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New Hope For Burnout Syndrome in the ICU



By Andy Nellis

Inside every hospital, past the winding halls and busy reception desks, there lies a special set of rooms reserved for only the most critically ill patients. It’s a place most people would never wish to visit and yet for those who are admitted, it may be a lifesaver. It’s the Intensive Care Unit, or ICU, and it is staffed by some of the most highly trained doctors and nurses found anywhere in medicine. But for those who work there a normal day on the job is hectic, demanding, and beyond stressful because the every day the lives of their patients literally hang in the balance. So, with so much on the line, it’s no wonder why those working in the ICU feel a unique strain.

It’s a strain that’s experienced all throughout the unit, by doctors and staff alike, but it’s particularly sharp for those working closest to the patients – the nurses. Theirs is a role anyone would consider demanding since they must attend to the patient’s every need, doing everything from answering medical questions to consulting with family members, to carrying out the many treatments prescribed by the physicians. And performing this enormous duty subjects those nurses to some of the most jarring and psychologically taxing experiences in healthcare, leaving many feeling exhausted, frustrated, and unsure about their career choice. This in turn can cause them to leave their job after only a few short years.

This phenomenon is called Burnout Syndrome, or BOS, and it affects around 80 percent of ICU nurses according to an article published in the journal Depression and Anxiety This problem has wide-reaching effects on both patient care and clinical operations, which is why a team of researchers at the University of Colorado School of Medicine are exploring ways to address BOS through innovative research. 

The research team, led by Marc Moss M.D. of the Pulmonary and Critical Care Division at the University of Colorado Denver, aims to help ICU nurses combat burnout syndrome through a therapeutic intervention called Mindfulness-Based Cognitive Therapy (MBCT). Their study, based on the work of the University of Toronto’s Dr. Zindel Segal, uses a combination of mindfulness practices and meditation to provide ICU nurses with constructive methods for coping with the strain of working in the ICU. Participation involves four sessions where the nurses are led through mindfulness exercises designed to refocus their awareness on the present and to navigate their way through negative, automatic thoughts. It’s a lifestyle-change intervention that has been applied to treat depression, anxiety, and Posttraumatic Stress Disorder (PTSD) in the past. The team hopes their MBCT adaptation will help ICU nurses better manage symptoms of Burnout Syndrome, and develop a lifestyle of self-care and self-compassion in the context of their work.

“Imagine a 29-year-old otherwise healthy person,” Dr. Moss explains, “who is admitted to the hospital because of the flu, develops Acute Respiratory Distress Syndrome (ARDS) and dies. That’s not easy to deal with… It’s sad, it’s tragic.” And yet it’s something nurses have to deal with on a regular basis, and listening to Dr. Moss, it becomes very clear how difficult it is for ICU nurses, and all ICU providers and staff to handle such ongoing human trauma. Most ICU nurses are never trained to deal with the emotional fallout, and even if they are, the recurring stress associated with their position requires a certain level of resiliency that allows these nurses to respond healthily to even the most challenging medical experiences. Resiliency can be taught, and Dr. Moss hopes to address this lack of training through the MBCT intervention. “we need to provide the proper support and training so that critical care healthcare professionals can continue to enjoy their jobs and deliver the best care to their patients.”

While the study is still in its pilot phase it is already garnering attention. This past July, Dr. Moss lectured on the subject to the National Academy of Medicine’s Action Collaborative on Clinician Well-Being and Resilience. The first cohort of MBCT sessions for the study began this summer (2017), and if the intervention proves effective, the team aims to launch a nation-wide program, providing new hope to the future of the ICU, and the nurses who work there.