Running head: NURSE BURNOUT PREVENTION 1

Nurse Burnout & Prevention

Rodricka D. Richardson

Delaware Technical Community College

NUR 340 Nursing Research

October 4, 2019
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Nurse Burnout & Prevention

Burnout is a term well known in healthcare for its prevalence in certain healthcare

professions. Though typically referenced with this field, burnout is not unique to healthcare

professionals. In the 1970’s, psychologist Herbert Freudenberger attributed the word “burnout”

to the results of increased stress and extraordinary morals experienced by those in serving

professions (Informed Health, 2017). When looking at how burnout is described it is significant

to note that it has similar symptoms to depression, however they are not the same. Burnout is

characterized by three components: depersonalization, emotional exhaustion and low personal

accomplishment (Dolan, et al., 2015). These components can significantly and negatively impact

an employee’s ability to be productive in their position. Due to the nurse’s role in healthcare and

patient outcomes, resolving burnout in nursing is important. The purpose of this enquiry is to

analyze current research and determine what prevention methods are being suggested and the

barriers to implementation of these methods.

Statement of the Problem

Discussion and research around burnout in nursing has been significant, however burnout

has continued to be a persisting issue in the profession. In the healthcare systems, nurses make

up the largest group of professionals and spend the most time with the patients. While the

nursing profession can be rewarding, nursing is also known to be a difficult and demanding

career. This is largely due to the nurse work environment which consists of high and increasing

workloads, high acuity patients, frequent changes in policies and practices, and short staffing

with expectations of provision of high-quality care delivery (Poghosyan, 2018). Inadequate

resources and assistance to deal with the high workloads also increase stress levels (Brown, et

al., 2018). Coupled with the long shift’s and the physical and emotional demands of the job, it is
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not surprising that burnout has significant effects on the nurse population. Burnout in nursing is

known to directly and negatively impact patient outcomes, nurse health and the healthcare

system.

Literature Review

Effects of Burnout

Burnout in nursing has been studied around the world over the span of approximately a

decade and it has been found that a significant number of nurses around the world experience

burnout (Poghosyan, 2018). Burnout impacts approximately half of the nurse population in the

United States (U.S.) (Dolan, et al., 2015). The effects of burnout in nurses are wide reaching.

Nurses who are burned out become more likely to suffer from depression, have relationship

issues & take more time off work (Dolan, et al., 2015). In addition to all of this, nurses

experiencing burnout become negatively impacted at work in reference to personality changes,

performance and productivity (de Oliveira, de Alcantara Sousa, Vieira Gadelha, & do

Nascimento, 2019). According to Mudallal, Othman & Al Hassan, burnout impacts the nurse’s

overall quality of life, makes them more likely to leave the place in which they work, increases

turnover rates and negatively impacts quality of nursing care provided to patients (2017). In

addition to personally impacting those men and women who practice as nurses, burnout has

effects on an organizational level and impact patient care.

Overall, many aspects of healthcare suffer as a result of burnout. Patient care becomes

linked to poor outcomes, worsening patient safety and patient satisfaction reduces (Dolan, et al.,

2015). Certain patient outcomes, such as health care associated infections, end up costing the

hospitals money, as they are not reimbursed by insurance companies. In addition to increased

costs from poor patient outcomes, the turnover rates that result from nurse burnout exacerbate an
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already significant shortage, which equates to increased costs to help onboard new nurses and

bring on travel nurses (Brown, et al., 2018). Due to the many effects of burnout, addressing what

strategies can help prevent burnout in nurses is key.

Burnout Reduction and Prevention

Research tailored to burnout prevention strategies in nursing is found to be lacking.

Despite this, minimal research has been done in reference to nurse burnout reduction and

prevention. Strategies were discovered to assist nurses in increasing resiliency and ability to cope

with high stress situations and improve self-care. These included workshops in mindfulness-

based stress reduction (MBSR) training, emotional distancing, conflict training and event

triggers exercise (Brown, et al., 2018). In addition to workshops, self-care activities were also

found to help reduce burnout such as meditation and yoga (de Oliveira, et al., 2019). While most

of the research focused on personal intervention and workshops, a small number did cite that

improved work environment decreased burnout as well (de Oliveira, et al., 2019). Unfortunately,

many of the findings in this research focused on decreasing burnout that was already existing in

nurses and not on prevention.

Analysis

In review of existing and recent literature, research on reduction and prevention largely

utilizes literature review via electronic data bases using key terms related to nursing burnout as

the methodology. The researchers then sort through their findings utilizing certain criteria based

on their goals for selection to then develop a literature review to evaluate. While there has been

success in utilization of workshops and self-care training to reduce burnout in nurses, regrettably,

this does not contribute to research on prevention of burnout. Despite workload, high

expectations, staffing issues and lack of resources are frequently cited as causes for nurse
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burnout, these issues are not often focused on in prevention and reduction research, leaving gaps

open in the already scarce research. World Health Organization (WHO) has made the statement

that, as opposed to investing on improvement of healthcare work environments and prevention

strategies to promote and protect health of employees, it appears that organizations are more

focused on investing in medical treatment (de Oliveira, et al., 2019). In review of the causes of

nurse burnout, the necessary interventions for prevention seem straight forward. However, it is

unclear what barriers prevent institutions from further researching prevention strategies.

Recommendations

Despite being aware of the causes of burnout and how to treat existing burnout in nurses,

prevention interventions are lacking. Since the research is so scarce, one literature review study

noted that more studies need to be completed to assess limitations (de Oliveira, 2019). Instead,

research strategies and interventions seem to focus on helping nurses learn to continue to

function in poor work environments. The issue with this is that expectations and workloads

continue to grow, in part due to the imminent and growing nursing shortage amongst other

healthcare system challenges. Nurses cannot and should not continue to be expected to work in

pressured conditions as this, according to Shirey, leads to poor nurse and patient outcomes

(Copanitsanou, Fotos & Brokalaki, 2017). This can cause an exacerbation of burnout in nurses,

worsening an already significant issue.

Coping skills, self-care and workshops can be helpful, and should be utilized. However,

more emphasis should be placed on improving working conditions. Nurses feel as though

acceptable workloads are those in which they are able to provide adequate and safe care to

patients, while nurse managers have noted that when trying to reduce burnout on their units, they

do not receive adequate support from administration teams (Van Bogaert et al, 2017).
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Organizations and administration reaching out to, as well as valuing, nurse input on burnout

prevention may be helpful. Increasing research in prevention strategies and improvement of

workplace conditions is important in avoiding the negative implications that are the consequence

of burnout in the nursing profession.

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References

Copanitsanou, P., Fotos, N., & Brokalaki, H. (2017). Effects of work environment on patient and

nurse outcomes. British Journal of Nursing, 26(3), 172–176. https://doi-

org.libproxy.dtcc.edu/10.12968/bjon.2017.26.3.172

Dolan, E. D., Mohr, D., Lempa, M., Joos, S., Fihn, S. D., Nelson, K. M., & Helfrich, C. D. (201

5). Using a single item to measure burnout in primary care staff: a psychometric

evaluation. Journal of general internal medicine, 30(5), 582–587. doi:10.1007/s11606-

014-3112-6

Informed Health. (2017, January 12). Depression: What is burnout? Retrieved October 2, 2019,

from https://www.ncbi.nlm.nih.gov/books/NBK279286/.

Mudallal, R. H., Othman, W. M., & Al Hassan, N. F. (2017). Nurses' Burnout: The Influence of

Leader Empowering Behaviors, Work Conditions, and Demographic Traits. Inquiry : a

journal of medical care organization, provision and financing, 54, 46958017724944.

doi:10.1177/0046958017724944

Poghosyan, L. (2018). Clinican Burnout: New Times, Old Issue. Nursing Economic$, 36(3),

109–155. Retrieved from

http://search.ebscohost.com.libproxy.dtcc.edu/login.aspx?direct=true&db=c8h&AN=130

397386&site=ehost-live

Van Bogaert, P., Peremans, L., Van Heusden, D., Verspuy, M., Kureckova, V., Van de Cruys, Z.,

& Franck, E. (2017). Predictors of burnout, work engagement and nurse reported job

outcomes and quality of care: a mixed method study. BMC Nursing, 18, 1–14. https://doi-

org.libproxy.dtcc.edu/10.1186/s12912-016-0200-4