Concept Analysis: Nursing Burnout Chamberlain College of Nursing

NR 501: Theoretical Basis for Advanced Nursing Practice

Definition and Explanation of Nursing Burnout

One of the most significant challenges in nursing that can impact a nurse’s career is burnout. Burnout is characterized by an overwhelming response to physical and/or emotional stressors that lead to feelings of exhaustion, ineffectiveness, distress, and confusion (Henry, 2014). Anxiety and trauma are prevalent in healthcare and can arise from various sources. Nurses are particularly vulnerable to discouragement and ethical dilemmas in healthcare settings (Kiss, 2017). When there is a discrepancy between perceptions and reality, burnout occurs. Factors such as workload, compensation, peer support, and ethical standards at both individual and departmental levels can contribute to this imbalance (Kiss, 2017). Nurses cannot effectively care for their patients if they are experiencing burnout, which can result in medical errors and harm to patients. This condition affects nurses, their peers, their families, and especially their patients. It can also lead to emotional exhaustion and depression, which can negatively impact nurse-patient relationships. Burnout is common in nursing due to the constant stress related to nurses' significant responsibilities and obligations (Jesse et al., 2015).

Three Defining Attributes

Nurse burnout is a comprehensive condition characterized by changes in intensity and energy, leading to emotional fatigue, loss of enthusiasm, and dissatisfaction that can reduce job effectiveness. Emotional exhaustion is marked by low stamina, restlessness, frustration, and powerlessness (Maslach et al., 2016). Mental fatigue can be difficult to resolve due to a lack of resources, inadequate sleep, and diminished encouragement. This persistent exhaustion can cause long-term health issues (Kiss, 2017). A lack of motivation manifests as feelings of inadequacy, inefficiency, and incompetence, leading to low job engagement. This often occurs when nurses strive to meet high standards but feel inadequate if goals are not met (Kiss, 2017). Finally, burnout can manifest as anger, leading to unfeeling, negative attitudes towards others, withdrawal from patient care, and irritability due to feelings of weakness and diminished productivity (Kiss, 2017).

Antecedents and Consequences of the Concept

Job stress is a primary antecedent of burnout in the healthcare field. Job stress involves extreme physical and emotional responses when job demands exceed a worker’s abilities, support, and needs. It affects nurses’ well-being and job performance. Stress triggers the release of stress hormones in the body, leading to significant health concerns. Ironically, healthcare professionals, who are often the most stressed, are also the ones most affected by job stress. Lack of control and high job demands are major contributors to work-related trauma and burnout (Maslach et al., 2016). Excessive work tension leads to fatigue, inefficiency, and skepticism. Nurses who feel they are not achieving their goals can become disheartened and depressed.

Burnout affects various aspects of healthcare, leading to physiological and psychosocial issues, including work frustration, poor care quality, medical errors, and job turnover. Nurses experiencing burnout have difficulty feeling empathetic and compassionate, which impacts their ability to provide high-quality care (Wakefield, 2018). Job dissatisfaction among staff can lead to harmful workplace conflicts, instability, and risks to patient safety. To improve nurse and patient well-being, it is essential to promote supportive workplace practices. Job dissatisfaction can lead to withdrawal from the profession, absenteeism, and decreased job performance (Kiss, 2017).

Model Case

A model case of burnout involves a new graduate nurse starting work in a psychiatric unit. The nurse experiences anxiety due to a lack of trust and comfort in handling psychiatric patients. Emotional exhaustion results from being overwhelmed and tense. To cope, the nurse works twelve-hour shifts, leading to mental fatigue and sleep deprivation. Feeling unable to adapt and progress, the nurse experiences a lack of personal success over time. This leads to disengagement, as the new nurse feels unsupported and unable to build relationships with peers. After six months of increasing workload and unmet expectations, the new graduate experiences burnout and requests a transfer after only a few months on the job.

Theoretical Applications of the Concept

Burnout is significant in nursing due to its widespread occurrence. The Neuman Systems Model (NSM) is a relevant nursing theory that addresses burnout. NSM is a practical framework for achieving quality care, focusing on stressors that affect health and well-being. It provides healthcare workers with strategies to defend against stress (Fawcett et al., 2017). Burnout aligns with NSM as it is a precursor to stress, and limiting stress can prevent burnout. The NSM addresses intrapersonal, interpersonal, and extra-personal stressors. Intrapersonal stressors involve internal emotions, interpersonal stressors involve discrepancies between nurse and patient expectations, and extra-personal stressors involve external circumstances such as lack of resources and administrative support.

Reflection

Burnout among healthcare professionals is a global and prevalent issue. Nurses often experience burnout at some point in their careers. Understanding the concept of burnout helps identify essential issues and aligns with the Neuman Systems Model’s emphasis on resilience to stress. As a future nurse practitioner, preventing burnout is crucial, especially in healthcare settings. This assignment provided insight into my own challenges with burnout, highlighting the importance of addressing emotional exhaustion. For instance, I experience stress when understaffed during shifts, which compromises both nurse and patient safety. Patient safety is the top priority, and understaffing exacerbates stress. Recognizing my experiences with burnout has led me to seek support, exercise, and reflect on my work to manage stress effectively. It is essential to provide the best possible care to patients while also maintaining our physical, mental, and emotional health.

References

Fawcett, J., & Foust, J. (2017). Optimal aging: a Neuman systems model perspective. Nursing Science Quarterly, 30(3), 269-276.

Henry, B. J. (2014). Nursing burnout interventions. Clinical Journal of Oncology Nursing, 18(2), 211–214.

Jesse, M., Abouljoud, M., Hogan, K., & Eshelman, A. (2015). Burnout in transplant nurses. Progress in Transplantation, 25(3), 196-202.

Kiss, T. (2017). Fighting burnout with self-care. Nursing Critical Care, 12(2), 6-9.

Maslach, C., & Leiter, M. (2016). Understanding the burnout experience: recent research and its implications for psychiatry. World Psychiatry, 15(2), 103-111.

Wakefield, E. (2018). Compassion fatigue in the perioperative environment. ACORN: The Journal of Perioperative Nursing in Australia, 31(2), 21–24.