The Importance Of Burnout In Nursing

According to Suzanne Gordon “ whether young or old, nurses are disillusioned because they believe that health care systems guided by bottom-line concerns simply don’t recognize the specificity of their work” (234). Nursing is more demanding than many other professions or occupations, due to the combination of difficult patients, exhausting schedules and arduous physical work (Gordon 235). It can take a significant emotional toll on many, hence the higher levels of burnout. Job dissatisfaction as a result of increased workloads and unreasonable demands, such as inappropriate nurse staffing levels, was cited as the number one reason that drives many experienced nurses to leave the profession (Sanford 38+). Studies have shown that such working conditions also affected the retention of new graduate nurses by leaving their first hospital jobs within two years of graduating (Sanford 38+).

The Question asked was “Why is burnout important in nursing?”, I look at the question as, “Why is burnout important to recognize before burnout happens?”. I don’t see burnout important as much as I believe recognizing it. Burnout is defined when nurses can no longer cope with the stresses and strains of professional nursing and choose to leave the profession to seek employment elsewhere (Masters, 2014). I believe if burnout is recognized as something that happens when entering a nursing career, nurses can proactively work on avoiding this. As a new nurse, these things are not thought of. New nurses are so focused on learning their job and performing at the best of their ability and while doing so they are slowly reaching burnout. Knowing what is expected to be a nurse, the work environment stresses, home life stresses, and knowing the unequal balance that can plague a nursing career, can be a platform to find strategies to manage burnout.

Those of us who graduated from nursing school and started their first job were full of dreams, aspirations, and had every intention of making a difference. Now fast forward five years; these same nurses have been on their feet for 16 hours and have not had time to eat or use the bathroom since leaving their homes this morning. The call lights will not stop going off long enough for them to give report to the oncoming nurses and once again they are late for their children’s dance recitals or soccer games. They can forget about trying to squeeze a yoga class in this week. I understand what it is like to rush to your car feeling as if some important task was forgotten; was Mr. Smith’s tube feed restarted, did room 8 receive their pain medication? Nurses all over the world are experiencing “burnout”. To avoid burnout, nurses must properly care for themselves by separating work from personal life, knowing when to say no, and making time for enjoyable activities to manage stress, because we cannot provide quality patient care if we are neglecting ourselves.

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 term burnout, according to Catalano, is a continuing depletion of energy and strength combined with a loss of motivation and commitment after prolonged exposure to high occupational stress (2015). When a unit or facility is understaffed, not only do the nursing staff get burnt out, the patients also don’t receive the quality of care they deserve. Due to the increase in workload, nursing staff are more prone to making mistakes and medical errors and sometime times do not fellow facility policies. The nurse-patient ratio aspect sometimes gets overlooked at and that could lead to possible medication errors, lack of communication, falls, neglect, abuse and/or death may occur. Sometimes, it become so overwhelming people turn to leave the workforce all together. When nurses and CNA workload increase, they become frustrated and unhappy, and the desire to leave

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).

Inconsistent nurse-patient ratios are a concern in hospitals across the nation because they limit nurse’s ability to provide safe patient care. Healthcare professionals such as nurses and physicians agree that current nurse staffing systems are inadequate and unreliable and not only affect patient health outcomes, but also create job dissatisfaction among medical staff (Avalere Health, 2015). A 2002 study led by RN and PhD Linda Aiken suggests that "forty percent of hospitals nurses have burnout levels that exceed the norms for healthcare workers" (Aiken, Clarke, Sloane, Sochalski & Silber, 2002). These data represents the constant struggle of nurses when trying to provide high quality care in a hospital setting.

Nurse fatigue affects a nurse’s ability to provide the best care for a patient. Fatigue is the overwhelming sense of tiredness and lack of energy. Nurse fatigue can lead to impaired cognitive and or physical functioning. A fatigued nurse not only hurts the care of patients, but it also affects the safety of the nurses themselves. Many individuals fall asleep while they

Similar to physical exhaustion, emotional exhaustion results from depletion of emotional resources and failure to restore one’s own emotional equilibrium. (Moore, 2009, p. 1) In today’s busy society the demands of life, job and family can be excessive and overwhelming. Combine these demands with the additional stressors of caring for another person or persons, increased demands of productivity with decreased personnel and the unrealistic expectations of one’s self or others and place all of this burden on one person, this would adequately describe the 21st century nurse. Nurses are continually engaged in emotional relationships with patients and their families which call upon the nurse to be in a constant supporting role. One reaches emotional exhaustion when this burden becomes too heavy to carry

The issue of healthcare personnel scarcity continues to be an ongoing challenge across the globe. Invariably, nurses are at the pinnacle in the delivery of quality care in any healthcare setting. The ever-increasing demands for care stem from a patient populace that is emergent, growing older and needing more care due to the escalating shift in their disease process. Hence, nurses are torn between balancing an overloaded schedule, working extra hours and maintaining astuteness and professionalism. This transcends to compromised patient care, nursing burnout makes it difficult for them to experience the rewards of caring for patients in the way they had expected; thereby, adding to the shortage of

Additionally, the study found that a high patient to nurse ratio resulted in greater emotional exhaustion and greater job dissatisfaction amongst nurses. Each additional patient per nurse was associated with a 23% increase in the likelihood of nurse burnout, and a 15% increase in the likelihood of job dissatisfaction. Moreover, 40% of hospital nurses have burnout levels exceeding the normal level for healthcare workers, and job dissatisfaction among hospital nurses is four times greater than the average for all US workers. 43% of nurses involved in this study that reported job dissatisfaction intended to leave their job within the upcoming year. (Aiken et al.)

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.

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