Managing Stress in the Professional Nurse to Prevent Burnout
Caring for others is a vital part of nursing, but sometimes the demands can be crushing. A nurse can become emotionally and /or physically exhausted, sometimes to the point where the nurse may stop working. The phenomenon described is nursing burnout. This paper will include facts and causes of burnout, individual & environmental factors contributing to burnout, ways to manage and decrease burnout and most importantly burnout prevention. Review of the Professional Nursing Literature
Facts & Causes of Burnout
Burnout is a psychological term for the experience of long term exhaustion and diminished interest. “Burnout is not the result of stress, but of mismanaged stress” (Roberts, 1997, p. 284). Nursing is not a field where guessing or mediocre work is acceptable. Nursing requires accuracy, dedication, skill and professionalism. Nurses have high expectations of themselves while patients and physicians expect perfection and quality care. Demands and high expectations lead to stress and burnout. Fewer nurses mean more work for all. Inadequate staffing results in events that is doomed to failure resulting not only in the loss of energy, burnout and disengagement, but also eventual loss of nurses. Many nurses feel overburdened by heavy patient loads and the increasing intensity of service that sicker patients require (Gelinas, 2003). Due to our economy and strict insurance guidelines, patients are not seeking medical care early, resulting in sicker and more critical patients. The poor economy has resulted in lower salaries, less annual salary increase, job losses and less funding for education. Today there is a higher demand for education status. Not only are nurses working 8-12 hour shifts, caring for their family and children but now having to find the time to advance their education. The balances are hard to find, but without balance stress and burnout is inevitable (Dollard, 2003). Individual Factors
Certain individuals have factors that make them more prone to stress and burnout. “The stress-prone (Type A) driven personality is a well recognized stereotype, but interestingly on model of the burnout process” (Edelwich, 1980, p. 4). Type-A people have idealistic rather that realistic expectations, become over-involved and have difficulty detaching. Type-A can be co-dependent and have a strong need to be needed, valued, appreciated and accepted (Vincent, 1983). Environmental Factors
Different areas of nursing require different levels of care. More acute areas include critical care units, units where patients are chronically or terminally ill, trauma patients, neonates, drug abusers and suicidal patients. The areas listed put nurses in a higher stress category and at a higher risk for burnout. Employers and management often deny the signs of stress and burnout and keep pushing the staff to their limits with little actions for recruitment and retention. Symptoms of Burnout
The signs and symptoms can be divided into three categories: emotional exhaustion, depersonalization and reduced personal accomplishment resulting in poor patient care, withdrawal from family and feelings of low self worth and self esteem. “Signs and symptoms of burnout can be described as four changes: Changes in behavior, Changes in feelings, Changes in thinking and Changes in health” (Maslach C. &., 1986, p. 4). “Changes in behavior” include frequent clock watching, resistance to go to work, working harder and later but achieving less, withdrawal and avoidance with colleagues, increasing use of mood altering drugs such as caffeine and nicotine. Examples of “Changes in feelings” include loss of humor, persistent sense of failure, guilt and self blame, frequent anger, resentment and increased irritability both at work and at home. Examples of “Changes in thinking” are frequent thoughts of quitting the job, inability to concentrate, resisting change...
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