As a companion tool to the second edition of Beyond Burnout: Overcoming Stress in Nursing & Healthcare for Optimal Health & Well-Being, this workbook is organized around the Practice Pearls from each of the book’s chapters. Reflective questions for journaling are posed to further your self-awareness, followed by Action Steps to help you develop your own set of coping tools for personal and professional growth. Numerous online sources are also provided for further exploration. (Note: Some of the online sources are behind a paywall or ask for you to create an account to access them or save the results of surveys. Use of those sources is not necessary to gain full benefit from this workbook; they are provided simply as additional options.)
The objective of this workbook is to expand the reader’s ability to take action toward an enhanced awareness of self, others, and the healthcare environment; provide a structure for self-reflection and embarking on change; and be helpful as a guide for overall self and team improvement with the provided assessments, activities, and tools. The hope is that it will inspire you to re-commit to self-care, prevent burnout or overcome it, and ground you with the confidence that you have the skills and tools to navigate the unpredictable and stressful aspects of your caring career as a nurse or other healthcare provider.
While primarily structured as an individual journey of self-exploration, this workbook can be used in a variety of settings: as an individual, as part of a leadership development program, or in a classroom setting for beginning nursing or other healthcare students, continuing education for practicing clinicians, and more. The workbook is also intended to be a resource to return to when you feel you need reminders about those coping tools, or you want to explore more of the online resources provided. After all, our mindset should be that of lifelong learners!
Practice Pearl
Know the signs and most common causes of burnout. Understanding what burnout actually is and the types of stress that lead to burnout is key to understanding how to prevent it.
Action Steps:
List three signs of burnout:
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Define what burnout is:
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Reflection: Think about how stress affects you and ways you might prevent it from progressing to burnout. You can write your thoughts here:
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Action Step: Use this tool for your own or a team assessment: Maslach Burnout Inventory: https://www.bswhealth.med/education/Documents/well-being-resources/burnout-self-assessment.pdf
Action Step: Here is another tool designed more for organizational use: Maslach Burnout Inventory for Medical Personnel (nominal fee): https://www.mindgarden.com/315-mbi-human-services-survey-medical-personnel
Design or improve systems known to cause stress. It’s important to know what drives you to feel stress. Is it perception, the environment, conflict with others, or a combination?
Action Step: If the stressors are system related in your work, seek to find alternative solutions by working with your leaders:
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If the stress you feel is more personal, this free scale can help you check your perception of stress. It may also help you to become better at identifying what is causing you stress at the time it happens.
Action Step: Complete the Cohen Perceived Stress Scale (open access): https://www.mindgarden.com/documents/PerceivedStressScale.pdf
Create a campaign of cultural awareness regarding the risks of burnout. If the symptoms of burnout are related to your place of work, work with your leaders and educate your team of coworkers. If the symptoms of burnout are more personal, educate those you spend the most time with outside of work.
Action Step: What do others need to know about burnout:
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In the diagram below, you can see a unique perspective of the progression from excessive drive and ambition to burnout. Use the diagram to evaluate your drive and ambition.

Action Step: Where are you in the process depicted in the figure?
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Action Step: Are there any changes to your life you would like to make?
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Nursing and healthcare provides a flexible and rewarding career. To reconnect yourself to passion and purpose, think about why you chose to be a nurse or work in another role in healthcare.
Action Step: You can write your thoughts here:
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Nurses and other healthcare providers have the ability to make a stable living wage. What boundaries have you set around how much you are willing to work? Do you feel your life is balanced?
Action Step: If not, what change(s) might you make?
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Nurses and other healthcare providers have many opportunities to continue learning and to change practice among specialties.
Nurses and other healthcare providers must be technologically savvy.
Nurses and other healthcare providers need to know the law about patient privacy and confidentiality. Do you know your organization’s policy about patient privacy? Do you know what the law says related to overall healthcare privacy (HIPAA)?
Action Step: If not, look them up. You can document what you learned here:
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Social media should only be used to improve patient access to appropriate information. Do you know your organization’s policy related to the use of social media?
Action Step: If not, look it up. You can document what you learned here:
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Understand what you can and cannot control in your environment to alleviate stress. Making an inventory of what can and cannot be controlled can be useful; it allows you to see what might be possible, what might be impossible, and facilitate learning to control your reactions.
Action Step: Commit to conducting an inventory for yourself to identify learning opportunities. You can either document your findings here or consider using a personal journal.
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Thoughts, feelings, and actions are connected. Be mindful about how you think and feel. Consider these questions: Do you speak before you think? Are you concerned about what you might say and how it makes others feel? Are you concerned about what you might do and how it makes others feel?
Action Step: You can document your answers here:
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You need to care for yourself first to be the best caregiver for others. Have you ever considered what you might need to do your best work?
Action Step: If not, do it now:
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Be resourceful, innovative, and creative in changing your workplace for the better.
Action Step: Brainstorm all the ways you could improve your workplace if there were no limits. Once you have a list, revisit the information to prioritize what might be realistic to implement and then talk to your leader(s) about your ideas for improving your work environment.
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Recognize stress and its consequences. When you are feeling stressed, take a moment to breathe. You can try the 4-7-8 breathing exercise developed by Dr. Andrew Weil.
Attempt early intervention to mitigate stress.
Adopt healthy coping strategies for stress tolerance.
Action Step: Consider using a journal to: 1) document your progress, 2) reflect on how current and new stress-reducing strategies are working, and 3) document how you are changing (for the better). Here are a couple of good examples: