Reducing the Burnout Phenomena in the Nursing Profession

Nurse Burnout
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Nurse Burnout
Burnout is an occupational phenomenon and is not specific to the nursing profession. People working in any industry can suffer from burnout due to work stressors. However, within the nursing profession, burnout is increasingly a relevant scholarly topic because of the sensitive nature of the work of a nurse (provision of primary care) and the increasing demand for nursing services against the diminishing supply of nurses. Nurse burnout is not only a problem for the nurse (as an individual) but also for healthcare organizations and the public health system. Solutions to nursing burnout range from interventions at the individual level to solutions at the systemic level. Causes of nurse burnout or more system-oriented and less individual-oriented. Therefore, to reduce the burnout phenomena in the nursing profession, solutions must address the system in which nurses work both at the organizational and industry level.
Causes of Nurse Burnout
The World Health Organization defines nurse burnout as the state of mental, physical, and emotional exhaustion resulting from sustained work-related stressors (WHO, 2019). Often, a combination of stressors can be compounding, leading to a nurse feeling detached and disengaged from work, the initial sign that a professional is experiencing burnout. In extreme circumstances, where burnout is not addressed, a nurse can feel hopelessness, cynicism, stress, and depression. Causes of work burnout can be classified into three categories: personal, organizational, and industry level.
Personal Level Causes
At the personal level, causes of burnout include lifestyle choices and habits, ranging from sleeping patterns, and use of digital media, to alcohol and substance abuse, often for recreational purposes and not necessarily abuse. These factors can be viewed both as independent or intertwined. For instance, excessive use of social media or other digital technologies, excessive engagement in substance and alcohol abuse, or other stressors at home such as caregiving can lead to pressure that results in loss of joy in work. For instance, excessive use of social media may limit the resting time of the already overworked nurse. This sleep burden is then transferred to work in reduced attention span, sleepiness, and sluggishness. In other words, even where there are perfect conditions, nurses' habits and behavior can contribute to them experiencing work burnout. Further, how nurses perceive and react to common stressors within the work environment, such as emotional breakdowns and traumatic images of gruesome injuries or the need for long-term care for terminally-ill patients, contributes to how they experience burnout. In this view, Salvagioni et al. (2017) concluded that burnout could be personal. It is unique because its routes can be within the individual or environment in which they rest, such as homes. Homes stressors combined with work stressors can also significantly lead to loss of joy in work because home-based activities such as raising a familiar becomes a priority over work on moral grounds.
Organizational Level Causes
But when nurses react positively or negatively to the expected stressors in the workplace, the environment plays a crucial role in creating these stressors. Looking at high-stress work environments, for instance, hospital organizations with high traffic of patients are examples. For example, at the onset of Covid-19, hospitals were overwhelmed by patients stretching the workforce, especially among nurses. In such an environment, nurses see an incredibly large number of patients daily, must consistently make quick and accurate decisions in life-threatening situations, and provide the necessary documentation, including patient data collection. In other words, high-stress environments are where nurses have demanding workloads consistently with little or no break. Studies (Shah, Gandrakota, & Cimiotti, 2021) indicate that nurses who have more than four patients experience higher rates of burnout. Further, each nursing specialty has unique challenges in that some specialties are more stressful than others. For instance, nursing working in emergency departments or intensive care units face significantly higher chances of facing combative patients, ethical dilemmas, traumatic injuries, and a higher mortality rate. These experiences are linked with high-stress levels, which enhance the rate of burnout.
Further, the increasing demand for nursing services against a diminishing supply of nurses means that the currently employed nurses are handling extra tasks that they should otherwise not focus on. An outcome of this burden is that nurses must work long hours to meet organizational and industrial expectations. As a result, they have little or no time to pursue social activities like bonding with family, pursuing other activities of interest, and receiving adequate rest between shifts. Sustained long-working hours, according to Lin, Lin, and Kuo (2021), are significant stressor that precedes burnout. However, long working hours are not a result of individual nursing decisions. Rather, it is an outcome of organizational or industrial decisions that limit the number of nurses available upon which work burden can be distributed.
At the organizational level, some of these decisions include the organizational culture, level of staffing, availability of resources, management efficacy, and leadership involvement. The leadership and management are responsible for cultivating the organizational culture and persuading nurses to buy into it as part of an organizational mission. Therefore, in a culture where leadership and management are silent and do not offer nurses support, the blame shifts from the individual to the organization. In another example, an organization that is blind to its understaffing problem burdens nurses with an excessive and unfairly distributed workforce. Here, a nurse will experience burnout not necessarily because of the time they spend on social media but because of the conditions created by the organization.
Industrial Level Causes
Decisions made at the industry level trickle down into nursing units and affect the nursing practice. Today, the primary cause of nurse burnout is the growing demand for nurses. According to the US Bureau of Labor Statistics, employment for registered nurses will grow by 12% before 2028 (USBLS, 2020). While this is good news for people with nursing aspirations, the drastic increase in demand is not in per with the supply of nurses. As a result, hospitals are understaffed, and available nurses are overworked. Thus, long working hours, lack of sleep, and high-stress environments are expected and will further fuel industry employee turnover. Thus, the continuous lack of solutions to the looming crisis at the industrial level will ultimately be felt in nursing units.
Lastly, the role of nurses is drastically changing in tandem with evolution in areas like technological advancement and changes in healthcare consumer behavior. The issues of nursing informatics and evidence-based practices, for instance, have called for drastic changes in the nursing practice at the industry level. Mutshatshi et al. (2018) argue that some of these decisions have only expanded the number of paperwork nurses must perform daily. This paperwork has subsequently increased the nursing workload and reduced the number of times nurses can rest or interact with patients. Therefore, decisions at the industry level influence the organizational and personal level factors that materialize into burnout.
Implications of Combined Levels Stressors
Therefore, in light of organizational and industry-level factors, significant causes of nurse burnout are system-based rather than individual-based. A good example is a working environment or culture with no deliberate emphasis on collaboration and teamwork. Cooperation and teamwork allow for equal workload distribution so that each professional has a fair share Dall'Ora, Ball, Reinius, & Griffiths, 2020). However, where such a culture is lacking, nurses are more likely to suffer from burnout. Thus, an organizational or industrial system in which a nurse works is responsible for defining and sustaining structures that enhance teamwork and collaboration among professionals.
Patient care is a rewarding aspect of the nursing profession. Nurses find pleasure in their work when they see patients recover and return home to lead healthy life. However, the downside of patient care, especially in end-of-life or critical care, can be emotionally draining. Nurses often experience compassion fatigue and emotional letdown when dealing with lower recovery rates and high mortality rates (Aslan, Erci, & Pekince, 2021). Where nurses are handing more than four patients and in cases where there is a lack of support, sustained emotional strain leads to lack of sleep and, subsequently, burnout.
Lack of sleep is partly a result of long working hours; a little rest is a lack of sleep. Nurses are forced to wake up early and sleep late to meet organizational demands. As a result, they do not have adequate sleep, which is a necessary component for healthy wellbeing and improved productivity at work. According to Shah, Gandrakota, and Cimmiotti (2021), 25% of nurses in the United States report facing sleeping difficulties between shifts. Chronic lack of sleep leads to mental and physical discomforts that affect nurses'' productivity and, therefore, the productivity of an organization.
Signs of Nurse Burnout
What is consistent across the causes of nurse burnout is that they are shaped more by the system and less by individual nursing decisions. However, nurse burnout manifests first at the individual before it spills into the system. According to Mudallal, Othman, and Hassan (2017), the common signs of nurse burnout include detachment & disengagement from...