Nurse burnout? Try telehealth, clinical decision support and analytics tools, expert says
Just like physicians, nurses can burn out. Healthcare is a highly demanding field, and sometimes nurses just hit a wall.
One of the things that can contribute to nurse burnout is health IT. Too much technology, demanding too much of a nurse's time and attention on a daily basis, can drive a nurse up the wall – especially if the tools are not designed well.
A Vocera report conducted by HIMSS Analytics, in fact, found that among 150 participating clinical and IT workers, including doctors and nurses, report that so many interruptions from alerts, alarms, pagers, phone calls and texts create stress that, in turn, fuels burnout.
That signals, at the same time, that one of the things that can help prevent nurse burnout is smart and well-designed tools that offload work from nurses, streamlining processes and generally make their lives easier.
JoAnn Lazarus, RN, a nurse and a principal who specializes in health IT at Philips Blue Jay Consulting said nurses can have a love-hate relationship with technology.
At times, it can require unwanted process changes for nurses, she explained. But health IT should support nurses' workflow, not force them to change it.
"For example, nurses want to admit their patients to the bedside monitor where they can check patient identifiers and ensure the right patient is added," she explained. "However, if a monitor is added without a keyboard, it forces nurses to go to the central monitor down the hall to enter the information, while usually carrying a patient sticker and getting interrupted a few times on the way from the patient's room to the central monitor."
With the distractions of walking through the department just to add in a patient's information, it can be very easy to enter the wrong patient, and subsequently all of the vital sign data onto the wrong patient's chart, she added.
It also can be frustrating for nurses when IT systems are implemented without measurable positive impact.
"For example, the hospital may implement new smart pumps that frequently go out of service because they have to be updated manually, when the previous smart pumps were able to be updated remotely and not delay nurses," Lazarus said. "Health IT delays can also come from needing to input the same information, whether it's patient information or information about the RN, into multiple systems because the various systems aren't interoperable."
An additional problem is that there's often not enough devices for nurses to use. If they have to wait 30 minutes to use the bedside lab label printer, for instance, here's a high chance they will end up turning to a workaround.
"Nurses want to know there is an open line of communication between them and management if technology isn't working the way it should. This transparency will build trust, improve satisfaction and ultimately reduce the chances of burnout."
JoAnn Lazarus, RN, Philips Blue Jay Consulting
"Not only do these types of delays wear down nurses, but then if they are held accountable by upper management for not using the new method, that makes nurses' outlook on their jobs and satisfaction even worse," Lazarus said. "Implementing technology without adequate support for the end user may create negative perceptions, impact the nurses' performance and may even delay adoption of the technology. These factors directly drive job dissatisfaction and can ultimately lead to nurse burnout."
Making IT work for nurses
Many of these issues can be addressed by incorporating nurses and front-line staff into the health IT review and testing, selection, determination of scope, education, roll out, and sustainability process, Lazarus said.
It's vital that nurses and other staff who are expected to use the technology are involved in order for the IT to be successfully adopted to improve hospital efficiency and patient care, she explained.
"In addition to sharing input, collaboration and transparency between hospital leadership and front-line staff is vital," said Lazarus. "Nurses want to be updated on the status of implementations and know that there is an open line of communication between them and management if technology isn't working the way it should. This transparency will build trust, improve satisfaction and ultimately reduce the chances of burnout."
Further, nurses are actively invested in technology that allows them to provide safe and effective care. When the tech supports patient care, is easy-to-use and works all of the time, it helps combat nurse burnout.
"For example, patient-specific clinical decision support tools can help nurses feel supported and confident in making the right care decisions for their patients," Lazarus said. "Predictive analytics tools also are helpful for nurse management as they can use this data to help drive staffing decisions, anticipate surges and manage resources effectively."
Also, IT that improves patient safety, such as medication barcode scanning at the point of administration, can be extremely beneficial to patients and support nurses' work, she added.
Another way IT that can help reduce burnout is enterprise telehealth programs such as an eICU, Lazarus said. In this case, a remote care team provides the bedside nurse with another set of eyes to watch trends in the patient's status, which reduces the stress on bedside nurses when they have multiple patients to care for simultaneously.
There are other areas where health IT can help prevent nurse burnout but the technology is being underutilized.
"Predictive analytics has great potential to help nurses effectively do their jobs and reduce burnout," Lazarus said. "Providing nurse leaders with this technology allows them to have real-time operational data at their fingertips, which means they don't need to ask for information they need to keep their unit running and can make care decisions more quickly."
Adding predictive analytics into an existing dashboard will allow the unit leader to better anticipate fluctuations in patient volume and allow for more accurate scheduling to ensure the team can meet the demands, she explained.
This also means if the leader has evidence that there are three weeks in the summer in which patient volume has historically been lower, it's possible to grant additional vacation hours during that time, increasing overall staff satisfaction, said Lazarus.