One of the most rewarding yet demanding roles is that of the senior clinical nurse. As the labelling of clinical grades varies across the country and between NHS trusts and independent health providers, I am using the term ‘senior clinical’ as an umbrella term, encompassing those registered nurses with more than 2 years' experience and all other senior clinical nurses who have direct patient responsibility, irrespective of their pay grade.
The senior clinical nurse post is the most important role within nursing as it provides the focus of direct patient care. For that reason, it is one of the most rewarding roles within nursing, yet also one of the most demanding, stressful and draining, often leading to burnout and staff leaving the profession. If the role of senior clinical nurse fits your job description, then spend a few minutes reflecting on your role.
The various roles of the senior clinical nurse
Why do you need to learn how to survive as a senior clinical nurse?
Each of the above roles are not individually unduly stressful. Some become routine and, with experience, do not create undue stress. Others would be rarer, such as attending a coroner's court, and most people find these stressful. However, if you consider how many of the above formed part of your duties over the past month, then you can begin to see why this particular clinical role is one that carries with it ongoing and cumulative stress and the danger of burnout. I would suggest that most of you reading this article would have undertaken at least 10 of those various roles in the previous month. It is this ongoing, consistent and relentless accumulation of stress factors that make learning to survive in this crucially important role so vital. If you do not learn to manage these additional roles then you will find that the enjoyment of patient care, the rewards of student mentoring and the pleasures of clinical leadership gradually disappear to be replaced by drudgery, worry, anxiety and, eventually, burnout.
Identifying priorities
Take a step back from your clinical role, find a quiet spot, take a pencil and notebook. First, identify which of those various roles identified above form part of your regular work. Then highlight the three most important that form part of your specific role. Then identify the next three areas that are slightly less important. Now take a few minutes to just reflect on those six areas as they represent your key role. The next stage is to explore the complete list again and this time identify which of the activities would occur every shift, those that occur once a week, once a month or which are the exceptional events. Finally, examine how those two perspectives combine—which activities are important and occur every shift, and which are not so important but occur every shift. You should now be in a position to identify your priorities and the activities that are likely to accumulate to become stressful.
Reducing stressors
Now look at ways to reduce the accumulation of stressors. For example:
These are just a few general suggestions—think through your own needs and make an appointment with your manager to explore how you can manage your work so that you can do justice to the variety of roles you have accumulated. If you are good at your role you will find that you will be asked to do more and more. You have to learn to say ‘No’.