training on-demand page in the customer portal.
“We want solutions personalized to nursing workflows that we can trust.”
Technology revolutionized healthcare’s data sharing and access, but that shouldn’t be at the detriment of nurses and physicians. Nurses are always on the move, so their devices should move with them, making it easy to multitask documentation while caring for the patient.
“A few things that we have done to address the documentation burden our staff experience is one, virtual nursing, but the other item that we have done is rolled out the use of our Point of Care devices. Our staff are able to take these handheld devices into the patient's room at any time and do quick assessments on those. They're not having to take a computer on wheels into the room too. Our staff are appreciative of that quick way that they can document versus having to go find a computer or push that computer on wheels in the room.”
- Kelsey Reed, DNP, FNP-C, Director of Patient Care, Phoebe Putney Health System
Appalachian Regional Healthcare leadership identified an opportunity to improve their nurse-driven diabetic ketoacidosis protocol in Expanse. The new protocol reduced the amount of time to DKA resolution by 25%. “To improve the quality of care for these patients, a multidisciplinary team (of physicians, pharmacists, nurses, and IT analysts) researched best practices to develop a new DKA protocol and built the workflow into our Expanse EHR. Automating much of the process in Expanse helps nurses feel more empowered when caring for these high-acuity patients.”
- Montie Hodge, Chief Information Officer, Appalachian Regional Healthcare
“Having the ability to use the mobile phone to scan meds, patient documentation, and lab collection has improved nursing workflow by providing added functionality to a tool already in use. Having the mobile phone provides an option for when the bedside scanners are not charged or synced to the computer, also if a computer is not readily available. It also empowers clinical support teams such as patient care techs to document quickly Bathing, VS, I&O more quickly which supports the nurses workflows. Additionally, it supports the nurses in critical situations with the ability to scan an armband and see the patient's record, allergies, and MAR to streamline responses.”
- Tara Haines, BSN, MSN, MBA, Associate Vice President, Nursing Informatics and Engagement, HCA Healthcare
The universal message is clear: when workers feel heard by their leadership, positive change follows.
By executing change guided by nurse feedback, organizations can work towards stabilizing the overarching issue of a chaotic work environment and better aligning workforce values. It takes time and patience to reignite the joy in work when dealing with burnout, but recognizing nurses as an invaluable resource will give back their sense of belonging, confidence, and appreciation as a strong start. It’s never too late to invest in a happier workforce.
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