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Burnout among Nurses in Intensive Care Units and Emergency Departments: An empirical study of Pakistani Government Hospitals

1. Introduction
Burnout is a pattern of emotional, physical, and mental exhaustion in response to chronic job stressors. It is a disorder characterized by emotional exhaustion, depersonalization and a low level of personal accomplishments, which primarily affects people who are dealing with other people in their work (Maslach, 1982). Burnout develops due to the persistent emotional strain, which is the result of dealing with other people who cope with serious problems. Thus, burnout could be considered as a type of professional stress, which results from the social interaction between the person who provides help and the person who receives that help. Nurses are more susceptible to the development of burnout, mainly because of the nature and the emotional demands of their profession. Burnout is a serious problem. It directly affects the worker and it presents with various symptoms, both somatic and psychological. It is related to the weakening of relationships between the nurse and the patients, the coworkers, the family and the social environment. Burnout is also closely related to the absenteeism of nurses from work, abandoning nursing profession and results in poor patient work overload. 1.1. Problem Statement. There is high degree of burnout amongst nurses working in ICUs and Emergency Departments of government hospitals in Pakistan. No research has ever been conducted in Pakistan to find out the factors leading to high rate of burnout in nurses. A research study was conducted in Greece for investigating burnout of nurses working in Intensive Care Units, Internal Medicine Wards and Emergency Departments. The researcher intends to conduct a similar study in Pakistani government hospitals. 1.2. Significance of the Study

1.2.1 Theoretical Contribution: This research will add to the body of knowledge as no research on the subject has ever been conducted in Pakistan. 1.2.2 Applied Aspects Involved: This research will help to identify the reasons of burnout of ICUs / Emergency Departments nurses working in Pakistani government hospitals and will recommend remedial measures. The study can also be helpful to private hospitals/ clinics. 1.3. Objectives of Study

• To study emotional exhaustion, depersonalization and personal accomplishment among nurses working in ICUs& Emergency Departments. • To study the degree of burnout experienced by the nurses working in ICUs and Emergency Departments of government hospitals in twin cities of Islamabad and Rawalpindi, Pakistan. • To identify job related factors and personal characteristics that contribute to the development of burnout. 2. Literature Review

The main reasons which contribute to the development of burnout are the time that nurses spend for the patients care (Cronin-Stubbs.D, 1985), the contact with patients having a poor diagnosis (Hare.J,1988), the contact with patients having increased emotional demands(Lewenson,1981),workload(Landsbergis.P.A,1988)ambiguity and role conflict(Pines A.M,1982), lack of support by the supervisors and colleagues(Firth H, McIntree J, 1982), lack of job satisfaction (Dolan N,1987) and fear of death (Mallett K,1991). Personality characteristics are also responsible for burnout those are the motivations for choosing humanistic profession (Vachon M.L.S, 1978), expectations from himself / herself and the others (Wessells D.T, 1989), his / her values, self-esteem, ability to express feelings, the control over the events and personal style. All these factors influence the way of handling an emotional strain (Maslach C, 1982). It is said, that some people are more stress resistant, and thus less vulnerable to the development of burnout.

The nurses working in different fields experience varying degree of burnout. This may be due to the...
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