Fatoumata Kamaso, Pace University, Pleasantville Campus

Why nurses’ are being burn out?

My name is Fatoumata Kamaso, I am a Nursing major at Pace University, Pleasantville campus in New York. I am obsessed with the topic “Why nurses’ are being burnout?” and the main objective of my blog is to look for interventions that will prevent the burn out syndrome among nurses, as they are the backbone of the healthcare industry. this video is about nurse burnout and patient welfare. Enjoy and please comment.

1. NURSE BURNOUT AND HOW IT AFFECTS PATIENT WELFARE

This video is about why nurses are being burnout and how burnout affects the welfare of the patient.

2. Why Nurses have the burnout syndrome:

Nurses have been found to report high levels of stress and burnout in relation to their jobs. Various studies have been conducted to find what the main problem is and solutions needed to help stop the burnout. A lot of research has been done on nurse’ burnout and its effect on the nurses and most importantly the patient. According to research, Burnout is associated with poor job performance, and this can lead to unsafe environment for the patient. The main focus of this paper is to look for problems related to nurses’ burnout, the correlation between nurses’ burnout and patient safety, and also find interventions that are needed to help stop this dilemma. Most of the research conducted was more focused on why they are burnout and emotionally drained; and interventions have been suggested by researchers that will help decrease nurse burnout, increase job performance and hence increase patient satisfaction in both inpatient and outpatient settings of the healthcare system. Job stress encountered by nurses can affect their health, and also affect their ability to provide the best care possible to their patients. Hospitals can start providing nurses with support services that will help them cope with the job stress that leads to burnout.

What is meant by Nurses being burned out?

Nurses’ main function in the healthcare system is to take care of their patients and their families as well. The nurses’ role is to be always taking care of their patients at all times, watch for any signs and symptoms of both the side effects and adverse effects of all medications that they give to their patients, and what interventions are needed to help prevent undesirable complications. They juggle through all of this, whilst still documenting any intervention done or any side effect or adverse effect that is experienced by the patient.

3.What are the causes of nurse burnout

There are so many variables that cause burnout, and one of the reasons is stress at the workplace. When people are stressed, they become emotionally and so physically exhausted to the point that it affects both their emotional, physical and mental well-being. Jennings wrote that the “Work stress in nursing was first assessed in 1960 when Menzies, identified four sources of anxiety among nurses: patient care, decision-making, taking responsibility, and change. The nurse’s role has long been regarded as stress-filled based upon the physical labor, human suffering, work hours, staffing, and interpersonal relationships that are central to the work nurses do (Jennings 2008).”This depicts that stress can be very detrimental to both the nurse and the patient, and the hospital as well; because it is both exhausting and can even delay the treatments needed by the patients and affect the recovery time for the patient that the nurse is taking care of. Nurses tend to hide their stress level and act like superheroes even at their weakest; and that they can overcome any obstacle that comes their way. Jennings said that “stress is not inherently deleterious, however, each individual’s cognitive appraisal, their perceptions and interpretations, gives meaning to events and determines whether events are viewed as threatening or positive. Personality traits also influence the stress equation because what may be overtaxing to one person may be exhilarating to another. Why does the system establish shifts that lead to nurse burn out? Is this a way to save money? What is at work in creating these shifts (Jennings 2008)?” This is true everywhere. Every human being has his or her own view of stress, what his or her reactions will be, and the interventions that is needed to over the stress. Some people do not like to show their weakness, because it shows that they are not strong enough to overcome the demands of life. Male nurses especially will never want to show how exhausting it is to work three days straight in a row, they will pretend that they are manly enough to do anything that comes their way, and it will not affect them; when in real life, the stress that comes with the workload is the same for everyone irrespective of our gender.
 In the olden days, nursing used to be just about trial and error , but as technology advances, and the changes in the healthcare system , it is now based on Evidenced based practice which utilizes research to implement all the standards practiced by the nurses in all aspects of the healthcare system. The main focus of every nurse is to make a difference in every patient’s life, every day irrespective of their culture, race, gender, or socio-economic status. Nurses are always with the patient for their entire shift, attending to the needs of the patient and making sure that they provide the best care possible as well as advocating for the patient at all times; but they are worst in taking care of themselves. 
 Being burnout is considered as being exhausted and that is exactly what happens to these nurses. They take less care of themselves, they eat at odd times and sometimes most of these nurses do not even take breaks which hospitals now make mandatory for all of them. They get caught up in their dues that they forget about themselves. Some nurses blame their exhaustion on the nurse-patient ratio and others blame it on the hours they had to work. Most of the hospitals now provide a 12-hour shift instead of the old and traditional eight-hour shifts that they used to work before. This 12-hour shift gives them opportunity to have four days off for three weeks in a month, and three days off on one of the weeks in the month; nurses that work eight-hour shifts, have to work five days in a week and nurses who work 12-hours a day normally work three days a week. Some nurses tend to take more overtime because of the three day shift and hence become so overloaded, exhausted and, stressed to point that the health and safety of the patient is put at risk. Other nurses argue that the eight-hour shifts were more exhausting. An excellent nurse with good time management skills is less exhausted as he or she tends to organize and prioritize what is needed and, what to do next; but a less experienced person with poor time management will be exhausted every shift irrespective of the hours spent at work or the nurse-patient ratio. Some research has been implemented on the nurse burnout and what the main causes are, and what can be done to prevent it or interventions needed for the ones that are already burnout. Some studies have shown the correlation between longer hours and exhaustion and others have shown the correlation between the nurse-patient ratios being the main problem. Despite the difference of opinions of these researchers, both nurse-patient ratio and the long hours are the reasons why nurses are burnout.

4. Effects of nurse burnout and interventions to reduce the burnout

This image shows the effects of nurses and the statistics behind it. The image shows how we can reduce the burn out syndrome and the benefits associated with it.

It is known that work environment that produce high levels of stress can lead to ineffective coping and hence burnout (Edward & Hercelinskyj, 2007; Sabo, 2008). Work stress is also considered as being a state of extreme emotional, mental, and physical exhaustion, and the signs of being burnout are feelings of both acute and chronic fatigue, anger, feelings of being helpless, and physical symptoms such as headaches, gastrointestinal problems, weight loss or weight gain, insomnia, and depression (Taylor & Barling, 2004). ). Other effects of chronic burnout include conflict with colleagues, indifference toward patients, alcoholism, and problems with relationships (Quattrin et al., 2006). All these signs and symptoms are devastating and very harmful to the safety and wellness of both the nurses and the patients as well. 
Correlation between Nurses’ burnout and the shifts worked by the nurses 
Traditionally, eight-hour shifts were the norms for all nurses in all hospital settings, but now they have become a thing of the past by most hospital.

Stimpfel, Amy, W. (2012, November 6). Long Shifts Leads to Nurse Burnout and Dissatisfied Patients. [Video file]. Retrieved from https://youtu.be/fbd_-f-TluE

5. The schedules difference is another big factor

Stimpfel, Amy, W. (2012, November 6). Long Shifts Leads to Nurse Burnout and Dissatisfied Patients. [Video file]. Retrieved from https://youtu.be/fbd_-f-TluE

Also nurse burnout is affected by scheduling should be Hospitals should be more control of their schedules and thus prevent burnout. There should be more flexible schedules for the nurses and other educational programs such as delegations, time management skills should be part of the educational materials given to nurses at all times. The Professional development of every hospital should try to find ways or interventions at all times to stop the burnout and hence increase the productivity of the nurses and hence improve patient and family satisfaction at all times.

What are the interventions needed to help reduce burnout and improve job performance 
 
While studies examining the correlation between burnout and poor job performance, there is still room for more ways in finding solutions to this problem. Intervention are needed to help reduce this disease called “burnout” crippling the healthcare system and pushing some nurses to even think about quitting their jobs. Demeroutie et al stated in their study that burnout can be prevented, if the nurses are assessed and their workplace is also monitored inorder to help identify the problems encountered by nurses and, hence find interventions needed to reduce their burnout. They also mentioned that the preventive methods will benefit from the conceptual model that integrate previous research findings in relation to work-related stress and burnout among the nurses (Demeroutie et al 2000). If supervisors are well trained on communication skills between themselves and their co-workers, a conducive environment will be created because the nurses will be feel comfortable enough to open up about the problems they are facing, whether the workload that they are given for their shift is too much or if the nurse-patient ratio for the shifts that they are given is unmanageable. This intervention will create a more democratic relationship in the hospital and hence increase their productivity. Another suggestion is to create suggestion boxes where nurses can talk about what they are facing and what changes they need to help them. 
Another study was conducted by Shoni Davis et al at Metropolitan cancer centers in Southwest Idaho to investigate the difference in burnout among oncology nurses by the type of work setting, coping strategies, and job satisfaction. They used a descriptive design to study 74 oncology nurses and the methods used to do the study consist of demographic data form, the Nursing Satisfaction and Retention Survey, and the Maslach Burnout Inventory. All oncology nurses who worked full-time were eligible to participate, except those with fewer than six months of oncology nursing experience. At the end of the study, their findings indicated that most of the participants used spirituality and co-worker support. The younger nurses scored lower on emotional exhaustion and higher for the older nurses. They also found out that the adult setting scored higher in personal accomplishment. Job satisfaction, according to them is inversely correlated with emotional exhaustion and the desire to leave oncology nursing (Davis 2013). 
 At the end of the study, they concluded that “social support can impact emotional exhaustion and depersonalization, and that the demographic may be more significant in helping to determine burnout than the setting itself” (Davis et al 2013). It is known that “the effects of workplace social context have a significant impact on all three dimensions of burnout syndrome (Lee & Akhtar, 2011)”. Staff conflicts, patient behaviors, and undervaluing nurses are social context issues that have been linked to burnout (Taylor & Barling, 2004), as have relationships with managers, coworkers, and physicians” (Leiter & Maslach, 1988).
Clearly we can all attest that there is still room for improvement in all the studies that were conducted on burnout in nursing and its effect on the healthcare system, more room is needed for improvement. Although there is more room for more research to conduct on this topic, the specialty area that a nurse works at can also affect poor job satisfaction and the desire to want to leave the specialty that one works at can be the problem; because if the nurse is dissatisfied with where she works at, she always comes to exhausted even before the beginning of a shift. Job stress encountered by nurses can affect their health, and also affect their ability to provide the best care possible to their patients. Hospitals can start providing nurses with support services that will help them cope with the job stress that leads to burnout. 
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References

Chipas, A., & McKenna, D. (2011). Stress and Burnout in Nurse Anesthesia. AANA Journal, 79(2), 122–128.
Davis, S., Lind, B. K., & Sorensen, C. (2013). A Comparison of Burnout Among Oncology Nurses Working in Adult and Pediatric Inpatient and Outpatient Settings. Oncology Nursing Forum, 40(4), E303–11. doi:10.1188/13.ONF.E303-E311
Demeroutie, E., Baker, A.B., Nachreiner, F., & Schaufeli, W.B. (2000). A model of burnout and life satisfaction amongst nurses. Journal of Advanced Nursing. 32(2), 454–464 
 doi:10.1046/j.1365–2648.2000.01496.x
Gandi, J. C., Wai, P. S., Karick, H., & Dagona, Z. K. (2011). The role of stress and level of burnout in job performance among nurses. Mental Health In Family Medicine, 8(3), 181- 194.
Jennings, B. M., (2008). Work and Stress Among Nurses: An Evidence Based Handbook For Nurses. Agency for Healthcare Research and Quality. Retrieved from: http://www.ncbi.nlm.nih.gov/books/NBK2668/doi: 10.1046/j.1365–2648.2001.01769.x
Leiter, M.P., & Maslach, C. (1988). The impact of interpersonal environment on burnout and organizations commitment. Journal of Organizational Behavior, [Remember that journals are italicized.] 9, 297–308. 
Lee, J., & Akhtar, S. (2011). Effects of the workplace social context and job content on nurse burnout. Human Resource Management Journal, 50, 227–245. doi:10.1002/hrm.20421

Miller-Keane. (2003).Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. Retrieved July 25 2016 from http://medical- dictionary.thefreedictionary.com/burnout

Stimpfel, A. W., Sloane, D.M., & Aiken, L. H. (2012). The longer the shifts for hospital 
 nurses, the higher the levels of burnout and patient dissatisfaction. Health Affairs (Project Hope), 31(11), 2501–2509. doi: 10.1377/hlthaff.2011.1377
Taylor, B., & Barling, J. (2004). Identifying sources and effects of career fatigue and burnout for mental health nurses: A qualitative approach. International Journal of Mental Health, 13, 117–125.
Quattrin, R., Zanini, A., Nascig, E., Annunziata, M.A., Calligaris, L., & Brusaferro, S. (2006). Level of burnout among nurses working in oncology in an Italian region. Oncology Nursing Forum, 33, 815–820. doi:10.1188/06.ONF.815–820