Nursing burnout is a widespread problem. Different methods of stress reduction are used to reduce the stress level and to overcome the problem. The PICO question of the project was as follows: Do medical-surgical nurses using light physical exercises as a stress reduction strategy (intervention) gain more competencies in dealing with burnout than those using multiple short breaks. In methods, the EBSCOhost, ProQuest, Health Source databases and Google web service were used to find the evidence needed to answer the PICO question. According to the literature data, two intervention strategies are effective in dealing with different types of stressors. Hence, the efficient stress reduction strategy that includes physical exercises and multiple short breaks is needed to be developed.
The nursing profession is considered to be one of the most physically, emotionally, psychologically, and mentally demanding (Millenbine & Sharman, 2012). It results in adverse nurse- and patient-oriented outcomes such as nursing burnout (Van der Colff & Rothmann, 2014). The problem of stress-related nursing burnout can be addressed through the multiplicity of strategies and intervention, including physical activities.
However, only a few studies have focused attention on exploring the relationship between physical activities and stress reduction. (Millenbine & Sharman, 2012). The present change proposal, therefore, will aim to demonstrate if light physical exercises are effective than multiple short breaks as a method for stress release and reduction of burnout.
Review of Relevant Literature
According to Khamisa et al. (2013, p. 2215), burnout, defined is typically characterized by:
- emotional exhaustion.
- lack of personal accomplishment.
According to (Grossi, Perski, Osika, & Savic, 2015), burnout among nursing professionals is characterized by three main aspects:
- physical fatigue or tiredness.
- emotional exhaustion.
- cognitive weariness.
A number of studies have focused attention on identifying the stressors that are most prevalent in healthcare settings, hence associated with more incidences of burnout. Zhou and Gong (2015) acknowledged that the major stressors include:
- work overload.
- professional and career issues.
- patient care and interaction.
- interpersonal relationships and management issues.
- resource and environment problems.
Zhou and Gong (2015) define coping as “a cognitive and behavioral effort one uses to confront a stressful situation” (p. 97). Nursing professionals, according to these authors, use active and passive coping strategies to reduce burnout. In their investigation, Millenbine and Sharman (2012) found no association between the participants Perceived Stress Scale (PSS) score and the amount of time spent undertaking physical exercises. In another study, Henwood, Tuckett, and Turner (2012) found that nursing professionals can reduce stress-related burnout by engaging in leisure-time physical activity and exercises such as bicycling, swimming and playing tennis. Lastly, Hertel (2009) highlighted a multiplicity of coping strategies for nursing burnout, which include adequate sleep, good nutrition, finding a good balance between work and leisure, relaxation and exercise, taking breaks between shifts, identification of values, maintenance of objectivity in practice settings, self-appreciation and reflection, application of appropriate levels of assertiveness, development of an effective support system, and development of a sense of empowerment.
Literature analysis was used to accomplish the task. The EBSCOhost, ProQuest, Health Source (Nursing/Academic Edition) databases and Google web service were used to find the information. Overall, seven research articles (quantitative, qualitative, reviews) were selected for the study.
Two methods of stress reduction were explored:
- physical activity.
- multiple short breaks.
Although most of the selected articles addressed multiple burnout reduction strategies for nursing professionals, care was taken to synthesize and undertake a clinical appraisal of data and results. The data was used to understand whether medical-surgical nurses using light physical exercises are able to gain more competencies in dealing with burnout than those using multiple short breaks. The clinical appraisal of the relevant literature sources was aimed at coming up with strategies that could be used to develop method or technique for stress release.
Discussion and Findings
The evidence achieved from analyzing the sampled research articles was mixed. In one of the most influential studies, Millenbine and Sharman (2012) were unable to find any evidence associating physical activity levels with a reduction in stress levels among medical-surgical nursing professionals. However, although no association was found between the nurses’ perceived stress scale (PSS) score and the number of hours spent undertaking physical exercises, it is important to note that the lowest PSS score was reported among nurses who exercised for less than three hours per week. In another significant study, Henwood et al. (2012) found that nurses who engage in leisure-time physical activity are better able to maintain their overall wellbeing and reduce stress-oriented burnout than nurses who do not engage in such activities. Other studies were concerned about using multiple strategies and interventions to reduce stress-related burnout. Some of them (Hertel, 2009; Zhou & Gong, 2015; Van der Colff & Rothmann, 2014) suggested that burnout is better addressed when multiple interventions are used to deal with different stressors.
- No evidence suggested that light physical exercises gain more benefits in dealing with burnout than multiple short breaks.
- The evidence adduced that the two intervention strategies are effective in dealing with different types of stressors.
Grossi, G., Perski, A., Osika, W., & Savic, I. (2015). Stress-related exhaustion disorder – Clinical manifestation of burnout? A review of assessment methods, sleep impairments, cognitive disturbances, and neuro-biological and physiological changes in clinical burnout. Scandinavian Journal of Psychology, 56(6), 626-636. doi: 10.1111/sjop.12251.
Henwood, T., Tuckett, A., & Turner, C. (2012). What makes a healthier nurse, workplace or leisure physical activity? Informed by the Australian and New Zealand e-cohort study. Journal of Clinical Nursing, 21(4), 1746-1754. doi: 10.1111/j.1365-2702.2011.03994.x.
Hertel, R. (2009). Burnout and the med-surg nurse. Academy of Medical-Surgical Nurses, 18(3), 16-19. Web.
Millenbine, C., & Sharman, C.J. (2012). Less stress. More sweat: An examination of the effects of physical activity on the stress levels of surgical-medical nurses. Journal of Undergraduate Research, 1(2), 122-126. Web.
Van der Colff, J.J., & Rothmann, S. (2014). Burnout of registered nurses in South Africa. Journal of Nursing Management, 22(5), 630-642. doi: 10.1111/j.1365-2834.2012.01467.x.
Zhou, H., & Gong, Y.H. (2015). Relationship between occupational stress and coping strategy among operating theatre nurses in China: A questionnaire survey. Journal of Nursing Management, 23(1), 96-106. doi: 10.1111/jonm.12094.