Nurse burnout was studied for years before COVID-19, and the pandemic brought nurse burnout to the public eye. Burnout is associated with workload and lack of support that nurses experience in critical care areas such as ICUs (Buckley et al., 2019, Forsyth et al., 2021). High rates of burnout, work-related stress, and compassion fatigue are also related to unsafe staff-patient ratios and feelings of being overworked when the units are understaffed. The issue raises the idea that nurses may benefit from having interventions implemented by hospitals to help decrease burnout rates and improve job satisfaction in nurses, therefore improving desired outcomes for patients.
Problem
Burnout is important in nursing because it may lead to disengagement in care leading to nurses leaving the profession (Ratliff et al., 2020). When nurses become disengaged it affects patient care and may lead to patients not trusting the healthcare system in general. Nurses leaving the bedside may result in units being left short staffed. Nurses may then feel obligated to pick up more shifts contributing to an increase in the burnout they are feeling.
Literature Review
Nurse burnout, work-related stress, and compassion fatigue have been studied through various surveys and questionnaires of nurses who work in bedside positions. The focus of several studies was on critical care units, such as pediatric ICUs and Emergency Departments, to determine burnout and compassion fatigue (Buckley et al., 2021). Nurses who work in critical care areas are more likely to report higher levels of burnout due to the increase in work demands, work-related stress, and grief that is experienced (Aslan et al, 2020; Faller et al, 2011; Forsyth et al, 2022). Yet, nurses tend to report lower stress levels, less burnout, and higher rates of personal accomplishment and job satisfaction when nurses can interact positively with patients and families in critical care and general care units (Buckley, 2019).
Several varied factors play a role in how nurses experience burnout and compassion fatigue, such as age, length of being a nurse, and which specialty or unit nurses work in (Berger et al, 2015). Survey results by Berger et al show nurses who are younger than 40 years of age, who have less than 10 years of experience, and who work in critical care specialties reported higher rates of burnout, compassion fatigue, and lower rates of job satisfaction.
Nurses may experience grief due to the loss of a patient or caring for chronic or critically ill patients (Adwan et al, 2014), if not provided with effective strategies and resources for coping and grieving. Nurses therefore may be less likely to continue developing careers at the bedside. It is important for nurses to be resilient and able to overcome work-related stress to avoid burnout and compassion fatigue and for overall health and wellness (Zhang et al, 2020). Hospitals, units, and nurses where healthier strategies for coping with work-related stress are implemented in accordance with Zhang et al will be more likely to remain in bedside nursing.
Recommended Interventions
Recommended interventions for nurses to overcome burnout are at the institutional level. Suggestions include adding softer lights at the nurses’ stations and breakrooms, consistent access to support services for nurses and patients, and lower nurse-to-patient ratios (Henry, 2014; Ratliff et al., 2020; Romppanen et al., 2017; Zhang et al., 2020). Nurse managers or supervisors can play a vital role in debriefing or communicating with nurses after a traumatic event occurs at work or after difficult shifts (Henry, 2014). Hospitals or facilities could implement educational classes on mindfulness and self-care techniques to help nurses cope with the stress experienced at work (Henry, 2014). Self-care techniques can relieve stress, alleviate burnout, and help improve staffing shortages (Ratliff et al, 2020; Shin et al, 2018). Providing nurses with tools to cope with work-related stress can impact the prevalence of burnout and compassion fatigue among nurses (Zhang et al., 2020).
Finding ways to provide more self-care can help reduce work-related stress. Yoga, meditation, and taking a break can help ease the mind of nurses who are at risk of experiencing burnout (Ratliff et al. 2020). Other strategies for nurses are talking with family, friends, or a therapist about the stress experienced at work, and exercising can help to reduce stress and improve mental health. Employers could implement staff counseling, adjust shifts for safer ratios, and implement change within the unit to help nurses cope with the grief and stress experienced (Johnson et al. 2017).
Conclusion
According to the literature reviewed in this study, the evidence suggests that a relationship exists between work environments and work-related stress and burnout among nurses (Adwan, 2014; Berger et al., 2015; Buckley et al., 2021; Faller et al., 2011; Henry, 2014; Ratliff et al., 2020; Rompanen et al., 2017; Shin et al., 2018; Vahey et al., 2004; Zhang et al., 2020). The data from these studies show that improved work environments correlate to lower rates of burnout and that rates of burnout have a relationship to patient safety. There is not yet enough data to determine the specific interventions that will reduce burnout in nurses.
Suggestions for further study
The evidence suggest that more research is needed for interventions that influence work-related stress among nurses (Faller et al., 2011; Forsyth et al., 2021; Romppanen et al., 2016; Buckley et al., 2019), and on effective interventions that can decrease nurse burnout and compassion fatigue (Zhang et al., 2020; Ratliff et al., 2020; Johnson et al., 2016; Vahey et al., 2004). Nurse burnout has become more prevalent since COVID-19, and more updated research is needed to determine if current interventions are still effective (Ge et al., 2023; Buckley et al., 2021). Nurse burnout and compassion fatigue are more pronounced than before COVID-19 making it important to conduct further research on interventions, work environments, and other factors contributing to nurse burnout and compassion fatigue.
Brief bio:
References
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