The Issue

As the shortage of nurses internationally and the need for healthcare for chronic population groups and baby boomers rises, the strain on healthcare workers rises. In particular, nurses, who make the predominant group of healthcare workers caring for populations, are experiencing a rise in burnout and work-related stress. This exists in both acute care and home health settings, causing nurses in these areas to look for less stressful jobs (Cadieux & Marchand, 2014). In a study by Aiken, Clarke, and Sloane (2002), 10,000 nurses from five countries found that burnout ranged from 54% in the United States (U.S.) to up to 32% among nurses in Scotland. Burnout also translates in the quality of care provided. Cimotti and colleagues (2012) found a correlation between high nurse-patient ratios coupled with nurse burnout, which led to an increase in surgical site infections and Urinary Tract Infections (UTIs). Cimotti et al. (2012) noted that a reduction in nurse burnout can improve both patient-care outcomes and overall nurse health and mental well-being. This prompts the need to provide ways to address and prevent burnout by alleviating the stress of providing care under the demands of low cost and less utilization of resources, with expectations for high quality care.

Defining Burnout

According to Maslach (2016), creator of the Maslach Burnout Inventory (MBI) scale, burnout can be defined as “a psychological syndrome emerging as a prolonged response to chronic interpersonal stressors on the job” (p. 103). The concept of burnout has existed since the 1970s, when Freudenberger noted the syndrome. These stressors include feelings of detachment from one’s job, sense of lack of accomplishment or ineffectiveness, exhaustion that can lead to decreased productivity, morale, and psychological stressors that lead to inadequate mental health. The physical effects of burnout may lead a nurse to engage in inadequate coping behaviors, such as drug or alcohol use and depression or anxiety. A longitudinal study done in Finland found a reciprocal relationship between burnout and depression (Ahola & Hakanen, 2007). As a result, the need for nurses to recognize burnout and tips for prevention are essential.

Signs of Burnout

The first step in addressing and managing burnout is early recognition. Signs of burnout can be physical and mental. They usually involve the following:

1. Insomnia (usually present in the early stages of burnout);
2. Lack of focus and frequent forgetfulness;
3. Chronic fatigue (physical and mental) that often leads to dreading what lies ahead for each day;
4. Lack of appetite (loss of weight can occur in the later stages when the condition has worsened);
5. Frequent irritability and anger;
6. Worsening anxiety or depression, especially in those with a history of mental illness, and;
7. Decreased immune system responses, leading to infections, colds, flu, etc. (Carter, 2013).

Individuals who believe they have one or more of these symptoms should seek assistance from a health professional or consider exploring tips for prevention and management. Failing to recognize these symptoms could lead to health and other consequences that could affect your life. Taking time to assess your own stress and if it is causing you harm can be beneficial.

Tips for Prevention

If you are experience signs of burnout consider the following tips for prevention:

1. Re-evaluate your priorities. Consider your career and life goals. Also, consider if you are neglecting things that are important to you. Now may be the time for reflection about your present and future.
2. Learn how to say “no”. Taking on too many roles can become overwhelming making your experience of burnout more likely to occur.
3. Take time to relax and care for your health. Make sure you get enough rest, exercise, and eat properly. It’s difficult to care for others when you aren’t caring for yourself.
4. Learn how to delegate and not handle everything yourself. Many times, as nurses, we often want to handle things ourselves to ensure it’s done correctly. Educate and train others to help you. Learn how to trust your other colleagues and family members to assist you when you need it.
5. Don’t be afraid to seek support and help. Many employees do not take advantage of the resources available to them. Utilizing employee assistance programs or other medical benefits can help. Many free resources are also available at local churches and other non-profit community organizations.

The increase in patient loads, long work hours, the stress of caring for critically ill patients, family demands, etc. can have its toll on one’s mental and spiritual well- being. This can lead to burnout and other health issues. Nurses need to take an inventory and become aware of their own limitations and issues that could lead to burnout. However, regardless of the setting or situation, recognizing the signs of burnout and taking the steps to prevent and decrease it can be life-saving strategies for nurses.

References:

Aiken L. H, Clarke, S.P, Sloane D.M. (2002). Hospital staffing, organization, and quality of care: Cross-national findings. International Journal for Quality in Health care, 14(1), 5-13. doi: 10.1093/intqhc/14.1.5

Ahola, K., & Hakanen, J. (2007). Job strain, burnout, and depressive symptoms: A prospective

study among dentists. Journal of Affective Disorders, 104, 103-110.

Carter, S. (2013, November 26). The tell tale signs of burnout…do you have them? Psychology

Today. Retrieved from https://www.psychologytoday.com/us/blog/high-octane- women/201311/the-tell-tale-signs-burnout-do-you-have-them

Cimiotti, Jeannie P. et al. Nurse staffing, burnout, and healthcare –associated infection. American Journal of Infection Control, 40(6), 486 – 490.

Maslach, C., & Leiter, M. P. (2016). Understanding the burnout experience: recent research and its implications for psychiatry. World Psychiatry, 15(2), 103–111. http://doi.org/10.1002/wps.20311