Causes of Nurse Burnout
Do counselling and stress reduction classes have a positive impact in reducing levels of nurse burnout in clinical settings.
The research topic divulges into an issue that had been plaguing the health care industry for years, the fatigue and burn out in the nursing workforce which negatively impacts the performance and competency of the nursing workforce. This research focuses on the positive impact that counselling and stress and reduction classes can have on reducing or minimizing the impact of the stress on the nursing workforce. This research study has utilized literature from the different sources like WebMD, PubMed, and Ovid online. The search items utilized for the research had been workplace stress in nursing workforce, health care stressors, burnout in nursing, counselling to reduce burnout, stress reduction classes, strategies to reduce burnout in health care, reduction of burnout in clinical settings.
Stress and work pressure is associated with any profession, but in some cases, the workload surpasses the limit that a single professional can take, when there is a chronic imbalance in the daily workload of a professional and the professional capabilities of the individual coupled with the resources provided to the professional (Back et al., 2016). In case of a profession so physically and emotionally invested like nursing excessive workload often causes immense burnout and fatigue in the professionals. Johnstone and his co-workers have opined in their article that the burnout represents a disruption in the relationship between a professional and his work responsibilities, and burnout in a profession causes the professional to detach himself from the job role and bring in elements like withdrawal, anger and cynicism (Johnstone et al., 2016). According to the author the impact of burnout the performance and mental health of the professional is paramount like decreased competence, decreased performance and compromised work quality, and these elements can be very detrimental to a profession like nursing.
In order to find a solution to any issue, the characterization of source of the issue is pivotal, in the nursing workforce burnout and compassion fatigue is a very alarming yet co0mmon occurrence. And there can be a lot of elements that can cause burnout in the nursing professionals. According to Bogaert et al., (2013) one of the major contributing factors behind the excessive burnout in the nursing professionals is the inadequate nursing staff and extremely low nurse-patient ratio in the health care facilities (Bogaert et al., 2013). The patient-nurse ratios in USA, especially in the rural areas are terrifyingly low. The nursing shortage situation is still worsening in the United States as the nurses are required to care for patient number larger than they can handle. As a result fewer numbers of nurses are forced to work long hours to compensate the shortage situation which creates immense burnout. This has been one of the effective measures that have been adopted by all the hospitals across the United States. However, one of the important matters in this case is due to the fact that the hospitals have to employ more number of nurses within the healthcare unit.
Preventative Strategies for Nurse Burnout
According to an empirical research study by Johnstone et al., one of the most threatening impact of excessive burnout in the nurses is due to the lack of sleep and extreme exhaustion which in turn affects the competence, performance quality and efficiency of the nursing staff and it slowly impacts the mental health of the nurses as well (Johnstone et al., 2016).
In the last few years there have been many instances when the nurses dealing with immense burnout had to resort to situations where the nurses had nervous breakdowns and withdrawal symptoms due to the negative impact on their physical and psychological well being by the burnout stressors (Johnstone et al., 2016). Hence the need for preventative strategies are paramount, although there have not been enough effort in the past for characterizing a standard workplace procedure to deal with the burnout and exhaustion (Awa, Plaumann & Walter, 2010). Many of the previous literature have discussed the impact of different strategies on reducing the impact of burnout on the nurses; one of the greatest strategies that have been discussed by the different authors had emphasized in the self reflection and self control strategies. However in case of excessive burnout the strategies like self control and escape avoidance don not yield enough results due to the disappointment it facilitates in the nurses. The need for person-directed and organization directed approaches have been highlighted ever since. In the article by Braunschneider, the impact of both person directed and group directed intervention activities have been seen to be conspicuously effective (Braunschneider, 2013).
According to many authors personal counselling and group based stress reduction classes can be excellent burnout intervention programs in the clinical setting. With the help of the classes, it is possible for the nurses to get the proper mode of training
According to Rushton et al., (2015), burnout can be characterized as a psychological syndrome that has the potential to impact the efficiency and competence of the professional and slowly impact the mental health of the profession as well by facilitating emotions like anger, cynicism, helplessness, irritation, withdrawal and most of all disappointment and lack of self-worth (Rushton et al., 2015). In a profession like nursing, where the nurses are expected to have a compassionate and perseverant approach to care at all times, regardless of the physical or emotional exhaustion, these elements can ruin the career of the nurse and can jeopardize the health and safety of the patient as well. Alike any other psychological syndrome, it can be stated that counselling can help the nursing individuals cope with the psychological breakdown. According to McTiernan & McDonald (2015), philophonetic counselling is the radical addition to the coping strategies as it can help the nurse to build self-controlling emotional and cognitive strategies to build self-resilience (McTiernan & McDonald, 2015). As the emotional stressors are much more heightened in case of nursing burnout, the self resilience can help the nurse deal with the stressors much more effectively by initiating activities like meditation, emotional detachment, timeouts and what not. It is evident from the matters that with the help of the counselling, it is possible to understand the current mental status of the individual nurses that can only be overcome with the help of proper mode of communication and discussion sessions that can be done within the counselling sessions (Skovholt & Trotter-Mathison, 2014).
Counselling for Nurse Burnout
As nursing is a profession that requires the professionals to work within a team environment, group based strategies to deal with the burnout can be much more effective in case of burnout prevention. As mentioned above, the psychological manifestation of the physical exhaustion makes the burnout issue so detrimental to the mental health and efficiency of the nurses, group based reflective settings where the nurses can share their feelings and reflect on their concerns, the probability of effectiveness increases multiple folds (Skovholt & Trotter-Mathison, 2014). One of the main concerns with burnout impact is the self imposed isolation that the victim struggles with, the group based stress reduction classes, where all the burnout victims can communicate and participate in stress reduction activities together can be extremely helpful. According to Stier-Jarmer et al, the stress reduction classes that incorporated elements like mindfulness strategy, intercommunication, meditation and cognitive therapies (Stier-Jarmer et al., 2016).
According to an empirical research by Fjorback and his co-authors, the stress reduction programs like mindfulness based coping strategies are effective in case of preventing burnout impact while mindfulness based cognitive therapies could prevent depressive relapses to a large extent in case of nursing professionals (Fjorback et al., 2013). It is essential for all the healthcare units across the society to have the ability to deal with the excess pressure of the nurse. Proper forms of stress reduction training needs to be incorporated within the nursing degree courses, which will allow the newly qualified nurse to deal with all form of challenges within the healthcare unit and departments. The stress training program will depend upon all types and the work pressure of each types of department within the healthcare unit each of the individual nurses will be deployed (Gunasingam et al.,2015).
The aim of the current study is to explore the effect the of the different intervention steps that are adopted by the healthcare organization to deal with the burnout and stress among the nurses. The study also has the objective to measure the effective strategies that are adopted to deal with the stress of the nurses in different departments within the healthcare unit.
The study will mainly focus of the quantitative form of methods and design that will help in the matters of establishing the relationship between the social groups that has the ability to establish relationship between different strategies that are adopted to deal with most of the stress that are encountered by the nurses. The study will mainly explore the previously conducted experiment related to the intervention methods adopted to deal with the stress level of the nurses. The study will also aim to collect data directly from the nurses that will help to get the idea about the practical condition of the nurse within the settings of the hospital. The survey for the investigation will mainly aim to collect data from the relative young and inexperienced nurses, who have the risks of facing up with the burnout experience. The data also will be collected from the healthcare units across the United States, which have adopted with the policies to deal with the stress and burnout experience of the nurses. The surveyor will also have to collect informed consent documents from the participants of the survey, which will ensure that only the genuine and reliable data and information being collected.
Group-Based Stress Reduction Classes for Nurse Burnout
The sampling methods for the experiment will have aim to focus on the nurses across all major healthcare who have encountered with high level of medical stress and burnout like experience. The criteria for the nursing burnout will be selected using the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) that has been published by the American Psychiatric Association, which included all the eight criteria written by the DSM-5 related to the stress and burnout like experience for the nurses (American Psychiatric Association 2013). There will be certain exclusion and inclusion criteria that have been applied in order to ensure that only the relevant data related to the study has been collected. The study will mainly focus on the aged and experienced nurses, who have to deal with long hours of duty within the workplace and also have to deal with critical condition patients. The nurses, who also have the ability to deal with the multiple stress and work pressure, will also be selected, as they will be able to provide the solutions that are gained from the intervention methods that are adopted for dealing with the burnout like experience. On the other hand, the newly qualified nurses are excluded from the sample size as they have yet to gather the experience related to stress and workplace burnout experience. The study can also include few of the candidates, who are among the nursing students as they have the chance of facing up with the burnout like experiences that can also be a part of the initial stage of their career. The participants who will meet the criteria will be invited for the survey analysis.
On the other hand, in order to collect information from the secondary sources the investigators will focus on different online medical databases. This will help them to focus on the relevant journals and articles and also on the literature relevant to the burnout experience of the nurses and the intervention steps that are adopted in order to minimize the effects of burnout and stress among the nurse. The databases used for this purpose will include NCBI, PubMed, Ovid, CDU and Cochrane library. The articles, which focus only on the burnout experience among the nurse and also the relevant intervention steps are only included with the in the research work. The journal articles that are published only after the year 2013 will be included and no older version will be selected. The relevant keywords will be used that include the “Burnout”, “Nurse Stress” and “Nursing Intervention” will able to ensure that only the relevant articles will be selected for the burnout experience.
Effectiveness of Mindfulness-Based Coping Strategies
It is important for the researcher to use effective forms of data collection methods that will allow the investigators to effectively collect the data that is relevant to the research subject. There are mainly two types of data collection methods that can be adopted in order to deal with the research work (Orkin, 2014). The primary forms of data are being collected from the direct source of the sample size of the research. The primary forms of data will also allow the researcher to collect the latest forms of data from the sample size (Orkin, 2014). In the current research work, it is important for the researcher to collect the data only from the experienced group of nurse, who has experience of more than 10 years in the relevant nursing field. The sample size will be divided into two categories. The first groups will include all the nurses, who have not been under any forms of intervention methods. The second groups will include all the nurses, who have been given the training to deal with the nursing stress and burnout. By comparing the data that has been collected from both the groups, it will be possible for the investigators to analyse the effects intervention methods to overcome the effects of nursing burnout.
The data that has been obtained from the survey need to be analysed and compared carefully in order to evaluate the result. The data that has been collected from each group will be recorded carefully in order to statistically analyse and evaluate the data that has been provided by the respective nurse from the each of the health care centres. The result of data is examined using quantitative mode of data analysis. The health condition of both group of nurse including the ones, who have been trained to deal with the burnout experience and also the group, who have got the same training is compared using different parameters that has been used to set up the survey questionnaires.
The result of the study is expected to reflect upon the actual difference that has been caused among the nurse to deal with stress and Burnout experience with the help of proper intervention measures. It can also highlight upon the effective measures that can be adopted by mother nurses in order to overcome the consequence of burnout. The result can also suggest upon other intervention measures changes to the existing intervention steps that can be made in order to deal with the issues of Burnout and stress among experienced and newly qualified nurses. The result of the published data can also be used as one of the reliable sources of data for all the future research work.
Research Objective
The research has yielded essential informative data to validate the cause of thus research. The Burnout has been characterized as an element to facilitate highly negative professional impact on the nursing professionals although there have not been only vague and ineffective strategies utilized in the past. The previous literatures have not tested the effectiveness of counselling and stress reduction programs in personal and group based respected, while the strategies individually have been utilized in individual settings. Furthermore, there has been a lot of gaps left behind by the previous research on the positive impact person centred counselling and group based stress reduction classes together as a intervention program. Hence this research will attempt to judge the positive impact of the said two strategies on reducing the negative effect of burnout on nursing workforce. It is important for the Healthcare organisation to adopt sufficient measures and training programs that can help all the experience the newly qualified nurses to overcome the Burnout experience and provide their best working ability in order to deal with all types of patients.
From the current research work it is possible to develop upon the intervention measures that have been adopted in all the Healthcare units of United States in order to ensure that the nurses are able to provide their best ability for quality health care service to the society.
References:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.
Awa, W. L., Plaumann, M., & Walter, U. (2010). Burnout prevention: a review of intervention programs. Patient education and counseling, 78(2), 184-190.
Back, A. L., Steinhauser, K. E., Kamal, A. H., & Jackson, V. A. (2016). Building resilience for palliative care clinicians: an approach to burnout prevention based on individual skills and workplace factors. Journal of pain and symptom management, 52(2), 284-291.
Bogaert, P., Clarke, S., Willems, R., & Mondelaers, M. (2013). Nurse practice environment, workload, burnout, job outcomes, and quality of care in psychiatric hospitals: a structural equation model approach. Journal of advanced nursing, 69(7), 1515-1524
Braunschneider, H. (2013). Preventing and managing compassion fatigue and burnout in nursing. ESSAI, 11(1), 11.
Fjorback, L. O., Arendt, M., Ørnbøl, E., Fink, P., & Walach, H. (2011). Mindfulness?Based Stress Reduction and Mindfulness?Based Cognitive Therapy–a systematic review of randomized controlled trials. Acta Psychiatrica Scandinavica, 124(2), 102-119.
Gunasingam, N., Burns, K., Edwards, J., Dinh, M., & Walton, M. (2015). Reducing stress and burnout in junior doctors: the impact of debriefing sessions. Postgraduate medical journal, 91(1074), 182-187.
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McTiernan, K., & McDonald, N. (2015). Occupational stressors, burnout and coping strategies between hospital and community psychiatric nurses in a Dublin region. Journal of psychiatric and mental health nursing, 22(3), 208-218
Orkin, K. (2014). Data Collection Methods. In Encyclopedia of Quality of Life and Well-Being Research (pp. 1430-1432). Springer Netherlands.
Rushton, C. H., Batcheller, J., Schroeder, K., & Donohue, P. (2015). Burnout and resilience among nurses practicing in high-intensity settings. American Journal of Critical Care, 24(5), 412-420.
Skovholt, T. M., & Trotter-Mathison, M. (2014). The resilient practitioner: Burnout prevention and self-care strategies for counselors, therapists, teachers, and health professionals. Routledge.
Stier-Jarmer, M., Frisch, D., Oberhauser, C., Berberich, G., & Schuh, A. (2016). The Effectiveness of a Stress Reduction and Burnout Prevention Program: A Randomized Controlled Trial of an Outpatient Intervention in a Health Resort Setting. Deutsches Ärzteblatt International, 113(46), 781.
Westermann, C., Kozak, A., Harling, M., & Nienhaus, A. (2014). Burnout intervention studies for inpatient elderly care nursing staff: Systematic literature review. International journal of nursing studies, 51(1), 63-71.
Yang, D. (2017). Stress and Burnout in Demanding Nursing Home Care: A literature review of the causes, prevention and coping strategies.
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