Introduction
The effective and responsible performance of nursing duties requires compliance with a wide range of conditions regarding both the professional duties for this type of activity and the moral and ethical principles of work. Tense schedules, dynamic care environments, and other factors are the result of nursing staff fatigue, which can eventually develop into burnout. In contrast, high rates of resilience developed through self-regulation and educational interventions can help overcome job stressors and stimulate productive activities. As a result, finding optimal fatigue mitigation approaches improve performance. This work aims to identify the relevance of the problem of burnout among nurses, critically evaluate relevant academic sources, and suggest rational ways to solve the issue based on the data collected.
Background
The importance of studying burnout among nursing staff is due to the negative impact of this condition on employees’ performance, which, in turn, affects patient outcomes. The less productive nursing staff are, the lower the likelihood of successful nursing interventions. According to Tahlil (2022), the state of burnout can be characterized by a positive correlation between increased workload and reduced job resources. In other words, nurses cannot maintain a consistently high pace of work due to personal constraints, such as fatigue, and external factors, including high workloads and low supervision. Wu et al. (2016) draw a parallel between burnout and the phenomenon of compassion fatigue, when nurses, devoting themselves to their profession comprehensively and making many efforts to meet patients’ needs, experience emotional exhaustion. Therefore, one can note that the reasons for the development of burnout can be different, which explains the significance of studying this topic and finding appropriate mitigation approaches.
Particular attention to the problem of burnout among nurses is due to excessively increased needs for their services. Clinton et al. (2022) consider this issue in the context of the current COVID-19 pandemic and note that along with burnout, high turnover rates are a consequence of the work burden on nursing staff and the entire medical community. The need to create conditions in which junior medical staff can work without experiencing physical and emotional exhaustion is an urgent task of the modern healthcare system. According to Hopp and Rittenmeyer (2021), work fatigue can be minimized through innovative solutions associated with the practice of medical professionals. However, not all healthcare facilities can afford to implement optimization solutions for a number of reasons, such as financial constraints or labor shortages. Thus, studying the problem of nursing burnout is extremely important for this occupation and the entire medical community.
Literature Review
In academic literature, the problem of nursing burnout is often discussed due to the significant impact of this issue on the work process itself and related factors, for instance, patient outcomes. Smythe et al. (2017) study the experience of junior medical staff working in nursing homes and note the high value of theoretical training of specialists. According to the authors, educational interventions can help address the problem at the local level if nurses’ experiences are low and employees lack knowledge about how to deal with burnout (Smythe et al., 2017). In a similar study, Dev et al. (2018) evaluate the impact of such a quality as self-compassion in the context of combating work fatigue. They argue that coping with stressful conditions through attention to one’s feelings and emotions is a potentially effective tool for medical professionals in combating burnout (Dev et al., 2018). This argument is presented as valid, but the problem persists if employees do not have sufficient work experience.
Numerous stressors are key causes commonly associated with burnout in nurses. Ching et al. (2020) note that to successfully cope with high workloads and emotional exhaustion, nursing staff should increase self-awareness through honing reflection skills. At the same time, the level of specialists’ preparedness and the specifics of the external environment, for instance, the work schedule and the size of the team, can be constraints that prevent successful self-help. Mäenpää et al. (2017) link the burnout factor with the motivation score and study how engagement in the work process correlates with fatigue. According to the researchers, nursing education is a source of critical knowledge on how to implement professional skills through the use of flexible work strategies (Mäenpää et al., 2017). However, not every organizational environment may be suitable for applying the available knowledge and skills, which is a barrier to the implementation of approaches to increase motivation and strengthen inclusiveness in a medical organization.
Along with the aforementioned motivators and stressors, additional criteria are usually taken into account when analyzing the impact of burnout on nursing performance. As Van Bogaert et al. (2017) state, employees’ personal characteristics often affect job satisfaction, and such aspects as the level of communication, the sustainability of group activities, and other collaborative criteria can correlate with burnout. In other words, poor teamwork can be a prerequisite for emotional exhaustion in medical staff. Many studies, such as that by Hancock et al. (2020), view the criterion of resilience as one of the key factors associated with productive nursing practice. The authors remark that based on a survey of involved medical specialists, organizational challenges, a high frequency of stressful situations, and poor teamwork are rated as the causes of weak resilience (Hancock et al., 2020). As a result, a number of criteria are crucial to consider to draw a conclusion about the prerequisites for the development of burnout in nurses.
Critique of the Articles
Quantitative
The theory of resilience is a concept relevant to the issue of nurse burnout. In their quantitative study, Dev et al. (2018) seek to elucidate relevant characteristics influencing the manifestation of resilience among nursing staff. Through the involvement of target participants, the authors identify what criteria are decisive in the formation of resilient attitudes and the ability to withstand the risk of burnout (Dev et al., 2018). The components of this theory include relevant variables that relate to the manifestations of the issue. The researchers identify demographic (gender, age, ethnicity, and other parameters) and clinical practice (experience, work patterns, and other parameters) factors as independent variables and a resilience level as a dependent one (Dev et al., 2018). By using these criteria, it is possible to assess how resistant nurses are to burnout manifestations and how effectively they can withstand job stressors.
Qualitative
The theory of resilience does not originate in the nursing profession but in the psychological disciplines. In their qualitative study, Ching et al. (2020) describe the origin of this concept and consider it as a framework that defines the ability to adapt to specific conditions and recover when faced with negative experiences. Applied to nursing practice, the idea of resilience defines how effectively nurses can deal with high workloads and stressors that are inevitable. Ching et al. (2020) also cite factors that increase resilience, such as peer support, real success in interacting with patients, sufficient autonomy, and some other criteria. Through interviews with target participants, the authors have found a positive correlation between self-regulation mechanisms and low burnout scores (Ching et al., 2020). Thus, the theory of resilience largely determines how successfully nurses can withstand job stressors.
Intervention Protocol
Enabling nurses to increase their level of self-awareness to successfully deal with burnout risks is a key intervention protocol strategy. As Dev et al. (2018) state, addressing the individual characteristics of medical employees should be a must because their personal and clinical practice characteristics are distinctive. Similar ideas are presented in the study by Ching et al. (2020) because the authors insist on the need to strengthen nurses’ self-regulation strategies to successfully cope with stressors that affect the perception of the care process. As the tools to apply, Hancock et al. (2020) recommend turning to constructive coping practices related to employees’ individual characteristics and interests while considering their personal drivers. Finally, Van Bogaert et al. (2017) argue that nurses’ self-management competencies are directly dependent on the workload indicator, which can be excessive and thus cause burnout. As a result, relevant resources emphasize the value of a personalized rather than mass solution to the problem. Thus, by combining the findings from relevant sources, one can note that promoting individual self-regulation practices is a potentially valid methodology to create an environment in which healthcare professionals can overcome burnout prerequisites.
Despite the potential value of the considered strategy for addressing the burnout problem, some limitations can be identified based on the assessment of relevant sources. In the study by Dev et al. (2018), data is collected through self-reporting, and although participants have a personal interest, their responses may be subjective and biased due to distinctive experiences. Regarding the study by Ching et al. (2020), data collection through focus groups is a potential limitation. Emphasis on individual characteristics is key, but the cumulative evaluation of the issue can preclude objective information and lead to distorted data. Regarding the study by Hancock et al. (2020), deterrents refer to a limited number of constructive strategies to apply to overcome burnout. No additional algorithms are proposed except for those relating to the intersection of professional and personal factors. The findings by Van Bogaert et al. (2017) may be characterized in terms of limitations by analyzing the interpretation of the collected information. A cross-sectional design requires increased attention to analysis, and the risk of evaluation errors is high. All the listed deterrents are essential to take into account when drawing up an effective intervention protocol.
In the resources under consideration, the findings have an appropriate evidence base. For instance, Dev et al. (2018) conduct a correlational analysis by creating a unique framework for assessing the impact of potential barriers on nurses’ perceptions of the workflow. This allows for obtaining credible information substantiated by real statistical results. The study performed by Ching et al. (2020) helps the researchers identify the individual views of the participants involved on the issue in question through original interview questions. By categorizing the members’ responses, an adequate picture of the situation is presented, which allows for highlighting the relevant risk factors. A similar principle is applied by Hancock et al. (2020), who show the prerequisites for burnout in nurses visually by compiling the respondents’ answers in a special framework. This original approach shows the key topics associated with the problem under consideration. Finally, based on the collected data, Van Bogaert et al. (2017) demonstrate numerical ratios showing the respondents’ attitudes to emotional exhaustion in personal practice. All these approaches are valuable strategies for reflecting burnout prerequisites and arguing for intervention based on a personalized method.
Overall Evaluation and Summary
Following the aforementioned intervention protocol, which promotes self-regulation among nursing staff through a personalized approach, can help improve decision-making significantly. As Clinton et al. (2022) argue, targeting auxiliary educational offerings can help stakeholders, including employees and their supervisors, avoid unnecessary or inefficient procedures. In addition, according to the authors, streamlined decision-making is directly associated with cost savings through well-defined steps, which is relevant in the context of limited funding (Clinton et al., 2022). Having a clear idea of subordinates’ satisfaction with the work process, team leaders can allocate resources efficiently. Moreover, any healthcare institution can utilize a nursing self-awareness-based assistance model, which eliminates any problems associated with complex analytical projects. As a result, the considered protocol can be productive and financially beneficial due to the convenience of decision-making and the absence of useless initiatives to implement.
Improving clinical decision-making with the help of the protocol in question may be achieved due to a sufficient and credible evidence base. From a patient care perspective, Hopp and Rittenmeyer (2021) argue that “evidence-based clinical decision-making is the individualization of care to the context of the patient’s situation” (p. 14). In relation to junior medical personnel, the same principle is relevant. Gathering objective data from target nurses can help personalize the intervention and select appropriate interaction algorithms to enhance self-awareness and increase knowledge about how to deal with job stressors. In addition, as Hopp and Rittenmeyer (2021) state, the nature of the evidence plays a crucial role. The authors highlight the value of qualitative evidence in the context of clinical decision-making (Hopp & Rittenmeyer, 2021). This is due to the distinctive needs and preferences of the target audience, as well as changing views on the aspects of the workflow. The proposed implementation protocol is based on the interpretation of qualitative data, which indicates the potential to improve the clinical decision-making process.
Conclusion
The analysis of relevant academic sources and the collection of a credible evidence base has allowed for compiling an intervention protocol designed to address the problem of burnout among junior medical staff. Emotional exhaustion that many nurses experience is a severe problem and can have a negative impact not only on employee productivity but also on patient outcomes. As an appropriate intervention, increasing self-awareness through educational mechanisms is seen as a universal method of helping employees with distinctive work experiences and cultural backgrounds. Despite the limitations identified in the analyzed academic resources, their usefulness is significant for the topic under consideration. Improving clinical decision-making through the personalization of support programs and cost reduction are the value implications of the proposed intervention.
References
Ching, S. S. Y., Cheung, K., Hegney, D., & Rees, C. S. (2020). Stressors and coping of nursing students in clinical placement: A qualitative study contextualizing their resilience and burnout.Nurse Education in Practice, 42, 102690.
Clinton, M., Bou-Karroum, K., Doumit, M. A., Richa, N., & Alameddine, M. (2022). Determining levels of nurse burnout during the COVID-19 pandemic and Lebanon’s political and financial collapse.BMC Nursing, 21(1), 1-11.
Dev, V., Fernando, A. T., Lim, A. G., & Consedine, N. S. (2018). Does self-compassion mitigate the relationship between burnout and barriers to compassion? A cross-sectional quantitative study of 799 nurses.International Journal of Nursing Studies, 81, 81-88.
Hancock, J., Witter, T., Comber, S., Daley, P., Thompson, K., Candow, S., Follett, G., Somers, W., Collins, C., White, J., & Kits, O. (2020). Understanding burnout and moral distress to build resilience: A qualitative study of an interprofessional intensive care unit team.Canadian Journal of Anesthesia/Journal Canadien D’anesthésie, 67(11), 1541-1548.
Hopp, L., & Rittenmeyer, L. (2021). Introduction to evidence-based practice: A practical guide for nursing (2nd ed.). FA Davis.
Mäenpää, K., Pyhältö, K., Järvenoja, H., & Peltonen, J. (2017). Nursing students’ motivation regulation and its relationship with engagement and burnout. Nordic Journal of Nursing Research, 38(3), 143-150.
Smythe, A., Jenkins, C., Galant-Miecznikowska, M., Bentham, P., & Oyebode, J. (2017). A qualitative study investigating training requirements of nurses working with people with dementia in nursing homes. Nurse Education Today, 50, 119-123.
Tahlil, T. (2022). Nurses’ burnout and its associated factors and impact on the quality of nursing services. International Journal of Nursing Education, 14(2), 24-33.
Van Bogaert, P., Peremans, L., Van Heusden, D., Verspuy, M., Kureckova, V., Van de Cruys, Z., & Franck, E. (2017). Predictors of burnout, work engagement and nurse reported job outcomes and quality of care: A mixed method study. BMC Nursing, 16(1), 1-14.
Wu, S., Singh-Carlson, S., Odell, A., Reynolds, G., & Su, Y. (2016). Compassion fatigue, burnout, and compassion satisfaction among oncology nurses in the United States and Canada.Oncology Nursing Forum, 43(4), 161-169.