Burnout in nursing is well known and has received attention since the 1980s, when Maslach and Jackson (1981) produced the Burnout Measurement Inventory. Burnout, also known as nervous exhaustion, is characterised by a reduction in the individual nurse's energy, with emotional exhaustion leading to a cynical attitude due to desensitisation, lack of motivation, and frustration. Burnout leads to a reduction in effective and efficient working (Kowalski et al, 2009).
Resilience training is often viewed as the panacea for coping with stress (Davies, 2020). Education on resilience is offered to staff, but Traynor (2018) has suggested that resilience training fosters a submissive approach, in that nurses are facilitated to cope with the pressures and strains in the workplace, rather than to question and challenge them.
There is still a substantial shortages of nurses in the UK, which has to be redressed, although there appears to be hope on the horizon, given that, in 2019, 30 390 applicants were accepted on to undergraduate pre-registration training programmes, a 6.1% increase on the 2018 figures (Pisavadia, 2020). In spite of this, the Health Foundation (2019) has stated that the UK needs to recruit at least 5000 more international nurses a year until 2023/2024 to prevent nurse shortages from impacting on patient care and acting as a brake on ambitions to improve the NHS.
When considering the further and continuous improvement of the NHS, of which nursing is at the heart, I pose the question whether the implementation of sabbaticals for registered nurses (RNs) might further enhance nursing professionalism by providing wider circles of activities relevant to the profession, and, by doing so, reduce burnout. It has been found that, in those experiencing burnout, there is a dissatisfaction with opportunities for personal growth and development on the job (Maslach and Jackson, 1981:107). For this reason, I suggest that sabbaticals for RNs would fulfil a desired need in individual nurses, and that the nature of the sabbaticals would inject both fresh and further advanced knowledge and skills relevant to the delivery of patient-centred care in an ever-changing organisational environment.
Sabbaticals have traditionally been seen as the purview of university faculty members to undertake research, or to write a textbook. A sabbatical is an extended period away from work, usually between two and 12 months. An agreed learning contract specifies the purpose of the activities, and the additional knowledge and skills being brought back to the employing organisation. A sabbatical can be paid or unpaid. I would argue that in the true spirit of continuing personal and professional development (CPPD), and in recognition of the advanced body of knowledge and competencies being brought back to the organisation, a sabbatical should be paid. A sabbatical is differentiated from a period of unpaid leave, and that of a secondment, which is a temporary period of assignment to another healthcare organisation to undertake work.
Examples of nursing sabbatical activities could include a clinical nurse spending time alongside nurse academics, thereby becoming even more immersed in the provision of pre- and post-registration education programmes; or an exchange between a clinical nurse and a nurse teacher, bridging the theory-practice gap. Spending time with a nursing journal could widen an individual's knowledge base and advance their communication skills. Honing end-of-life and palliative care nursing skills in a hospice, or gaining wider awareness of the political and cultural aspects of healthcare delivery, and how these influence nursing, could be gained by working with various charities.
With the combined expertise and leadership of the directors of people development and the chief nurses at NHS trust boards, ably supported by nurses' professional organisations and trade unions, it should be feasible to introduce RN sabbaticals, thereby raising the quality of standard CPPD activities.