Nursing Practice Environment And Burnout Among Nursing Personnel

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).

For over a decade researchers have been performing studies examining the effects patient-to-nurse ratios have on adverse outcomes, mortality rates, and failure-to-rescue rates of patients and on job dissatisfaction and burnout experiences of nurses. Aiken, Sloane, Sochalski, and Silber (2002) performed a study which showed that each additional patient per nurse increased patient mortality within 30 days of admission by 7% and increased failure-to-rescue by 7% as well. This same study also showed that each additional patient per nurse resulted in a 23% increase in nurse burnout and a 15% increase in job dissatisfaction. Additionally, Rafferty et al. (2007) performed a study in which the results showed that patients in hospitals with higher patient-to-nurse ratios had a 26% higher mortality rate and nurses were twice as likely to have job dissatisfaction and experience burnout. Blegen, Goode, Spetz, Vaughn, and Park (2011) performed a study where results showed that more staffing hours for nurses resulted in lower rates of congestive heart failure morality, infection, and prolonged hospital stays. The same study also showed that increased nursing care from registered nurses resulted in lower infection and failure to rescue rates and fewer cases of sepsis.

Once they arrived in the war zone, Army, Navy, and Air Force nurses experienced professional strains of working with young, severely wounded casualties who were often younger than them. A Navy nurse recalled,

Some had barely seen an operating room, let alone worked in one" (Scannell-Desch, 4). Along with the lack of experience, to make things worse, the nurses would receive 20 to more than 100 patients within a few hours. An army nurse recalled, "The day I arrived in the O.R., we had a 'mass-cal', 185 casualties. They came in Chinooks (large helicopters). They were on the floor, all over. Every Chinook was overloaded…I just remember that every ward in Nam was full. We had body bags lying around the hospital and the morgue was full" (Scanell-Desch, 4).

Because the effects of multiple deployment is a nascent topic, it is becoming increasingly important to look at how the survivors f the hostile environments can be made to feel at home and connect with the environment, the health care environment without feeling slighted or overlooked. Some of the most important nursing qualifies include autonomy, assertiveness, advocacy and accountability. Above all, it is important to look at how the veterans can be helped

Research Critique, Part 1: Hospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job Dissatisfaction

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.

In another recent study by Mealer, which was not included in the aforementioned meta- analysis, the combined occurrence of burnout syndrome and symptoms of PTSD, anxiety and depression were studied. To a certain extent, this study confirmed the previous data by the same authors, and highlighted the high prevalence of PTSD symptoms among critical care nurses. Furthermore, the authors found a relationship between specific traumatic factors and stress-related psychiatric symptoms (Mealer et al., 2009). In our study we aimed (a) to check whether there are differences in the incidence of psychiatric symptoms between intensive care and general medical and surgical ward nurses; (b) to map the occurrence of selected stress factors in ICU and on general wards; (c) to determine whether specific stress factors and selected causes of job dissatisfaction can increase the risk of psychological symptoms; and (d) to address the issue of workload in relation to psychological

Nearly ten years ago I entered the Army service. Through these years my work in the medical service as a medical laboratory technician, biomedical research, and most recently as a registered nurse has challenged me to examine my own practice and technical skills. I have learned about compassion, respect, empathy, equity, understanding, benevolence, and other attributes that contribute to being a proficient nurse. Our service members, families, and military culture present unique challenges that demand diversification, flexibility, and adaptation to sometimes overwhelming circumstances. My love for our military men and women and the families that stand behind them causes me to seek best practices, and innovation. The military has done a tremendous job at advancing battlefield trauma care, and statistics indicate that we have standard setting rates of battlefield lifesaving.

Hospitals nationwide are experiencing nurse shortage and increased workloads because of shorter hospital stays, fewer support resources and higher acuity in patients (Vahey, D. C., Aiken, L. H., Sloane, D. M., Clarke, S. P., & Vargas, D., 2004). Higher nurse workloads are directly associated with job burnout and job dissatisfaction which in turn causes more voluntary nurse turnover and relates to the increased nursing shortage. According to the Missouri Hospital Association the turnover rate of nurses has increased by fourteen percent in the last five years (Browning M., 2012). Nursing shortage is a real threat to the patient population. According to the Quality Health Outcomes Model by the American Academy of Nursing by Donabedian, effects of the healthcare interventions are characterized by the environment the staff works in (Vahey et al., 2004). Donabedian describes that quality metrics can be divided into three broad categories, structural, process, and clinical.

Nurses, always involved in patient care, sometimes experience detrimental effects with prolonged stress or “burnout” during their career throughout the years. Burnout is defined as an extended response to physical or emotional stressors. Some examples of these stressors are; memories of witnessing death, patient and family suffering, emotional stress of losing patients, feeling emotionally and physically drained, or emotional disconnect from staff which can all contribute to burnout. As a result, nurses can experience; exhaustion, anxiety, dissatisfaction and low capacity. Overall, burnout can have negative effects not just on the emotional and physical health of nurses but also on; patient satisfaction, outcomes and mortality of nurses and patients. Although, there are ways to reduce or prevent these negative effects of burnout from manifesting. For example, nurses can apply interventions to reduce these risks including; staff support, onsite counselors and psychiatrists for nurses and salary increases and reimbursement opportunities for nurses through clinical ladder programs. Nurses can also start by just saying no to certain requests, being aware of their tolerance level, by taking care of themselves and having fun outside of work. On the other hand, others do not think nursing burnout is fatal and nurses just need a break from their job to initiate change. Although, the issue of burnout is prevalent in nurse’s careers which need to be addressed more in society in

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).

The relevant issue I chose for this posting related to nurse’s burnout due to work related stress. In my work place I noted few nurses who are retiring earlier than planned and some who want to leave nursing due to high levels of stress. The other day a colleague of mine started to cry when I inquired how she was doing because she was overwhelmed with work and could not get out of work on time to be with her family. Nurses are asked to do more with no assistance or limited assistance. Stress can lead to physical and psychological health problems such as anxiety, depression, fatigue, insomnia, and lack of concentration. Furthermore, emotional exhaustion, reduced personal accomplishment and depersonalization, or lack of empathy with patients