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"No matter how invincible we think we are, sooner or later we all need to “step away from the plate,” as they say in baseball, and rest." —Barbara Ann D’Anna |
ADVANCING KNOWLEDGE THROUGH COLLABORATION
Nurses need rest, too! by Barbara Ann D’Anna In 1930, philosopher Bertrand Russell predicted the imminent arrival of the four-hour workday. Russell was convinced that happiness and prosperity would be found in technological advancements and mass affluence, thus allowing all classes to devote their lives to “higher intellectual pursuits” and unrestricted leisure time (Leggiere, 2002). However, this expectation was never realized. Instead, a 24/7 workplace emerged. Rather than reducing the 40-hour workweek, productivity-enhancing technologies increased it to 60-plus hours. In addition, PDAs, PCs and cell phones keep us tied to the workplace by invading nonwork hours, including weekends, holidays and vacations. People cannot sustain a 100-mph pace, day after day, and continue to function without a break or rest of some kind. No matter how invincible we think we are, sooner or later we all need to “step away from the plate,” as they say in baseball, and rest. A recent study by the New York-based Families and Work Institute, which surveyed more than a thousand full-time workers in a variety of professions, found that almost 50 percent often felt overworked and overwhelmed by their schedules. Overworked and overstressed health care professionals make mistakes that are sometimes fatal. A report by the Institute of Medicine (1999) revealed that errors in the nation’s hospitals cause between 44,000 and 98,000 deaths per year. Throughout the United States, nurses give similar reports: “I leave work at the end of the day, and I put my head on the steering wheel and I wonder, did I do something because of the fast pace and being tired that caused a patient harm?” (Robinson, 2003). As health care organizations strive to function effectively in a world that is increasingly turbulent and unstructured, working in those environments can be challenging and frustrating, However, if the turbulence is not navigated with care and attention to self, there can be a negative impact on the health of the caregiver (Ramlakhan, 2002). This begs the question: What is the human toll for keeping this “always-on” pace going? We may think we are getting more done at a nonstop work pace, but when we operate in a rote hurry-worry mode, without thought or design, it takes longer to do things and we may have to redo them later. Robinson refers to this state of mechanical frenzy, in which we are convinced we cannot let up for a second because there is too much to do, as the false urgency of performance momentum—activity done without conscious intent or awareness of purpose (Robinson, 2003). Today’s organizations seem to be testing the theory that people can work forever with no time to recover (Maslach & Leiter, 1997). Long stretches of work, mountains of paperwork, managed care and systems integration are just some situations that can push health care providers to performance momentum, leading to exhaustion and burnout. In the years following Freudenberger’s (1974) pioneering work on burnout among caring professions, there has been an explosion of interest in and research about this syndrome. Burnout has been described as failing, wearing out or becoming exhausted by reason of excessive demands on energy, strength or resources. Maslach & Leiter (1997) defined burnout as loss of concern for people with whom one is working—a physical and emotional exhaustion in which the professional no longer has any positive feelings, sympathy or respect for patients. Negative effects of burnout can be devastating. Rudeness, sarcasm, criticism and insults become the rule rather than the exception (Maslach & Leiter, 1997). The symptoms of burnout can vary, however. Some people become irrationally angry, while some become quiet, introverted and isolated, possibly indicating the onset of serious depression. Other manifestations of burnout include eating too much or too little, abusing alcohol and drugs, or suffering physical symptoms such as chronic malaise, hypertension and frequent headaches. Burnout causes a downhill spiral that disintegrates relationships with family, friends and colleagues and leads to a fading sense of dedication and commitment to the organization (Maslach & Leiter, 1997). Burned-out people are too depleted to give of themselves in a creative and cooperative fashion (Montague, 1994). The extra hours that we work have to come from somewhere, and it’s usually sleep time that is shortened. Sleep and vacations are low priority on our lists of things to do. But it’s really the opposite; we cannot afford not to get the rest we need. Researchers at the National Sleep Foundation report that 63 percent of American adults don’t get the recommended 8 ½ hours of sleep. Their study suggests a direct relationship between the amount of hours worked and a corresponding loss of sleep. Chronic sleep loss can lead to hazardous and even fatal situations. Every year, sleep deprivation causes more than 100,000 traffic accidents, killing more than 1,500 people (Robinson, 2003). Working to exhaustion and not stopping to restore and refresh forces one’s body to take its own break. Those who rest when needed are able to combat burnout and manage workplace stress. Conversely, those who do not rest will experience physical and emotional exhaustion that leads to resentment, loss of interest and inability to function. The Hawthorne Studies, conducted from 1927 to 1932, revealed that five-minute rest breaks increase worker output, and 10-minute breaks increase it even more. Life satisfaction comes from a host of things that do not have price tags or prestige attached to them: close relationships, a sense of belonging, positive attitude, managing expectations, strong self-esteem, work goals consistent with personal values and an active leisure lifestyle (Charles, 2003). The path to long-lasting life satisfaction starts with a sustainable pace. Striking a healthy balance between work time and leisure time provides the human body and mind with the required restorative maintenance needed to be able to operate at top capacity. RNL
References Charles, J. (2003). Inspire yourself! Meetings and Incentive Travel, 31(3), 14. Connor, T. (2004). Recharge your batteries. National Driller, 25(2), 20. Freudenberger, H. (1974). Staff burnout. Journal of Social Issues, 30, 159-165. Kohn, L., Corrigan, J. & Donaldson, M., eds., Institute of Medicine. (1999). To err is human: Building a safer health system, National Academy Press: Washington. Leggiere, P. (2002). What happened to the leisure society? Across the Board, 39(4), 42. Maslach, C., & Leiter, M. (1997). The truth about burnout. San Francisco: Jossey-Bass Publishers. Montague, J. (1994). Averting burnout crucial to health of care-giver, hospital survival. Hospital & Health Networks, 68(15), 178. Ramlakhan, N. (2002). OHP heal thyself. Occupational Health. Sutton, 54(8), 26. Robinson, J. (2003). Work to live. Toronto, Canada: Perigee.
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