Introduction
Burnout is one of the major problems that medical workers around the world, including nurses, encounter. It is characterized by emotional exhaustion, reduced performance, and dissatisfaction with the work (Jun et al., 2021). As such, the previous research identified that more than half of nurses in the U.S. suffer from this condition (Jun et al., 2021). As a result, all the stakeholders suffer from the negative consequences of worker burnout. Hospitals and other medical facilities are hurt by high employee turnover rates, reduced productivity, and decreased revenues. On the other hand, nurses experience high levels of stress and depression, which adversely affects their physical as well as mental health. Lastly, patients receive lower quality healthcare which subsequently results in the diminished well-being of the local community.
Therefore, it is seen that the problem of burnout is quite common and causes serious damage to the whole healthcare system. In this regard, the current paper seeks to discuss the current literature regarding this issue, including workplace fatigue symptoms, antecedents, and consequences. Moreover, patient safety strategies and necessary competencies to avoid the adverse impact of burnout will be analyzed. Finally, Heinrich’s Domino Theory will be used to illustrate the failure of the patient safety program.
Literature Review
The problem of burnout has received significant interest in the academic and non-academic literature. As mentioned above, the common symptoms of burnout are constant tiredness and fatigue, depersonalization, and reduced performance. They usually manifest themselves through increased levels of cynicism and introversion, decreased empathy, and slight deviation in behavior compared to the past (Kelly et al., 2021). Additionally, nurses would experience a decline in motivation and self-esteem (Kelly et al., 2021). Although the majority of healthcare specialists can exhibit those symptoms at some point during their career, burnout becomes an issue when it lasts for a longer period of time.
In the latter case, burnout can cause significant damage to nurses’ physical and psychological health. The studies identified that experiencing burnout increases the risk of having obesity, hyperlipidemia, type 2 diabetes, problems with the heart, pain in the muscles and bones, and high levels of cholesterol, to name a few (Salvagioni et al., 2017). Additionally, affected professionals have significantly larger chances of dying before they reach the age of 45 (Salvagioni et al., 2017). As for the mental well-being, those nurses who suffer from burnout are found to seek psychological treatment and have insomnia more often than other specialists (Salvagioni et al., 2017). Moreover, some healthcare workers confessed to having suicidal thoughts, which disappeared only when the burnout issue was resolved.
This, in turn, leads to the decreased quality of provided healthcare services. In particular, burnout is strongly associated with the number of mistakes that nurses make during practice (Montgomery et al., 2021). For instance, Montgomery et al. (2021) discovered that affected professionals were more prone to make medication administration errors than their colleagues. Thus, it becomes clear that burnout is a problem that necessitates constant control from healthcare managers to ensure patient and employee well-being.
Contributing Factors
There are numerous factors that can contribute to the development of burnout. Among them, the major and most important one is overwork, which is caused by employee shortage (Taleghani et al., 2017). Furthermore, some personal qualities and organizational characteristics affect an individual’s propensity to suffer from burnout. As for the former, the research found that a person’s professional qualifications, communication skills, work experience, and age predict burnout (Rodrigues et al., 2017; Taleghani et al., 2017). For example, Emilia et al. (2017) found that agreeableness, extraversion, and openness decrease the risk of work-related exhaustion. As for the latter, a leadership style that empowers the subordinates and support from the colleagues are negatively correlated with the instances of burnout in the team of healthcare workers (Rodrigues et al., 2017). On the contrary, workplace abuse and violence lead to burnout (Liu et al., 2019). Therefore, it is seen that work-related exhaustion is a complex phenomenon that has several antecedents.
Patient Safety Strategies
In order to mitigate the possible negative consequences of burnout in the healthcare facility, managers should develop an adequate patient safety plan. The first aspect that leaders should pay attention to is the cultivation of patient-centric culture. In this respect, Rogers et al. (2017) assert that the promotion of respectful attitudes toward clients and educating personnel concerning patient safety can significantly reduce the number of treatment errors. In addition, managers should seek to promote worker resilience or the nurse’s ability to adapt to new, normally adverse conditions. To achieve that, they should empower their employees by including them in the decision-making process, instill a sense of workers’ value for the organization and the local community, and promote a friendly and supportive environment (The Joint Commission, 2019). Finally, leaders should ensure that the organization has a sufficient number of professionals to serve the needs of patients without overloading the former.
Risk Theories
If one of the following precautions is violated, it can lead to great damage to patients and healthcare institutions. For example, the Domino Theory developed by Heinrich shows how understaffing can lead to errors. The scholar names five stages, namely social environment, fault of the person, unsafe act, accident, and injury that occur consequentially before the adverse event. In this case, nurse understaffing creates a social environment that increases the risk of employee physical and emotional exhaustion. At the same time, if a worker is not resilient, he or she will experience burnout which eventually will result in an unsafe act such as medication error, for instance. This mistake, in its turn, can cause an accident where the patient may be hurt. For this reason, leaders should always consider the consequences of their decisions.
QSEN Competencies and Burnout Risk Mitigation
The previous discussion suggests that the two particular Quality and Safety Education for Nurses (QSEN) competencies can help to prevent burnout among nurses, namely patient-centered care and collaboration. As such, patient-centered care presumes a greater involvement of a patient and family members in the treatment process (NEJM Catalyst, 2017). This partly implies that the client is aware of the prescribed medicine and procedures and would be better able to identify when a nurse makes an error regarding his or her treatment. On the other hand, the ability to effectively collaborate with others would allow nurses to feel that they are part of the team and faster solve certain issues with colleagues and patients. As a result, that would help to alleviate a significant amount of pressure that causes burnout.
Conclusion
Overall, the current paper discussed the problem of burnout among healthcare workers. Firstly, it was established that the symptoms of burnout include exhaustion, depersonalization, and reduced performance. Secondly, it was shown that this issue could have a negative impact on all the stakeholders involved in the healthcare process. Thirdly, personal and organizational factors which are associated with burnout were presented. Next, patient safety strategies were proposed, and two of the QSEN competencies (patient-centered care and collaboration) were emphasized as important skills to mitigate burnout-related risks. Lastly, Heinrich’s Domino Theory was adopted to illustrate how the failure in the patient safety program may occur.
References
Emilia, I., GĂłmez-Urquiza, J. L., Cañadas, G. R., AlbendĂn-GarcĂa, L., Ortega-Campos, E., & Cañadas-De la Fuente, G. A. (2017). Burnout and its relationship with personality factors in oncology nurses.European Journal of Oncology Nursing, 30, 91-96. Web.
Jun, J., Ojemeni, M. M., Kalamani, R., Tong, J., & Crecelius, M. L. (2021). Relationship between nurse burnout, patient and organizational outcomes: Systematic review.International Journal of Nursing Studies, 119, 103933. Web.
Kelly, L. A., Gee, P. M., & Butler, R. J. (2021). Impact of nurse burnout on organizational and position turnover.Nursing Outlook, 69(1), 96-102. Web.
Liu, J., Zheng, J., Liu, K., Liu, X., Wu, Y., Wang, J., & You, L. (2019). Workplace violence against nurses, job satisfaction, burnout, and patient safety in Chinese hospitals.Nursing Outlook, 67(5), 558-566. Web.
Montgomery, A. P., Azuero, A., Baernholdt, M., Loan, L. A., Miltner, R. S., Qu, H., Raju, D., & Patrician, P. A. (2021). Nurse burnout predicts self-reported medication administration errors in acute care hospitals.The Journal for Healthcare Quality, 43(1), 13-23. Web.
NEJM Catalyst. (2017). What is patient-centered care?Web.
Rodrigues, C. C. F. M., Santos, V. E. P., & Sousa, P. (2017). Patient safety and nursing: interface with stress and Burnout Syndrome.Revista Brasileira de Enfermagem, 70, 1083-1088. Web.
Rogers, E., Griffin, E., Carnie, W., Melucci, J., & Weber, R. J. (2017). A just culture approach to managing medication errors.Hospital Pharmacy, 52(4), 308-315. Web.
Salvagioni, D. A. J., Melanda, F. N., Mesas, A. E., González, A. D., Gabani, F. L., & Andrade, S. M. D. (2017). Physical, psychological and occupational consequences of job burnout: A systematic review of prospective studies.PLOS ONE, 12(10), e0185781. Web.
Taleghani, F., Ashouri, E., & Saburi, M. (2017). Empathy, burnout, demographic variables and their relationships in oncology nurses. Iranian Journal of Nursing and Midwifery Research, 22(1), 41-45. Web.
The Joint Commission. (2019). Quick safety: Developing resilience to combat nurse burnout. Web.