Burnout is something that nurses were feeling before the pandemic, but COVID-19 pointed a big spotlight on just how burnt out nurses really are. Out in Alberta, there is an amazing nurse, Darlene Schindel, who is lovingly referred to as the “Nurse’s Nurse” and who has made it her mission to help nurses go from burnt out and on the verge of giving up their careers to thriving and enjoying the practice again. Darlene is a very busy woman, but the Caring Support Podcast was lucky enough to get the chance to sit with her to discuss the struggles nurses are facing and how she is working to provide assistance and change to the industry.
Well, first of all, I'd just like to say hello to everyone out there and thanks for tuning in from wherever you are tuning in from.
My name is Darlene Schindel, and I am a Registered Nurse. I have practiced in Alberta for many years now. My background is in neuroscience nursing, and it's taken me through the full scope of opportunities in caring for the people of Alberta or wherever they came from, to get care.
In my career, I've worked from the bedside to the boardroom table and everywhere in between. I was always very inquisitive about how can we do things better. It's funny because when I first started nursing, I was always like that, and I still have those very first nurses that became my best friends and I don't know how they put up with me, but they did, and they nurtured me and taught me, but that was me, always wondering how can we do things better?
From my nursing career, I went on to get a degree. I went on to get a baccalaureate in nursing, and then I did a master's degree in health Studies in leadership with a focus on leadership in health care. It's interesting, in all my work, the patient or the person that I was caring for and their families is what mattered most.
Surprisingly in 2013, I received the Medal of Honour for a non-physician from the Alberta Medical Association for my contributions to health and health care for the people of Alberta. This honour, which I was totally surprised about and totally honoured to receive, was really a reflection of what we can do when we work collaboratively across the healthcare professions.
That's an interesting story and probably one that many people, and certainly many nurses, can relate to.
Organizations, and that includes health care organizations, decide how they run their businesses, who they employ, how many people they employ, how many they need, and how many they can afford to have on their staff. That's their system structure and we certainly know it well in health care. Whenever management makes changes, it usually involves staff because they often are the biggest cost to the business. We know that is the case in healthcare because when you look at expenditures across healthcare, the biggest expense to the employer is the employees of any healthcare system or nurses. That's often where money is saved. Let's just cut those jobs, thin things down and we'll save money. So, that's what happened. That was my experience.
My job, which I loved, was eliminated and so was I. Suddenly, I was there one day doing this major project that the government had wanted us to work on and then it was, “Oh, sorry, we're changing now” and so it was gone. I was devastated because at that time the work that I was involved with was key to turning and bringing new care plans into Alberta. It was huge. I had a lot of people that trusted me across different professions, and I really felt like, Is that what it feels like to have your work to what you're doing?
It was a real shock, but out of all the life experiences we have come to, our greatest potential and this certainly was my experience. That is where I learned about coaching. I saw a huge potential in health care, especially about how this could serve nurses. People always said to me, as I was going through this, I studied for two and a half years and really got immersed in the profession and became a certified coach, and people would say to me, “Oh my gosh, Darlene, you could do it here, and we need to have it here and we need to have it there” and I struggled as to where could I really serve.
It was that year when I was doing my nursing registration here in Alberta, and I had this epiphany that the people that I really cared about were the nurses themselves. Now a lot of people across Alberta, especially here in Edmonton, in my women's business group, say, “Oh, you're the nurse's nurse” and yeah, that's what I am, but I really am focused on transformational leadership in health care and that includes systems redesign.
Yeah, it’s a huge problem. Burnout is a work-related stress syndrome and it involves emotional exhaustion, depersonalization, and reduced personal accomplishment. Nurse burnout is related to our nurse’s deteriorating mental health, poor patient care, and quality of care. It's a significant concern in health care.
Burnout is a very real and debilitating, emotional and physical state for anyone and what has happened with the onset of the pandemic is that the demand on the acute health care system has continued to increase with absolutely no relief in sight for long periods of time. As the patients were getting sicker and we were dealing with the isolation required due to the virus plus not being allowed to see their families, they were restricted and nurses were increasingly unable to provide care the way they felt that they needed to provide care for their patients needs and what they deserved. It led to this daily grind of feeling that they were not good enough. If you feel that you are not good enough to provide that care and compounded by loss of life, no family support allowed for the patients, it literally was unlike anything that our acute care systems have experienced.
Burnout has been going on in professions forever, but it can be easily hidden. What happened during the last several years in living and experiencing that pandemic was that now we had such a huge shift in focus to acute care, and all of a sudden everybody needed that care and everybody realized that there wasn't enough staff to look after all those patients that were there. That was the biggest insight: burnout was everywhere, and nurses were deep into it.
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When I have the privilege to coach a nurse or any health care provider for that matter, it all starts with listening and really hearing what is being said. It sometimes takes time to allow a person to tell their story because most of these people are not where they want to be. They're overwhelmed. They get up in the middle of the night and they're thinking, ‘oh, my gosh, I just can't even go to work anymore’.
So, you listen. You allow them to come up with the words to express what is going on for them in their heart, in their mind, and let their emotions out. Once they've poured all those emotions and feelings out, we can begin to talk about what they would love for their life and for their career and what their values and beliefs are. It would be surprising to you how many people have never made the connection that the decisions they make are based on their values and beliefs and they've never stopped to think about what matters to me. What do I believe about that?
That's another thing that has come out of the pandemic, because there's so much us and them and back and forth and all this stuff and it's really stressed nurses out a lot. But again, it's made them realize, I have to think about which side am I on what do I believe etc. It's made us really think about our profession and what are the principles that our profession is built on.
It's important here to mention that every nurse is a whole person. They are part of some family. They have people that care about them, they have things that they like to do, hobbies that they have etc. Work is only a small piece of who they are and what they do. Now, for most nurses, they go into it for all kinds of reasons, and they really care about the profession, but what happens at work affects them and how they show up at home and what is going on at home can affect them at work.
People often have referred to the idea of work-life balance. When you think of balance, there’s a scale, right? And it goes this way or that way. I like to think of it as not a scale, but of harmony, work life, harmony. So when you come to work, what's happened at home is affecting you at work and what you take home from work affects you at home. That whole idea of when you drive home, you get home, sit in the car, breathe, just let it go before you go in and greet your family. That’s important. Nurses could tell you stories that would curl your hair about them coming home and sleeping in a garage for all these months because they didn't want to infect their kids and families. We have a lot of healing to do in this regard.
Along with coaching nurses individually, I ran a small program to explore how group coaching would serve nurses. I was thinking about the new nurses that have been in nursing less than five years. They've just come out of academia and they're trying to fit in. It's a tough deal to get on board because it takes a lot of mentoring and nurses don't even have time for that. So, those new nurses are struggling a lot and it's not fair. We need to address that. Then there are those nurses that have been in the professions for between five and 25 years of practice and they've been in the thick of things and they're not feeling like they're being heard. They're in blame game and victim mode and they're just totally stressed and the last thing they need is to mentor that new nurse.
Then there was executive nurses, who are in middle or upper management, and they're expected to take the messages from high down to their nurses, make it happen, get the budget done, and make sure it's all working. They're in a really stuck place, too. Again, what we find is they're not listening to the nurses. They're not taking that message up. They're just delivering and they're not supporting the system's redesign that needs to happen.
What I learned from listening to this group of nurses in my pilot was the last thing that they wanted was to be put in a silo. They wanted to learn from each other. They wanted to find out, ‘Well, you're the nurse manager, how come I haven't had an evaluation for five years?’ Those are the small details, but they wanted to understand all the nurses in all capacities. That was a huge learning curve for me and it's what prompted me to transition my coaching of individual nurses into working with groups of nurses as well and it's really a much richer conversation.
What we're going through right now in health care is very much a systems problem. What I mean by that is that we know that 94% of the results that we get in any business, health care is certainly one of them. It doesn't matter what kind of businesses or what kind of work, but the problems come from the systems that we have in place. Our healthcare system has our health professionals so burnt out, exhausted and abandoning a profession that they once loved. The most caring thing that we can do for our healthcare staff right now is to actually provide them with good systems in which they can deliver care. How to Recognize the Early Signs of Burnout?
Instead of the current ones, which are so bad, they're burning out staff, we got to do something different. So how will we do this? Well, it all starts with listening and documenting the issues that nurses, for example, are dealing with on a daily basis and that they struggle with. It’s not just about going and protesting that we need more money. I don't think that's really what they're saying. They struggle with the care of their patients and for the families that they're dealing with.
Once you start talking then you need to identify what is the issue. Just let it all rise from inside them until they feel they've exhausted all the challenges that they've had. From there, you can start to get clarity on the priority challenges, organizing them and saying, okay, what do we need to do first? It isn't those big I.T. tech issues that we're going to address. It's little things. Is the coffee room clean? Can I actually go for lunch today? Can I have a bathroom break? How do we build that in? Does that mean we need different staffing levels and different staffing patterns and all of those things?
It's not the same for every care unit. You can’t design a system and say, okay, all the units are going to be like this because that's not what patient care is. The nurses can tell you what is needed for the care of that patient. That's what they're trained in. That's what they're experienced in, and that's who we must look at. We look at the priority changes that need to be made and then we engage in the sources and how do we going to do this.
Unfortunately, the “now” leadership in health care isn't going to do that. It's not because they're heartless, but it's because they're ignorant to the power of systems to define the quality of care for patients and work life for staff. Nurses need that education and training in systems-based problem-solving. As we get that into nursing, then we will start to see the changes and if we don't improve the systems, we can't improve outcomes and sustainability and resolve the problems.
There was a situation I just heard about from a nurse over the holidays, as a matter of fact. She is a relief nurse, so she works casual, part-time casual. She goes to many different units, and she works in an acute care setting. Now, these nurses are golden because if you're a floor nurse, you often will go to specific areas because just like you wouldn't want a heart surgeon doing your brain surgery, it's the same thing with nurses. They have amazing talent in certain areas.
However, this nurse was very valuable because she would go to many different areas, and she had been working for 15 years. During the pandemic, as a single parent, she was struggling with kids in school, then out of school, home-schooling etc. She decided that she needed to take a break. She spoke to HR and requested to go on a leave of absence for 6 to 8 months and said that she would come back when things are settled down. Maybe the next school year starts or whatever. She wasn't allowed to do that.
Here's an example of a systems problem. The HR system said no if you're a float nurse, you can't be on leave of absence. She ended up resigning and that’s contributing to the rise in resignation stats, but that wasn't the situation. She had to quit to take care of her family and now she's wondering if she really wants to come back. We're going, yes, you have a lot of service left inside of you.
This is what you care about. Sometimes a tiny situation like that shows that HR isn't working with the staff and listening to what they need.
I had the opportunity to coach a student nurse and she wrote a great testimony to me and one of the things she said is that she knew that there were things in her life that she wanted to change and that she needed to invest in herself. But she often felt frustrated, stressed, and angry in both her personal and professional roles. She struggled to make decisions, especially when people disagreed with her choices. She was just all over the place and not doing well at all.
When we started working together, I encouraged her to adopt other perspectives. Rather than just keep seeing the way the things are I helped her to shift her mindset. She would often assume that everything that was happening to her was her fault, and that when people were unpleasant to her, that was her fault. Then we really started to uncover her core values and their fundamental role in her life and how she could use them to recognize what's most important for her at any crossroads. It was like a light bulb went on for her.
I always tell my clients I'm just the cocoon. I'm holding you in a cocoon. From our work together, you will emerge to the person that's inside of you that's meant to be there.
The other thing that she often said, and again I hear this from all the nurses I coached, is that you're a nurse, Darlene. You understand what it's like when I tell you a story, when I share something, you understand. You've probably lived that exact same experience.
It’s amazing to see where this young nurse has gone and how she's excelled in her career just warms my heart. I'm so grateful that she saw the value of being coached and her career has really taken off and it's just such a great story.
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The best way to connect with people is through conversation. I think that's quite clear from our conversation today. It's the start of listening to what people are saying, what someone wants and what they want to share. I would love it if people would just reach out to me directly. I'm on LinkedIn. They can send me an email or call me, leave me a message and say, you know, hey, I want to tell you about what's happening with me, or can we have a conversation? Then we will set up a time for us to have a conversation, because that's how it all starts. With a conversation.
When I go back and look at how I've been able to help people, all I want is for everybody to live to their full potential. Yeah, that's all. Not something beyond what they can do, but just live to your full potential.
For nurses, if I can help more nurses live to their full nursing potential, that would mean their whole life would be healthier, happier. After all those years, working in neuroscience and fixing broken brains and bodies in the acute health care system, I've now shifted upstream to focus on building better brains and bodies. That's what I'm all about. If I can help you be the most passionate, successful, powerful person in your life and feel that you're doing what you're on this earth to do, that's what I want to do.
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Based out of Spruce Grove, Alberta, Darlene Schindel is an RN, Transformational Leadership Coach, Mentor, Teacher & Speaker inspiring healthcare professionals to 'be the change'. Through her work she coaches nurses, helping them with their purpose, burnout, and so much more.
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