Burnout is a term that is often associated with professionals discharging their services in the helping professions. During the 1970s, the term burnout was first tabled by an eminent psychologist Herbert J. Freudenberg (Shbail, 2018). The concept of burnout describes that any individual working in the helping professional having exposed to long durations of stress associated with work might feel emotionally exhausted, dissatisfied, and discontent with their job. The concept of burnout is widely associated in different contexts. However, any individual who experiences it might witness unprecedented changes in their lives. Nurses in general and new graduate nurses, in particular, are susceptible to experience burnout due to various contributing factors.
Experienced nurses might fight the burnout by taking care of their mental and physical health. However, new graduate nurses, due to the fact they lack experience in fighting with burnout, may find it difficult to deal with the stress associated with their work. New graduate nurses might fall prey to burnout due to excessive physical and emotional stress associated with their environment. More often than not, new graduate nurses might become emotionally exhausted due to continuous exposure to stress associated with their work. Many studies have shown that emotional exhaustion tops the list of the factors associated with burnout in new graduate nurses (Gitto & Trimarchi, 2016).
Sadly, new graduate nurses battling burnout might develop psychosomatic complications such as insomnia and weakness. Moreover, new graduate nurses might suffer emotional consequences of burnout and become anxious and depressed. Additionally, new graduate nurses can become aggressive, isolated, irritated, hostile, apathetic, and cynical due to changes in attitude and behavior as a result of burnout. This paper intends to describe a clinical scenario in which a new graduate nurse can experience burnout. Moreover, a comprehensive literature review will be conducted to analyze the scourge of burnout. Additionally, this paper would analyze the advance practice nursing role to reduce burnout in new graduate nurses. Lastly, this paper will take into consideration the cultural perspective contributing to the problem under discussion. Lastly, this paper will recommend some ways using which the new graduate nurses can easily fight burnout.
Clinical Scenario
The following clinical scenario was witnessed in the healthcare setting in which I work. There was a nurse named Sara. Sara was a newly graduated nurse with full dedication, passion, and positive energy. During the early days of her career, Sara worked energetically and enthusiastically. However, due to unavoidable circumstances, our hospital suffered a significant cut in its budget and resources started to decrease subsequently. The unit in which Sara worked witnessed a decrease in staffing. As a result of this decrease in staffing, the workload on Sara increased. Before budget cuts, Sara had a daily patient load of five patients. However, after the budget cut, Sara’s daily patient load increased from five to ten patients. Due to an increase in workload, Sara struggled a lot. As a result in the increase in workload, Sara could not care equally for every patient she was assigned to. To fend off the consequences of budget cuts, the hospital enacted a policy of mandatory overtime for every staff member to manage the shortage of staff. Soon Sara was working way beyond a regular 12-hour shift every day. As a result of these long shifts, Sara started to feel tired most of the time, a once passionate and dedicated new graduate nurse. Moreover, Sara found it relatively hard to stay focused on the closing hours of her shift. Moreover, the personal life of Sara took a hit as well as days went by without her calling her parents. Furthermore, the social life of Sara saw her never meeting her friends for long periods of time. In this case, Sara is at increased risk of facing burnout. As Sara is young, single, highly talented and educated, and early in her career, the excessive workload and unsupportive work environment lead to her feeling dissatisfied with her job. Ultimately, Sara becomes emotionally, mentally, and physically exhausted. Sadly, Sara became one of the 65% of nurses who are newly graduated and work for shifts longer than 12 hours. However, Sara worked to fight the causes of burnout and become the dedicated and passionate nurse she once was. Sara started to give a lot more attention to her professional and personal lifestyle which was central to prevent and manage work-induced stress effectively (Ndawula, 2016). Moreover, Sara incorporated comprehensive interpersonal relationships, immaculate time management, and self-care into her lifestyle which helped with maintaining physical health. Moreover, Sara integrating proper and healthy diet with sufficient exercise and sleep can fight the physical effects of work-related stress. Another thing that Sara did was she started to self-reflect. The advantage of self-reflection is that it reminded Sara she became a nurse in the first place. It helped Sara to regain all the lost energy and she started to feel connected to the work, staff, patients, and environment as a whole. Sara tried to take sufficient time away and enjoy with close friends. This enabled Sara to restore her social life and catch up with friends and deal with work-related stress more accurately. Sara started to work smarter and took mini breaks frequently to deal with the stresses associated with the workload of being a new graduate nurse. All this combined resulted in Sara finding her passion back which was lost due to burnout and exhaustion. Moreover, Sara started to perform well in the job.
Literature Review
In this section, four studies will be discussed that will analyze the issue under discussion.
Satisfaction a patient is the primary measure of the extent of the relationship between healthcare providers and healthcare users. This satisfaction determines the quality of the care which is delivered to the patients (Ríos-Risquez & García-Izquierdo, 2016). Due to continuous work-related stress, burnout among new graduate nurses is prevalent. Many studies have revealed there is a strong link between stress experienced by a new graduate nurse and patient satisfaction. The first study included in this paper intends to evaluate the link between the satisfaction of patients with emergency services and their view on the burnout that new nursing professionals might experience. The researchers collected data from twenty urban hospitals in the US to evaluate the satisfaction of patients and stress and burnout the new graduate nurses might experience. The researchers have sampled and surveyed all registered and licensed practitioner nurses who were assigned to look after for two units in these twenty hospitals. Of all the nurses working in these twenty hospitals selected for this study, only 86% agreed to complete a questionnaire that had items pertaining to personal attributes and features of the work environment, apart from questions related to burnout. Moreover, 86% of the patients who were admitted in these twenty hospitals agreed to complete a questionnaire (Ríos-Risquez & García-Izquierdo, 2016). The patients provided information related to their satisfaction with nursing care, processes of healthcare delivery, and medical history. The following is the result of the study conducted. The patients admitted in the units which had adequate nurses deployed reported high satisfaction with the healthcare services that were delivered to them. This number is twice as high as the patients admitted in units with an inadequate number of nurses. Therefore, the new graduate nurses reported a lower burnout rate, unlike the nurses that had to care for more patients and increased workload. To conclude this study, it must be noted that a better work environment and conditions reduce rates of burnout in graduate nurses and increase the satisfaction of patients with the care delivered to the patients.
It is a widely agreed view that new graduate nurses are at increased risk of experiencing emotional exhaustion and subsequent burnout when they work for longer durations in unsupportive work environments. Despite the seriousness of this issue, little research has been done to address the burnout in new graduate nurses. The purpose of this study was to analyze, evaluate, and compare the common patterns related to personal development in burnout symptoms in new graduate nurses for three years (Rudman & Gustavsson, 2015). The following is the methodology employed by the researchers of this study. The researchers collected data for more than 1200 nurses. The data of the nurses helped the researchers to ascertain various causes which resulted in the burnout in newly graduated nurses with the first three years after being graduated. The researchers investigated not only the background characteristics but outcomes of education near the end of the tenure of the study. Moreover, the researchers identified that various individual and work-related factors contributed to burnout in new graduate nurses and lead to poor health conditions in the first three years of the first deployment. By analyzing the collected data, researchers were able to identify eight contributing factors that lead to burnout in new graduate nurses. Another thing the researchers identified that seven of these factors changed significantly as time passed. Moreover, during the first three, one out of five nurses reported that they have experienced increased levels of burnout (Rudman & Gustavsson, 2015). Burnout levels in nurses were related to depression and anxiety which made the new graduate nurse leave their job. Moreover, the researchers found out that the newly graduate nurses did not feel adequately prepared for the job. The researchers have concluded that there are eight different factors that lead to burnout in new graduate nurses during the first three years of the first job. Another thing the researchers found out that every second newly graduate nurse said they felt mentally and emotionally exhausted during the first three years of the graduation.
Over time, nurses have experienced bullying in the clinical setting in which they were deployed. The result of the bullying was that the nurses started to feel isolated and felt devalued. Many nurses experienced rudeness, abuse, and humiliation in the clinical setting. Many newly graduate nurses who experienced bullying in the clinical workplace had their health deteriorated as a result of excessive stress taken. The study that is incorporated in this section intended to establish the link between bullying in the workplace and burnout among the new graduate nurses (Laschinger et.al, 2016). The method that was used to complete this study was to analyze and interview around 1400 newly graduate nurses having experience less than three years that served in different capacities in various units of a healthcare setting. The nurses were handed over a questionnaire that contained various questions intended to record exposure to bullying at the workplace. Moreover, the researchers sent each nurse who participated in the study of a coffee voucher to extend their gratitude. Additionally, the researchers had taken approval from the relevant ethics board to carry out the study. The results of the study show a grim picture of the situation that is prevalent in modern-day healthcare setup. Many newly graduate nurses have reported experiencing bullying in their workplaces (Laschinger et.al, 2016). Almost one-third of the nurses who participated in the study were found to have had experience bullying once in their tenures as nurses. These results show that workplace bullying can have detrimental effects on not only nursing but for any profession. The most significant aspect that was related to bullying was that the nurses felt mentally exhausted and thought to leave their jobs. This study concluded that many new graduate nurses have experienced bullying in the healthcare setting once in the first three years of their deployment. The effects of work-related stress induced through bullying had negative health impacts on nurses.
Burnout in the new graduate nurses is an issue of grave importance for the entire healthcare system. Burnout among nurses can be described as the instinctive response to any sort of stress which is related or induced from work. The last study incorporated in this literature review focused on finding a link between the ratio of nurse to patient and subsequent burnout. Apart from establishing a link between nurses to patient ratio, the study intended to find how the psychological, mental, and emotional health of the new graduate nurses was affected. The researchers used a relatively simpler methodology to complete this research. The researchers conducted a qualitative literature review that indicated the link between burnout and nurses to patient ratio (Gutsan et.al, 2018). The literature review was completed to establish the factors, reasons, and implications of burnout among newly graduate nurses due to nurses to patient ratio. The results of the study have revealed that high nurses to patient ration might be a source of burnout among nurses. This burnout among the nurses has serious consequences attached. The nurses who became emotionally fatigued resigned from their jobs and retaining the workforce became a challenge for many healthcare providers. Due to a large ration of turnover in nurses, the quality of care and patient safety was compromised eventually. The researchers concluded that nurses to patient ratio hold significant importance in determining the healthcare outcomes. Any healthcare system in which newly graduated nurses were deployed to look after for a large number of patients that they cannot manage easily resulted in burnout (Gutsan et.al, 2018). This burnout has the potential of making the nurses become emotionally exhausted and think to quit their job. When nurses felt emotional burnout, they leave their jobs. As a result of this turnover, the provision of quality healthcare services to patients was compromised.
Advanced practice nursing role
Advance practices nurses are equipped with advanced healthcare education, have years of knowledge and skills that place them miles ahead of anyone else in the healthcare domain. Advance practice nurses employ skills, knowledge and years of experience in conducting the assessment, evaluation, and implementation of various healthcare programs (Mudallal, Othman & Al Hassan, 2017). Advance practice nursing role is imperative in reducing the burnout among the new graduate nurses. As the advance practice nurses are experienced professionals, they can play an important role in reducing the burnout among the new graduate nurses. The burnout among newly graduated nurses can result in reducing the energy and devoid of motivation they once had. Since newly graduated nurses can drift out of their jobs due to increased workload, the safety of the patient is the first thing that is affected by the lack of nurses. The World Health Organization (WHO), on numerous occasions, has shown concerns regarding the reduction in numbers of healthcare providers due to increased burnout (Mefoh, Ude & Chukwuorji, 2019). Advance practice nurses can play an important role in addressing the burnout in nurses. Advance practice nurses can act to increase the meaning of the work for the new graduate nurses. This act can result in an increase in the self-worth of the new graduate nurse. Another thing which Advance practice nurse can do to address the growing burnout among newly graduated nurses is to express confidence in the performance of nurses (Khamisa et.al, 2016). Moreover, advance practice nurses can provide freedom and autonomy to the new nurses aimed to reduce burnout in any healthcare setting. This would help the newly graduated nurses to be more creative and efficient without having to worry about restrictions. Moreover, the factors contributing to burnout can be controlled when senior members of healthcare help new nurses to attain personal development goals. This act would improve the skills and knowledge of new nurses and they will perform effectively (Akman et.al, 2016).
Cultural perspective and nursing burnout
In order to perform effectively within a healthcare setup, nurses must ensure they are competent in a variety of skills. Of all the areas which require the nurses to be competent, cultural competence is something that holds significant importance in the effective delivery of healthcare services. Having cultural competence ensures that nurses have a diverse knowledge of various cultural components of patients. Since the world has become a global village and people from all around the world have headed towards the US in search of better opportunities, nurses must ensure that they are well aware of the cultural background of patients coming from different socio-economic backgrounds (Lahana et.al, 2017). Nurses must be able to cater to the needs of patients from a variety of culture by providing healthcare service which is culturally competent with the patient. It is imperative for new graduate nurses to be competent with a range of different cultures (Buunk & Schaufeli, 2017). Studies have shown that new graduate nurses having a lack of cultural knowledge about a patient coming from a culture other than theirs resulted in the nurses become depressed, stressed, and anxious. As a result of these problems, new graduate nurses feel burnout and the delivery of quality healthcare services experiences a fall. New nurses might argue that achieving perfect cultural competence is not possible. However, they must know that failing to become culturally competent can result in patients feeling less cared and it can hamper their progress. Therefore, it is imperative for nurses who are newly graduated to become culturally competent and reduce their chances of experiencing burnout.
Summary of the literature of future direction
Working in a healthcare environment is not an easy task. Of all the healthcare staff working relentlessly to effectively deliver healthcare services, nurses hold an important position. Moreover, the role of nurses cannot be understated. The new graduate nurses have an important role to play in the healthcare industry. Due to the stress of the job, nurses can develop numerous health-related complications. These complications might force the nurse to become mentally, emotionally, and physically burnout (Dyrbye et.al, 2017). The concept of burnout describes that any individual working in the helping professional having exposed to long durations of stress associated with work might feel emotionally exhausted, dissatisfied, and discontent with their job. Burnout is an issue of grave concern for the entire health care industry. Sadly, new graduate nurses battling burnout might develop psychosomatic complications such as insomnia and weakness. Moreover, new graduate nurses might suffer emotional consequences of burnout and become anxious and depressed (Hong & Lee, 2016). There are detrimental consequences attached to the burnout which nurses might experience. The job performance of nurses can decline and it is related to increased rates of mortality, greater infection rate, greater turnover, sky-high cost incurred by the patients. Certain changes can be integrated by the nurses into their personal and professional lives. The primary change which the nurses can bring in their personal lives is to adopt a healthy diet and exercise regularly. Another thing that the nurses can do is bring significant changes in their social lives. Nurses must become actively engage with their friends and families. This would help the nurses to feel less stressed about their jobs. Moreover, nurses can develop strong emotional intelligence as a way to fight stress and subsequent burnout. Certainly, by incorporating these recommendations and changes, both experienced and new graduate nurses can battle burnout and its complications (Rushton et.al, 2015).
References
Akman, O., Ozturk, C., Bektas, M., Ayar, D., & Armstrong, M. A. (2016). Job satisfaction and burnout among paediatric nurses. Journal of nursing management, 24(7), 923-933.
Buunk, B. P., & Schaufeli, W. B. (2017). Burnout: A perspective from social comparison theory. In Professional burnout (pp. 52-69). Routledge.
Dyrbye, L. N., Shanafelt, T. D., Sinsky, C. A., Cipriano, P. F., Bhatt, J., Ommaya, A., ... & Meyers, D. (2017). Burnout among health care professionals: a call to explore and address this underrecognized threat to safe, high-quality care. NAM perspectives.
Gitto, L., & Trimarchi, E. (2016). When passion becomes a nightmare: the burnout syndrome in healthcare workers. A case study. Mediterranean Journal of Clinical Psychology, 4(1).
Gutsan, M. S. H. A., Patton, J., Willis, W. K., & PH, C. D. (2018). Burnout syndrome and nurse-to-patient ratio in the workplace.
Hong, E., & Lee, Y. S. (2016). The mediating effect of emotional intelligence between emotional labour, job stress, burnout and nurses' turnover intention. International journal of nursing practice, 22(6), 625-632.
Khamisa, N., Peltzer, K., Ilic, D., & Oldenburg, B. (2016). Work related stress, burnout, job satisfaction and general health of nurses: A follow‐up study. International journal of nursing practice, 22(6), 538-545.
Lahana, E., Papadopoulou, K., Roumeliotou, O., Tsounis, A., Sarafis, P., & Niakas, D. (2017). Burnout among nurses working in social welfare centers for the disabled. BMC nursing, 16(1), 15.
Laschinger, H. K. S., Grau, A. L., Finegan, J., & Wilk, P. (2016). New graduate nurses’ experiences of bullying and burnout in hospital settings. Journal of advanced nursing, 66(12), 2732-2742.
Mefoh, P. C., Ude, E. N., & Chukwuorji, J. C. (2019). Age and burnout syndrome in nursing professionals: moderating role of emotion-focused coping. Psychology, health & medicine, 24(1), 101-107.
Mudallal, R. H., Othman, W. A. M., & Al Hassan, N. F. (2017). Nurses’ burnout: the influence of leader empowering behaviors, work conditions, and demographic traits. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 54, 0046958017724944.
Ndawula, M. (2016). BURNOUT AMONG STAFF NURSES: Examining the causes, coping strategies and prevention.
Ríos-Risquez, M. I., & García-Izquierdo, M. (2016). Patient satisfaction, stress and burnout in nursing personnel in emergency departments: A cross-sectional study. International journal of nursing studies, 59, 60-67.
Rudman, A., & Gustavsson, J. P. (2015). Early-career burnout among new graduate nurses: A prospective observational study of intra-individual change trajectories. International journal of nursing studies, 48(3), 292-306.
Rushton, C. H., Batcheller, J., Schroeder, K., & Donohue, P. (2015). Burnout and resilience among nurses practicing in high-intensity settings. American Journal of Critical Care, 24(5), 412-420.
Shbail, M. O. A. (2018). The Associations of Internal Audit Quality with Job Burnout and Job Satisfaction Based on Theory of Reasoned Action. International Journal of Academic Research in Accounting, Finance and Management Sciences, 8(2), 208-217.
