From bathing to mobility to cataloging changes in condition, CNAs (certified nursing assistants) provide essential services that help people meet their daily needs when they are unable to do so themselves. Like other healthcare professionals, CNAs are at a high risk for burnout due to the emotional and physical demands of their work. In addition, the workforce shortage, a wider, systemic issue, is a major contributing factor in burnout — one that will need to be addressed collaboratively by government agencies, facilities, professionals and technology.
Understanding CNA burnout
Burnout is a state of emotional, physical and mental exhaustion caused by prolonged and excessive stress. It occurs when individuals feel overwhelmed, emotionally drained and unable to meet constant demands, and it can lead to decreased motivation, reduced performance and a sense of helplessness.
Burnout is common: In late 2022, more than 42% of 10,000 workers throughout the world reported it. In the nursing profession, burnout affects the majority. Our “Solutions to Healthcare Burnout Report” found that 81% of nurses have been burned out before, and 62% are at risk of burnout right now. What’s more, 94% have made personal sacrifices for their work, including missing weddings, graduations and funerals.
Causes of CNA burnout
Many factors contribute to CNA burnout. Here are a few:
1. Heavy workloads
A heavy workload can be caring for more patients than you can reasonably handle or working too many shifts. A 2022 study focused on CNA burnout found that over 70% of CNAs attributed their burnout to the nursing shortage, and 79% of nurses surveyed by nurse.org attributed burnout to it.
2. Demanding shifts
A demanding shift occurs whenever stress levels increase. That can happen for many reasons, like dealing with a patient emergency or having to choose which patients get care during workforce shortages.
3. An unsafe work environment
Unsafe healthcare environments are increasingly common trends exacerbated by the pandemic: 41% of nurses surveyed by nurse.org said they felt unsafe at work. Workforce shortages also create unsafe environments for both patients and nurses.
4. Lack of support
Lack of support from teammates and supervisors can also be an issue: 61% of nurses from the nurse.org survey felt unsupported at work, and 95% of nurses in our “Solutions to Healthcare Burnout Report” feel misunderstood.
A study focused on acute care CNAs during COVID-19 attributed burnout to staffing challenges, lack of respect and recognition, the physical and mental toll of the job, lack of facility leadership support and lack of pay or incentives.
The reason people leave the field is not because they don't love the work. They love the work. These are people who get into it because they want to care for people. They care about keeping people healthy and safe and heard, but it's the confines of the work structure that make it impossible for them to do that.
Signs and symptoms of burnout
Christina Maslach, burnout expert and creator of the Maslach Burnout Inventory, which is the gold standard for measuring burnout, says burnout is a combination of the following:
1. Emotional exhaustion
Emotional exhaustion may include physical symptoms such as fatigue and headaches and can lead to a loss of motivation or interest in work, along with increased irritability or cynicism. (Emotional exhaustion may also lead to medical errors. More on that soon.)
2. Depersonalization
Depersonalization may make CNAs feel like robots, begin to see patients as “impersonal objects” or behave as if in a dreamlike state.
3. Reduced sense of personal accomplishment
While experiencing burnout, people also tend to have a reduced sense of accomplishment. Since poor performance can be a result of emotional or physical exhaustion, that may be warranted, although it isn’t always.
Impact of CNA burnout on patient care
When nurses are burned out, patients can suffer. A meta-analysis of 82 studies on burnout identified that burnout negatively impacts quality of care and patient safety. It also cited several studies that claim burnout leads to increased absenteeism and turnover. Depersonalization, a burnout symptom, has been linked to poor patient satisfaction.
Cognitive issues associated with burnout, such as attention deficits, can lead to medical errors, which can lead to poor patient outcomes: A 2016 study found that medical errors caused 250,000 deaths annually in the U.S.
Building resilience as a CNA
CNA burnout is more of a systemic issue than a personal one. Even so, you can start to relieve it by building resilience, which helps you rebound from stress much quicker. To start building resilience:
Tap into your support network
Make time to show appreciation for others, ask for help, and stay in touch with your friends and family. It’s also important to make sure your relationships are actually good for you. If you don’t have people you can count on, figure out ways to meet people who share your interests and values, such as volunteering or joining local groups.
Examine your thinking and reframe events if appropriate
Start to notice how you interpret the events around you. Also observe how you handle negative emotions and how you feel when faced with obstacles or failures. Do your interpretations and reactions make events feel more stressful? If so, see if there are any other ways you can think about what happened.
Take action when needed
It’s critical, however, not to downplay events that require action. Ask for help from your team when needed, and report harmful incidents to the appropriate authorities.
Find meaning and purpose
Chances are you became a CNA because you care for people and want to help. Lean into that when times are stressful. Or lean into the other parts of your life that feel meaningful or provide you with a sense of purpose.
Take better care of yourself
Self-care alone can’t relieve burnout, but taking care of the basics, like getting enough sleep, staying hydrated and looking after your nutrition, can help.
Strategies for preventing CNA burnout
Set realistic goals and expectations
Be real about what you can and can’t change about yourself or your work environment. Take action on what you can change, like carving out time for a 10-minute break or regulating your breathing for a few minutes. Chunk larger goals down into smaller, more achievable action items.
Manage time and prioritize tasks
There’s only so much one person can do in a day, and sometimes there’s more to be done than time to do it. Recognize that, and prioritize to the best of your ability. Reach out for help if you need it — asking for help can even you feel more connected to others.
Seek professional development opportunities
Building your skill set can increase your sense of personal achievement at work. There are many career paths CNAs can take, and working toward a self-defined goal can help improve work satisfaction levels.
Balance work and personal life
Work-life balance can be hard to manage for those in the healthcare profession. Making time for what really matters to you, taking time away from work and scheduling breaks while working can help.
Try mindfulness
Mindfulness practices show great promise for helping to reduce stress levels. Pick a practice that works for you — a few minutes of meditation, breathwork or even just noticing the sights and sounds around you can make a difference.
Create a healthy work environment
A healthy work environment is one of teamwork, support and open communication. As a CNA, you don’t have control over much of what happens in a facility, but you can make an impact on those you work with. One nurse headed an initiative at her facility to encourage nurses to take breaks. She called it the "Restorative Break Initiative.” Other nurses, like Hazel W. Johnson-Brown, changed history.
Using the ShiftKey app to address CNA burnout
You can reduce some of the effects of CNA burnout by introducing more flexibility into your schedule. Gloria, a CNA pursuing a bachelor’s degree in nursing, uses the ShiftKey app to pick up PRN shifts around her classes. Linkeitha, also a CNA, uses the ShiftKey app to be there for her five children. Gloria, Linkeitha and hundreds of thousands of independent professionals use the ShiftKey app to work on their terms, set rates they prefer and more.
CNA burnout and you
CNA burnout is a complex issue. You can’t fix it alone, but you can find relief. If you’re experiencing any signs of burnout, such as anxiety, concentration issues, depression or fatigue, it’s important to take action. In 2022, the U.S. Surgeon General put out a burnout advisory declaring burnout a national crisis and priority and outlining what healthcare professionals (as well as facilities, policymakers and insurers) can do about it. See “Addressing Health Worker Burnout” in the reference section for a link. If you’re looking for more flexibility in your schedule, see how ShiftKey can help.
References
“Future Forum Pulse” (Future Forum).
“Solutions to Healthcare Burnout Report” (ShiftKey).
“Nurses are Burned Out. Can Hospitals Change in Time to Keep Them?” (New York Times).
“What Are The Symptoms Of Emotional Exhaustion?” (Healthline).
“Regan Parker: ShiftKey Offers Healthcare Workers Freedom, Choice, and Control” (FRIED. The Burnout Podcast).
“How to Measure Burnout Accurately and Ethically” (Harvard Business Review).
“The Relationship Between Professional Burnout and Quality and Safety in Healthcare: A Meta-Analysis” (NIH).
“Influence of Burnout on Patient Safety: Systematic Review and Meta-Analysis” (NIH).
“Building Resilience” (Cornell Health).
“Asking For Help Is Hard, but People Want To Help More Than We Realize, Stanford Scholar Says” (Stanford Report).
“The Surprising Connection Between Goal-Setting and Burnout” (Thrive Global).
“Meditation and Mindfulness: Effectiveness and Safety” (NIH).
“Take a Break! The Case for Prioritizing Rest Breaks” (University of Utah).
“10 of the Most Influential Nurses in History” (Nurse Journal).
“Job Burnout: How to Spot It and Take Action” (Mayo Clinic).
“Addressing Health Worker Burnout” (HHS).
