Assignment: Evidence-Based Practice Guideline

The Impact of Burnout syndrome on Nurse Workers !1

The Impact of Burnout Syndrome on Psychosocial Wellbeing, Expected Outcomes, Self-efficacy,

Turnover, and Interest in Career of Nurse Workers.

Olajumoke Omiyale

Aspen University

Author Note

Essentials of Nursing Research N494

Dr. Keshea Britton

Date of Submission February 11, 2020

Burnout Among Nurses !2

Background

Burnout is a very common condition across the world and especially in the nursing

career. It’s the reduction in the energy and zeal of nurses manifesting in form of being

emotionally exhausted, lacking motivation, feeling frustrated, fatigued, and low reaction time

which reduces individuals’ output and work efficacy in general. Burnout has been strongly

attributed to the deficit in the number of healthcare professionals, a concern that goes way to be a

matter of global importance. The rapidly changing healthcare landscape that brings a paradigm

shift to increased demand for healthcare services in the world population has come with its

challenges. Although experts associate the change to improvement in the quality of life for which

people become capable of seeking healthcare services, the move has placed a lot of pressure on

not only the healthcare systems but particularly on the workforce (Mudallal, Othman, & Al

Hassan, 2017). However, governments have not moved at a similar pace to address these

pressures, leaving the mantle on the health institutions and professionals. To be specific, nurses,

as well as other healthcare providers, are left with a large number of patients to takes care of, a

number that keeps on increasing day after day, keeping them on the run all the time. The absolute

result of this healthcare environment is burning or wearing out, which without doubt minimizes

the efficacy of the nurse’s output.

The working environment for which the nurse staff doesn’t match the care demand

culminated by poor leadership creates unattractive working conditions. Indeed, WHO reports

indicate that shortages of nurses would nationally and internally interfere with the efforts to

health and well being of the world population. Where staff shortage exists, human resources are

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overstretched, working conditions become poor and unbearable, work becomes increasingly

hazardous to the health of the nurse- they get no rest, become stressed, productivity decrease

with the poor patient outcome which add up to the trauma of the workers. They end up losing

interest in their job, become highly dissatisfied, burnout and increase the chances of quitting the

job. In return, the turnover of nurses affects the quality of healthcare services offered because of

a lack of expertise and increasing the workload burden on the remaining staff (Sobral, et. al,

2018).

The research topic in question is consistent with the PICOT format which requires the

development of answerable and researchable questions. The research question of what impact

does burnout has on productivity or self-efficacy, career interest, expected outcome, turnover,

and quality of healthcare services in the nursing profession can have the following formula.

Population- the population is comprised of nurses in the wards; palliative care wards,

maternity and newborn, renal, ICU wards among others.

Intervention/Indicator- indications would include stressors such as social, psychological,

and work-related factors.

Comparison/control- may have placebo form nurses in private hospitals or theater staffs,

who in most cases are relatively sufficient. They usually take enough rest, do the work for a few

hours and thus less predisposed to burnout.

Outcome- nurses in these wards show a decrease in the reaction time, often get fatigued

and sick, may lose hope in the career, high dissatisfaction levels, and increased rate of turnover.

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Time-research can be cross-sectional.

Why burn out Syndrome is a Clinical problem

Productivity in many working environments, particularly in the provision of healthcare

services depends majorly on the motivation, energy, and the ability of the nurses to make fast and

accurate decisions regarding the circumstances they are confronted with. While this freshness

remains significant for a nurse to give the best they can to their client, many factors do affect that

state of consciousness and health for a nurse. just like other workers, nurses require enough time

to rest after work, take vacations to refresh and maintain the fitness of both the mind and the

body. However, in reality, nurses rarely get this rest, in most cases being on call, working for

long-hour shifts and in a stressful working environment.

The palliative care ward where I work has a capacity of between sixty to a hundred

patients. The nurses assigned to this ward are 20. Taking this as a reflection of the entire

healthcare system, we find that the ratio of nurses to the patient is 1:3 on the bare minimum. The

implication of this is that one nurse would at least take care of 3 patients daily on the minimum

with this number likely to increase every other day. Because the aged population is growing

rapidly and are prone to lifestyle diseases, the likelihood of demands for these services would

increase. Ultimately, nurses would have a huge burden on the care they have to take care of a

large number of patients, possibly over a long time. If the number of nurses remains the same

with the increasing workload, the department is likely to experience higher rates of turnover.

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Literature Review

According to Rola, et. al, (2017), burnout Syndrome is a trend that is synonymous in the

entire world with some areas severely suffering from the condition due to the limited workforce.

In this study that was conducted in Jordan, burnout among the working staff is characteristic of

depersonalization, emotional exhaustion, personal accomplishment and correlates to work

conditions, demographic traits, and leader empowering behaviors. the high level of burnout in

this part of the word subjective to poor working conditions including unfairness, an overload of

work, lack of leaders, personal and social issues necessitate improvement of health care services

to focus on eliminating burnout among the healthcare workers. Besides, nurses working on fixed

schedules demonstrated a greater level of emotional exhaustion and depersonalization compare

to the ones working on rotating shifts due to work overload. Besides, nurses working in private

environments felt to be in favorable conditions in terms of the quality of care, staffing, resource

capabilities, and leadership and collegial support (Mudallal, Othman, & Al Hassan, 2017).

A study done by Chang in Taiwan involving nurses on full-time basis self-efficacy,

outcome expectations, and positivity in career interests were measured. The study showed a

strong association between the three factors and burnout. Both self-efficacy and expected

outcomes showed an inverse relationship with a burnout in which it negatively impacts them.

Since self-efficacy was positively related to outcome expectations, any negative effects on the

two by burnout would consequently result in the diminishing the other factor. Interest in nursing

career negatively impacted the intention to quit the organization as well as leaving the

profession. The study concluded that since when nurses leave the profession, patient outcomes

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are negatively impacted, policymakers must focus on satisfying the expectations of nurses and

adequately compensate them fairly to retain them.

According to sabral, et. al, (2018), burnout syndrome is experienced by workers as a

result of being exposed to interpersonal stressors for a prolonged duration. The author notes that

burnout has become an issue of global concern by the justification of the number of researches

that have been previously done concerning the topic. More than 4000 articles on nursing burnout

have been found in PubMed with the database recording over 6000 publications on burnout

generally. Prevalence of burnout among the public university hospital workers in Sāo Paulo was

found to be 4.8% which was consistent with studies done in a general hospital in Recife,

Pernambuco, brazil. It outlined that burnout could have contributed to the high rate of sick nurses

observed during the study. In most cases, the participants indicated working unfavorably-forced

to deliver services with their exhausted minds and bodies. Also, the study identified failure of

getting support from colleagues and supervisors, lack of dialogue in workplaces, relationship

issues, lack of autonomy work overload as well as failure to be recognized as the major sources

of stress for nurses. Hence, organizations have a big role to play in identifying and minimizing

stressors congruent in their various work station in order to prevent employee burnout and

turnover (Sobral, et. al, 2018).

Elin in a study of the role of burnout in new professional’s problem of task mastering,

social acceptance, and role clarity, he noted that the is a gap in the goal to improve healthcare

because despite burnout being a common phenomenon there are no preventive measures.

Effective intervention programs for enabling socialization processes within an organization can

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play a role in reducing cases of burnout for new employees. When the programs target on

clarifying the new role, enhancing social acceptance, and mastering of tasks within the first year

of work, it creates positive impacts of work in the years to come. This emphasizes the

importance of incorporating such an intervention program in establishing a favorable work

environment (Frögli, et. al, 2019).

According to Petitta et. al, (2016), that investigated the role of various stakeholders such

as leaders, patients, and colleagues as the sources of emotional exchanges and how they

determine the absorption of negative, (like anger) and positive (joy) emotions which culminate to

burnout. It outlined that emotional exchanges in workplaces are contributors to emotional

contingency and thus, burnout. However, while doctors are capable of joy and anger from

colleagues but less from leaders or patients, nursing absorbs emotions from both patients,

leaders, and colleagues. Emotions absorbed by doctors are likely to result in exhaustion but only

cynicism in nurses (Petitta, Jiang, & Härtel, 2017).

The article that Supports Nursing Intervention for Burn out Syndrome, why?

Both Rola’s and Sabral study provides that intervention programs are critical in burnout

reduction among workers. Rola stipulated that leaders and empowering leadership play a critical

role in helping nurses cope with stress at work. Identifying and devising preventive measures to

the causes of burnout is paramount in motivation at work, productivity, and the probability of

increased chances for career progression. This is synonymous with Sabral’s finding that removal

of various stressors by the management stand a big chance of retaining of employees (Sobral, et.

al, 2018). Creating a favorable environment requires employees to work for favorable shifts,

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getting support from management and collaboration form colleagues to enable not only

experienced but also new employees from exhaustion and burnout.

Conclusion

From the discussions above, Burnout remains a world concern in the healthcare

profession. Many studies, both cross-sectional and case studies implicate a reduction in

employee nurses as the main cause of burnout. However, many types of research implicate

burnout in workplaces as a multifactorial condition developed sequentially by many social and

health environment under which nurses work. hence, the leadership of various institutions must

address the need as they vary from one institution to another in order to achieve a highly

motivated workforce, with energy to deliver quality healthcare and essentially reduce burnout

and the likelihood of experiencing the detrimental employee turnout.

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References

Frögli, E., Rudman, A., Lövgren, M., & Gustavsson, P. (2019). Problems with task mastery,

social acceptance, and role clarity explain nurses’ symptoms of burnout during the first

professional years: A longitudinal study. Work, 62(4), 573-584.

Mudallal, R. H., Othman, W. A. M., & Al Hassan, N. F. (2017). Nurses’ burnout: the influence of

leader empowering behaviors, work conditions, and demographic traits. INQUIRY: The

Journal of Health Care Organization, Provision, and Financing, 54, 0046958017724944.

Petitta, L., Jiang, L., & Härtel, C. E. (2017). Emotional contagion and burnout among nurses and

doctors: Do joy and anger from different sources of stakeholders matter?. Stress and

Health, 33(4), 358-369.

Sillero, A., & Zabalegui, A. (2018). Organizational factors and burnout of perioperative

nurses. Clinical practice and epidemiology in mental health: CP & EMH, 14, 132.

Sobral, R. C., Stephan, C., Bedin-Zanatta, A., & De-Lucca, S. B. (2018). Burnout and work

organization in Nursing. Rev Bras Med Trab, 16(1), 44-52.