Essay on Managing Stress to Prevent Burnout

Nurses must support each other and “start a movement” (Tucker, S. 2016) to eliminate nursing “burnout”. The quality of nurse’s lives will improve and accordingly, their ability to provide exceptional care will be the “icing on the cake”. Now picture this; it is 2:50 pm and 1st shift is coming to an end, patients were checked one last time and all of their needs have been met. It was busy shift, but there was time for a walk and some breathing exercises. A nurse is giving report to the next shift and she actually has time to get in a quick workout before dance recitals soccer games, and PTA meetings; but more importantly, she made a difference

Staff nurses have great responsibilities in caring for patients. Often, these nurses experience heavy workload. Heavy patient load and stress contributes to burnout. Why is burnout important to discuss in relation to nurses? Burnout affects the performance of the nurse and the quality of care he or she provides to the patient. Therefore, it is imperative that staff nurses decrease the possibility of burnout and increase or maintain excitement and enjoyment in the field of nursing. If nurses do so, they will find joy in their work and quality of patient care will be increased. Contributors to burnout and

Workload was described to be heavy, stressful, increase in intensity and overtime hours. As a result 25.8% consider resigning, 20.2% consider retiring and 25.6% consider leaving profession. Another problem that was observed at individual level was poor commitment to care. One of the factors that often limited nurses to provide therapeutic care was the change in nurse to patient ratio. As nurses assignments increase with the increase in the number of patients (i.e. 1 nurse to 6-8 patients) the quality of care provided decreases. Nurses’ ability to maintain safe environment became challenging. As part of caring, nurses also showed decreased amount of time spent with their patient. This eventually led to nurses being less satisfied with their current job. Self – efficacy was often low. Nurses felt that they did not have enough knowledge and skills required for professional practice (Newhouse, Hoffman, & Hairston, 2007). This often led into stressful transition and the ability to care for a patient even harder. New graduate nurses often had difficulty maintaining leadership role. They often felt that they did not have the ability to self advocate and raise their voice to be heard by others. They often feared that they would be over heard and that no one would listen to them (Mooney, 2007).

The profession of nursing requires a capacity and joy for caring and healing others both mentally and physically. Nurses spend their careers caring for patients and their families often in the worst and most frightening periods of their lives. Nursing responsibilities can be lengthy, stressful and physically and emotionally demanding. The demands of the nursing profession coupled with the nursing shortage and longer work hours put even more stress on nurses. Despite these extreme demands, many nurses do not fully appreciate the importance self-care. Yet without proper care for themselves, nurses are not able to provide the best care for their patients.

The profession of nursing is usually described as high-demand job, as well as stressful. The American Association of Critical-Care Nurses believes that nurses can empower their work environments and truly make a difference (AACN, 2016). Although nurses have the ability to join committees and help make changes slowly, there are many factors in the nursing that cannot be changed by nurses. “The global increase in the aged population, the intensity of health care problems, the incidence of chronic illnesses and advanced technology, nurses are faced with a variety of work-related stressors” (Lambert & Lambert, 2008, p. 38). Regardless of nursing communication and social aspects of units, nurses need to accept some stressors as they are and

Burnout is a gradual onset with symptoms coming on over time slowly. Burnout symptoms may include physical exhaustion, hopelessness, negative self-concept, having difficulty leaving home, and inability to concentrate are just some of the symptoms. Due to the gradual onset of symptoms, it is often hard to detect early (Dass-Brailsford, 2007). In McCann and Pearlman’s article they discuss burnout as a, “psychological strain from working with difficult populations” (McCann & Pearlman, 1990).

In fact, I am currently experiencing burnout concerning my college degree. When I have an objective, I invest everything in my power to accomplishing it; it is almost as if I have tunnel vision- the accomplishment of the objective supersedes everything else. I invest so much of myself that I reach a point when there is nothing left to give. I also become stressed and anxious when I cannot achieve my goals to my standards. Whatever the particular situation, when I reach the burnout stage, I become disillusioned and lose my commitment to the

Christina Maslach and Susan Jackson are the most well documented researchers on burnout and the most frequently referenced in the literature. Maslach and Jackson (1981) defined burnout as consisting of three component: overwhelming emotional exhaustion, depersonalization, and reduced personal accomplishments. The feeling of being overworked/overextended and drained of physical and emotional resources is at the core of emotional exhaustion. Depersonalization refers to a cynical, negative attitude towards people one is interacting with (coworkers, clients, etc.), and excessive detachment and emotional numbing from the various aspects of the job. Feelings of emotional exhaustion subsequently lead to depersonalization. Depersonalization is a protective state of cynicism that spurs dissonance, either cognitive or emotional, with others as a coping strategy for work demands and exhaustion (Halbesleben & Buckley, 2004). Reduced personal accomplishment (also referred to as personal efficacy) refers to the feeling of ineffectiveness, unproductiveness, personal incompetence, and lack of the feeling of accomplishment on the

Due to the ever changing health care system and the reduction of resources, nursing demands are greater which has led to work related stress and ultimately nursing burnout. Nursing burnout has had a significant impact on nurses not only personally, but professionally in addition to impacting the delivery of quality care. Sadly, "we are facing an unprecedented crisis in the profession of nursing; many would be (and should be) nurses are choosing other careers, many wonderful nurses are leaving nursing, and many of the nurses who are staying in the profession are not happy" ( Todaro-Franceshi, n.d., para 3). As a nursing leader, the first step is recognizing that your staff may be potentially suffering from burnout and act upon it immediately, thereby, preventing job dissatisfaction and burnout. Literature continues to reveal that care providers, especially nurses and physicians struggle with this pervasive issue "which impacts their ability to relate to patients and focus on work in a way that avoids medical errors" ( cited by Rousell, 2016, Shandafelt et al., 2012, p. 51). The strategies in creating a positive work environment for nurses would be the

Theories for burnout in the nursing profession are presented in the jobs-demands resources model. “This study uses the job-demands resources model to clarify the role of burnout among nursing staff in the relationship between stress factors and intention to leave the profession”

Stressful work environments, long work hours and inadequate sleep all contribute to an increase in physical and mental exhaustion amongst nurses. Typically, people choose nursing as a career to help others and to make a difference in their lives, without realizing the number of duties this career demands. Nurses may suffer in silence when they are experiencing stress. The effects can impact safe and reliable care by decreasing job satisfaction, decreasing productivity, causing poor personal health, and compromising patient care. Many facilities would benefit from implementing evidence-based strategies to address nurse fatigue and burnout.

Burnout is a combination of factors, including emotional exhaustion, depersonalization, and the reduced sense of personal accomplishment (Maslach, 1982). Emotional exhaustion is accompanied with a lack of compassion and motivation to work, while depersonalization leads to irritability.

There are numerous elements that contribute to stress in the healthcare setting. Nurses’ days are full of physical, mental and emotional demands. There are societal demands and workplace demands created by the shortage. These stressors can become increasingly overwhelming and if there is no stress relief, job performance can and will be hindered. When fatigue and stress combine there is potential for “performance decrements”. This can include diminished capacity to manage a specific level of workload resulting in errors in the delivery of nursing care. This can produce damaging effects on the safety and advantageous outcomes for both the nurses and patients. (Reese, 2011). Therefore, finding a balance between lowering stress levels of

Nurses are especially vulnerable to several related effects of stress, such as burnout, job dissatisfaction, increased interpersonal problems, increased health complaints, disturbances in sleep patterns, as well as clinical depression and anxiety (Villani, Grassi, Cognetta, Toniolo, Cipresso, & Riva, 2013). The potential for stress can be reduced by resolving difficulties in the workplace promptly, addressing staff shortages, turnover and absenteeism, and developing clear objectives and plans (McIntosh, & Sheppy, 2013). Learning to manage and reduce stress by developing insight and coping strategies will help to maintain and promote nursing integrity and consistent patient care (McIntosh, & Sheppy, 2013).

By recognizing that burnout is a serious problem that impacts an organization’s viability, an assembly of staff nurses, nursing supervisors, human resource staff, social services, nurse administrators, and a physician champion will be arranged to construct mission, objectives and strategies to help ameliorate the issues at hand. Researching literature on nursing burnout is essential so that the members of the task force has a solid grasp on potential underlying hardships contributing to nursing burnout within the facility as well as the financial effects on the organization. Furthermore, in order to determine a solution, the nurse’s work environment should be assessed (Nedd, 2006) and measured using the 26-item Brisbane Practice Environment Measure (B-PEM) (Flint, Farrugia, Courtney, & Webster, 2010). The B-PEM instrument was developed to measure nursing satisfaction within the work environment and the perceived facilities inadequacies (Flint et al. 2010; Hayes et al., 2014; Nedd, 2006). Next, the Conditions of Work Effectiveness - Questionnaire-II (CWEQ-II) will also be utilized to measure the nurses’ perceived access to the four job related empowerment structures: opportunity, information, support, and resources will be administered (Laschinger et al., 2003). Then nursing burnout will be assessed and analyzed by using the Maslach Burnout Inventory (MBI) which is a widely used instrument to assess burnout and is considered the gold standard due to its established