What's In a Name?

One of the topics in oncology nursing that I am passionate about is the unparalleled stress we encounter in our work. It is multifocal, often unrelenting, and overwhelmingly unappreciated by others. It emanates from difficulties in teamwork; staffing; competing demands on our time between technology and the human side of caring; under-recognition of our skills by physicians and the organizational hierarchy; and our constant exposure to the grief of others. Unlike other colleagues, nurses can’t leave the scene when the stress becomes so overwhelming you want to implode. We are immersed in a work setting often characterized by negativity. Some may even call this environment toxic.

I have recently noted an increased press about health professionals’ burnout. Physicians are generally highlighted as being prone to this phenomenon. Rarely are nurses acknowledged for their risk. Being a frequent speaker on the emotional sequelae of nursing, one of the issues I often stress is the distinction between burnout and compassion fatigue. I often find myself critiquing the correctness of these concepts’ definitions and association, however, I recently had a realization: Does it matter what we call it? Ultimately, the most important thing is that we acknowledge this adversity and get help to minimize and manage it.

Nurses’ emotional distress has numerous roots. They include moral anguish, grief, frustration, impatience, guilt, witnessing constant trauma, and feelings of powerlessness. These can culminate in physical, social, and work-related sequelae such as fatigue, insomnia, loneliness, purposeful isolation, work performance compromise, and turnover. It is time that the reality of our stressful practice is not just recognized by oncology nurses, by the larger healthcare world as well.

Decades ago, an insightful chief nursing officer at my place of employment, decided to develop a program to expose non-nurses to the realities of our work. It was called “Walk in a Nurse’s Shoes.” Representatives from the mayor’s office, large insurers in our area, philanthropists, chief executive officers of major employers, university presidents, religious leaders, police and fire officials, and others, were invited to spend a day at our hospital to learn what nurses do. Each visitor spent 4 hours with 2 different nurses. I spent my day accompanied by the mayor’s assistant and a managed care insurance official. At the end of the day, there was a large group de-briefing.

When sharing their experiences, a number of these community leaders were moved to tears. Many voiced a sense of awe about what nurses were responsible for, and what they were able to accomplish. The majority relayed personal dismay at their lack of understanding about nursing work. They also shared that their time spent in this program completely changed their perceptions of nurses.

This is 1 example of showing, rather than telling, what the emotional labor of nursing practice looks like. It is exemplars like this that can drive the needed awareness of decision-makers about the realities of nurses’ work. We need people resources and financial backing to provide counselors, mentors, and teachers who can provide us with the needed skills to work in this stress-laden context.

I have decided not to get fixated on the name given to the stress that is part of our daily practice. Rather, I am going to lobby for interventions that will enlighten the power-brokers’ understanding of the resources we need to cope with this often-unrelenting stress. I encourage you to identify who a prominent decision-maker is in your setting who needs to witness firsthand the emotional sequelae you face when you nurse. Take their phone away and invite them to immerse themselves in your world to understand your situation better.