Burnout in nursing
Burnout is a syndrome that develops against chronic stress and leads to depleting the emotional, energy, and personal resources of a working person. Professional burnout occurs due to the internal accumulation of negative emotions without a corresponding “discharge” or “release” from them. Emotional exhaustion refers to the feeling of emotional exhaustion and fatigue caused by one’s own work. It manifests itself in a decrease in emotional tone, loss of interest in the world around us, or emotional oversaturation to protect oneself from excessive stress, aggressive reactions, outbursts of anger, the appearance of symptoms of depression, and physical malaise. The person feels that he cannot devote himself to work as before. There is a feeling of “dullness,” “muffledness” of emotions. Sometimes “burnt out,” professionals say that they “run out of emotions,” and “do not have enough strength to work.” In extreme cases, emotional breakdowns are possible.
Depersonalization presupposes a cynical attitude towards work and the objects of one’s labor. This is the development of negative, callous, indifferent attitudes towards people. Contacts with recipients are becoming formal. There is a noticeable deformation of relations with other people (depersonalization): an increase in dependence on others or, on the contrary, the cynicism of attitudes and feelings concerning recipients. In the recipient (in the case of medical personnel, this is the patient), the nurse ceases to see the person. At the same time, the “burnt out” often blames others for his irritation.
Reduction of personal achievements (or a decrease in the significance of their own achievements, or a reduced professional realization) is the emergence of a feeling of incompetence among employees in their professional sphere, an awareness of failure in it. The reduction of personal achievements is manifested in a negative self-perception in a professional sense, decreasing the sense of self-worth. This burnout component is usually considered an indicator of work motivation (Prapanjaroensin et al., 2017). A specialist has a feeling of low professional efficiency and returns, low self-esteem, dissatisfaction with themselves as a professional, inability to assess themselves adequately, and their work results. Thus, professional burnout is viewed as a symptom complex or a syndrome that occurs due to prolonged occupational stress.
Burnout negatively affects the organization: involvement in work decreases, job satisfaction decreases, staff turnover increases, the socio-psychological climate worsens, unfavorable physical and emotional symptoms progress, quality and quantitative performance indicators deteriorate, and compensation ensures the health of workers increases (Kelly et al., 2021). Also, empirical studies show that nurses’ professional burnout leads to a decrease in the humanistic orientation in the structure of their work motivation, the main indicator of which is the factor “Helping people” (White et al., 2019). Thus, patients are the first to suffer as the quality of care for them decreases. As White et al. (2019) state, the majority of nurses “reported missing one or more necessary care tasks on their last shift due to lack of time or resources. One in five RNs reported frequently being unable to complete necessary patient care” (p.2065). These results indicate the direct link between burnout’s effects on nurses’ professional activity and potential legal issues arising from negligence or inappropriate care provision. Ethical issues arise because it is a national priority to provide the best care for patients, while most healthcare professionals experience burnout, preventing them from providing it.
The most critical elements of self-help in professional burnout are visiting a psychologist and physical or massage rooms to relax muscle tone and relieve physical stress. Burnout is less of a concern for people who have a history of successfully coping with occupational stress and are capable of constructive change in stressful conditions. He is also more staunchly opposed by people who have high self-esteem and self-confidence, abilities, and capabilities. An important distinguishing feature of resistance to professional burnout is their ability to form and maintain positive, optimistic attitudes and values in themselves, both concerning themselves and other people and life in general.
Two issues that lead to nurse burnout and Their Solutions
Among the reasons contributing to burnout, there are individual, role, and organizational characteristics. The content of the work of medical staff in itself presupposes the severity of altruistic motives, a willingness to understand, provide assistance, and show concern. The expressiveness of the motivation of this orientation, combined with the corresponding professionally essential qualities, should primarily ensure the success of the nursing staff’s professional activity. Medical workers are constantly in the circle of both their problems (experiencing all the real difficulties of their own lives) and patients’ problems while carrying a double socio-psychological burden. Their professional activities involve emotional saturation and a large number of stressors. That is why doctors and nurses are at risk of burnout occurrence, and the issues of the peculiarities of its formation, prevention, and treatment are of particular relevance for them.
Research shows a close relationship between high professional psychological stress and the development of burnout among nurses (Kelly et al., 2021). The main reason nurses and other medical staff develop professional burnout syndrome is the internal accumulation of negative emotions and the inability to get emotional “release” from their presence. For example, one of the most important issues leading to burnout is constant close communication with patients who, moreover, can be negatively minded (White et al., 2019). Besides, a specific reason may also be professional difficulties (for example, problems in the field of career growth or not having too high a salary, given the workload of the employee) (Kelly et al., 2019). The workplace state can also be a stimulus to the onset of burnout syndrome—for example, the lack of equipment necessary for a doctor’s work or insufficient medicines.
Techniques for overcoming and preventing professional burnout can take place at three levels. First, at the organizational level: this includes the use of programs of mutual assistance to employees and health programs (consultations of psychologists, organization of recreation, health sports sections); also important is the rotation of personnel, based on the priority of the personal qualities of employees and the qualified and competent work they perform (Kelly et al., 2021). Also, at this level, there can be an increase in the level of education, vocational training, and information programs and the inclusion in the staff of employees who assist staff in relieving psychosomatic stress arising in the operation of a medical institution.
The other two levels are related to individual work. Firstly, these are the adaptive mechanisms of the nurses themselves: eliminating the stress agent, setting goals (short-term and long-term), organizing a work and rest regimen (for example, using technical breaks to prolong working capacity), as well as mastering ways to manage stress (auto-training, relaxation techniques) (Prapanjaroensin, 2017). Finally, individual prevention of burnout is essential. Within the framework of professional activity, it is necessary to select a job that matches individual inclinations and capabilities, improve qualifications and the level of professional competence, and periodically change the work schedule. When there is a desire to do someone’s work, you should evaluate how much help is needed. At the same time, it is necessary to organize regular, sufficient, and full-fledged rest with a change of scenery, preferably active, to balance the diet, to disconnect from thoughts about work, and going home. A walk or meeting with friends can facilitate the latter. One should not think that one can live the life of other people – one needs to live with them, helping and accepting help.
My Own Experience of Burnout and the Process of Its Overcoming
At some point, I felt that I am approaching professional burnout. I decided that the time had come to take the “borderline” situation consciously: after all, at this time, I was crossing the invisible boundary between my private life and my professional life. I tried to grasp this moment on the way to work and return to this thought again, returning home. I told myself that work is not my whole life, and there I perform specific duties and solve essential tasks, but when I leave work, I should not carry the whole load of the same problems in my soul.
I tried to find factors that could increase my performance during the working day and cope with stress and overexertion. Among them were photographs of loved ones; I set one of my favorites as wallpaper on my phone. Also, I tried to go outside for fresh air for 5-10 minutes at least two times during the working day. I also bought myself a small jar of mandarin essential oil: I really love the citrus scent and have noticed that it boosts my mood in energy levels throughout the day.
At first, these small steps helped to stay in a productive and healthy workflow, but at one point, I realized that there were not enough of them anymore, and I still feel constant stress and anxiety. Since these experiences and symptoms are the main symptom of an incipient and developing burnout, I decided to take a short timeout. I was lucky, and my leadership went to meet me, providing three days off. During this time, I found a psychologist who helped me get through this challenging period. He suggested to me that, first of all, if possible, devote more time to communicating with friends and family. They help to return to the world of pleasant emotional communication and rapprochement, and thanks to this, the likelihood of emotional burnout is significantly reduced. At the same time, it is crucial to have friends from other professional fields in order to be able to be distracted from your work.
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.
Prapanjaroensin, A., Patrician, P. A., & Vance, D. E. (2017). Conservation of resources theory in nurse burnout and patient safety. Journal of Advanced Nursing, 73(11), 2558-2565.
White, E. M., Aiken, L. H., & McHugh, M. D. (2019). Registered nurse burnout, job dissatisfaction, and missed care in nursing homes. Journal of the American Geriatrics Society, 67(10), 2065-2071.