Burnout syndrome in hospital nurses

Burnout is a state of mental, physical and emotional stress resulting in a chronic state of pressure or stress at work and is associated with individuals who do “people work” (Aiken and Sloane, 1997), a category into which nurses obviously fall. The number of nurses suffering from burnout has increased over the years, possibly causing negative effects on patient care, working environments and staffing shortages. Hospitals should focus on creating a healthy work environment in which nurses feel supported by their coworkers and management. Hospitals should also make available stress management programs that address symptoms of burnout and assure safe nurse staffing patterns are in place. A decrease in nurses’ perceived burnout could potentially help to decrease the national nursing shortage and help hospitals eliminate costly expenses in recruiting nursing staff. Lower patient to nurse ratios, a better work environment created by better management, higher pay and shorter working shifts would all make the nursing field more desirable and attract more people to train in the field. INTRODUCTION The American psychologist, Herbert Freudenberger, first used the term “burnout” in the 1970s to describe the result of unyielding stress and high standards experienced by people working in “helping” occupations, such as nursing (IQWiG, 2013). The three main symptoms considered to be signs of Burnout Syndrome are emotional exhaustion, alienation from job-related activities and reduced work performance (Poncet et al., 2007). Nurses experiencing emotional exhaustion feel depleted, overworked and lethargic. Alienation from job-related activities has included emotional separation from work responsibilities, dissociation from coworkers and pessimistic attitudes toward the work environment (Jennings, 2008). Burnout can affect daily tasks at work, home and when caring for family. Nurses with Burnout Syndrome view responsibilities negatively, find it difficult to work and have an absence of innovation, causing an overall reduced performance with all daily responsibilities (IQWiG, 2013). Nursing has been one of the fastest growing professions for the past 20 years and is projected to keep growing 19% faster than all other occupations at least until the year 2022 (Health Guide USA, 2012). Baby boomers will contribute to this growth because of aging and retirement, leading to the need for more medical care (Health Guide USA, 2012). In the 2000 census, the United States population qualified for Medicare totaled 35.1 million. By 2030, the same population is estimated to increase to 69.7 million and by 2050 to 81.9 million (U.S Census Bureau, 2000). The number of nurses suffering from Burnout Syndrome has risen over the years due to several factors. Burnout Syndrome in nurses has been shown to increase about 23% for each additional patient added to the nurse’s shift workload (Blakeney, 2003). Many nurses are required to work mandatory overtime and also noted that they may not have a choice when asked to work voluntary overtime (Rogers et al., 2004). In 2007, an estimated 500,000 RNs in the U.S. alone were not practicing in their profession because of challenging working conditions caused by long working hours and limited staffing (Herbst, 2007). Burnout Syndrome has affected 49% of Registered Nurses (RNs) under the age of 30and 40% of RNs over 30 (Aiken et al., 2001). Symptoms from Burnout Syndrome have possibly caused negative effects on patient care, working environment and staffing shortages (Jennings, 2008). The hospital nurse workforce is experiencing increased workloads due at least in part to a national nurse shortage, suspected to be caused by nurses leaving the profession because of experiencing Burnout Syndrome. Higher nurse workloads (a ratio of one nurse to eight patients at worst) have been related to Burnout Syndrome and more than 40% of hospital staff nurses score in the high range for job-related burnout, with more than one in five hospital staff nurses reporting that they intend to leave their hospital jobs within one year (Aiken et al., 2001). Research on Burnout Syndrome in hospital nurses has also indicated that stressors in the work environment are key elements of Burnout Syndrome, which consequentially are contributing to the nursing shortage by nurses voluntarily leaving their positions (Applebaum et al., 2010). The purpose of this research was to analyze the effects of the Burnout Syndrome of hospital nurses to determine the relationship with the nursing shortage experienced nationwide. METHODOLOGY The working hypothesis was that a poor work environment caused by insufficient staffing of nurses and higher nurse-to-patient ratios in the hospital setting will have greater impacts on nurses suffering from Burnout Syndrome, which will negatively contribute to the staffing shortage. The second working hypothesis was that nurses suffering from Burnout Syndrome will be more costly to hospitals because of recruiting new staff due to the turnover rate. The methodology for this study of Burnout Syndrome in Hospital Nurses was performed following the steps of a literature review supported with a semi-structured interview from an experienced RN of 12 years, M. Nance (in results see: Questions asked in semi-structured interview of Burnout Syndrome in Hospital Nurses ). This interview was tape recorded and only pertinent answers were used to validate the data encountered in the literature review to offer a more comprehensive overview of Burnout Syndrome and its effects. The research method followed was conceptual framework in Figure 1 below, which illustrates the needs caused by Burnout Syndrome in Hospital Nurses. First, the research conducted recognized the needs caused by Burnout Syndrome and examines the benefits and barriers created by those needs. Second, different resolutions can be determined to define possible outcomes from the created needs. Finally, as a result of analyzing the literature, the benefits and barriers of Burnout Syndrome can be identified. Figure 1: Conceptual Framework