ICU Nurse Rebecca Prill talks nursing burnout and scope of practice

Morning Brew's healthcare edition features a Weekly Rounds, checking in with clinicians from various specialty areas. It's a great way to grow understanding of real world healthcare - always remembering that each facility and each region have their own unique issues.

https://www.healthcare-brew.com/stories/2023/06/26/icu-nurse-rebecca-prill-talks-nursing-burnout-and-scope-of-practice

How treating trauma patients and aggressive behaviors can affect nurse burnout.

June 26, 2023 · 3 min read

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This week’s Making Rounds spotlights Rebecca Prill, a trauma intensive care unit (ICU) nurse at Atrium Health Wake Forest Baptist Medical Center in North Carolina. Prill spoke with Healthcare Brew about the factors leading to healthcare worker burnout and how policy changes can help nurses practice at the top of their professional scope.

This interview has been lightly edited for length and clarity.

Tell me about your background and work as a nurse.

I’ve worked at medical-surgical (med-surg) units in South Dakota and I’ve worked at med-surg units in North Carolina. Now I’m working in a trauma ICU at a Level 1 trauma hospital. I see a lot of gunshot wound victims, I see a lot of motorcycle/motor vehicle accidents, I see a lot of self-harm and self-inflicted wounds, as well as pretty much everything and anything in between.

What’s the best change you’ve made or seen at a place you’ve worked?

Nursing-driven protocols: Our providers are really working toward getting the nurses to be able to do a lot of things on their own, so we don’t need to get provider orders for everything that we do. Something as simple as [removing or inserting] a Foley catheter—which is a catheter that basically goes into the bladder and drains out your pee when you have any kind of bladder or urinary obstruction. That saves phone calls, it saves providers from having to take the time to put in orders. It allows nurses to use their own judgment and their own education and critical thinking skills to do things.

What’s the biggest misconception people might have about your job?

A lot of people think that nurses go into the career because they love it and it’s amazing—and a lot of people do—but there are a lot of people who get burned out very, very quickly. They’re not happy with their jobs, they’re not content—they’re pretty miserable, actually. We experience a lot of abuse within our careers from patients. I’ve been choked out by patients, I’ve been spit on, I’ve been assaulted more times than I can even count, verbally assaulted all the time. It’s just something that we are constantly exposed to. And we’re constantly exposed to trauma, death, and dying—that can really mess with your psyche.

Half the people I know and work with are on antidepressants or going to therapists—or anything along those lines—just to help them cope with what we see and what we go through on a day-to-day basis.

From your perspective, is there anything that could be done to help change that?

Hospitals do their best. It’s not so much a policy issue; it’s a human condition issue, I think largely. Hospitals could possibly provide defense training or education on how to defuse escalating situations. Not many do and it’s not widely available—or widely known about. That would be really beneficial, as a whole.

I’ve done online training, but online training and real-life training are two very different things. And I didn’t do it within a hospital setting; I did it in other environments.

Shannon Young is a Massachusetts-based reporter for Healthcare Brew. Most recently she covered healthcare for POLITICO New York in Albany. Shannon has reported on federal and state government in New York, Massachusetts, Ohio, and Connecticut. She is a graduate of Boston University.

I can recall two nurse safety training opportunities: both were in-hospital. One offered psychiatric insights and techniques, the other had self-defense tips stressing harm avoidance for both patient and staff.

Were Michigan blessed with fewer state mandates, perhaps more such excellent opportunities would be possible.