N9001 Professional Issues and Policies: Nursing Burnout Exploration

This essay, submitted by Komal Preet Kaur, addresses the contemporary professional issue of nursing burnout. It begins by defining burnout and its three dimensions: exhaustion, depersonalization, and reduced professional accomplishment. The essay explores the causes of burnout, including increased workloads, staffing shortages, and the emotional demands of the profession, especially exacerbated by the COVID-19 pandemic. It details the stages of burnout and lists its symptoms, both physical and mental, such as exhaustion, decreased performance, and increased distance from work-related activities. The essay highlights the use of the Maslach Burnout Inventory (MBI) for diagnosis and discusses various coping strategies, including self-care, setting boundaries, utilizing employee assistance programs, and prioritizing tasks. It emphasizes the importance of recognizing and addressing burnout to improve patient outcomes and maintain a functional healthcare system. The essay also references numerous studies to support its claims, offering a comprehensive overview of the issue.

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Nursing Burnout
Student Name: Komal Preet Kaur
ID Number: M2222905
Unit code and title: N9001 Professional Issues and Policies
Title of assignment: A contemporary professional issue impacting the
discipline of nursing.
Name of Unit coordinator: Shine K
Due Date: 17/04/2022
Word count: 1500
Academic Integrity Declaration
I verify that
1. I have not cheated in any way in regard to this assessment.
2. This assessment is my original work and has been done in accordance with the
Academic Honesty and Integrity Policy and Procedure.
3. All sources are duly cited using the APA citation style.
4. No part of this assessment was or will be reproduced as a part of any assessment to
attain any other qualification.
I Agree
Student name: Komal Preet Kaur
Student Signature: Komal Preet Kaur
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Nursing Burnout
The term “Burnout” was first defined by the American Psychologist Herbert
Freudenberger in 1970s. Burnout is a work-related stress syndrome resulting from chronic
exposure to job stress. Workplace stress has been reported as fundamental issue for workers
and their employers (eg. Dewe et al 2000). According to Maslach et al (2001), Burnout
consists of three dimensions that include mental exhaustion, depersonalization, reduced
professional efficacy and accomplishment. Burnout can be seen in any kind of profession and
not just in healthcare (Leiter et al.,1996). This cannot just have personal and professional
consequences like substance abuse, decreased quality of care, lower patient satisfaction (Haas
et al.,2000) or even suicide, but also can have substantial effect on cost of care as per Jones et
al., 1988.
Burnout at workplace is often characterized by three main symptoms:
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1. Lack of motivation at work
2. Lack of pleasure at work
3. Sense of inefficacy where one lacks belief in their abilities.
The nurses experience burnout due to few major reasons, especially during and after
pandemic, which include major rise in demand for nurses, lack of supply, decreased
staff and reduction in length of stay of patients according to Carayon and Gurses
(2005). Shirom et al in 2003 suggested burnout is a result of long-term exposure to
emotionally demanding circumstances in both work and life which defines burnout is
not exclusive to occupation.
Stages of Burnout
1. First stage of Honeymoon- This phase has feelings of being excited, optimistic and
energetic like initial phase of marriage, hence named Honeymoon.
2. Onset of stress- Eventually the feelings of being excited all about starts to dwindle.
Where employees must deal with stress more often than every other day.
3. Chronic Stress Phase- Physical symptoms start to intensify. You may feel self-doubt,
sense of lack of motivation or even feel quitting. People around will notice behavioral
changes.
4. Stage of Habitual Burnout- If left untreated, can lead to mental health issues including
anxiety and depression. This impacts your day-to-day life including behavior changes
at home with family as well as at workplace.
Symptoms of Burnout
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A stressful workplace can put employees under extreme pressure, to the point that they feel
exhausted, empty, burned out, and unable to cope. Physical and mental symptoms can
be caused by stress. Here are some early signs of professional burnout:
1. Exhaustion- drained, inability to relax, disturbance in sleeping pattern, lack of energy,
lack of motivation, decreased sense of decision making, etc.
2. Increased distance from work-related activities- forgetfulness, irritability, trouble
completing tasks, lack of interest at work
3. Reduced Performance- lack of creativity, delays in completing tasks at work, feeling
lost or disconnected at work.
4. Other symptoms- insomnia, loss of appetite, increased agitation, addiction such as
alcohol. Sense of failure, self-doubt, feeling helpless, trapped and defeated.
Diagnose Burnout
Shirley in 2019 described nursing burnout as depletion of energy for
prolonged times that is a consequence work related stress. There are several tools that are
available to diagnose burnout, but Maslach Burnout Inventory (MSI) is the widely used one,
which is also used for different professionals (Maslach et al.,1996). The MBI explores three
components: exhaustion, feeling down and reduced performance. The questionnaire includes
22 items that are multiple choice question to check frequency of feeling ranging from “never”
to “daily” where “never” scores 0 and “daily” scores 6. Higher score in MBI is related to
higher levels of burnout.
Causes of Burnout
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Extreme levels of stress at work can develop due to excessive
workload, lack of staff and lack of supplies to aid care of the patients. Burnout usually occurs
when level of stress increases the ability to cope with workplace stress. Burnout has noted to
be very common in nurses who does night shifts and overtime. The number of hours worked
are significantly associated to emotional exhaustion and lack of efficacy. According to Demir
et al.,2003, Nurses working night shifts are mostly at risk of burnout whereas the higher
education level, experience level and higher rank at workplace decreases the chances of
burnout. In addition, having difficulties in families including childcare, doing house chores
and having to deal with health issues of nurse herself or her children, financial hardship,
economic hardship or having relationship issues at work are some other factors that increase
risk of burnout.
Handle Burnout
Although the state feels overwhelming, but it doesn’t have to be permanent.
Most of the nurses choose to quit workforce, however, this doesn’t help the situation.
Eventually developing habits at workplace can help cope with this feeling. Practicing self-
care and mindfulness can help prevent nursing burnout. Nurses need to take care of
themselves before taking care of their patients. Some examples include paying attention to
your feelings, setting boundaries to commitments at workplace, increasing social interactions
outside work areas and discussing with managers if unable to cope. Changing lifestyle can
also help with coping with day-to-day stress. It has been researched by Heidly et al., 2020,
the increased use or telecommunication including use of smart phones, tablets and laptops
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during pandemic, has increased nursing burnout high demands of nurses versus supply. Know
your limitations while at work. People who are new employees tend to say “yes” to
everything, as they feel it’s important and necessary to show their values to their seniors and
bosses. This can affect in a negative way. This can lead to feeling drowned in multiple tasks
sooner or later. Employees should not be afraid to say “No”. Setting limits on the time you
give to others can help you manage stress while recovering from burnout. Accessing
Employee Assistance program (EAP) at workplace helps a great deal to cope with stress and
depression at it includes counselling and psychological support programs. Attending all the
trainings from work that help with professional development is another way to keep up with
up-to-date knowledge of healthcare procedures and can boost motivation that can in turn help
with burnout. The tasks should be prioritized as some tasks needs to be attended to straight
away and some that can be attended later. This can prevent from having multiple tasks
pending which in turn reduces stress of completing delegated tasks in time. Also learning to
leave work at work and not stressing about work at home can help prevent anxiety and
burnout. After leaving work, focus on relaxing and getting ready for the next day at work.
Strategies to cope with Burnout
Coping with burnout can be a slow process. It is so motivating to observe the
frontline nurses making interventions to cope with stress as per Khalid et al., 2016. It has
been noted that acknowledgement of efforts made by nurses in frontline had positive effects
on stress (Alsubaie et al., 2019). Clear and appropriate communication, interactive activities
and career promotion are some other strategies to aid coping mechanism as stated by Lee et
al., 2007. Employees has found to be appreciating employment assistance programs in
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organization such as hospitals where they are able to receive counselling and psychological
support (Hall et al.,2003). Family support and participation in social activities outside work
has proven to be considerable useful as said by Munnangi et al.,2018. Morale support
interventions such as support from management, allowances and materialistic support should
be considered to help frontliners cope with work related stress that can lead to burnout.
Decreased burnout or less level of stress at work increases positivity and in turn can increase
better health outcomes for the patients. This can also aid organization to function
appropriately by not meeting the supply of nurses with the increased demands of nurses
especially during these special circumstances of Covid-19 pandemic where nurses are the key
professionals. Nurses should be encouraged to observe and diagnose symptoms of elevating
symptoms of work-related stress in self and others so interventions can be applied at early
stages to reduce adverse events. Programs such as professional development with regular
classes and training are other measures to increase knowledge and reduce stress at workplace.
Fatigue management is also highly regarded intervention where shifts are scheduled in a way
that ensures appropriate rest periods taken in between working hours. This could help
improve energy levels during work which in turn increases productivity and less mental
health issues such as stress and depression related to workplace. Furthermore, healthy and
active lifestyle that include balanced diet and at least 30 mins exercise, walk or performing
yoga in a day can help reduce stress.
References:
1. Dewe, P., Leiter, M. and Cox, T. (2000) Coping, health and organizations. New York:
Taylor and Francis.
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2. Freudenberger HJ. The staff burn-out syndrome in alternative institutions. (1975)
Psychotherapy; p.12:73–82.
3. Maslach C, Schaufeli WB, Leiter MP. Job burnout.(2001). Annu Rev Psychol; p. 52:397–
422.
4. Leiter MP, Schaufeli WB. (1996) Consistency of the burnout construct across
occupations. Anxiety Stress Coping. p. 9:229–243.
5. Haas JS, Cook EF, Puopolo AL, Burstin HR, Cleary PD, Brennan TA (2000). Is the
professional satisfaction of general internists associated with patient
satisfaction? J Gen Intern Med; p. 15:122–128.
6. Jones JW, Barge BN, Steffy BD, Fay LM, Kunz LK, Wuebker LJ (1988). Stress and
medical malpractice: organizational risk assessment and intervention. J Appl
Psychol; p. 73:727–735.
7. Carayon P, Gurses AP, Hundt AS, et al (2005). Performance obstacles and facilitators of
healthcare providers. In: Korunka C, Hoffmann P, eds. Change and quality in
human service work. Vol. 4. Munchen, Germany: Hampp Publishers; (2005).
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8. Shirom A (2003). Job-related burnout: a review. Handbook of occupational health
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9. Maslach C, Jackson SE, Leiter MP(1996). Maslach Burnout Inventory Manual. 3rd ed.
Palo Alto, CA: Consulting Psychologists Press.
10. Demir, A., Ulusoy, M. and Ulusoy, M., (2003). Investigation of factors influencing
burnout levels in the professional and private lives of nurses. International
Journal of Nursing Studies, 40(8), pp.807-827.
11. Mheidly, N., Fares, M. and Fares, J., (2020). Coping With Stress and Burnout Associated
With Telecommunication and Online Learning. Frontiers in Public Health,
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12. Khalid I, Khalid TJ, Qabajah MR, Barnard AG, Qushmaq IA (2016). Healthcare workers
emotions, perceived stressors and coping strategies during a MERS-CoV
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13. Alsubaie S, Hani Temsah M, Al-Eyadhy AA, Gossady I, Hasan GM, Al-Rabiaah A, et al
(2019). Middle East Respiratory Syndrome coronavirus epidemic impact on
healthcare workers' risk perceptions, work and personal lives. J Infect Dev
Ctries. p.13:920–6.
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14. Lee AM, Wong JG, McAlonan GM, Cheung V, Cheung C, Sham PC, et al (2007). Stress
and psychological distress among SARS survivors 1 year after the
outbreak. Can J Psychiat. p. 52:233–40.
15. Hall LM, Angus J, Peter E, O'Brien-Pallas L, Wynn F, Donner G (2003). Media portrayal
of nurses' perspectives and concerns in the SARS crisis in Toronto. J Nurs
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Trauma Nurse. P.25:4–13.
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