Nurse Manager Burnout - Emerging Nurse Leader

By Rose O. Sherman, EdD, RN, NEA-BC

Executive leadership turnover in healthcare in 2022 is skyrocketing, with 18% more CEOs leaving their roles than in 2020 or 2021. Burnout, exhaustion, and frustration with reimbursement are reasons why executives are rethinking healthcare leadership roles. And while undoubtedly these roles are taxing, the burnout and exhaustion among leaders at the front lines of care are even more significant. Like their executive suite colleagues, many frontline nursing leaders successfully navigated the challenges of 2020 and 2021 with an eye toward a more normal future.

2022 has, in some ways, proved more difficult as it has become increasingly clear that challenges with staffing, patient volumes, staff wellbeing, and inadequate reimbursement will likely persist well into the future. As I talk with nurse managers across the country, they cite many reasons for burnout, including the following:

Relentless staffing shortages coupled with financial constraints.
Expansion of spans of control as budgets tighten and more staff shift to part-time.
Spending 60-80% of their time on recruitment, staffing, and scheduling – sometimes with limited success.
Being a medical-surgical manager who has no applicants as new graduates seek specialty roles.
A shift in staff attitudes about teamwork and a move toward transactional relationships with a focus on cash compensation.
Skyrocketing patient and family complaints.
Watching nurses struggle with mental health issues and then calling them on their days off to come into work.
A lack of work-life balance as the tenure levels of staff have dropped, and they need more coaching and reassurance 24/7.
Guilt in knowing what is happening with nurse workloads is not sustainable but trying to convince staff that it is.
Struggling to remain positive in a culture of discontent.
Surging patient volumes and an expectation to keep admitting even if it means managers and charge nurses take full patient care assignments.

As we look at reasons for burnout, it is also vital to highlight best practices in helping nurse managers combat their burnout. The things that seem to help include the following:

Attending sessions with other leaders to share best practices and know that they are not alone.
A CNO commitment to frontline leader boundary setting (no emails on the weekends, a hard stop at the end of the day, reducing required meeting attendance) to achieve work-life balance.
Using the battle buddy program with managers, especially those new to the role.
Shoring up the manager role by either reducing span of control or supplementing with co-managers or assistant managers who are not in the staffing count.
Being vulnerable with staff about what is possible and what is not and staying in the manager’s circle of influence.
Weekly nurse manager support groups facilitated by psychologists and chaplains.
Covering nurse manager vacations with interim managers.
Nurse leader development strategies that are tactical and focus on how to coach a very different nursing workforce, especially Gen Z nurses.
Monthly or quarterly nurse leader appreciation days where leaders receive development and spend time with one another with no expectation that they will be at work that day – CNE and executive team take all staffing calls on these days.

In his recent advisory report, US Surgeon General Dr. Vivek H. Murthy sounded the alarm bells on healthcare worker burnout. He emphasized the need to not only look at staff well-being but also consider how infrastructure impacts wellbeing. He talked about the power of connection in healthcare environments. We have long known that frontline leaders play a major role in enhancing the well-being of staff. But they can’t do this if they themselves are burned out. Enhancing frontline nurse leaders’ well-being needs to be a priority in every organization.

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