As a nurse, you dedicate your working life to other people, you listen, provide support, and see people in extremely challenging times. However, nurses, being human as well, are also prone to the same struggles and difficulties as their clients.

When do we stop to consider caring for the carer? Who nurses the nurse?

There seems to be an undertone of the expectation of nurses, and mental health nurses included, that we do not become physically or mentally unwell. There is a lack of support for nurses, and nurses often fear seeking help due to the potential repercussions on their registration.

When nurses focus so much of their time on other people and work in a high stress environment, they can forget that they also need to care for themselves. When this occurs, we can reach the state known as burnout. Burnout is often the result of a combination of factors including work, self-care, and mental health. Burnout often manifests as feeling exhausted, lacking motivation, becoming disillusioned with your work, losing passion, and becoming ‘jaded’.

For nurses, this can often exhibit a change in the way we practise. It can lead us to become rash, impatient, rude, short or lack genuine care for the client. This has a major impact on the experience, perception, and outcome of nursing care for clients. This is why, as nurses, we need to prioritise self-care and prevent burnout. We became nurses to help people, and when we become burnt out, our ability and capacity to care for others is reduced. This is especially important for mental health nurses, who work with clients in distress. Without good self-care, we may be worn down by these experiences, and our ability to support others can be reduced.

Signs of burnout in nurses might include the following:

• Increased cynicism and indifference towards clients.
• Blunted or restricted emotions.
• Lacking confidence or doubting your clinical skills.
• Mental health concerns like anxiety, depression, low mood, and stress.
• Dreading going to work.
• Social isolation and withdrawal.
• Irritability or avoidance of work or clients, absenteeism.
• Reduced performance at work and increased number of errors.
• Increased substance use or reliance on alcohol, nicotine, coffee or even food.

• Recognition: Recognising you might be burnt out opens the opportunity to address it.
• Seek Support: As a nurse, you have just as much of a right to receive quality care as your clients do. Speaking with your General Practitioner, a counsellor or a psychologist would be a suitable first step. What we may be worried about as nurses is someone making a mandatory notification to AHPRA. To delve into this further, a mandatory notification can be made when another practitioner has concerns about impairment, intoxication, departure from standards or sexual misconduct. If you seek support for burnout, depression, anxiety, or other concerns, but you are still able to practise safely, there is no reason a mandatory report would be made. As a mental health nurse, I have cared for many other nurses, doctors, and health professionals, and I have not once felt compelled to make a mandatory notification yet. It would be inequitable and paradoxical to prevent nurses seeking help for their mental health. There are also programs like Nurse and Midwife Support, and the new Nurse Midwife Health Program Australia available. Some psychiatrists and psychologists may also bulk bill health practitioners for their service, though this depends on the individual clinic.
• Take Time Off: Taking some leave can provide you with well needed rest, and time to plan.
• Set Boundaries: Establish a strong separation between work and your personal life.
• Change Work: A change in your workplace can bring about a new perspective and fresh start.
• Education: Learning about mental health, burnout, and strategies to improve self-care can be especially useful. One such resource is the Navigating Burnout course from the Black Dog Institute: https://burnout.blackdoginstitute.org.au/. This anonymous online course is designed for health practitioners and applies to our unique context and situation.
• Prevention: Establish strong boundaries between work and your personal life, engage in positive self-care, take time for yourself, use your time off, have clear communication with your team and manager, and know when it’s time to take a break.

As we as nurses continue to navigate the healthcare landscape, the recognition and intervention of burnout is essential to ensure the wellbeing of nurses, as well as the quality of care for our clients. Remember, nurses are humans too.

Navigating Burnout Courses

Nurse and Midwife Support

Nurse Midwife Health Program Australia