Burnout in Nursing in the Acute Care Setting

Burnout in Nursing in the Acute Care Setting

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Problem Statement

Nurse burnout within the confines of acute care settings constitutes a pressing concern with repercussions for healthcare practitioners and patient care delivery. The demanding milieu characterized by protracted work hours, emotional intensity, and frequently life-or-death scenarios precipitates a trifecta of nurses' physical, mental, and emotional fatigue. This exhaustion exerts a deleterious influence on the nurses' welfare and jeopardizes patient safety and the overall caliber of healthcare (Kleinpell et al., 2020).

This quandary is further exacerbated by understaffing, elevated patient-to-nurse ratios, a need for more administrative backing, and insufficient resources. These contributing elements engender a vicious cycle of stress and burnout, engendering an atmosphere where nurses cannot perform optimally. Furthermore, the ramifications extend to elevated turnover rates, compounding staffing quandaries and perpetuating the predicament (Andel et al., 2022).

Empirical evidence underscores the nexus between nurse burnout, diminished job satisfaction, heightened propensity for errors, and deleterious consequences for patient well-being (Efil et al., 2020; Bruyneel et al., 2023). In acute care contexts, marked by amplified demands, the repercussions of burnout are accentuated. This state of affairs not only jeopardizes patient health but also threatens the viability of healthcare systems, given the substantial costs associated with replacing skilled nursing staff (Shah et al., 2021).

This investigation's primary objectives encompass identifying pivotal factors precipitating nurse burnout in acute care settings, an appraisal of burnout's impact on nurse welfare, and formulating strategies to ameliorate these concerns. This entails an exploration of interventions at both individual and organizational strata, such as training in stress management, enhancements in staffing paradigms, and policy alterations aimed at cultivating a more nurturing work milieu. The ultimate aspiration is to augment nurse job satisfaction and well-being while ensuring high-caliber patient care.

Organizational Culture and Readiness

Organizational Culture

The culture within the acute care hospital strongly emphasizes addressing nurse burnout, fostering inclusivity, and involving nurses in decision-making. It actively embraces change, adapting its policies and practices to proactively address nurse burnout and creating a responsive and dynamic environment for its staff.

Organizational and Leadership Structure

The hospital's decentralized leadership structure empowers nurses to actively participate in decision-making processes, which is crucial in reducing nurse burnout.

Mission and Values

The organization's mission statement prioritizes nurse well-being, highlighting its dedication to providing necessary resources and support for nurses, thus promoting a culture centered around addressing and preventing nurse burnout.

Interprofessional Collaboration and Team Engagement

The hospital promotes interprofessional collaboration through regular wellness initiatives and interdepartmental support groups. This recognizes the importance of mutual support and shared experiences among healthcare professionals in combating nurse burnout.

Communication

Open and transparent communication channels enable nurses to express their concerns and ideas, with the organization actively listening and responding. This approach builds a culture of trust and responsiveness to nurses' evolving needs.

Perception of the Organization by Employees

Nurses view the hospital as a caring institution that genuinely values their well-being. This positive perception reinforces a culture of support and resilience, motivating nurses to actively address nurse burnout.

Organizational Readiness

Organizational Tool

The Survey of Organizational Research Climate (SCORE) survey serves as an organizational evaluation tool. It includes scales to assess various facets of the organizational context, such as work-life atmosphere, teamwork dynamics, safety culture, burnout climate, personal burnout experiences, and local leadership effectiveness (Adair et al., 2018).

The survey findings from SCORE revealed concerning issues within the organization. Burnout at the organizational and individual levels stands out as a significant concern, reflecting inadequate support and resources for staff well-being. The "Improvement Readiness" sub-scale suggests a general reluctance to embrace change or improvement initiatives, highlighting prevalent resistance within the organization.

Strategies to Foster Preparedness in the Organization

Identify the Signs and Symptoms of Burnout. Burnout is characterized by enduring responses to chronic stress, including constant exhaustion, sleep problems, reduced concentration, detachment from work-related activities, decreased job performance, emotional indifference, heightened frustration and anger, chest pain, and shortness of breath, among others (Thomas et al., 2019).

Address Burnout. According to de Oliveira et al. (2019), strategies to address nurses' burnout encompass yoga, cognitive coping techniques, compassion fatigue programs, systematic clinical supervision, meditation, web-based stress management programs, and the Psychological Empowerment Program.

Create Supportive Policies. The absence of scientifically informed policies regarding nurse burnout contributes to increased verbal and physical violence against nurses. This is particularly concerning as nurses lack the same legal and policy-based protections afforded to other service workers, amplifying their disillusionment with leadership and the public (Schlak et al., 2022).

Evidence-Based Practice

The acute care hospital's organizational culture is well-suited to support and sustain evidence-based practice changes. Its strengths lie in its commitment to nurse well-being, proactive adaptation to change, and a decentralized leadership structure that empowers nurses.

Healthcare Process and Systems to Improve Quality, Safety, and Cost-Effectiveness of the Organization

Productivity Measurement and Enhancement System (ProMes). ProMes is an organizational intervention that adopts a participative, "bottom-up" approach, focusing on improving work organization and the work environment. It addresses work-related risk factors, including insufficient autonomy and control, ineffective communication with colleagues, ambiguous and conflicting task assignments, limited involvement in decision-making processes, inadequate recognition and rewards, and a lack of constructive feedback. It fosters a culture of lower turnover rates, reduced recruitment costs, and better retention of experienced nurses by improving the work environment and preventing nurse burnout (Jensen et al., 2022).

Key Stakeholders and Team Members. These include nurses, nurse leaders, healthcare professionals from various departments, and organizational leadership. Nurses play a central role in engaging with burnout prevention strategies, while nurse leaders oversee effective implementation. Healthcare professionals from various domains contribute to interdepartmental support and shared experiences. Organizational leadership is responsible for providing support, resource allocation, and implementing policies to enhance nurses’ well-being and prevent burnout.

Information and Communication Technologies (ICTs). ICTs encompass technologies that facilitate information access through telecommunication. They focus on communication methods like the internet, wireless networks, and cell phones, serving as a multidisciplinary field with scientific, technological, and engineering dimensions. ICTs enhance information exchange, communication, and healthcare service quality and efficiency (Ratheeswari, 2018).

Nurses will play a central role in utilizing ICT tools to monitor their workloads and promptly report signs of burnout, aligning with the hospital's focus on nurse participation and well-being. Nurse leaders will oversee the integration of ICT, ensuring proper training for nurses and collaboration with IT teams to select tools in line with the hospital's mission. Healthcare professionals from various departments will use ICT for interprofessional collaboration, reinforcing the hospital's emphasis on team engagement. Organizational leadership will allocate resources and work with IT for seamless ICT integration, reflecting the hospital's commitment to nurse support and burnout prevention.

Importance to Nursing Practice and Care Delivery. The incorporation of ICTs will significantly advance nursing practice and care delivery. Nurses will effectively monitor workloads and report burnout signs, nurse leaders will oversee ICT integration, and healthcare professionals will collaborate better, enhancing patient care. This reflects the hospital's commitment to nurse well-being and positions ICT as vital in addressing burnout, ultimately improving patient outcomes and resource utilization.

Literature Review

The World Health Organization (WHO) has officially recognized burnout as a syndrome delineated within the International Classification of Diseases (ICD)-11. It encompasses three distinct dimensions resulting from chronic workplace stress mismanagement: persistent energy depletion and fatigue, escalating emotional detachment from one's job, often coupled with negative sentiments or pessimism towards it, and a notable decline in professional efficacy. It is vital to emphasize that burnout pertains exclusively to work-related challenges and should not extend to experiences in other life domains (Sharifi et al., 2020).

The array of burnout symptoms encompasses frequent work absences, a propensity to exit the profession, diminishing self-esteem, and potential engagement in substance abuse, among others. Burnout is intimately linked with compromised patient care standards, elevated medical error rates, and diminished patient safety. In parallel, burnout can take a toll on healthcare professionals' overall quality of life. Various studies have scrutinized the prevalence of burnout across diverse healthcare sectors. A decade ago, a meta-analysis revealed that roughly 11% of nurses worldwide had encountered burnout (Sharifi et al., 2020).

Shah et al. (2021) examined the prevalence and