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BURNOUT AMONG ER NURSES

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on 29 April 2015

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Transcript of BURNOUT AMONG ER NURSES

...or "industry versus rest"
the psychological combination of emotional exhaustion, cynicism, and inefficiency (Maslach's theory of job-related burnout)
25 sources utilized; the issue is evident!
emphasis on risk identification and problem-solving
“Don’t worry about anything; instead, pray about everything. Tell God what you need, and thank him for all he has done. Then you will experience God’s peace, which exceeds anything we can understand. His peace will guard your hearts and minds as you live in Christ Jesus”
BIBLICAL APPLICATION: Ambition vs. Stewardship
LITERATURE REVIEW
BURNOUT DEFINED:
National Burnout Rates
ER Burnout Rates
experienced after dealing with long-term emotional and interpersonal stressors in the work environment
often exhibited among nurses who work in high-stress environments
results in apathy, job dissatisfaction, role strain, lateral violence and bullying, nurse turnover and nurse shortage
a negative cycle
$1.25
Wednesday, April 29, 2015
Vol MMXV, No. 911
The "Issues" Paper
Nursing Shortages Nationwide
Baby Boomers Retire
Intrapersonal
Poor personal coping methods
Lack of autonomy
FACTORS CONTRIBUTING TO JOB DISSATISFACTION AND BURNOUT
The
Bureau of Labor Statistics
predict 526,800 vacant nursing positions in the United States by 2022 (BLS, 2014)
Is this good news for new grad nurses, or a herald of future stress in hospitals?
STRESS AND BURNOUT AMONG ER NURSES
Objectives
Examine burnout rates among nurses both nationally and in the emergency department (ED) specifically

Learn the signs and symptoms of burnout

Identify intervention measures to reduce burnout on extrapersonal, interpersonal, and intrapersonal levels
Burnout Contributes to Nursing Shortages
Consider the stress of being hired into an understaffed nursing unit as a new grad RN:







Burnout has been linked to
depression
,
anxiety
, and
poor physical health
among nurses, as well as
poor patient outcomes
and increased nurse turnover in hospitals (Peterson et al., 2008; Aiken et al, 1994)

For every nurse lost, hospitals must pay between
$22,000
to
$64,000
to recruit, hire, and train a replacement nurse (Jones & Gates, 2007)
shortage
burnout
turnover
by Sarah Wittenberg
Questions for Discussion:
How would you define "burnout"?
..or what words or phrases do you associate with this term?
Where have you seen this in practice?
..a particular setting? a personal experience with a nurse?
Outline of Content
- Significance to practice
- Objectives
- Discussion
- Recommendations
- Biblical Leadership Application
- References
What can hospitals do to minimize stress for their nurses?


What can WE do as nurse leaders to help?
(Maslach, Schaufeli, & Leiter, 2001)
One study found that 34% of nurses nationally report burnout and job dissatisfaction
In the same study examining 5 different countries, the U.S. was highest for emotional exhaustion and burnout (41%)
Most at-risk group: Americans under 30 years planned to leave their jobs within the next year
Up to 13% of new graduate RNs leave their positions within the first year because of negative work conditions
(Aiken et al., 2001; Kovner et al., 2007)
Research emphasizes burnout is heavily associated with workplace 'flow' or pace
Few current studies that were large-scale enough to be representative of all emergency nurses
All studies, however, suggest ED nurses are at a high risk for burnout, and are at greater risk than nurses from other departments
(Hooper et al., 2010; Dominguez-Gomez & Rutledge, 2009; Hunsaker, Chen, Maughan, & Heaston, 2015)
(Hayes, Bonner, & Pryor, 2010)
Interpersonal
Negative co-worker interactions
Negative patient/family interactions
Lateral violence
Negative workplace atmosphere
Extrapersonal
Organizational policies
Poor unit structure
Busy workflow
Inadequate resources
Few educational opportunities
Philippians 4:6-7 (New Living Translation)
Proverbs 13:4 vs. Psalm 127:2
RECOMMENDATIONS
MASLOW'S HIERARCHY OF NEEDS
Extrapersonal
Intrapersonal
Interpersonal
Assurance of adequate salary
Sufficient orientation to the unit
Adequate meal breaks during work
Fair and satisfactory working hours
Paid time off or vacation time
Physical safety within the workplace
Resources for the employees that include health, education, and stress relief
Quality and safety improvement
(Brunges, & Foley-Brinze, 2014)
Education
When healthcare organizations invest in nursing human capital, they demonstrate to the nurses that they are valued for the work and knowledge they provide (Covell & Sidani, 2013)
Physiological, Safety:
Belonging, Esteem, Self-Actualization:
Mentorship associated with decreased bullying (Frederick, 2014)
Mentoring program
Orientation is a key phase!
Community-building activities
Community support promotes positive coping skills and decreases job dissatisfaction (Breen & Sweeney, 2013)
Standardized communication methods (SBAR)
Appropriate conflict management - discretion and professionalism should be expected!
Nurse leaders play a significant role in shaping the culture of a workplace by influencing the beliefs of individual nurses through one-on-one relationships (Cumming et al. 2010; Laschinger, Wong, & Grau, 2013)
Authentic, transformational and relational leadership is key to developing happy and committed employees (Cumming et al. 2010)
Strategy: empowerment!!
Routine one-on-one meetings with nurses/staff
Promote positive coping methods
Be a living example of love, patience, and compassion
REFERENCES
Aiken, L. H., Clarke, S. P., Sloane, D. M., Sochalski, J. A., Busse, R., Clarke, H., ... & Shamian,
J. (2001). Nurses’ reports on hospital care in five countries. Health affairs, 20(3), 43-53.

Aiken, L. H., Clarke, S. P., Sloane, D. M., Sochalski, J., & Silber, J. H. (2002). Hospital nurse
staffing and patient mortality, nurse burnout, and job dissatisfaction. Jama, 288(16), 1987-1993.

Aiken L.H., Smith H.L. & Lake E.T. (1994) Lower Medicare mortality among a set of hospitals
known for good nursing care. Medical Care 32(8), 771–787.

American Nurses Association. (2014). How to Cope with Stress on the Job. Nursing World.
Retrieved April 12, 2015.

Breen, M., & Sweeney, J. (2013). BURNOUT: THE EXPERIENCES OF NURSES WHO
WORK IN INNER CITY AREAS. Mental Health Practice, 17(2), 12-20.

Bureau of Labor Statistic (2014). Occupational Outlook Handbook. Retrieved April 9, 2015,
from http://www.bls.gov/ooh/healthcare/registered-nurses.htm.

Brunges, M., & Foley-Brinza, C. (2014). Projects for Increasing Job Satisfaction and Creating a
Healthy Work Environment. AORN Journal, 100(6), 670-681. doi:10.1016/j.aorn.2014.01.029.

Cottingham, S., DiBARTOLO, M. C., Battistoni, S., & Brown, T. (2011). PARTNERS IN
NURSING: A Mentoring Initiative to Enhance Nurse Retention. Nursing Education Perspectives, 32(4), 250-255. doi:10.5480/1536-5026-32.4.250.

Covell, C. L., & Sidani, S. (2013). Nursing Intellectual Capital Theory: Implications
for Research and Practice. The Online Journal of Issues in Nursing. Retrieved April 9, 2015.

Dominguez-Gomez, E., & Rutledge, D. N. (2009). Prevalence of secondary traumatic stress
among emergency nurses. Journal of Emergency Nursing, 35(3), 199–204.

Hayes, B., Bonner, A. N. N., & Pryor, J. (2010). Factors contributing to nurse job satisfaction in
the acute hospital setting: a review of recent literature. Journal of Nursing Management, 18(7), 804-814.

Hooper, C., Craig, J., Janvrin, D. R., Wetsel, M. A., & Reimels, E. (2010). Compassion
satisfaction, burnout, and compassion fatigue among emergency nurses compared with nurses in other selected inpatient specialties. Journal of Emergency Nursing, 36(5), 420-427.

Hunsaker, S., Chen, H., Maughan, D., & Heaston, S. (2015). Factors That Influence the
Development of Compassion Fatigue, Burnout, and Compassion Satisfaction in Emergency Department Nurses. Journal Of Nursing Scholarship, 47(2), 186-194. doi:10.1111/jnu.12122

Frederick, D. (2014). Bullying, Mentoring, and Patient Care. AORN Journal, 99(5), 587-593.
doi:10.1016/j.aorn.2013.10.023

Jones, C., Gates, M., (2007) "The Costs and Benefits of Nurse Turnover: A Business Case for
Nurse Retention" OJIN: The Online Journal of Issues in Nursing. Vol. 12 No. 3, Manuscript 4.

Kanter R.M. (1993). Men and Women of the Corporation, 2nd edn. Basic Books, New
York, NY.

Koltko-Rivera, M. E. (2006). Rediscovering the later version of Maslow's hierarchy of needs:
Self-transcendence and opportunities for theory, research, and unification. Review of general psychology, 10(4), 302.

Kovner C.T., Brewer C.S., Fairchild S. et al. (2007). Newly licensed RNs_ characteristics, work
attitudes, and intentions to work. American Journal of Nursing 107(9), 58–70.

Laschinger H.K.S., & Finegan J. (2005) Using empowerment to build trust and respect in the
workplace: A strategy for addressing the nursing shortage. Nursing Economics 23(1), 6–13.

Laschinger, H. S., Wong, C. A., & Grau, A. L. (2013). Authentic leadership, empowerment and
burnout: a comparison in new graduates and experienced nurses. Journal Of Nursing Management, 21(3), 541-552. doi:10.1111/j.1365-2834.2012.01375.x

Nevidjon, B., & Erickson, J. I. (2000). The nursing shortage: solutions for the short and long
term. Online Journal of Issues in Nursing, 6(1), 4-4.

Maslach, C., Schaufeli, W. B., & Leiter, M. P. (2001). Job burnout. Annual review of
psychology, 52(1), 397-422.

Peterson U., Demerouti E., Bergstrom G. et al. (2008) Burnout and physical and mental health
among Swedish healthcare workers. Journal of Advanced Nursing 62 (1), 84–95

Stewart W., & Terry, L. (2014). Reducing burnout in nurses and care workers in secure settings.
Nursing Standard, 28(34), 37-45.

Watts, J., Robertson, N., Winter, R., & Leeson, D. (2013). Evaluation of organisational culture
and nurse burnout. Nursing Management - UK, 20(6), 24-29.
Love, Belonging, Esteem:
Esteem, Self-Actualization:
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