Research in Nursing and Midwifery: Burnout and Ethical Issues

This report delves into the critical issue of nursing burnout and its ethical implications within the healthcare sector. It begins by defining burnout as a state of physical, emotional, and mental exhaustion, highlighting its prevalence and impact on nurses' motivation and well-being. The report identifies the ethical concern of poor quality care and treatment rendered to patients as a direct consequence of nurse burnout, exploring how this compromises the core principles of the nursing profession. It examines the factors contributing to burnout, such as long working hours and increased workload, and how these lead to exhaustion, depersonalization, and cognitive impairments, ultimately affecting patient safety and satisfaction. The report references existing research and studies to establish the link between burnout and diminished quality of care, including patient safety, and ethical standards. It emphasizes the ethical principles that nurses must adhere to, such as valuing quality care, respect, diversity, informed decision-making, safety, and ethical information management. The report concludes by underscoring the need for nurses to uphold these principles despite the challenges of burnout to ensure high-quality patient care.

Research in
Nursing and Midwifery –
Assessment Task 1

Table of Contents
INTRODUCTION...........................................................................................................................1
Ethical issue that may arise when conducting research in area of practice............................1
Key ethical principles underlying the issue............................................................................4
CONCLUSION................................................................................................................................5
REFERENCES................................................................................................................................7

INTRODUCTION
Burnout can be referred to as physical, emotional as well as mental exhaustion. It can be
said that burn out within nursing is illustrated by disengagement and tends to result in
detachment as well as dull emotional state. This declines the level of motivation among nurses
and instils a feeling of hopelessness. The ones who undergo this phenomenon consider everyday
to be worse for them. It is usually seen that when nurses burnout, it does not just impact upon
them but also the care users that are under their charge. The impact cascades to the extent of
quality treatment as well as care received by patients within hospitals. In this regard, the present
research is based upon “burnout on nursing profession and its impact on respective profession”.
The ethical issue that is considered in this regard it the ‘poor level of care and treatment’
rendered to patients by nurses undergoing burnout.
Ethical issue that may arise when conducting research in area of practice
Nursing can be referred to as a respectable and well regarded profession in the confines
of health and social care sector which emphasizes upon provision of care services and treatment
to families, communities and individuals so as to make them lead a quality standard of living.
Nurses are distinguished from other kinds of care service providers owing to the approaches
undertaken by them to training, practice and patient care. The individuals engaged in nursing
profession hold the role of developing a plan of treatment and care by operating in collaborative
manner with therapist, physician, family of care user, patient and other personnel of team. They
are engaged in provision of treatment for enhancement of quality of life for patients. Nurses
render care in two ways: independently (as nursing professional) as well as interdependently
(along with physicians).
Burnout within nursing profession is caused as a result of constant emotional and mental
stress that arises with the long hours of engagement that nurses give within care service units.
Many a times, nurses are found to be working round the clock in order to render due care to
patients and to duly attend to all the patients that are assigned to them by the hospital authorities.
This constant working makes the nurses undergo physical exhaustion. Further, the nurses even
have to operate overtime at times to effectively meet the ever increasing needs and requirements
of service users. This results in burnout within nursing profession.
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The most evident form of ethical issue associated with nursing profession is the provision
of poor quality services or wrong treatment as a result of the mental or physical exhaustion that
tends to result in a state of sub-consciousness of nurses in care units. This is against the ethics of
the respectable and universally regarded profession of nursing whereby the prime duty and role
of nurses is to render high quality care and treatment to service users by practising due diligence
and non-negligence. Burnout is usually considered as a threat posed to the safety of care users
owing to the fact that depersonalization results in poor level of communication with patients.
Nurses with burnout are likely to subjectively rate patient safety lower and to admit to having
made mistakes in delivering substandard care at work.
It is usually seen that burnout within nursing profession is often characterised by huge
extent of cynical behavioural characteristics, exhausted mind and a declined state of individual
achievement in relation to the respective profession. A number of studies, surveys and researches
have previously been carried out upon this topic to find a problem creating link between the
quality of care as well as treatment provided to service users and the burnout evident in regard to
nurses. Further, a large number of alterations have taken place within health and social care
service delivery in elapsed course of time, thereby raising concern regarding the high probability
of worsening care and treatment delivered to patients by the nurses who have been undergoing
burnout experiences at the time of work. This happens because within large scale clinical units
and hospitals, it is usually seen that one nurse is in charge of many patients due to which they
have to constantly rush from one patient to other service user to give them the right dose of
medicine, care or treatment in order to ensure their recovery in the estimated course of time by
doctor or higher authorities of the respective hospital. A recent study conducted upon burnout
found out that this phenomenon is rapidly increasing among the nursing profession owing to the
burden or pressure of work that they have in daily course of time.
Burnout is largely associated with a number of issues specifically linked to nursing
profession. This is seen to be largely influencing the magnitude of quality and safe care services
rendered by care unit to patients. As per the respective job demands-resources model of burnout,
the job demands (such as communication with patients who are in need of extensive care and
treatment, balance of competing priorities) need efforts over the course of timeframe and thus
lead to huge cost (emotional exhaustion) for the health service providers, especially in case
whereby the resources available are significantly lower. When nurses get exhausted, they get
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lethargic and as a result of this, withdraw zeal, passion and energy from operations thereby
largely resulting in depersonalisation. The preservation of resources even results in nurses
incurring less efforts as well as timing with service users, thus, becoming more of directive than
patient centric and collaborative. All the more, burnout is even linked to cognitive impairments
such as attention deficit that can result in erroneous outcomes. Along with the colleagues,
Williams described a model wherein burnouts adversely affect the quality of service delivery to
patients. This causes dissatisfaction among the service users and implies poor compliance ethical
standards and principle of health and social care sector. The outcome of this can be seen in the
form of worsened health of patients. Whereby the patients constantly complaint regarding the
low quality services or care received and/or treatment or dosage received at wrong timing, this
tends to even lower down the morale and energy of nurses more. It ultimately results in
additional burnout within nurses which is adverse for the clinical units or hospitals whereby they
are engaged in provision of care facilities.
While links between burnout and quality of care have been theorized since the term
burnout was introduced, research empirically linking burnout to quality of care has varied widely
across healthcare specialties and types of quality domains (e.g., patient satisfaction, self-reported
quality, errors). Some studies have reviewed aspects of these relationships, but none has
attempted a comprehensive, quantitative review across disciplines and domains. There would be
negative relationships between each aspect of burnout (emotional exhaustion, depersonalization,
and reduced personal accomplishment) and quality and safety. In this regard, the outcomes
would be the most for nursing perceptions, compared to more objective indicators of quality
(e.g., observation or medical records).
In this regard, it has been acknowledged that a number of times, nurses are asked to work
for long shifts, i.e., 12 hours instead of 8 hours. This results in stress among them as they have to
cater to the medical needs and demands of care users at the right time by keeping an alert mind.
However, it is usually seen that when nurses are made to work for extra long shifts so that the
patients can be given timely care and treatment, the contrary takes place in reality. This happens
because the nursing professionals get lethargic, tired and exhausted already by working to their
full potential, zeal and passion in the 8 hours of their working time. This reduces their power,
energy and drive within the additional hours when they are asked to stay back as some of the
patients need additional care and treatment at due intervals of time so that their recovery can take
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place in the expected course of time. Thus, this implies that the exhausted mental and physical
state tends to reduce the efficiency of nurses thereby resulting in delayed care service delivery or
failure of provision of treatment. At times, it is even noticed that burnouts cause a sense of
frustration as well as anguish among the nurses, due to which, they do not practice due care and
diligence while providing care to patients. As an outcome of this, nurses sometimes end up
giving wrong / inadequate or over dosage of medicines to service users. It causes repercussions
in the bodies of patients and rarely, but sometimes, even results in their deaths.
Thus, it is essential for the individuals who are engaged in the profession of care
provision to practice the ethical principles of medical sector so that do not lead to any kind of
malpractice or poor quality service for patients. In this regard, there are various ethical principles
pertaining to the social care sector that need to be followed by Healthcare professionals such as
physicians, General Practitioners and nurses at all times. Burnout is not an exception to this and
thus, it is required that nurses do not consider it as an excuse to deliver poor quality of services
and treatment to service users at any point of time.
Key ethical principles underlying the issue
Ethics are the moral values that are present within an individual with the help of which
they reach to a decision regarding a task to be morally right or wrong. In this regard, there are
various ethical principles that pertain to the nursing sector of Australia and have to be followed
by nurses and midwifery at all times. It is laid out in the Code of Ethics for nurses within the
confines of Australia. This is applicable for the nurses engaged at all areas and levels of practice
inclusive of those who encompass management, education, research and clinical domains. While
taking into due consideration this respective Code along with its companion, the Code of
Professional Conduct for Nurses in Australia, it is required to be kept in mindset that both of
them are specifically developed and devised for several audiences consisting of students
pursuing nursing, nurses, people in receipt of nursing care, Nursing Regulatory authorities,
community, employers of nurses and Consumer Protection Agencies as well. In this regard, it is
essential to be taken into account that the concepts of morality and ethics are significantly the
same, and is often interchangeably used all through out the respective Code. It lays down the
commitment of nursing profession to encourage, regard, conserve and uphold the basic rights of
people who are both the recipients and providers of nursing and health care.
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The Code of Ethics for Nurses in Australia have laid down the below mentioned
principles for nurses pertaining to nursing and health care profession, that need to be followed by
nurses, midwifery and students pursuing this field:-
1. Nurses value quality nursing care for all people.
2. Nurses value respect and kindness for self and others.
3. Nurses value the diversity of people.
4. Nurses value access to quality nursing and health care for all people.
5. Nurses value informed decision-making.
6. Nurses value a culture of safety in nursing and health care.
7. Nurses value ethical management of information.
8. Nurses value a socially, economically and ecologically sustainable environment promoting
health and wellbeing.
In relation to the ethical issue of nursing burnout and its outcome in the form of poor or
low quality care services, it can be said that nurses should practice all the above mentioned
ethical standards or principles. The proper as well as adequate compliance with the above
mentioned standards imply provision of satisfactory quality of care and treatment to patients so
that they can lead a quality life and undergo recovery at a rapid rate. Nurses tend to lose their
energy and zeal to provide high quality services as a result of burnout but this is acknowledge to
be the breach of the Code of Ethics for Nurses in Australia. Thus, the ethical issue should be
considered in the light of the respective code by nursing professionals and thus due diligence and
care should be ensured by them at all times so that no patient receives low standard of care or
wrong treatment.
CONCLUSION
Nursing is a reputed and a well recognised profession all across the globe as it is engaged
in provision of High Quality Services and due care to patients at all times. Further, this has been
analysed that burnout is an emerging issue that is being noticed within the field of nursing and
nursing and Healthcare nowadays. This takes place due to high level of work stress and
exhaustion noticed within the nurses as a result of long hours of shifts and large quantum of
patients under the charge of one nurse within a day. This tends to cause lethargic state as well as
laziness as nurses develop a sense of absence of individual accomplishment. As an outcome of
this, it is seen that an ethical issue emerges, that is, provision of low or poor standards of care or
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treatment. This causes dissatisfaction among service users as they are devoid of the basic level of
satisfactory services that should be received by them within care units at all time so that they can
undergo quick recovery. This ethical issue is a breach of the respective ethical code of conduct
that is laid down for nurses and midwifery and has to be adhered to, by them in order to render
quality care services to patients.
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