Burnout is a common problem in the nursing profession and a critical factor in patient safety and quality of care. Previous research has reported many strategies for minimising burnout among nursing professionals. One of the strategies for avoiding nursing burnout is self-care and self-reflection. Examples of self-care strategies include physical exercise, getting enough rest, having a well-balanced diet, remaining positive in life, yoga, and walking. Another strategy of alleviating and burnout is keeping work life separate from home lives. Nurses should also take a walk outside after lunch, intersperse between highly demanding patient care and paperwork instead of working on paperwork at the end of the day, embrace teamwork and work delegation, adopt self-care activities after work, and use advanced technology to decrease workload. Additionally, reward strategies such as increased remuneration via implementation of clinical ladder programs and reimbursement of professional organisation dues can help to alleviate burnout.
The adoption of authentic leadership in healthcare management aimed at improving work climate and, consequently, nurses' psychological well-being is also negatively associated with burnout. Enhancing nurses' coping skills or social support is also another strategy for minimising burnout. At the organisational level, improving communication and social skills through training can help alleviate burnout. Other strategies that are necessary for burnout reduction include mindfulness training, supervisory support, and reduction of work overload, conflicts in the workplace, and role ambiguity.
The proposed systematic review will collate findings from research studies focused on the prevention of nursing burnout. The literature for this review will be obtained from scholarly databases, especially Google Scholar. Inclusion and exclusion criteria will be used to search for relevant articles related to the topic in scholarly databases. The inclusion criteria for this systematic review include books, primary research articles, and any other peer-reviewed articles published in the past six years. The exclusion criteria include articles published more than six years ago and burnout studies that focus on health care professionals other than nurses.
Burnout refers to a syndrome of physical and emotional exhaustion that is caused by work-related stress characterised by poor self-concepts, poor work attitudes, and a loss of feeling and concern for patients (Kadushin and Harkness 2014, pg. 164). Burnout first gained recognition as a psychological construct in the 1970s. Based on the Maslach Burnout Inventory, the definition of burnout is based on three key characteristics: decreased perceived personal accomplishment, depersonalization, and emotional exhaustion. Decreased personal accomplishment refers to dissatisfaction in achievement and works productivity. On the other hand, depersonalisation takes place when an individual tries to protect himself or herself psychologically from further strain through detachment. Lastly, emotional exhaustion occurs when an individual feels weighed down and emotionally burdened. Burnout has been linked to the persistent disparity between what an individual gives and what he or she receives in the workplace. This disparity has been described as the reciprocity in expectations between the worker and the employee; also referred to as a psychological contract. When the employee outcomes are far more than what he or she receives regarding expectations, there is a breach of psychological contract. The disparity between the worker's expectancy and the extent to which the employer is meeting these expectancies is crucial in the burnout process (Fearon 2011, pg. 34).
Burnout is a critical factor in the nursing profession. It is an important topic in nursing because of its potential adverse impacts on patient outcomes. For instance, a study conducted by Nantsupawat et al. (2015) to determine the effect of nurse burnout on patient events and outcomes and nursereported quality of care revealed that burnout is highly prevalent in nursing. It was further revealed that nurse burnout leads to decreased quality of care and increased cases of infections, medical errors, and patient falls (Nantsupawat et al., 2015). Apart from its detrimental impact on quality of care, burnout has been found to have a negative effect on productivity, performance, and job satisfaction (Khamisa et al., 2015). Other detrimental impacts of burnout include medical errors (Hall et al., 2016), maladaptive thinking patterns (Balevre, Cassells and Buzaianu, 2012), and job dissatisfaction (Vahey et al., 2004; Holden et al., 2011).
Even though the problem of nursing burnout is prevalent in the nursing profession, research has also shown that burnout can be prevented using different evidence-based strategies. One of the strategies for avoiding nursing burnout includes self-care and self-reflection. It is critical for nurses to use self-reflection after a tiresome day because it enables them to recognise their emotions as well as why reason for their feelings. Sometimes the feelings expressed by nurses are not directly associated with their work, but their day to day lives. Consequently, it is vital for nursing professionals to distinguish between the two sources of fatigue and burnout to manage them appropriately. Self-care has been reported to be useful in the prevention of exhaustion and burnout. Some of the essential strategies of self-care needed to prevent fatigue and burnout include physical exercise, getting enough rest, having a well-balanced diet, and remaining positive in life. Other approaches required for the prevention of fatigue and burnout include stress relief activities such as yoga and walking (Braunschneider 2013, pg. 16).
Another useful way of preventing fatigue and burnout in nursing is keeping work life separate from home lives. It is worth noting that nurses are not only concerned with the lives of their patients but also those of their families. In most of the cases, nurses are emotionally engrossed in their work and cannot stop thinking about their families, which may result in problems in their personal lives. Because of their job pressure as well as their family demands, it is crucial for nurses to find time to relax. This can be accomplished through relaxation exercises such as meditation and deep breathing (Braunschneider 2013, pg. 16).
A recent study conducted by Henry (2014, pg. 211-214) compiled and described interventions that serve as a reference to nurses and healthcare organisation leaders interested in preventing burnout. The author identified areas associated with burnout and provided ways of reducing burnout in these areas. First, Henry (2014, pg. 213) noted that burnout is caused by heavy workload (amount of work to be finished per day and unexpected events). Due to heavy workload, the nurses suffer physical and emotional fatigue. Workload-related burnout is also caused by skipped lunches and breaks and the pressure that results from doing the work alone. In order to curb workload-related burnout, Henry (2014, pg. 213) proposed that nurses should take a walk outside after lunch, should intersperse between highly demanding patient care and paperwork instead of working on paperwork at the end of the day, should embrace teamwork and work delegation, should adopt self-care activities after work, and should also use advanced technology to decrease workload.
Henry (2014, pg. 213) also noted that burnout is caused by nurses' participation in decisions that affect their work and poor quality of leadership. In such cases, the intervention strategies include the provision of nurse support and bereavement groups, the establishment of counselling services and pastoral care, and setting up of a bulletin board where patient thank you notes, and sympathy cards are pinned. Nursing burnout can also be reduced through implementation of various reward strategies. Some of these strategies include increased remuneration through the implementation of clinical ladder programs and reimbursement of professional organisation dues. Further, burnout linked to feelings of disconnectedness, isolation, and loneliness can be eliminated using two key strategies: motivating staff to speak out about their feelings and increased interactions in daily work activities, out of work activities, and staff meetings. It is also worth noting that burnout can be prevented through provision of equal opportunities to all the staff. More specifically, every staff should be accorded the equal chances during the allocation of rewards and promotions (Henry 2014, pg. 213).
Authentic leadership has also been found to contribute positively to nurses' psychological wellbeing thus reducing burnout. For instance, in a study conducted by Nelson et al. (2014, pg. 90-101) to explore the association between authentic leadership and psychological well-being by considering the mediational effect of work climate, authentic leadership was found to be positively associated with nurses' psychological well-being. Additionally, work climate was found to mediate the association between authentic leadership and nurses' psychological well-being. More specifically, in the absence of the mediating effect of work climate, authentic leadership was reported not to affect psychological well-being. From these findings, the authors recommended the adoption of authentic leadership in healthcare management with the aim of improving work climate and, consequently, nurses' psychological well-being.
Authentic leadership has also been reported to prevent nursing burnout through its negative impact on workplace bullying. Decreased workplace bullying has been reported to have a positive influence on emotional exhaustion. Additionally, authentic leadership decreases burnout through its direct positive impact on job satisfaction. The negative relationship between authentic leadership and nursing burnout is associated with the latter's capacity to create supportive working environments (Laschinger, Wong, and Grau et al. 2012, pg. 1266).
Programs for individuals have also been used to reduce burnout in the nursing profession. According to Morse et al. (2012, pg. 8), burnout can be decreased by improving nurses' coping skills or through social support. Some of these strategies necessary to improve coping skills include recreational music, enhanced spiritual development through humanistic therapy, and psychosynthesis. Cognitive-behavioural interventions have also been found to be effective in reducing burnout. These intervention techniques are aimed at equipping nurses' competence and skills in socialisation, communication, muscle relaxation, and cognitive restructuring. These interventions have been found to be effective in reducing emotional exhaustion, a common form of burnout among nurses.
Studies have been carried out to establish whether cognitive-behavioural interventions are effective in reducing burnout (e.g.). In one of these studies, Orly et al. (2012, pg. 152-157) sought to examine the effect of the cognitive-behavioural program on the nurses' well-being. The outcomes of interest in this study included mood states, perceived stress, and sense of coherence. The participants in this study consisted of 36 nurses (20 participated in the cognitive-behavioural program while 16 did not). At the baseline, both the treatment group and the control group showed no differences in mood states, perceived stress, and sense of coherence. However, after administration of the cognitive-behavioural program, only the participants who were enrolled in the cognitive-behavioural program showed a significant increase in mo...
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