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Hello, and welcome to episode 22 of The Haelan Nurse Chronicles. I’m Dr. Lorre Laws, your host, and today we’ll be discussing the challenges faced by nurses in the healthcare industry. We will delve into the recent survey results highlighting the burnout and dissatisfaction among nurses, particularly younger generations. Let’s explore the impact of avoidable  nurse-specific traumatization in the form of overwork and understaffing on nurses’ well-being and patient care outcomes.

In our exploration of the recent survey of over 18,200 registered nurses, we uncover a concerning trend of declining job satisfaction and increasing emotional strain among healthcare workers. The high patient loads, limited time for individual patient care, and lack of recognition are all contributing to the mental and physical exhaustion experienced by nurses worldwide; especially the early career nurses who are leaving the profession in droves while advising their friends to choose a non-nursing career path . This nurse-specific trauma of inadequate resources not only affects the well-being of nurses but also poses a significant risk to the quality of patient care and the safety of healthcare settings.

The stark contrasts in job satisfaction and career recommendations among nurses of different generations highlight the pressing need to address the challenges faced by healthcare workers. For example, in 2023, 25% of nurse respondents report being dissatisfied with their career.  

But when it comes to career satisfaction, age matters.  A whopping 57% of Gen Z and Millennial nurses report that they would NOT recommend a nursing career to their peers.  By contrast, 38% of Baby Boomers would NOT recommend nursing as a career choice.  This speaks to the ever increasingly difficult practice conditions . . .that avoidable nurse-specific traumatization . . .among other factors . . .taking a toll over time.  

Let’s unpack the nurse trauma-related factors as pertains to this study.  It surprises no one when reports indicate that nurses are stressed out and burned out.  What no one seems to be studying, discussing, or addressing is what lies beneath the tip of the burnout iceberg – nurse-specific traumatization – much of which is avoidable.

It’s true that vicarious/secondary trauma is inherent to our profession, as is the trauma that results from disasters.  We are all trained and have resources to support us in those instances.  As you’ll see below, the unavoidable trauma exposure is the least of our professional concerns.

Where nurses are unsupported is in the massive trauma exposure.  Nurses are among the high-risk professions, right along with combat military personnel and other first responders.  Yet 86% of nurses report having little to no support in addressing these traumatic events and their devastating impact on all aspects of one’s health.

The Questions No One Is Asking . . .Yet

I wonder what would happen if we studied the impact of historical trauma that is being transmitted from one generation of nurses to the next.  Nurses have always been devalued, overworked, under-resourced, and expected to be ever-resilient even beyond the physical limitations of the body.

Or what if we studied the impact of workplace violence of all forms – physical, verbal, emotional, lateral and vertical violence, bullying, hazing, gaslighting, extortion, etc.  How are those factors affecting professional wellbeing?  Safety?  Job satisfaction? Career longevity?

The same holds true for system-induced trauma and insufficient resource trauma.  I wonder how these factors affect nurses?  I think we all know and we can infer that these factors are at play for the more than 75% of nurses who report being emotionally drained and the 70% of nurses who fear that their job is actually hazardous to their health – up 19 percentage points from when that same question was asked at the peak of the pandemic (2021).

More than half of the nurses surveyed feel unappreciated and frequently want to quit their jobs or leave the profession.  Why?  In most cases, traditional stress management and self-care strategies . . .while helpful for symptom management . . .do not address the root cause.  For nurses experiencing nurse-specific PTSD, an entirely different approach is needed.  It starts with education and then training about how trauma imprints and disrupts bodily systems . . .right down to the level of the mitochondria!  Then, facilitated healing needs to happen with and for the nurses.  Not just pushing resources out and asking nurses to heal themselves.  That’s not how it works.

Nurses need to be seen, heard, felt, understood, supported, and facilitated as they heal from nurse-specific traumatization.

It’s no wonder that 75% of nurses surveyed report that the nursing shortage is worse than it was five years ago.  And a whopping 80% of nurses surveyed indicate that the nursing shortage . . .the shortage of nurses who are rightfully unwilling to work in unsafe and toxic conditions . . .will only get worse.  

This is due, in part, to the lingering stigmas around mental health and seeking support for nurse-specific traumatization, burnout, compassion fatigue, moral injury, etc.  Ours is not always a safe and just culture where nurses feel supported.  Nearly half of nurses surveyed reported that their employer supports a culture of wellness.  Let’s repeat that finding.  Nearly 50% of nurses surveyed said that their employer minimally supports or does not support at all a culture of wellness.  For example, 35% of nurses NEVER access their wellbeing or mental health resources and benefits.  At the other end of the spectrum, only 12% of nurses in this study reported participating in daily wellbeing or mental health promoting activities.

Importantly, only 20% of those surveyed utilized mental health programs at work.  Why?  Perhaps they don’t perceive that they need support, despite the statistics that suggest otherwise.  Or . . .and I suspect this is the more likely cause . . .is that nurses don’t feel safe to access employer-offered support for fear of stigma, retaliation, or termination.  That’s why I am here.  Through my nonprofit organization, I offer confidential educational and recovery services for those affected by nurse-specific traumatization.

So now that we are clear about the issues and challenges before us, let’s ask the big question of what do nurses need to alleviate these challenges?

-90% increase support staff

-89% reduce patient-nurse ratios

-87% increase salaries 

-86% safe working environments

-86% include nurses in decision-making process

 

Small gains are being made where policy supporting safe nurse-patient ratios are concerned.  Currently, California is the only U.S. state that has a law mandating a minimum nurse-patient ratio. The state of Main has a bill pending,  The Maine Quality Care Act, that would similarly require safe staffing ratios.

When it comes to safe working environments, it is crucial to adopt supportive trauma-informed structures and processes to ensure that the avoidable nurse-specific trauma exposures are addressed.  Also needed are external programs that educate nurses on how to insulate their nervous system so they can thrive in a regulated state instead of the survival mode state in which most nurses are forced to practice.  External programs are also needed where nurses can anonymously and privately be facilitated in their healing process, independent of employer knowledge.  For nurses to heal, they must – above all – feel and be safe.  That is definitely not the case in today’s healthcare culture.  And that is why I’m here. 

After conducting five years of research across four disciplines, I developed an evidence-based framework to guide and facilitate nurses in their healing.  These services are offered by my nonprofit organization, The Halean Academy.  If you or someone you know has been affected by nurse-specific traumatization, please seek support immediately.  I and my team are standing by to support nurses however possible.  Please join my Nurse Trauma Masterclass or schedule a personal call with me to explore the best healing options for you.

Until next time, thank you for all that you are and do.  

I see you.

I feel you.

I hear you.

And I am here for you.

From my healer’s heart to yours,

Dr. Lorre 💕

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