Consultation Fatigue: Advice for Nurses Facing Burnout Behind the Desk

There are many aspects to nursing work and the problems we face as healthcare professionals but one part we tend not to think about are the trials and tribulations we face when it comes to desk based nursing. Whether that’s conducting face-to-face consultations, telephone, virtual appointments or wrestling with electronic devices and health records, these problems can be just as exhausting as bedside care but can come with a different set of pressures. Constant decision making, prolonged screen time and dealing with emotional clients can lead to consultation fatigue. This form of burnout is easy to overlook yet common in modern nursing and can cause high levels of nurse sickness and absences due to mental health related issues.

The Workforce Burnout and Resilience in The NHS and Social Care Report, 2021, states that even though Covid-19 had seen a huge mental impact on nurses due to workforce pressures and staff shortages, it had highlighted an already trending issue that has been on-going long before Covid-19 emerged. NHS England released key statistics in January 2025 that looked at how many NHS full time workdays had been lost due to mental health issues. It states that the overall absence rate was 5.7% (638,900 full time equivalent days lost) with a reported reason for sickness being anxiety, stress, depression and other psychiatric illnesses accounting for 24.7% of absences.

While there are no official figures for how much it costs the NHS and other health care providers to cover the cost of nurse sickness due to mental health reasons, it has been estimated in the report ‘Hidden Annual Cost of Absenteeism to UK Employers’ 2025, that employee sickness across the UK economy reached an estimated £103 billion in 2023. Due to high costs, the 2025 Spending Review announced plans that will raise NHS England’s day-to-day budget by around £29 billion per year (in real terms) by 2028/29 compared with 2023/24. By increasing the NHS budget, the government’s aim is to try and work at ways to reduce mental health and prevent further stress and pressure on already working healthcare professionals.

Mental health is a topic, which highly affects nurses, and this article will discuss the necessary importance of consultation fatigue by:

• Explaining what consultation fatigue means.
• Why consultation fatigue matters.
• How do nurses and health organisations take steps to help prevent and recover from mental health related issues.
• How employees, managers and team leaders help towards improving healthcare services when it comes to nurses working behind the desk.

But first, let’s start with… 

What is Consultation Fatigue?

When discussing consultation fatigue, it is best to focus on the main issues surrounding the word fatigue and the impact it has on nurses both within the NHS and the Private Health Sector. Burnout is described by the British Journal of Nursing (BJN, 2025) as a psychological syndrome caused by prolonged exposure to work stresses, with emotional exhaustion, depression and a reduced sense of personal accomplishment. Fatigue is closely linked, acting as both a symptom and a contributor to burnout. Consultation fatigue, whilst not formally defined in medical literature, can be understood as mental and emotional exhaustion caused by prolonged, high-intensity desk based clinical work. Unlike physical burnout from patient bedside care, this aspect of nursing often arises from:

• Cognitive overload: Making high stakes decisions in rapid succession.
• Emotional strain: Providing face-to-face, high-level support OR support without face-to-face interaction and immediate feedback.
• Prolonged screen time: Contributing to eye strain, headaches and poor posture.
• Environment: Being based in a work setting with reduced access to other colleagues, limited windows and not enough sunlight. Clinical work environments can be located in basements, single rooms with nurses sitting in artificial lighting for prolonged periods of time.

What Are Possible Signs and Symptoms of Consultation Fatigue?

• Brain fog or slower decision making.
• Increased risk of small mistakes in documentation, or errors in administering medications or vaccinations.
• Irritability or emotional detachment.
• Trying to avoid phone/computer tele consultation shifts.
• Persistent headaches, sleep disruption, or musculoskeletal discomfort.

A further report launched by the Health Services Safety Investigation body (HSSIB, April 2025) states that:

‘fatigue is not just a wellbeing concern but a critical patient and staff safety risk, with implications ranging from impaired decision making to increased risk of errors and accidents’.

The Royal College of Nursing (RCN, 2025) responded to the HSSIB’s report with a warning that:

‘nursing fatigue is deadly and should be treated as a public health emergency’.

However, it is important to state that not all nurses in every setting experience these challenges as certain conditions make nursing roles and environments more vulnerable to fatigue than others. Behind the desk nursing can still be overlooked in comparison to other areas of nursing and we are not always aware that the role can bring with it many challenges that lead to burnout.

 How Can Desk Based Nursing Lead to Burnout?

 There are many situations that can lead to burnout, including:

• No recovery time between appointments: Back-to-back consultations leave little room to reset mentally.
• Emotional labour without closure: You may not see the impact of your work in real time.
• Multitasking overload: Switching between computer systems, calls, face-to-face appointments and chat messages can reduce efficiency and induce exhaustion.
• Working after-hours: Work can often continue after the shift has finished.
• Workflow and system issues: Poorly designed digital tools and ambiguous protocols create unnecessary strain.
• Toxic work culture: Experiencing bullying, gaslighting, manipulation and emotional distress from colleagues.

What Practical Strategies Can Nurses Use to Beat Fatigue Behind the Desk?

There are a few strategies nurses can use to deal with fatigue and reduce the potential risk of burnout including:

Taking Breaks: The Working Time Regulations 1998 and Working Time Regulations (NI) 2016, govern the rest breaks an employee is entitled to with the key aim of maintaining standards of health and safety in the workplace. The RCN, April 2025 state that nurses can take a break of 20 minutes if working over 6 hours and that breaks should be:

• Uninterrupted.
• Be away from your workstation.
• Be during working time.
• Not to be taken at the start or end of the working day.
• Not overlap with your daily rest.
• Make time to eat and stay hydrated (especially when conducting consultations throughout the day).
• Go for a walk outside for fresh air when working in confined workspaces.

Organise and Prioritise Your Workload:

• Use checklists, planners to organise yourself when conducting consultations.
• Check your calendar at start of your shift to prepare for the day ahead.
• Stay consistent with similar tasks instead of switching constantly.
• Close non-essential website tabs and mute alerts when making clinical decisions.

Prioritise Your Time

• Place catch up blocks in your calendar.
• Block out “no-call” periods for focused documentation.
• Ensure you use simple handovers to avoid repeated mental overload.

There are also healthy habits nurses can adopt when away from the desk and outside of work such as:

• Regulating Sleep patterns: Getting a good night sleep can make improvements and boost cognitive performance.
• Emotional decompression: When you get home at the end of your shift, go for a walk, write in a journal to offload the day’s challenges, exercise and make sure not to bring problems home from work. Switch off and allow yourself to find your joy.

What Can Organisations, Managers and Team Leaders Do to Reduce Burnout Behind the Desk?

• Design or implement electronic health record workflows to minimise clicks and duplicate work.
• Scheduling blocks between appointments.
• Providing peer support groups and debrief sessions.
• Enforce realistic after-hours policies.
• Offer training and support to help educate nursing staff on potential mental health challenges.
• Monitor absenteeism and high turnover rates of nursing staff to help improve working environment, working relationships and to reduce cost.

The NHS employers’ article, ‘Beating Burnout in the NHS’ (February 2025) outlines their tips on how managers play an important role in beating staff burnout and how they can help support their staff. They include: 

• Ensuring optimum staffing levels where possible.
• Shifting towards a culture of prevention and early intervention.
• Overcoming the stigma of mental health conversations at work.
• Recognising pressures of maintaining a ‘hero identity’.
• Up skilling staff to understand burnout symptoms.
• Up skilling managers to support staff effectively.
• Encouraging compassionate leadership.
• Building organisational resilience.

A Final Thought:

Employers, managers and team leaders should be trained to identify early warning signs of nursing fatigue and burnout. Sarah Murphy from the RCN counselling service (May 2022) elaborates further by stating:

“It’s the employer’s responsibility to provide a safe working environment as it’s the nature of your work that’s the main contributing factor to developing compassion fatigue. There’s lots you can do to care for yourself. Talk to your colleagues, share experiences and don’t be worried about seeking help”.

The British Journal of Nursing (February 2025) advises that managers, team leaders and employers should create a strategy for coping with and preventing burnout for their team. This strategy should involve practical, evidence-based strategies geared to nursing individuals and the healthcare setting, focusing on daily practices and research and allowing a proactive approach to help reduce burnout effectively.

A few tools can be offered to nursing staff, such as:

• NHS Better Health: Every Mind Matters
• Mind: Supporting Healthcare Workers Mental Health
• Royal College of Nursing (RCN): Five ways to combat Compassion Fatigue
• RCN: Health, Safety and Wellbeing
• RCN: Managing Stress
• RCN: Watch Time and Space – Mindfulness videos for nursing staff
• RCN: Counselling Service