Work Stress And Burnout Among Nurses

Work Stress And Burnout Among Nurses

It is easy to focus solely on caring for others in the nursing profession during high-stress situations. It is also easy for nurses to become neglectful of their own needs. This paper will examine the facts surrounding nurse burnout. This will include specific burnout risk factors, how burnout affects the nurse legally and ethically, how it affects patient care and overall healthcare delivery, and how specific theoretical frameworks can assist nurses in preventing or overcoming the issue. This issue must be understood so that nurses, managers, and organizations can collaborate to help avoid the negative consequences of nursing burnout.

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Review of Literature

Searching the CINHAHL Complete database via the Shapiro Library website yielded current and peer-reviewed journal articles on nursing burnout. This database was searched for burnout-related issues such as emotional well-being, health promotion for nurses, and stress among nurses. The articles that supported this paper were about burnout and ways for nurses to promote their well-being to prevent and overcome burnout.

The article “Nurses and Health-Promoting Behaviors: Knowledge May Not Translate Into Self-Care” was chosen for this paper as a source because it discusses specific barriers that may influence why a nurse does not participate in health-promoting behaviours, which can lead to health problems and burnout (Ross et al., 2017). Participation in positive behaviours such as good diet, exercise, stress reduction, sleep hygiene, and maintaining healthy relationships can hurt patient care and the nurse’s overall well-being (Ross et al., 2017). The article acknowledges intrinsic and extrinsic barriers to a nurse’s participation in health-promoting behaviours. Ross et al. (2017) also make suggestions and recommendations for nurse leaders or managers to follow to increase nurses’ active participation in healthy behaviours. With the lack of control and the high demands of this profession, it is easy to forget to care for yourself fully. Conversely, poor self-care leads to various issues, including burnout and other health issues that prevent the nurse from providing the best care possible.

The article “Burnout and Resilience Among Nurses Practicing In High-Intensity Settings” by Hylton Rushton et al. (2015) was chosen as a resource for this paper because it discovered certain factors and characteristics as predictors of burnout. Emotional exhaustion, depersonalization, and decreased personal accomplishment are all symptoms of burnout. Hylton Rushton et al. (2015) conducted a study that discovered significant predictors of burnout, such as emotional exhaustion and moral distress. It was found that greater resilience protects nurses from emotional exhaustion. According to the article, increasing a nurse’s strength, spiritual well-being, physical well-being, and hope, as well as “helping nurses reconnect to the meaning of their work may reduce moral distress and burnout,” may reduce moral distress and burnout (Hylton Rushton et al., 2015). Knowing personal characteristics that may either protect or lead a nurse to burnout can help to reduce the issue of burnout together.

The final article chosen to support this paper, “Can mindfulness be an effective tool in reducing stress and burnout, while enhancing self-compassion and empathy in nursing?” discusses mindfulness-based stress reduction (MBSR), a health-promoting method that can help nurses reduce stress and increase their overall emotional well-being (Kelly & Tyson, 2016). The article discusses the severe consequences of workplace stress and the numerous benefits of practising mindfulness. The study’s goal described in this article (Kelly & Tyson, 2016) was to see if increased mindfulness is associated with less burnout and psychological distress. Overall, MBSR was an effective intervention that assisted nurses in reducing stress and burnout while increasing empathy and compassion (Kelly & Tyson, 2016). Education on how to reduce stress and burnout aids in the resolution of the practice issue discussed in this paper.

Implications for Ethical/Legal/Licensure

Burnout in nurses can lead to ethical difficulties, legal issues, and licensure repercussions. Every day, the nursing profession must make numerous ethical decisions. Emotional exhaustion, a significant contributor to burnout, is defined as “feeling overextended and emotionally and physically depleted at work,” whereas burnout results in a “reduction in compassion and caring” (Geuens et al., 2017). According to Hylton Rushton et al. (2015), moral distress can be caused by insufficient staffing, uncertainty about treatments, and insufficient time and preparation when dealing with both patients and patients’ family members. This can lead to guilt and a general sense that they are not providing patients with the care they deserve. Compassion fatigue and burnout, according to Kelly and Tyson (2016), “contribute to a significant decrease in nurses’ ability to convey empathy, communicate effectively, and establish meaningful relationships.” Burnout can be the cause of unethical decisions made by nurses, both knowingly and unknowingly.

In addition to the ethical issues that can arise from burnout, there are potential legal issues and nursing licensure ramifications. After receiving complaints about nursing care, the Board of Nursing (BON) may investigate and take disciplinary action, which may include: mistakes during the nursing process, mishandling or misuse of controlled substances, any abuse, neglect, or mistreatment of patients, and failure to follow through with the standards of care outlined in the nurse practice acts (Russell, 2017). Critical thinking, decision-making, and communication with other members of the health team about patient status, needs, and changes, among other things, are all standards of care outlined in the nurse practice acts (Russell, 2017). According to Russell (2017), the BON’s disciplinary actions may include a fine/civil penalty, limitation or restriction of aspects of practice, suspension of license, or permanent loss of licensure.

Nurses who are burnt out are more likely to make mistakes at work. Kelly and Tyson (2016) explain that compassion fatigue, which leads to less mindful attention, can cause many patient safety issues, such as missing essential symptoms and medication errors. Sleep deprivation is associated with reduced vigilance and reaction time and cognitive impairment in memory and executive function in 12-hour shift nurses (Ross et al., 2017). Any patient safety mistake may result in legal ramifications for the nurse. Furthermore, distracted or burned-out nurses may not only harm a patient, but they may also injure themselves or contribute to the injury of a coworker. All of these distractions and potential causes or errors can lead to minor or fatal problems, which can lead to any legal issues discussed above.

Patient Care & Overall Healthcare Delivery

Burnout hurts almost every aspect of healthcare delivery and how we care for our patients. According to Geuens et al. (2017), burnout is a problem for the entire organization because it can spread from one nurse to others, increasing staff absences and turnovers. Burnout can cost organizations billions yearly, compromising patient care (Magtibay, Chesak, Coughlin, & Sood, 2017). Kelly & Tyson (2016) believe “providing empathic and compassionate care can elicit better patient information to inform care plans, leads to enhanced patient satisfaction, and subsequent adherence to treatment and recovery. Burnout and associated symptoms contributing to errors may result in decreased patient compliance, lower satisfaction, increased hospital-acquired injuries, and possibly higher death rates.

When dealing with burnout, illness, lack of sleep, and highly stressful situations, the ability to focus on the patient diminishes, and the risk of missing details and mistakes increases. Nurses who are burnt out frequently experience a lack of mindful attention as well as a lack of sleep, both of which endanger the patient’s safety. Working in an emotionally draining environment, according to Kelly and Tyson (2016), can cause levels of compassion to decrease over time, as well as the nurse’s empathy, communication skills, and ability to form a trusting relationship. These abilities are required to provide the best possible care for the patient. If a nurse is not in a good mental state, it often shows in their work, and the patient will notice. It may be the source of the error and the patient’s loss of trust in both the nurse and the healthcare team.

Theoretical Structure

The majority of nursing theoretical frameworks are developed for and applied to patients. However, two conceptual frameworks can be linked to the issue of nurse burnout. Both Nola Pender’s Health Promotion Model (HPM) and Jean Watson’s Human Caring Theory will be briefly explained and related to burnout in the following sections.

The HPM incorporates three categories to achieve positive health outcomes and increase well-being: individual characteristics/experiences, behavioural-specific cognitions and affect, and behavioural outcomes (Health Promotion Model, 2016). Geuens et al. (2017) demonstrated that certain personalities and behaviours contribute to burnout. This is an example of the HPM’s first category, which included personal characteristics. Extreme stressful and demanding jobs are motivational reasons for not participating in health promotion activities. Specific examples from the second category of the HPM and how they may be related to nurses include perceived barriers such as a lack of time and money or a lack of institutional and social support, feelings related to job demands or feelings that nurses experience following codes or deaths, and competing demands from outside of work (Health Promotion Model, 2016). According to the HPM (2016), encouraging healthy behaviour improves health and functional abilities and can result in a higher overall quality of life. The HPM is relevant to the issue of burnout because being aware of risk factors for burnout and improving the nurse’s well-being will help to reduce the likelihood of experiencing burnout.

The Human Caring Theory focuses on the human aspect of caring for someone and the small interactions that occur between the nurse and the patient. “A nurse should use faith-hope to provide a sense of well-being through a belief system meaningful to the individual,” according to the American Nurses Association (Jean Watson Nursing Theory, 2016). According to Hylton Rushton et al. (2015), nurses who reported higher levels of hope and spiritual well-being, among other things, had lower levels of burnout and related symptoms like emotional exhaustion. Nurses should make an effort to be more sensitive. “The nurse promotes health and higher-level functioning only when person-to-person relationships are formed” (Jean Watson Nursing Theory, 2016). Burnout, however, has been shown to reduce a nurse’s compassion and ability to form trusting relationships, communicate effectively, and demonstrate empathy, as Kelly and Tyson (2016) explained. Nurses who experience burnout lose their ability to show kindness, compassion, and full attention, all of which are components of caring. Patients will not receive the complete care potential they deserve unless this human aspect of caring is present.

Conclusion

As a new nurse, I am fortunate not to have experienced burnout. However, I have worked with nurses who were burned out for various reasons. Nurses understand that their patients’ lives are in their hands, but they also know that the outcome and whether the patient lives or dies is not entirely within their control. Nurses frequently lack the time required to provide each patient and family member with the care and attention they deserve for various reasons. Nurses often cannot decompress after a patient emotionally codes and either dies or is transferred to another unit because multiple other patients are waiting for them. As a result, the nurse must maintain her calm to care for the remaining patients safely. Many nurses work full-time and then care for others when they get home. Even if no one requires additional home care from the nurse, family members frequently rely on them to help them with problems as they arise. These are just a few examples of the challenges nurses face and the causes of high stress, physical and emotional exhaustion, poor mental functioning, a lack of self-care, and overall burnout.

Burnout hurts the nurse, the patient, and the entire healthcare system. Burnout can result in various consequences from the Board of Nursing, including loss of licensure. Errors by the nurse could harm or kill a patient, injure others, including coworkers, or seriously harm themselves. Burnout can develop gradually and become unrecognizable. People don’t always realize they’re making mistakes until something terrible happens, which is much more likely when a nurse is burnt out. There are ways to determine if a nurse is at risk of burnout, and I believe they should be much more widely publicized. Many adverse outcomes could be avoided if adequate teaching and training help people better understand the internal and external factors contributing to burnout.

Nurses must take care of themselves physically and mentally to provide the safest and most efficient care for their patients. Committing to health-promoting behaviours such as stress management (mindfulness), physical activity and eating healthy, getting enough sleep, increasing resiliency, and maintaining hope and spiritual well-being, among other things, all help to reduce and prevent burnout. It must be a priority for the nurse to fully care for themselves, as the consequences of a lack of self-care and burnout can be devastating.

Similar Post: Developing a Culture of Evidence-Based Practice

References

Geuens, N., Van Bogaert, P., & Franck, E. (2017). Vulnerability to burnout within the nursing workforce-The role of personality and interpersonal behaviour. Journal Of Clinical Nursing, 26(23/24), 4622-4633. doi:10.1111/jocn.13808

Health Promotion Model. (2016). Retrieved from http://www.nursing-theory.org/theories-and- models/pender-health-promotion-model.php

Hylton Rushton, C., Batcheller, J., Schroeder, K., & Donohue, P. (2015). BURNOUT AND RESILIENCE AMONG NURSES PRACTICING IN HIGH-INTENSITY SETTINGS. American Journal Of Critical Care, 24(5), 412–421. doi:10.4037/ajcc2015291

Jean Watson Nursing Theory. (2016). Retrieved from http://www.nursing-theory.org/theories- and-models/watson-philosophy-and-science-of-caring.php

Kelly, M., & Tyson, M. (2016). Can mindfulness be an effective tool in reducing stress and burnout while enhancing self-compassion and empathy in nursing? Mental Health Nursing, 36(6), 12–17.

Magtibay, D. L., Chesak, S. S., Coughlin, K., & Sood, A. (2017). Decreasing Stress and Burnout in Nurses: Efficacy of Blended Learning With Stress Management and Resilience Training Program. Journal Of Nursing Administration, 47(7/8), 391-395. doi:10.1097/NNA.0000000000000501

Ross, A., Bevans, M., Brooks, A. T., Gibbons, S., & Wallen, G. R. (2017). Nurses and Health- Promoting Behaviors: Knowledge May Not Translate Into Self-Care. AORN Journal, 105(3), 267–275. doi:10.1016/j.aorn.2016.12.018

Russell, K. A. (2017). Nurse Practice Acts Guide and Govern Update 2017. Journal of Nursing Regulation, 8(3), 18–25. doi:10.1016/s2155-8256(17)30156-4

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1. Describe the national healthcare issue/stressor you selected and its impact on your organization. Use organizational data to quantify the effect (if necessary, seek assistance from leadership or appropriate organisational stakeholders).

2. Briefly summarise the two articles you reviewed from outside resources on the national healthcare issue/stressor. Explain how the healthcare issue/stressor is being addressed in other organizations.

3. Summarize the strategies used to address the organizational impact of national healthcare issues/stressors presented in your selected scholarly resources. Explain how they may impact your organization both positively and negatively. Be specific and provide examples.