Introduction
The expected outcome of this study is that most participants will highlight a high number of patients per nurse as the most significant factor for burnout in the Emergency Department team. Although other external and internal influences should be evaluated, it is critical to note that the same factors may cause less emotional detachment issues in other departments. In contrast, emergency medicine often requires quick decisions and actions; hence, the same nurse-to-patient proportions may be more stressful than nonacute cases (Jose et al., 2020). Therefore, it is anticipated that a high patient-to-nurse ratio will be the most important contributor to burnout.
Discussion
Another expected outcome of this study is that the majority of participants will agree that a lower patient-to-nurse ratio in the Emergency Department not only improves patient outcomes but reduces stress on clinicians. This study hypothesizes that having fewer patients may increase the emotional connection and the level of compassion in healthcare workers. In fact, the opposite was found to be true: more hospitalized individual nurses lead to emotional detachment from the profession (Moukarzel et al., 2019). As a result of emotional exhaustion, the resilience of the staff working with critically ill patients drops, which is an undesired consequence (Jose et al., 2020). According to Adams et al. (2019), prolonged stress and exhaustion cause cynicism and a decrease in clinicians’ personal effectiveness. All these factors combined contribute to burnout and even increased turnover rates in hospitals. We contemplate that in this interventional study, reducing the patient-to-nurse proportion will make clinicians feel more connected to their work, resulting in lower burnout and higher resilience.
Implementation
The results of this study may be implemented in other Emergency Departments and Clinics across the country. The problem of burnout and high turnover rate among nurses costs thousands of dollars for U.S. hospitals. For example, it was estimated that the approximate financial loss from a nurse leaving a position could range from $10,000 to $90,000 per vacancy (Adams et al., 2019, p. 2). These numbers can be summed up to $8.5 million in annual losses for a healthcare organization (Adams et al., 2019, p. 2). Moreover, burnout may lead to poor work morale and a negative culture among clinicians (Adams et al., 2019). It is deleterious to the well-being of patients, especially if they are in an acute and unstable condition, which is common in the Emergency Departments.
Before introducing the same approach proposed in this study, it is essential to inform nurses about the problem and the benefits of the intervention. Indeed, the issues, in this case, are burnout and mental exhaustion. As obvious as they seem, these concepts should be clearly defined and articulated to healthcare workers to help them recognize the signs of these issues in themselves and others (Adams et al., 2019). The knowledge about these mental health problems may be provided during lectures, group training sessions, and in the form of brochures and short videos. Notably, offering these informational sessions before implementing the intervention is essential to ensure that clinicians understand that the change in the nurse-to-patient ratio is done to reduce burnout levels, not to pay them less. The same approach was used in the research by Adams et al. (2019).
Conclusion
In that study, nurses were first provided with lectures about burnout and negative culture in hospitals and only then were exposed to the stress-reducing program that substantially improved the working environment. Thus, explaining the goals and final outcomes of the proposed strategy is crucial when introduced in any other Emergency Department.
References
Adams, A., Hollingsworth, A., & Osman, A. (2019). The implementation of a cultural change toolkit to reduce nursing burnout and mitigate nurse turnover in the emergency department. Journal of Emergency Nursing, 45(4), 452-456. Web.
Jose, S., Dhandapani, M., & Cyriac, M. C. (2020). Burnout and resilience among frontline nurses during COVID-19 pandemic: A cross-sectional study in the emergency department of a tertiary care center, North India. Indian Journal of Critical Care Medicine, 24(11), 1081-1088. Web.
Moukarzel, A., Michelet, P., Durand, A.-C., Sebbane, M., Bourgeois, S., Markarian, T., Bompard, C., & Gentile, S. (2019). Burnout syndrome among emergency department staff: Prevalence and associated factors.BioMed Research International, 1-10. Web.