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In this article, the symptoms and some ways to combat burnout in the work environment were discussed. Nurses are the people who will take care of the patient and have the most contact with the patient in a medical facility. They take on a lot of responsibility and problems with staffing and a toxic environment could cause a bad turn of events.

This specific article was set up in a chronological order. It had started off by defining what a burnout is considered by the WHO. Then it moved onto nursing students who plan on becoming nurses before officially moving into current nurses and their symptoms while experiencing a burnout. Once these were listed, it went into causes of these burnouts. One which we know of the shortage and the toll that takes on current nurses. All the causes had brief descriptions of why. After this, they included what nurses are at higher risks for once they do experience burnout. Finally, the article listed three main ways one could avoid burnout. But of course, everyone has different ways of combatting stress, so these methods vary.

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Nurse Burnout: Symptoms, Causes and Recovery | University of Phoenix

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Burnout is a common issue among nurses due to the long hours, demanding schedules, and stress that come with the profession. Learn how to prevent it.

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After reading this article, I have reason to believe that this is a trade source. I was stuck between popular or trade but since this url does end in an "edu", I decided to choose trade. 2 other reasons why I stuck to trade was that in the MSU criteria in identifying sources section stated that in a trade source, the article is usually reviewed by the general editorial staff. For this article, it stated that it was vetted by the Universitiy's editorial advisory committee. Second, there was rarely any ads and the ones that were included, were related towards the university and I had also seen this is the trade criteria.

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I enjoyed reading this article as it was pretty easy to read. It was in chronological order, so it was easy to follow. I do think that this will be a source I will be using for my research. It covered the symptoms and causes which will be helpful when I talk about what burnout is and why is happens in the field. I had an idea of why burnout happens, and this became my evidence. The only question this sparked for me was how burnout causes changes depending on the facility or position a nurse takes on. Such as the difference in an ER nurse compared to a Hospice nurse or nurse in a pediatric facility.

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This article was written in 2021 when we were still experiencing the Covid-19 pandemic. The main purpose of this article was to shed light on how the care for patients had changed since the corona virus pandemic hit. The news group had added a story about a girl's grandfather that passed away due to non-proper investigation if what the grandfather could swallow or not due to frequent swelling of the throat in corona patients. After added this story, they had mentioned that the care patients were receiving had declined because many of these facilities were understaffed and the nurses had to take on a large number of patients. This caused lower patient satisfaction as there was a long wait time. In the effort to combat this problem they tried recruiting new nurses but because of the # of patients that were being admitted, the training time was also rarely ever there and this cause hostility in the work environment. The writers kept on piling reasons for why nurses were losing satisfaction in their career field. They felt as though they had lost their reason for sticking to this field and it was all due to the increase of patients and how high their stress levels were due to COVID 19. Towards the end they offered some solutions such as allowing staff to have control over some of the practices that would ease time between patients. Other were the basics such a prioritizing themselves and limiting the patients they took on

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The desperate and frantic pace of hospital work in 2020 in New York, the epicenter of the U.S. pandemic at the time, was more chaotic than anything intensive care nurse Matthew Crecelius had ever seen. "It was like watching a bomb go off in slow motion," he says.

He was caring for double the usual number of critically ill patients and navigating hospital halls that looked more like construction zones, with giant fans and plastic tubing blowing a deafening level of extra ventilation. He couldn't hear his patients, or see them through the giant wooden doors of the negative pressure chambers.

"You shout out to somebody, 'Hey, can you check on my other people?' " he says. " 'I can't even see a monitor; I don't know how they're doing.' "

Once, while Crecelius tended to one COVID-19 patient, another ripped off his oxygen mask, triggering a heart attack. Alarms blared. Crecelius rushed to the room, swathing himself in a new gown, to try to revive the man -- who died clutching a photo of his daughter. As other nurses rushed in to help, other unattended patients started to crash.

Crecelius says he can recall numerous moments like this one, when the crush of work and burnout among health care staff had a direct impact on patient care.

"That plays out again and again, day by day, at many hospitals, and in my opinion, I think it's getting worse," says Crecelius, a traveling contract nurse who has worked in a dozen hospitals since the pandemic began.

Many health care workers surveyed say they feel burnt out and that is impacting patient care. The prolonged battle against COVID-19 has left many doctors, nurses, medical assistants, respiratory therapists and others on the front lines of care exhausted and overwhelmed, fueling greater levels of burnout that were already high. The advent of vaccines against the coronavirussparked hope of a return to normal - only to be dashed by the latest surge of cases, driven primarily by people who aren't vaccinated.

Medicine is a team sport. ... How many clinicians need to be experiencing burnout until we see an effect on quality?

Burnout is a common term many associate with sheer exhaustion. But the World Health Organization says it's also characterized by greater cynicism and reduced effectiveness at work. It was a huge problem in health care long before the pandemic. But now the short staffing and the crushing and unpredictable workload is contributing to epidemic levels of burnout.

"It's not good for their mental health; it's not good for the work environment. There's increased chance for mistakes, medication errors," says Ernest Grant, a specialist in burn care andpresident of the American Nurses Association. Many fellow nurses he talks to say they're at the end of their rope, which Grant says presents a hazard for any patient needing urgent care right now. "There is no health without nurses," he says.

Caregivers under extreme stress

But just how much burnout affects patient care is very hard to gauge. Multiple studies have linked burnout to lower quality of care. But many of those studies rely mostly on subjective measures, such as patient surveys and self-reporting by nurses and doctors. So drawing a cause-and-effect connection isn't easy.

What happened to Carolyn Dewa in California illustrates why.

After her father was hospitalized in April with cancer, Dewa had a hard time reaching his physicians. Pandemic-related restrictions at the hospital limited when family could visit, and the sheer volume of patients left the staff no time to call the family with updates or to explain treatments.

At one point, doctors treating Dewa's father halted his anti-stroke medication, thinking his throat might be too constricted to swallow the pills. "No one asked me," says Dewa, who had been taking care of her father before the hospitalization and knew he was still able to eat and swallow.

As doctors rushed between patients, she says, they were relying more than usual on numbers and charts to make decisions about how to care for each person.

A short time later, her father died of a stroke.

A painful irony that only adds to Dewa's grief: As part of her work as a professor at the University of California, Davis, she studies the effect of burnout on medical care. "I know what good care is supposed to look like," she says.

Speaking from a personal perspective, Dewa adds, she does feel burnout cost months of her beloved dad's life. But she also recognizes the extreme stress his caregivers were under. It would be very hard, she says, to pinpoint objectively how much that burnout contributed to his death.

"Medicine is a team sport," Dewa says. "So can you attribute it to one clinician? How many clinicians need to be experiencing burnout until we see an effect on quality?"

Not enough staff, no empty beds

Clearly, one huge problem is a shrinking field of seasoned professionals in medicine. Since the pandemic's start, some health care workers have retired early and many say they're considering leaving the field.

Crecelius, the traveling ICU nurse, says that increasing reliance on less-experienced health workers can hurt patients. At the small Michigan hospital where he works now, he recently discovered that a nurse on a previous shift had inadvertently put a heart attack patient on the wrong medication.

It's really a game of dominoes where the doctor is just emotionally devastated because they can't fix it.

"She's a newer nurse and doesn't know this is completely inappropriate. Had someone more experienced been here, we would have been able to catch that," he says.

Crecelius says he used to think of such incidents as teaching moments. These days, he has no time or energy to mentor. He just complains to his colleagues, about his colleagues.

That shortness of time, staff and fuses can fuel still more burnout.

Recently in Indianapolis, for example, a combination of the latest surge in COVID-19 cases and a dire shortage of staff meant all the acute-care beds across the region were full. Lindsay Moore-Ostby, a family doctor in the city and member of the advocacy group Physicians for Patient Protection, says one doctor dealing with that crisis tried to transfer a patient, personally calling every hospital within several states - around 40 hospitals - she recalls.

This doctor was "trying desperately to find a bed for a patient who needed ICU care," Moore-Ostby says. At that point, the doctor told her: " 'Now I'm spending time trying to make this transfer happen - so, what if I can't provide the care I need to the other patients who need me?' "

"It's really a game of dominoes," adds Moore-Ostby, "where the doctor is just emotionally devastated because they can't fix it."

A few months into the pandemic, Moore-Ostby started her own concierge practice, cutting backon her roster of patients. She did so, she says, primarily because having no time to talk to patients robbed her of what had led her to the profession in the first place.

"That little bit of time connecting with the patients - that's what they like, that's what they need and deserve," she says. "And it's what I love about medicine."

Solutions are in the details

As the problem of burnout multiplies, some health care systems are trying to find solutions - discovering they often are found in the small details of the work.

For much of this summer, Tampa emergency doctor Damian Caraballo couldn't staunch the flow of unvaccinated COVID-19 patients coming in. Nor could he stop the stampede of co-workers - nurses, EMTs, and lab techs - who kept leaving, making the pace of work more frantic for those who remained.

"Even things as simple as registration; we're short registration people, and that puts a delay on everything," Caraballo says. The average waiting time in his ER ballooned to over 10 hours. "So it has a downhill effect."

"People keep saying, 'What is the one thing we can do?' There is no one solution. There are many.

On balance, the pandemic has made all the normal bureaucratic hassles of the medical system that much more grating, Caraballo says. But he can also point to recent changes that have made a difference: His hospital started allowing remote monitoring of some COVID-19 patients.

"I've been able to send people home" if they have sufficient internet connectivity, says Caraballo, who is a member of patient-advocacy group Physicians for Patient Protection. Florida also recently relaxed rules about where patients could receive IV infusions of monoclonal antibodies to treat COVID-19, a move that also eased Caraballo's patient load. "All those things would take stress off the hospital because we wouldn't have to admit these patients."

Certainly, chronic short-staffing and overwork are huge factors intensifying burnout. But better management can also help alleviate it, even under extreme conditions, says Christina Maslach, a psychologist at the University of California, Berkeley, whose Maslach Burnout Inventory is the basis of the World Health Organization's definition of the workplace syndrome.

"We have to get past this notion that the job is what it is and you can't fix it, you can't change it, you just have to deal with it no matter what," Maslach says.

Often it is a collection of irritants at work that make people feel undervalued, disregarded and eventually burnt out, she says: "Little stuff. What are the chronic pebbles in your shoe?"

She says the fixes, therefore, are often small and targeted.

One of the most common complaints health care workers talk about, Maslach says, is a perfect example: not having a functioning copier.

That might seem minor, she says. But what makes the broken Xerox so toxic is that it taps into a simmering rage that health care staff universally bemoan: The byzantine paperwork and insurance forms that suck up their after-hours and weekends. So having to hunt down a copier that isn't out of ink or jammed doesn't just make the patient backlog worse, it ignites an existing fury within.

Maslach says she's seen huge morale boosts just from hospital management buying a new copier. In addition to making the work faster, "it gives people the sense they are being listened to, that they're being taken seriously," she says.

And she says combating burnout means identifying and tackling these kinds of problems that plague the workplace.

"People keep saying, 'What is the one thing we can do?' " she says. "There is no one solution. There are many."

Implementing staff ideas for fixes

Often the best suggestions come from those who do the work.

Massachusetts General Hospital realized that early in the pandemic.

As the nation's supply of rubber gloves ran critically low, a triage nurse came up with an idea for a plexiglass wall at a patient's bedside. It had arm holes cut into it, where a set of sleeve-like rubber gloves could be attached. That way, caregivers could slide their arms through and adjust a patient's oxygen line or check a pulse - it was quicker and safer and didn't require a new pair of gloves.

"I thought it was a great idea, so we implemented it very quickly," says Ali Raja, executive vice president of emergency medicine at Mass General. "And the triage staff absolutely loved it."

One of the things they loved about it, Raja says, is that adopting staff ideas gave them a sense of agency over their work lives. "Implementing as many ideas as possible - especially if they're not very expensive - can definitely not only acknowledge the staff's expertise and what they're going through, but quite honestly can give you some really good solutions that the leadership just won't have thought of, because they don't have boots on the ground."

He says staff came up with other ideas: to set up a COVID triage unit outdoors in the ambulance bay and to give iPads to patients, so they could more readily communicate with staff, who then didn't have to suit up in personal protective equipment.

Another critical way of fighting burnout is addressing the mental health challenges that come with it. Officially or unofficially, many hospitals and workers talked about the importance of camaraderie.

Some hospitals converted waiting rooms left vacant because of visiting restrictions, into staff lounges or to be used for peer counseling. Talking about the difficulties of managing work and life sometimes led to staff volunteering to cover for one another in family emergencies.

"I've been asking my friends for help when I've needed it," says Raja, and his co-workers urged him to seek therapy for the first time. "That's not something I would've been willing to do, but the fact is, so many of my colleagues have acknowledged that same burnout and told me how much that helped."

ER doc Damian Caraballo says he encourages the same at his hospital in Tampa: "Offer moral support for them. In the short term, I think that's the best we can do."

For the most part, there are not too many quick ways to solve burnout, he says. It doesn't help knowing the crush of work these days is largely preventable; two-thirds of patients he sees are people with COVID-19 who didn't get vaccinated - even though they could have - often young people. That fact, combined with staff shortages, " it just creates this really tough environment that makes burnout even worse," Caraballo says.

Losing passion for the field

The worst part, say health care workers like traveling nurse Crecelius, is that burnout is robbing them of their sense of purpose - making it harder to care about the work itself.

"Last year this time, I had a greater sense of 'This is kind of my duty,' " says Crecelius, who says he's always had an instinct to run toward disaster - wherever help is most needed. While working in the hotspots during the early months of the pandemic, he says, he told himself: " 'I'm able, I'm young; I can make a difference. Let's go and see if we can put this fire out.' "

In those days, he donned a kind of emotional armor, he says - muscling through shifts during which he lost patient after patient, then prepared them for the morgue.

Then, on a road trip this summer in an RV he built with his wife, Crecelius was standing in line at a grocery store, waiting to buy bananas and yogurt, when he glanced at a tabloid with a cover story about the pandemic.

"And it had a picture of someone loading zipped-up bodies onto a truck," he remembers. "I lost it."

He trembled as he looked at the picture, flooded with memories of volunteering to load bodies into the morgue. He thought of the families he'd helped say goodbye, holding a phone to the ear of his patient.

The work feels different to him now, Crecelius says. Though he's a fifth-generation nurse, he is looking to switch careers.

"Now that there is a vaccine, people aren't getting it," he says. Nursing has changed for him. "I'm not interested anymore."

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Health workers know what good care is. Pandemic burnout is getting in the way

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The desperate and frantic pace of hospital work in 2020 in New York, the epicenter of the U.S. pandemic at the time, was more chaotic than anything intensive care nurse Matthew Crecelius had ever seen. "It was like watching a bomb go off in slow motion," he says.

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For this article, I believe that it is a popular source. For one, it is written by a news station. This was the main identifier. Another reason would be the constant advertisements that appeared as I read the article. Both of these reasons were solidified by checking MSU's identifiers between popular, trade and scholarly sources.

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I think reading this source was helpful as I did want to include the covid 19 pandemic into my research. I believe this was on of the biggest contributors to why there is a demand for nurses. And since covid was a global pandemic, it was a big issue that would have added a large amount of stress on nurse and any medical worker. Since it was a popular source, it was easy to read as well as entertaining since it was meant for a general audience.

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"Nurses' Burnout - Working conditions..."

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"Nurses' Burnout - Working conditions..."

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As I skimmed through the source, I was able to see that there was research conducted in order to find what caused Jordanian nurses' burnout. Since this is a scholarly source, reading it was a bit difficult but I was able to identify three main causes for the burnout. They were the poor workinhg conditions, unsupportive leaders as well as outside social and personal factors. All of this data was collected from different possible factors that affected this. Some of these included the type of hospital they work at, their at home life and the type of shifts they took on. Having considered all these outside factors had allowed their research to become more solid.

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Abstract

Nurse burnout is a widespread phenomenon characterized by a reduction in nurses' energy that manifests in emotional exhaustion, lack of motivation, and feelings of frustration and may lead to reductions in work efficacy. This study was conducted to assess the level of burnout among Jordanian nurses and to investigate the influence of leader empowering behaviors (LEBs) on nurses' feelings of burnout in an endeavor to improve nursing work outcomes. A cross-sectional and correlational design was used. Leader Empowering Behaviors Scale and the Maslach Burnout Inventory (MBI) were employed to collect data from 407 registered nurses, recruited from 11 hospitals in Jordan. The Jordanian nurses exhibited high levels of burnout as demonstrated by their high scores for Emotional Exhaustion (EE) and Depersonalization (DP) and moderate scores for Personal Accomplishment (PA). Factors related to work conditions, nurses' demographic traits, and LEBs were significantly correlated with the burnout categories. A stepwise regression model-exposed 4 factors predicted EE: hospital type, nurses' work shift, providing autonomy, and fostering participation in decision making. Gender, fostering participation in decision making, and department type were responsible for 5.9% of the DP variance, whereas facilitating goal attainment and nursing experience accounted for 8.3% of the PA variance. This study highlights the importance of the role of nurse leaders in improving work conditions and empowering and motivating nurses to decrease nurses' feelings of burnout, reduce turnover rates, and improve the quality of nursing care.

Keywords: burnout, cross-sectional study, decision making, demography, Jordan, leader empowering behaviors, leadership, work conditions

Introduction

The shortage of health care providers is a major concern worldwide. A 2006 World Health Organization (WHO) report addressed the issue of the health care provider shortage, particularly the shortage of nurses, and how it will interfere with national and international efforts to enhance the health and well-being of the global population. The nursing profession in Jordan, as in other countries, is facing an increase in the annual turnover rate among Jordanian nurses as a result of labor migration, the low number of females selecting a nursing career, and unattractive work conditions, which has led to a shortage of skilled and experienced nurses and a young nursing workforce. This nursing shortage has been associated with both work and personal conditions, such as unrealistic job expectations, poor work conditions, work demands that exceed resources, poor collegial relationships, increased work hazards, and poor autonomy and control over practice. In addition to shortage, health care sector in Jordan has special situation of massive increase in demand on health care services with ineffective supply of resources-as a result of Syrian crisis (around 25% of present Jordanian population are Syrians' refugees). This has strengthened nurses' feelings of dissatisfaction and burnout. Abundant studies have documented the negative impact of burnout. Burnout lowers nurses' quality of life, performance level, and organizational commitment and increases their intention to leave the job. As well, burnout increases turnover rates and negatively affects the quality of nursing care. Thus, it is important to assess burnout levels among Jordanian nurses specially with the situation of lack of studies in this field in Jordan.

Meanwhile, organizational characteristics and leader behaviors-that empower nurses to use their knowledge, behaviors, and skills to control their work-can improve organizational commitment, job satisfaction, and quality of care; increase trust in management; and reduce the level of nurse burnout. Structural empowerment was found to be important for both nurses' job satisfaction and quality of patient care as mediated by professional practice environment characteristics. In addition, both structural and psychological empowerments were found to be important for decreasing burnout and subsequently increasing intent to stay. Empowering leadership style (leading by example, informing, and showing concern with team) reduces nurses' feelings of emotional exhaustion and depersonalization through the mediation of trust in the leader and organization.

Indeed, leadership is considered a key factor in creating workplace empowerment and a positive work environment.

Previous studies have revealed that various personal and work-related variables are associated with nurses' feelings of burnout. Recently, head nurses have been required to serve as leaders rather than simply managing nursing functions; they are tasked with creating positive change in the work environment and motivating and empowering nurses to achieve the best outcomes for clients, employees, and the organization. Thus, leaders' empowering behaviors are logically an important element in creating a professional practice environment, decreasing nurses' burnout, and improving the quality of nursing care. Despite this, few studies have discussed these variables in Jordan. The aims of this study were thus as follows: first, to assess the level of burnout among Jordanian nurses and, second, to examine the influence of leader empowering behaviors (LEBs) on nurses' feelings of burnout, while controlling variables related to work conditions and nurses' demographics to better understand the importance of nurse leaders' role in mitigating the impact of burnout and consequently reducing turnover rates.

Leader Empowering Behaviors

Power generally reflects the ability to control or influence others' behaviors and attitudes. In a work environment, power is the ability to attain, organize, and control resources, information, and support to achieve organizational goals. The term workplace empowerment refers to employees' ability to access the resources, information, and support needed to perform their work and to gain the opportunity to learn and develop. Empowerment can be achieved in the work environment through LEBs. Four categories of LEBs were developed by Conger and Kanungo in 1988, and in 1994, Hui added another category (Providing autonomy and freedom from bureaucratic restrictions) and provided a conceptual definition for each category:

Enhancing the meaningfulness of work: leader behaviors that infuse employees' work with purpose and give meaning to their contributions, thereby increasing employees' sense of worth and motivating them.

Fostering opportunity to participate in decision making: leader behaviors that allow employees to express their opinions and share in decisions related to their work.

Expressing confidence in high performance: leader behaviors that demonstrate confidence in employees' abilities to fulfill expectations of high performance and that recognize employees' accomplishments.

Facilitating the attainment of organizational goals: leader behaviors that improve employees' skills and knowledge and provide required resources for effective performance.

Providing autonomy and freedom from bureaucratic restrictions: leader behaviors that minimize the constrains of rules, restrictions, and commands to allow efficiency and creativity.

Hui found that LEBs have both direct and indirect influences on employees' performance and that they significantly influence workplace empowerment. In nursing, LEBs are positively associated with nurses' feelings of empowerment in acute care settings; in addition, both LEBs and workplace empowerment are effective in decreasing workplace tension and improving work effectiveness. Moreover, Greco et al found that LEBs have an indirect influence on emotional exhaustion via the mediation of structural empowerment and the areas of work life (workload, control, reward, community, fairness, and values).

Burnout

Burnout is a common psychological phenomenon among nurses. It is characterized by a decline in physical, emotional, and psychological energy resulting from work-related stress that leads to cynicism toward clients and colleagues and feelings of low self-efficacy. Burnout may arise because of work overload; a lack of resources, control, and justice; value conflicts; and the absence of a sense of community. Burnout includes 3 key aspects:

Emotional Exhaustion (EE): the state of being physically and emotionally exhausted by work stress, which is characterized by low energy, fatigue, depression, hopelessness, and helplessness.

Depersonalization (DP): the interpersonal aspect of burnout that manifests in unfeeling, negative behaviors toward others, and detachment from caring and instructions.

Low Personal Accomplishment (PA): the state of negatively evaluating ones' self as being incompetent, unsuccessful, and inadequate; consequently, employees exhibit low levels of contribution to their work.

In fact, burnout is a costly problem for both organizations and employees because manifestations of burnout-including reductions in physical and psychological energy, insomnia, headache, fatigue, and depression-lead to an increase in absenteeism and turnover rates and consequently have negative effects on the quality of care. Thus, nurse burnout has been studied widely. Abundant studies have examined the influence of different variables on burnout as part of efforts directed to reducing this phenomenon. Lower levels of burnout are associated with professional practice environment characteristics, social support, and structural and psychological empowerment. High levels of burnout are linked to work overload, job dissatisfaction, and turnover. Some demographic characteristics are associated with high levels of burnout: low education levels, night-shift work, and male gender with married marital status.

Materials and Methods

Design

A cross-sectional, descriptive, correlational design was used to explore the influence of head nurses' empowering behaviors on nurse burnout.

Sample and Setting

The sample size was estimated using statistical power procedures. The researcher assumed relatively high power (0.80) to reflect higher precision, small effect size (0.03) with alpha (0.05). The estimation was based on the F test: Multiple Regression - omnibus (deviation of R ² from zero), fixed model through specific software G*Power 3.1.6 for Windows. The estimated sample size was 364 participants.

The data for this study were collected from nurses employed at different teaching, private, and public-Ministry of Health (MOH)-hospitals in Jordan. The hospitals with the greatest capacity (more than 150 beds) were selected from each sector because these hospitals affect the highest number of health service providers and consumers. A convenience sample of 407 registered nurses from 11 hospitals was recruited. The inclusion criteria were as follows: registered nurses who had at least 6 months of experience in the investigated area (nurse managers not included), and who had the ability to read and understand English. English is the official language of nursing education in Jordan.

Ethical Considerations

The researchers received ethical approval to use the study instruments. Institutional review board (IRB) approval was obtained from the university (Hashemite University) and from each hospital that participated in the study. Each participant was informed of the purpose of the study, the estimated time required to complete the questionnaires, and their right to withdraw without penalty. Returning the completed questionnaires was considered to signify written agreement to participate in the study. To keep anonymity, the questionnaires did not include any information regarding the participant identity. After the nurses completed the questionnaires, the questionnaires were coded with numbers and kept in a sealed box.

Measurement

The data for this study were collected using the following tools.

Maslach Burnout Inventory (MBI)

The MBI-Human Services Survey was used to measure nurse burnout. This instrument consists of 22 items that employ a 7-point Likert scale ranging from 0 "never" to 6 "every day" to operationalize 3 dimensions of burnout: Nine items are used to measure EE, 5 items are used to measure DP, and 8 items are used to measure PA. The responses for each subscale were summed, and high scores for EE and DP indicated higher levels of burnout, while high scores for PA indicated lower levels of burnout. The instrument has been found to be valid and reliable in various studies. For this study, the reliability coefficients (Cronbach's alpha) for the 3 subscales ranged from 0.77 to 0.93.

Leader Empowering Behaviors Scale

In 1994, Hui developed a scale to empirically examine nurses' perception of their leaders' empowering behaviors. The scale consists of 27 items designed to address the 5 categories of LEBs: (1) 6 items are used to measure the meaningfulness of work, for example, "My leader makes me believe that my work can "make a difference" in this organization"; (2) 5 items are used to assess participation in decision making, for example, "My leader provides many opportunities for me to express my opinions"; (3) 5 items are used to assess the expression of confidence in employees, for example, "My leader always shows confidence in my ability to do a good job"; (4) 6 items are used to evaluate the facilitation of organizational goal attainment, for example, "My leader helps me identify what I need in order to achieve my performance goals"; and (5) 5 items are used to evaluate providing autonomy and freedom from bureaucratic restrictions, for example, "My leader encourages me to cut through the bureaucracy to get things done." The response options for each item range from 1 "strongly disagree" to 7 "strongly agree." The responses for each subscale were summed to obtain an overall LEBs score. High scores reflected high levels of LEBs.

The LEBs scale was found to be valid and reliable in many studies in which it was used, and the Cronbach's alpha values for the overall scale and subscales ranged from 0.71 to 0.96. For this study, the Cronbach's alpha values for the overall scale and the subscales ranged from 0.89 to 0.95.

Nurses' demographic and work characteristics

The following nurse demographic traits were included: gender, age, education level, marital status, and years of experience as a staff nurse. Work characteristics included hospital type, department type, nursing care model, head nurse leadership style, nurse's work shift (either fixed on A-morning shift from 8 am to 4 pm; or rotating on different shifts A, B, C; or day, night), and department daily census (the average number of inpatients in the department).

Data Collection

The study data were assembled by trained research assistants, during the first 5 months of 2015. The research assistants were present in the hospital setting during the data collection process to answer any questions related to the study. Nearly 460 registered nurses were invited to participate. The response rate was approximately 88.5% (407 out of 460).

Analysis

By screening the data, few random missing data were detected and treated by imputation. Actually, no univariate or multivariate missing data were identified in this study. Descriptive and inferential statistics were employed in the analysis. Frequencies were used to describe the demographic characteristics and work conditions of the sample. Stepwise regression analysis was used to understand the influence of the head nurses' (leaders') empowering behaviors, work conditions, and nurses' traits on nurses' feelings of burnout. Before conducting the regression model, the researchers examined the data for multiple regression assumptions. To reduce potential statistical errors, the following inferential statistics were performed to determine the factors that may influence nurse burnout: (1) Pearson correlation coefficients (Pearson r) were used to assess the relationship between nurse burnout and various continuous variables, including LEBs, daily census, age, and nursing experience and (2) an 3 × 8 multivariate analyses of variance (MANOVA) was used to analyze the categorical variables for the nurses' demographic characteristics and work conditions. Having 3 subscales of dependent variable (burnout) supports using MANOVA rather than multiple ANOVA tests to reduce the risk of type I error. To determine significant differences among groups, post hoc analysis (Tukey) was used. However, preliminary analysis did not reveal violations for the MANOVA assumptions, such as normality and linearity of the dependent variables, homogeneity of variance, and independency of variables.

Results

Demographic and Work Condition Variables

The descriptive statistics, comparisons of means, and correlations among the study variables are presented in and . A total of 407 registered nurses participated in the study. Approximately 57% (n = 233) of the participants were female. The mean age of the nurses was 29.78 years (SD = 6.51) and ranged from 22 to 53 years. The nurses had approximately 7.22 mean years (SD = 6.20) of experience, and approximately half of the nurses were married (n = 216, 53.07%). Most of the nurses in the study (n = 373, 91.65%) had a baccalaureate degree and were working either on rotating shifts (A, B, C or day and night) (n = 287, 70.52%) or on a fixed A shift (n = 120, 29.48%).

Table 1.

Table 2.

The data for this study were collected from hospitals in 3 health care sectors: MOH (n = 145, 35.63%), private (n = 204, 50.12%), and teaching (n = 58, 14.25%). The nurses were recruited from different departments: Approximately 237 (58.23%) were working in general medical and/or surgical departments, 88 (21.62%) were working in intensive care units, and the remaining nurses were working in obstetric, maternity, or pediatric departments. The average daily census for these departments was 19.85 patients (SD = 17.61). In terms of nursing care model, approximately 155 (30%) of the nurses were assigned to total patient care, whereas 174 (42.75%) were assigned to teams. According to the results, 158 (38.82%) of the head nurses adopted a democratic leadership style, 92 (22.60%) were autocratic, and 74 (18.18%) of the head nurses employed a permissive leadership style.

Nurse Burnout

The Jordanian nurses in this study exhibited relatively high levels of both EE (mean = 31.50, SD = 12.84) and DP (mean = 15.24, SD = 6.87) and moderate levels of PA (mean = 32.30, SD = 10.98). Nearly 61% (n = 248) of the nurses scored higher than 27 for EE-the cut point for severe EE-and approximately 65% (n = 265) of the nurses scored higher than 13 for DP, which is the cut point for severe DP. However, 43% (n = 175) of the nurses had low scores (less than 31)-the cut point for nurses' feelings of low PA, which indicates high levels of burnout ().

Table 3.

MANOVA test revealed a significant main effect for 5 factors on the 3-burnout categories: gender, F(3, 403) = 12.516, P ≤ .01, partial η ² = 0.081; work shift, F(3, 403) = 3.644, P ≤ .05, partial η ² = 0.026; department type, F(3, 403) = 3.499, P ≤ .01, partial η ² = 0.025; nursing care model, F(9, 401) = 2.356, P ≤ .05, partial η ² = 0.017; and hospital type, F(6, 401) = 8.735, P ≤ .01, partial η ² = 0.061 ().

Separate analysis of variance (ANOVA) tests were conducted for each individual dependent variable to understand the influence of significant factors on each category of burnout. The study results indicated that the main factors that influence nurses' feelings of EE were as follows. The first was hospital type ( F = 11.10, P ≤ .01), which was highest among the nurses who were working in MOH hospitals. The second was department type ( F = 3.77, P ≤ .05), and the highest scores were observed for nurses in intensive care units. The third factor was nurse's work shift ( F = 3.01, P ≤ .05); nurses who were on fixed A shifts had higher EE scores than those who were rotating on different shifts (). In addition, EE was positively correlated with age ( r = 0.111, P ≤ .05) and nursing experience ( r = 0.117, P ≤ .05) and negatively correlated with the LEB of participating in decision making ( r = −0.110, P ≤ .05) ().

Nurses' feelings of DP was significantly associated with department type ( F = 5.28, P ≤ .01)-the highest level of DP was observed for intensive care unit nurses-and with gender ( F = 3.79, P ≤ .01), as female nurses had higher scores for DP than male nurses (). In addition, DP was negatively correlated with the 3 categories of leadership empowering behaviors: enhancing the meaningfulness of work ( r = −0.132, P ≤ .01), expressing confidence in employees' performance ( r = −0.106, P ≤ .05), and fostering opportunity to participate in decision making ( r = −0.101, P ≤ .05) ().

In relation to PA, the results revealed a significant influence for hospital type ( F = 4.11, P ≤ .05) and gender ( F = 2.15, P ≤ .05); male nurses exhibited better scores for PA than female nurses (). In addition, PA was reliably and positively correlated with all categories of LEBs, age, and nursing experience ().

Although the results show significant correlation values, they are quite low; this could be related to both effect size and sample size. Based on Cohen (1988), the effect size for correlation test in this study ranged from small 0.1 to medium 0.3; hence, results of this study need to be taken with caution.

Predictors of Burnout

Three separate stepwise regression analyses were performed to identify the predictors of the 3 categories of burnout. All the significant variables associated with each burnout category and all the LEB categories were entered into the regression analysis model in Step 1. However, some variables were omitted such as age, which was correlated with nursing experience, and "overall empowering behaviors," which encompasses the other behaviors. For EE, the overall model was significant for 4 variables: hospital type, which was responsible for 3% of the variance in EE; nurse's work shift; providing autonomy; and fostering participation in decision making. Regarding DP, 3 variables were significant predictors of DP: gender, fostering participation in decision making, and department type. These variables accounted for 5.9% of the variance in DP. The regression model for PA was significant for 2 variables: facilitating goal attainment and nursing experience. These variables predicted 8.3% of the total variance in PA (). LEBs were associated with the 3 categories of burnout. However, the predictive power of the 3 categories was lower than that observed in previous studies.

Table 4.

Discussion

This study demonstrates that most Jordanian nurses suffer high levels of burnout as reflected by their high levels of EE and DP and moderate levels of PA. This result strengthens the findings of a previous Jordanian study conducted by Hamaideh and sheds light on nurse burnout as an extensive problem in Jordan; if the compass is directed toward improving health care system outcomes, then efforts must be made to decrease burnout. However, Jordan is not alone; nurse burnout is a worldwide problem, and abundant research studies of burnout have revealed moderate to severe burnout among nurses. High levels of burnout among Jordanian nurses could be related to poor work conditions, such as work overload, unfairness, lack of resources and control, low collegial support, and uncooperative and unsupportive leaders, as well as to personal and social factors.

In this study, the researchers investigated the influence of LEBs, nurses' work conditions, and nurses' demographic characteristics on nurses' feelings of burnout. As the findings demonstrate, nurses on fixed A shifts reported higher levels of EE and DP than nurses who were rotating on different shifts; this is perhaps because nurses on fixed A shifts are typically overloaded with both clinical and managerial responsibilities. Nurses with high workloads are more likely to develop burnout. Conversely, the nurses on fixed A shifts reported higher levels of PA, and this result is consistent with Demir and colleagues' findings suggesting that nurses on fixed A shifts are typically more experienced nurses who contribute more to their work and have a better understanding of their role, which enhances their feelings of PA.

The level of burnout was significantly different among the 3 types of Jordanian hospitals included in this study: The nurses who were working in MOH hospitals exhibited the highest levels of EE and DP and the lowest levels of PA compared with nurses who were working in teaching and private hospitals. Indeed, those 3 health sectors have been found to be different in terms of their organizational traits. Nurses from private hospitals perceive their hospitals as a favorable environment in terms of better hospital organization, support for quality of care, leadership and collegial support, staffing and resource capability, and nurse-to-patient ratio, as well as low daily census rate. This indicates that organizational traits could be a significant factor for burnout in Jordan, which supports the findings of Leiter and Laschinger and Van Bogaert and his colleagues. However, further investigations are needed in this field.

According to the present study, intensive care unit nurses and medical/surgical nurses exhibited significantly high levels of both EE and DP, and this may be associated with high workload, continual interactions with patients who are suffering, and the need to cope with complex technology. Greco et al and Gillespie and Melby found that medical/surgical nurses were more exhausted than nurses working in other hospital departments. These significant results suggest that more attention is needed to support nurses in these departments by increasing human and informational resources and improving nurses' leadership skills and feelings of PA.

Although nursing care model, leadership style, and daily census rate are important work-related variables, they were not significant variables for nurse burnout in the present study. Further studies of leader behaviors and their influences on different outcomes are recommended. In addition, daily census rate did not correlate significantly with burnout; this result was incongruent with other studies. However, census rate did not adequately represent workload in this study; thus, it is recommended that future studies use nurse-to-patient ratio and standardize the level of disease acuity.

In relation to demographic traits, the results reveal that female nurses reported higher levels of EE and DP and lower levels of PA than male nurses. This result supports the findings of some previous studies. High levels of burnout among female nurses could be associated with their complex roles in Jordan: In addition to their professional responsibilities, females have more social responsibilities related to home and family than males. Furthermore, more than 65% of the Jordanian population are children and women who require female nurses to meet their health needs. Indeed, it is not accepted culturally in Jordan for male nurses to work in females departments or pediatric departments where the mothers are rooming with their children. The health sector in Jordan is suffering from a shortage of female nurses because fewer females are choosing nursing as a career and because female nurses leave the nursing profession early after marriage, which has led to increased workloads in the departments in which female nurses work. Indeed, poor staffing is associated with higher workloads, unstable work environments, and negative outcomes. However, efforts are now being directed toward increasing the number of female nursing students in Jordan.

This study reveals that high levels of burnout, as represented by high levels of EE, are positively associated with increases in age and nursing experience; this could be related to the increase in both social and professional responsibilities that accompany increases in age and experience. However, age and experience are also positively associated with PA, which could be related to increases in nurses' satisfaction with their contribution to their work. This result corresponds to the findings of Demir et al and Patrick and Lavery. The authors of these studies recommend that, for older and more experienced nurses, redesigning of a work scheduling-for example, a regular short-term breaks during their work duration, make voluntary overtime, decrease workload, and enhance control over their practice-is required because they become to be more vulnerable to EE while their self-esteem and self-efficacy on performances grow as times go on.

Despite the significant influence of marital status and education level on nurse burnout observed in previous studies, this study's results did not support those of prior studies. However, this may be related to the small samples in some categories, which therefore could not exhibit sufficient statistical impact. For example, only 34 of the 407 participants had a master's degree, and only 12 of the participants were divorced or widowed.

The results of this study demonstrate the significant influence of LEBs on the categories of nurse burnout. Fostering opportunity to participate in decision making was the behavior that had the strongest negative influence on EE. The 3 LEBs-enhancing the meaningfulness of work, fostering opportunity to participate in decision making, and expressing confidence in high performance-had a negative influence on nurses' feelings of DP. By contrast, all the categories for LEBs positively contributed to the nurses' feelings of PA. These results indicate that nurses' feelings of empowerment will reduce their feelings of burnout. These results are consistent with all previous studies related to empowerment and burnout. In fact, this result supports the importance of the leader role in the nursing work environment.

Finally, this study endeavored to identify the factors that may influence nurse burnout by using stepwise regression analysis. The most important factor for EE was hospital type, which suggests that the nursing work environment may play an important role in nurses' feelings of burnout. In addition, 2 of the LEBs were influential factors for EE: providing autonomy and fostering opportunity to participate in decision making, which indicates that nurses' lack of autonomy and control over their practice may initiate feelings of burnout. In relation to DP, 3 factors were found to be influential: gender, fostering opportunity to participate in decision making, and department type. In fact, sharing in decisions related to work provides nurses with a feeling of importance regarding their contribution to work, which improves their attitudes toward patients. Moreover, 2 factors predicted PA: leader's role in facilitating goal attainment and nursing experience. Achieving organizational goals is important for nurses' PA as it offers evidence of their success in their work, and this feeling is enhanced by increases in experience. However, the low predictive power observed in this study indicates that other factors may play a mediator role between LEBs and burnout or that, in contrast to nursing in North America, nursing in Jordan is not a female-dominated profession, which makes empowerment different in Jordan than in other countries. Therefore, further studies are suggested to understand the nature of nursing empowerment in Jordan. Additional studies are also recommended to examine the impact of other variables on burnout and the mediation role of factors such as work environment traits, trust in leader and organization, and structural empowerment. The results of the present study suggest that nurses' work conditions and demographic traits and LEBs are important factors for nurses' feelings of burnout. Strategies to decrease burnout in Jordan are important for retaining experienced nurses, increasing the number of females in the nursing profession, and improving the quality of nursing care.

Limitations and Implications

This study addresses the influence of LEBs, nurses' work conditions, and nurses' demographic characteristics on nurses' feelings of burnout. Although the results of this study are robust, the study has some limitations: Because nonprobability sampling was used, the sample size in some categories was not sufficient to reveal a statistical effect, which may limit the generalizability of the results. Also, both partial η ² and R ² coefficients show weak effects which may decrease the generalizability of related results; hence, results of this study must be taken with caution.

Future studies are encouraged to use larger and more representative samples for all the analyzed variables to improve the generalizability of the findings.

The results suggest that nurse managers and policy makers should improve nursing work conditions using the following strategies: reduce nurses' workload through appropriate staffing, improve access to information, distribute resources fairly, provide professional development opportunities, and improve nurses' leadership skills such as decision making and empowerment. In addition, more experience should not be sufficient to obtain a managerial position in nursing; nursing leadership is an advanced role that requires nurse leaders to have at least a master's level of education to contribute effectively to shaping the future of health care. Additional efforts are needed to attract more females to study and practice nursing, and nurse managers should endeavor to enhance the quality of life for working women by offering self-scheduling and part-time opportunities and by providing child care services and transportation.

This study raised the issue of burnout as a research priority, and further research is required to assess the unique impact of different factors on burnout, such as work environment, salary, daily distance traveled to work and child care for working mothers. In addition, more clinical trial and intervention studies are suggested to develop programs to reduce work stress as a strategy for attracting nurses, improving quality, and achieving optimal organizational outcomes.

Conclusion

The present study suggests that nurses' work conditions and demographic traits and LEBs are significant factors for nurse burnout. The results of this study highlight the importance of the leadership role in creating a positive work environment by enhancing the meaningfulness of work, enabling employees to participate in decisions related to their work, expressing confidence in employees' abilities to perform at a high level, facilitating goal attainment, and providing autonomy. In addition, attracting more female nurses to the profession may be achieved by improving nurses' work conditions, which may enable nurses to remain in the profession longer. These approaches are expected to decrease nurse burnout and consequently contribute to ongoing efforts to reduce the nursing shortage and improve the quality of care provided.

Footnotes

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding: The author(s) received no financial support for the research, authorship, and/or publication of this article.

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# data[].attributes.attachment_link.title
Nurses' Burnout: The Influence of Leader Empowering Behaviors, Work Conditions, and Demographic Traits

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Nurse burnout is a widespread phenomenon characterized by a reduction in nurses' energy that manifests in emotional exhaustion, lack of motivation, and feelings of frustration and may lead to reductions in work efficacy.

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This article was a scholarly source. It had the headings such as "abstract, introduction, and discussion". This was showcased in the video we had to watch for the week names "how to read scholarly sources". The article was also set up so much differently than the rest, so it was an easy identifier.

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"Nurses' Burnout - Working conditions..." Response

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"Nurses' Burnout - Working conditions..." Response

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I think this article was helpful as there were different factors tied into the experiment and this would better help support my research. As this is a scholarly article, I have less of articles to search for since I have got one already. This was also conducted on Jordanian people but the paper did mention how this was a global issue and I think it will be interesting to see how I can tie this into my paper.

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What are the different contributors to burnout and how does that vary across different specialties (ER nurse, hospice, etc)

What are the consequences of burnout and how does that effect patient care?

How do nurses cope with burnout?

How would reducing burnout help the healthcare environment?

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'Healthcare Burnout" - Smith, Suzzane (17 April, 2023)

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'Healthcare Burnout" - Smith, Suzzane (17 April, 2023)

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This article was separated into 6 sections. It started with some causes of burnout and finding the symptoms of the burnout. It then moved onto how this burnout affects the nurses primarily. After elaborating how it affects the nurse, they move onto how patient care is affected. Which of course then lowers patient satisfaction because the nurse is not one hundred percent in the moment. A good add in that I did not see in the other articles is that the author for this mentioned the economic impact of nurse burnout. Going through burnout may cause a nurse to want to leave the field completely and this will then affect the hospital economically. They then end up wasting more effects because the high turnover rate. So not only will the nurse be affected, the patient and their work will be affected as well as the overall economic state of the hospital. The deep dwell into this shows the importance of burnout and how serious it is. The last few sections then talked about ways the workplace can lower nurse burnout. Because sometimes it isn't just taking care of oneself but also making sure hospital policies take care of their nurses and alleviate stress because they are such hardworking employees.

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The Healthcare Hub

Healthcare worker burnout and job-related stress have always been a concern for many healthcare organizations. As hospitals and other care providers continue to navigate the post-COVID environment, workforce stabilization and the well-being of their front-line caregivers continues to be top-of-mind for many healthcare leaders.

A survey conducted by Bain and Company revealed that nearly 25% of clinicians are considering leaving healthcare altogether. Nearly 89% of those clinicians that are considering leaving cited "burnout" and job-related stress as the main cause for their desire to leave the healthcare workforce early.
Table of contents

1. Causes and symptoms of healthcare burnout

2. Impact of burnout on healthcare workers

3. Burnout impact on patient care and experience

4. Economic impact of healthcare worker burnout

5. Prevention strategies for burnout in healthcare

6. Reducing the administrative burden in healthcare

Causes and symptoms of healthcare burnout

Stress on the job contributes to physical, mental, and emotional fatigue - this phenomenon is often referred to as "burnout". Burnout symptoms and causes can vary from person-to-person.

Signs and symptoms of healthcare burnout

Burnout is a syndrome that includes symptoms that can show up in the form of emotional exhaustion, depersonalization, and a sense of low personal accomplishment that can lead to decreased effectiveness at work. Burnout is largely a function of prolonged work-related stress.

Healthcare workers routinely operate in high-stress, fast-paced, resource-constrained environments. Constant healthcare stress exposure can lead to feelings of cynicism, detachment, and an overall sense of ineffectiveness among those responsible for providing direct patient care.

Primary causes of healthcare burnout

"When Medical Economics® recently asked doctors what contributed most to their feelings of burnout, 31% cited "paperwork" - more than twice the percentage of the second-leading cause, poor work-life balance."

Medical Economics, Top challenges facing physicians in 2021

Healthcare worker burnout spans across all levels of caregivers including physicians, nurses, advanced practice providers, and others that are involved in patient care, including support staff. It is not just confined to hospitals- it is a problem throughout many different patient care settings that rely on front-line care givers to provide patient care.

Factors that contribute to burnout among healthcare workers

Long hours

Burdensome workloads

Inadequate support

Lack of control over work environment

Excessive time spent on non-clinical tasks and work

Impact of burnout on healthcare professionals

Healthcare burnout is problematic for all levels of clinicians, resulting in significant challenges for health systems and patient care. In particular, turnover, along with difficulty recruiting and hiring medical staff, can present many challenges for the healthcare industry.

Burnout and nurses

Health systems and hospitals are experiencing high nursing vacancy rates - as nurses leave, recruiting and hiring new nurses is becoming exceedingly difficult. Recent estimates put the nurse vacancy at 17% and the turnover rate at 27%.

Nurse burnout and attrition can create increased risk for health systems and hospitals. Some of the many issues associated with nursing shortages include:

Patient satisfaction

High contract labor costs

Decreased volume and decreased access to care (due to the inability to staff beds)

Increased risk for adverse events and negative outcomes for patients

Low employee engagement

Patient/visitor experience and overall patient satisfaction

Burnout and physicians

The pressure to deliver high-quality care while navigating complex healthcare systems, managing patient expectations, and coping with the emotional impact of their work is also taking its toll on doctors.

More than half (53%) of physicians report burnout, with women significantly more impacted (63%), according to Medscape's Physician Burnout and Depression Report 2023. The specialties most at risk of burnout were:

1. Emergency medicine (65%)

2. Internal medicine (60%)

3. Pediatrics (59%)

4. Ob/Gyn (58%)

5. Infectious diseases (58%)

With U.S. physician shortages predicted to rise by as much as 37,800 to 124,000 by 2023, tackling healthcare burnout is a critical challenge for hospitals in the coming decade.

💡Read more: The secret to a successful sourcing initiative? Physician input

Burnout impact on patient care and experience

Healthcare worker burnout doesn't just affect professionals, it can have a detrimental impact on patient care and their experiences in hospital environments. According to the U.S. Surgeon General 's office, it affects the care journey in a variety of important ways:

decreased time spent between provider and patient

increased medical errors and hospital-acquired infections among patients

staffing shortages

This was confirmed by a recent GHX survey of more than 2,000 U.S. adults. Over half of those surveyed stated that hospitals having more nurses and more support staff would help improve both the patient and visitor experience.

Nearly 50% of those surveyed stated that they would avoid going to a hospital due to concerns about adequate staffing levels. Overall workforce stabilization issues and nursing staffing challenges continue to be top-of-mind for many healthcare leaders.

💡Read more: Want to improve physician-supply chain collaboration? Use physician-level data

The economic consequences of burnout on health systems

Aside from the quality, safety, and patient experience issues that result from turnover linked to healthcare worker burnout, the financial impact on hospitals can be significant.

For example, a recent Becker's article noted that the average cost of turnover for a staff nurse (RN) is $52,350 and each percentage of change in nurse turnover will cost or save the average hospital $380,000 per year.

And it's not just limited to nurses. According to Healthcare Finance News, "current annual cost estimates place burnout-related physician turnover at about $5 billion".

Prioritizing the well-being of healthcare workers doesn't just support job satisfaction and turnover rates, it influences the financial sustainability for health systems in a challenging labor market and macroeconomic environment.

💡Read more: How to strengthen your hospital's financial position

Prevention strategies for healthcare burnout

Addressing burnout among healthcare workers is a priority for many healthcare organizations. In addition to workplace interventions, hospitals are optimizing and automating administrative processes within hospitals.

Workplace interventions for healthcare burnout

Burnout prevention strategies that have been implemented to alleviate the burden of burnout on healthcare professionals include:

1. Providing better compensation

2. Creating and fostering a positive work environment

3. Ensuring support to help deliver high-quality patient care

4. Adopting a more manageable workload

5. Implementing more flexible work arrangements

6. Promoting and encouraging self-care practices

7. Enabling more clinically focused job responsibilities

Reducing the administrative burden on health workers

Healthcare workers, including nurses and physicians, spend a significant amount of time on non-patient care activities and tasks. Overcoming burnout involves re-thinking how nurses and other caregivers do their work.

"Nearly a quarter of US national health expenditure goes toward administrative costs."

McKinsey, The Gathering Storm: The Uncertain Future of US Healthcare (Sep 2022)

This includes focusing on reassessing the amount of low-value, non-patient care work that comprise a big part of a clinical professional's daily workload. Outdated processes and manual workflows can rob healthcare workers of precious time - time that could be spent on direct patient care.

Automating routine tasks to mitigate healthcare burnout

Healthcare providers that can automate and reduce human-dependencies relating to routine, administrative tasks will be better positioned to provide some relief to overburdened staff. Investing in and leveraging technology-enabled solutions designed to reduce human touchpoints, decrease manual daily work, and improve overall efficiency is critical to reducing the administrative burden that frustrates clinical workers.

Solutions and tactics related to reducing administrative burden include:

delegating tasks in order to promote practicing at the top of one's license

leveraging automation between medical devices and electronic health records (EHR).

Leveraging data is an important aspect when it comes to reducing administrative burden. Enterprise technology investments can help healthcare organizations gain access to clean, accurate, and complete information that is synchronized across systems. In short, embracing technology-enabled solutions can lead to greater automation and improved clinical productivity.

Removing low-value work through process re-design and enhanced, technology-enabled solutions, coupled with building a robust supportive environment can go a long way when it comes to reducing burnout among nurses and other clinicians.

💡Read more: Administrative simplification: how data and automation can streamline healthcare processes

Reducing healthcare worker burnout will continue to be a top focus for healthcare organizations and their leaders - and the stakes have never been higher. Safety, quality, employee engagement, patient experience, and financial performance all stand to benefit if healthcare organizations continue to embrace proven tactics and best practices.

💡For additional information and resources related to healthcare worker burnout, view the U.S. Surgeon General's Advisory on Building a Thriving Health Workforce.

***
Disclaimer: The contributor of this piece is solely responsible for its content and accuracy, and the views expressed do not necessarily reflect the opinion of GHX.
Sources

1. Bain and Company. "A Treatment for America's Healthcare Worker Burnout."

2. Agency for Healthcare Research and Quality. "AHRQ Works: Burnout."

3. Medical Economics. "Top Challenges Facing Physicians in 2021: Administrative Burdens and Paperwork."

4. NurseJournal.org. "Nurse Burnout."

5. Healthcare Finance News. "RN Turnover in Healthcare on the Rise."

6. NSI Nursing Solutions. "NSI National Health Care Retention Report."

7. Medscape. "Physician Burnout and Depression Report 2023."

8. Association of American Medical Colleges. "AAMC Report Reinforces Mounting Physician Shortage."

9. Becker's Hospital Review. "The Cost of Nurse Turnover in 24 Numbers."

10. Healthcare Finance News. "Cost of Burnout-Related Physician Turnover Totals $5 Billion Annually."

11. U.S. Surgeon General's Office. "Building a Thriving Health Workforce."

12. GHX. "New GHX Study: Half of Americans Avoid Seeking Care in Hospitals Due to Staffing Shortages and Virus Exposure Concerns."

13. McKinsey & Company. "The Gathering Storm: The Uncertain Future of US Healthcare."

14. U.S. Department of Health and Human Services. "Advisory on Building a Thriving Health Workforce."

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Healthcare Burnout: Impact, Consequences & Administrative Burden

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Explore how healthcare worker burnout affects patient care and bottom lines. Discover how to reduce the administrative burden for healthcare workers and tackle burnout.

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I believe that this is a trade article because there is little to no ads (1 and it related to the work field). Another main hint was the listed sources of information at the bottom of the article. I do not see that in popular sources so it led me to this conclusion.

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I enjoyed reading this article because it had a bit more information and different perspectives than the other three articles I had read before. It talked about the economic side which then led me to think that maybe a big factor for change and advocation for burnout has anything to do with the high economic loss they take once these nurses leave. Because it is seen that most companies care more about profit rather than how the employees feel which sounds wrong to say but it is true for the most part. Having this mindset is not well though because nurses are very hardworking and they should be more appreciated.

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"Nurse Specialty and burnout" (Browning, Ryan, Thomas, Greenburg, Rolniak)

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"Nurse Specialty and burnout" (Browning, Ryan, Thomas, Greenburg, Rolniak)

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This article seems to be a research article that conducted a study between three different job titles. A nurse practitioner, a nurse manager and an emergency nurse. With their results they were able to determine that the emergency nurse with the least amount of control in their work environment has the highest burnout rate. On the other hand, the nurse practitioner with the highest control over their environment has the least amount of burnout. I could not see the full article so I will figure that out, but the results support one of the questions I was looking to research.

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Abstract

We examined the relationship between perceived control and burnout among three nursing specialties: nurse practitioners, nurse managers, and emergency nurses. Survey data were collected from 228 nurses from 30 states. Findings indicated that emergency nurses had the least control and the highest burnout, whereas nurse practitioners had the most control and the least burnout. Mediational analyses showed that expected control, hostility, and stressor frequency explained differences between specialties in burnout. The implications of these findings for interventions that reduce burnout and promote nursing retention are discussed.

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[The world of nursing burnout. A literature review].

Bernardi M, Catania G, Marceca F. Bernardi M, et al. Prof Inferm. 2005 Apr-Jun;58(2):75-9. Prof Inferm. 2005. PMID: 16219175 Review. Italian.

Work environment, health outcomes and magnet hospital traits in the Canadian nephrology nursing scene.

Ridley J, Wilson B, Harwood L, Laschinger HK. Ridley J, et al. CANNT J. 2009 Jan-Mar;19(1):28-35. CANNT J. 2009. PMID: 19354155

Predicting nurse burnout from demands and resources in three acute care hospitals under different forms of ownership: a cross-sectional questionnaire survey.

Hansen N, Sverke M, Näswall K. Hansen N, et al. Int J Nurs Stud. 2009 Jan;46(1):95-106. doi: 10.1016/j.ijnurstu.2008.08.002. Epub 2008 Sep 26. Int J Nurs Stud. 2009. PMID: 18823625

[Research: analysis of factors on nurses' burnout--relationship among perception of stress, coping and burnout].

Chikasawa N. Chikasawa N. Kango Kenkyu. 1988 Winter;21(2):157-72. Kango Kenkyu. 1988. PMID: 3373875 Japanese. No abstract available.

Cited by

Factors associated with nurse well-being in relation to electronic health record use: A systematic review.

Nguyen OT, Shah S, Gartland AJ, Parekh A, Turner K, Feldman SS, Merlo LJ. Nguyen OT, et al. J Am Med Inform Assoc. 2021 Jun 12;28(6):1288-1297. doi: 10.1093/jamia/ocaa289. J Am Med Inform Assoc. 2021. PMID: 33367819 Free PMC article. Review.

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national center for biotechnology information

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We examined the relationship between perceived control and burnout among three nursing specialties: nurse practitioners, nurse managers, and emergency nurses. Survey data were collected from 228 nurses from 30 states. Findings indicated that emergency nurses had the least control and the highest bur ...

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"Nursing Specialty and Burnout" Evaluation 

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"Nursing Specialty and Burnout" Evaluation 

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Right of the bat I could tell this was a scholarly article. The set up for this article was one that a scholarly article is usually set up in, with an abstract. A DOI was also included and those are usually used for scholarly articles. Aside from this, so far, all the articles I have read from this website are all scholarly articles. These were the biggest giveaways for me.

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As stated, when I was reading this I was not able to get the full article. Still, I decided to use this article because it answers one of my questions. The ending results to the study shows that the nurses with the least amount of control have the highest rates of burnout. This led to think if there is any other factors that were included to measure burnout in the work environment.

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I was hoping to find an article that had talked to nurses and had their firsthand experiences with burnout and how they dealt with it. I wanted to see how different people handled this differently. I could not find anything that was firsthand, but this article did have a comment section and there were nurses that were relating to this which is what I wanted. This was a great article, but it was repetitive in the sense that all the other articles that I have read have pretty much the same info. This article repeated possible causes for burnout and some coping mechanisms in order to get over the burnout. What made me choose this article though, was the comments. There were a couple that stated the methods work. Two of which were taking selfcare days for yourself and switching over to a less stressful unit. Having this being said by an actual person is what gravitated into the choosing of this article.

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Recognizing & Coping With Nursing Burnout | Modern Nurse Magazine

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Nurses are often compassionate by nature. After all, one of the reasons you may have chosen nursing is to help people. But nursing can be a demanding career and at some point, you may find your wide-eyed enthusiasm for the profession is fading.

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This article has stumped me. I am a bit unsure if it is a popular or trade source. Of course, I had a rubric to go by so I am 99% sure it is a trade source. The intended audience were nurses. It has words such as "you" implying that those who are reading are nurses since the article's title is "Nursing Burnout". Aside from this, the ads were nurse focused and in a popular article, they would be random. The stumper for me was the comment section. That was what made it feel like a popular source.

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My favorite part of this article was the comment section. I was hoping to find some interviews but I could not find any. So, instead I decided to look through the comment section and that was were I saw someone stated that what the article had said about coping with burnout did in fact help. The rest of the comments were also talking about their experiences with burnout and briefly stated their struggles and what they did in order to combat the burnout. The article was easy to ready. It was in a cause and effect format which allowed me to gain more perspectives on what can also cause burnout.

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visual biblography works cited.docx