Why Depression Is Causing Nurses To Leave The Profession

Another day on the unit.

No sooner do you arrive when you hear all the commotion of doctors, nurses, patients and families bustling around.

You sit down to get report. You immediately tense up when the night shift nurses starts off by telling you how horrible your assignment is and that the family is soooo painful.

The family of your patient calls at least three times while you are getting report despite the fact that they’ve been told to call back in a half-hour. Just after the night shift nurse leaves, the doctor storms into the unit and demands to know why your patient’s MRI isn’t done and that the tech is waiting for you now.

You haven’t even had a sip of coffee yet. Your eyes narrow, your start to get a pain in the side of your head and the anger starts to mount inside of you. There are 12 hours left in your day and you’re already exhausted and burned out. All you can think about is how you can break free of this job.

Is this a normal stress response or something else?

Shocking Statistics On Depression In Nursing

We all know that burnout is an issue in nursing. In survey done by the RN Network, they found over 50 percent of nurses were thinking about leaving the profession because of burnout — feeling overwhelmed, swamped with paperwork and a lack of job satisfaction.

Everyone gets annoyed with their job or stressed out, but there is a big difference between burnout and depression. Psychologists say burnout and depression are distinct entities.

Burnout is typically confined to the workplace. Over a period of time, untreated burnout can lead to depression. Depression can also exacerbate burnout causing nurses to leave the profession sooner, thereby creating a vicious cycle.

Depression is more general and overflows into different parts of one’s life and may affect relationships with family, friends and interest in hobbies.

According to research done by the Robert Wood Johnson Foundation, more than 18 percent of hospital-employed nurses exhibit signs of depression. That is more than double the rate of the general population. This statistic should raise alarms for multiple reasons.

Depression can lead to poor health, chronic diseases, increased absenteeism and an increase in medical errors. Depressive characteristics may also develop that could erode a nurse’s performance on the job, such as difficulty concentrating or responding to a crisis. Short tempers, irritability and a lack of interpersonal skills can cause tension with families and result in poor patient care.

The Dark Secret Of Depression In Nursing

Nursing culture may prevent nurses with depression to admit to having a problem or seeking help. After all, nurses are supposed to take care of other people’s problems. They are supposed to help others, not need help.

There is a significant amount of stigma around having mental illness in healthcare, such as the notion that it is a weakness or something a nurse might try to dismiss. Nurses may also try to hide it from their nurse manager, fearing it could put their job at risk. Therefore, many nurses struggle with depression and try to just “coping with it.” The pain of depression can lead to self-medicating, which unfortunately most commonly occurs with alcohol or opiates

With easy access to opiates, nurses can easily make the issue worse if treating themselves.

The impact of depression on the profession is profound as well. With fewer nurses entering the profession, and many nurses indicating that they want to leave, nursing is in a crisis. The lack of resources to help nurses who are at risk for burnout can lead to depression.

Seven Early Signs And Symptoms Of Depression For Nurses

Signs and symptoms of depression can include sadness, irritability, absenteeism, apathy, changes in sleeping habits, somatic complaints and weight fluctuations. While this list is not exhaustive, these signs and symptoms can help nurses recognize depression in themselves or their colleagues.

Sadness in a state of depression is more than a temporary feeling. Of course, everyone gets sad at times. Sadness is normative emotional state and a normal reaction that is triggered by something. In depression, a person tends to be sad about everything — in the absence of any trigger, this is more concerning.
Irritability can become accentuated as the threshold of a person’s outlook is lowered. A nurse might become quicker to get angry, frustrated or subject to emotional outbursts. They tend to break down faster and take longer to bounce back.
Nurses who are depressed call out more often, which can leave the unit understaffed and overstressed. Absenteeism brings down the collective nursing morale and breaks down the team approach on the unit.
Apathy is a loss or decrease of interest. Apathy is the lack of any compelling emotion to direct behavior. This type of behavior is displayed as indifference, detached and unresponsive. These qualities are detrimental to the care of patients, where emotion drives nurses to respond to issues on their behalf — whether it’s calling the physician to address a concern, pain management or coordinating care. A nurse who doesn’t care can be dangerous.
Changes in sleep vary from person to person in depression and can include anything from sleeping too much to insomnia. Sleep complaints are one of the key symptoms of depression and are one of the few proven risk factors for suicide. Restless sleep can significantly reduce quality of life and can exacerbate depressive symptoms. Night shift nurses are particularly at risk for disturbed sleep due to the unnatural sleep-wake cycles they must maintain in their jobs. However, day shift nurses who rotate to nights are more vulnerable to sleep disturbances, which can lead to depression.
Somatic complaints in depression include feeling fatigued, sluggish or having low energy. Nurses may complain about problems with thinking, difficulty concentration or not being able to make decisions.
Weight fluctuations are common in depression, as a nurse has changes in appetite. Weight fluctuations can be difficult to tease out from typical weight gain seen on the units from parties, families bringing in “treats,” donuts and other high fat foods. People who are depressed tend to gain weight faster according to researchers. Foods that have a high fat content or “comfort foods” provide a sense of contentedness that people with depression may experience.

Why Coping With It Isn’t Enough

Depression isn’t something you just “get over” or deal with. Nurses wouldn’t expect their patients to just smile to make everything better. The consequences of depression in nursing are high not only for themselves, but for patients and for the profession.

Studies show depressed nurses make more errors, have a higher incidence of chronic illness, obesity and are at increased risk for having cancer and cardiovascular disease. Nurse managers need to be aware of signs and symptoms of depression and let their nurses know that confidential treatment is available.

Advanced practice nurses are also in a position to recognize depressive symptoms in nurses with whom they work. A study in 2012 points out that using standardized depression screening tools can accurately identify nurses at risk.

How To Get Help

Treatment for nurses with depression are same for the general public, but finding a therapist who can tailor a management plan to the nursing lifestyle is preferred.

The stressors nurses have day to day can be intense. They may feel like they can’t take care of themselves, so creating a space at the beginning and end of each day is vital. Nurses need to focus on helping each other as well.

Aside from anti-depressant medications, cognitive-behavioral therapy is also highly recommended for nurses. In addition, yoga, mediation and exploring creative opportunities have been shown to engage the depressed mind while in therapy.

Having a physical and mental treatment plan can be highly effective in managing depressive symptoms.

Learning to love nursing again

Depression is a serious issue in healthcare that can leave you feeling angry, sad, frustrated and deflated.

Awareness is vital in this process. The most important thing is to recognize that depression is affecting your life and your work. The good news is nurses don’t need to go it alone. They aren’t the only ones in this situation. Depression is a problem that all nurses need to address. The stories and experience of nurses coping with depression inspire others to come forward.

With the right support we can tackle this issue together. If you recognize signs or symptoms of depression in yourself or your colleagues use the tips above to get the help needed.

Soon enough you’ll start to gain momentum and find the passion you once had for nursing.

Originally published at medium.com

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