Causes, Symptoms, and Prevention – Dr Paul's By The Sea (2024)

Nurse Burnout

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Clinical nurses are constantly in a stressful fast-paced work environment. During times like this, Nurse Burnout has created even more of a risk among healthcare professionals. To prevent this from happening. healthcare professionals need to take extra precautions for their physical and mental health. To learn more about Nurse Burnout and how you can prevent it from happening to you or a loved one, continue reading.

Nurse Burnout: What is it?

Nurse burnout is a severe issue characterized by mental, emotional, and physical exhaustion in nurses. This kind of burnout can lead to physical and mental health issues in nurses who experience it, turnover in the institutions they work for, and low quality of care and even mortality in their patients. ¹

Burnout can be quite common for nurses, and the COVID-19 pandemic has created even more risks for burnout among healthcare workers. ² Fortunately, employers and nurses can implement practices to help prevent burnout. It is essential to utilize these strategies, especially during the COVID-19 pandemic.

The term "burnout" was coined in 1974 to describe workers' reactions to chronic stress in workplaces that require regular and direct interactions with others.³
Burnout refers to intense mental, emotional, and physical exhaustion resulting from continuous work-related stressors. ¹

Some of the stressors that cause burnout include long shifts, the pressure to make quick decisions, and caring for patients who may have poor outcomes. This type of burnout can lead to disengagement and detachment. If the issue is not properly addressed, it can eventually lead to cynicism, hopelessness, and even depression.¹

Burnout can also indirectly affect patients cared for by nurses who experience it. There is a link between nurse burnout and an increased likelihood of infections in patients. Often, hospitals that experience high burnout rates have lower overall patient satisfaction. ⁴

In health care organizations, nurse burnout can contribute to increased nurse absence and high turnover, leading to a decline in quality of care. ³ It is crucial to address nurse burnout for the nurses who experience it and for the sake of their patients. ⁴

Causes

Nurses may experience burnout due to a variety of causes. Some of the most common reasons for nurse burnout include long work hours, sleep deprivation, a high-stress work environment, lack of support, and emotional strain from patient care. ¹

Long Hours

The demand for nurses has increased alongside the Baby Boomer generation's aging and the subsequent increase in chronic disease prevalence. Because of the increasing demand, registered nurses' employment will grow by 12% between 2018 and 2019. Unfortunately, many hospitals have not been able to keep up with the growing demand for nurses, which has resulted in many nurses working even longer hours, increasing their likelihood of experiencing burnout. ¹

Sleep Deprivation

A chronic lack of sleep is one of the most significant burnout risks for working professionals in any industry. Sleep deprivation is widespread in the nursing profession, as they work long hours and consecutive shifts. In 2018, 25% of nurses reported they could not get adequate sleep between their work shifts. ¹

High-Stress Environment

Working as a nurse can bring about high levels of stress. Some nursing specialties are even more stressful than others. For example, working in the emergency department or intensive care can mean dealing with combative patients, traumatic injuries, ethical dilemmas, and high mortality rates. These circ*mstances can create high-stress levels and increased burnout. In 2018, 30% of oncology nurses reported emotional exhaustion, a major burnout symptom. ¹

Lack of Support

Burnout is also more prevalent in a workplace that lacks teamwork and collaboration. In a profession like nursing, collaboration can help to save lives. When there is conflict, poor communication, lack of cooperation, and peer bullying in the workplace, it can foster an unpleasant work environment, which can cause nurse burnout and even medical errors. ¹

Emotional Strain from Patient Care

Caring for patients can be one of the most rewarding aspects of nursing and is often a primary motivation for joining the profession. Nurses who work in critical or end-of-life care can experience emotional hardship when dealing with low recovery and high mortality rates. These emotional letdowns can lead to compassion fatigue and increased burnout rates. Additionally, nurses who care for more than four patients per nurse are at higher risk of experiencing burnout. Each additional patient increases their burnout risk by 23%. ¹

Additional Causes for Burnout

Additional reasons why nurses may experience burnout include:⁵

- Work overload and time pressures
- Exposure to infectious diseases and needlestick injuries
- Exposure to work-related violence or threats
- Role ambiguity and conflict
- Career development issues
- Dealing with difficult patients

Symptoms

If nurse burnout is not properly addressed, it can lead to a variety of health issues for the affected nurse and his or her patients. Some of the symptoms of nurse burnout include constant fatigue, feeling overworked or under-appreciated, lack of enthusiasm related to work, compassion fatigue, overwhelming anxiety, and illness.⁶

Constant Fatigue

Someone experiencing constant fatigue may consistently go to bed tired and still feel tired in the morning upon waking. It can also be challenging to find the energy to exercise, enjoy time with friends and family, or fall asleep. ⁶ Nurses who experience burnout may even find themselves experiencing extreme physical exhaustion, dozing off at abnormal times, and unable to catch up on sleep. This kind of fatigue is more extreme than the typical fatigue nurses may feel due to working long shifts.⁷

Feeling Overworked or Under-Appreciated

Nurses who experience burnout may feel overworked and like their efforts aren't noticed. These feelings can lead to frustration and resentment, which isn't healthy for nurses, coworkers, or patients. In this case, it is essential to discuss these feelings with a supervisor and seek help.⁶

Lack of Enthusiasm Regarding Work

Burnout can also cause a loss of once held enjoyment in the nursing profession. Nurses who experience burnout may dread going to work, and once they are there, focus only on going home. This dread and distraction can create a lack of focus on patient care, reducing the patient's overall level of care. It can also begin to affect other areas of a nurse's life.⁶

Compassion Fatigue

Most nurses decide to enter the profession because they are compassionate individuals who want to care for others. The emotional stress nurses experience, and the pain and suffering they witness, can cause nurses to lose their compassion. They may start to experience detachment from patients, cynicism regarding their job, and feelings of failure.⁶

Overwhelming Anxiety

Anxiety is a normal feeling in many professions, especially the nursing profession. Nurses may experience normal feelings of anxiety about patients and the potential to make mistakes, but it is not normal for this anxiety to become crippling. This kind of anxiety can cause someone to feel extremely overwhelmed when dealing with small and straightforward changes. They may also experience constant work thoughts, making it difficult for them to sleep, eat, or carry out other necessary daily activities.⁷

Illness

Nurse burnout can cause physical illnesses, including a weakened immune system, gastrointestinal issues, chronic pain, and heart palpitations. These illnesses may manifest in easily contracting viruses, experiencing regular diarrhea or constipation, having unexplained aches and pains, or even heart issues.⁷

Experiencing any one of these symptoms on their own may mean it is time to practice some stress reduction techniques. However, if a nurse is experiencing multiple burnout symptoms, more drastic measures may need to be taken.⁷

Dangers

There are a variety of dangerous outcomes that can result from nurse burnout. These dangers affect the nurse experiencing burnout, the nurse's coworkers, the hospitals they work for, and their patients' health. These dangers include high turnover, low quality of care, and even mortality. ¹

High Turnover

There is a correlation between increased burnout and increased turnover in nurses. An increase in turnover can create more stress for other nurses and additional hospital staff. The extra stress staff members experience can also lower the quality of care patients receive.¹

Low Quality Care

The most significant danger associated with nurse burnout is decreased patient care quality. Exhaustion associated with burnout can lead to mistakes that create patient discomfort, infection, and even death. A study found that patients under the care of nurses experiencing burnout had increased tract infections and surgical site infections.¹

Mortality

If nurses are responsible for more than four patients per nurse, they are at higher risk of experiencing burnout. There is also a 7% increase in hospital mortality rates for each patient added to this ratio.¹

Nurse Burnout During COVID-19

The rise of COVID-19 has contributed to increased burnout in the nursing workforce. The pandemic has created an extreme loss in both tangible and financial resources, which has directly affected nurses who may need to work longer hours and work harder than usual to ensure their patients' well-being.⁸

In an effort to understand healthcare workers' experiences during the pandemic and offer adequate mental health resources to these workers, 1,119 of them participated in a survey. Of those surveyed, 93% said they are experiencing stress, 86% said they are experiencing anxiety, 77% said they are experiencing frustration, and 75% said they are overwhelmed.²

These healthcare workers are also worried about potentially exposing their loved ones to the virus. More than 75% of healthcare workers who have children are worried about exposing their child, almost 50% are worried about exposing their partner, and 47% are worried about potentially exposing an older family member.²

Additionally, 82% of healthcare workers reported experiencing emotional exhaustion, 70% reported having difficulty sleeping, 68% reported experiencing physical exhaustion, and 63% reported having dread related to work.²

Surveyed healthcare workers are also experiencing additional symptoms related to burnout. A total of 57% said they are experiencing changes in appetite, 56% said they have physical symptoms, 55% said they are questioning their career path, and 52% said they are experiencing compassion fatigue. ²

Nurses who participated in the survey said they experience higher exposure to COVID-19 than other healthcare workers and were more likely to feel extreme fatigue. Nurses are also less likely to receive adequate support than other healthcare workers. Of those surveyed, 54% outwardly expressed that they are experiencing burnout.²

In another survey, 84% of healthcare workers said they feel mildly burned out from work, and 18% said they felt completely burned out. Additionally, 90% said they are getting less than eight hours of sleep each night, and more than 30% said they are only getting four hours of sleep a night or less.²

Prevention Tips

Finding ways to reduce nurse burnout is essential at any time and has become increasingly important in the face of the COVID-19 pandemic. There are workplace prevention strategies institutions can use to reduce burnout and strategies nurses can utilize on their own to help reduce their potential to experience burnout.

Workplace Prevention

There are many things employers and supervisors can do to decrease nurse burnout in their hospitals. Some of these strategies include:⁹

Enhancing the meaningfulness of work. Supervisors should encourage purpose in nurses' work and give meaning to their contributions through praise and acknowledgment, which ultimately increases their sense of worth and motivates them to move forward. ⁹
Fostering opportunity to participate in decision-making. Supervisors should encourage nurses to express their opinions and participate in making work-related decisions, which can motivate nurses to feel like they are a part of the solution. ⁹
Expressing confidence in performance. Supervisors should express that they are confident in nurses' abilities to fulfill work-related expectations and recognize their accomplishments. ⁹
Facilitating attainment of goals. Supervisors should enhance nurses' skills, teach them new practices, and provide necessary resources to ensure workplace effectiveness. ⁹
Providing autonomy and freedom. Supervisors should minimize rules, restrictions, and commands to foster individual nurses' efficiency and creativity. ⁹

Personal Prevention

Hospitals should incorporate workplace prevention practices to help reduce nurse burnout. Unfortunately, not all hospitals will engage in these practices, and even when they do, it may not be enough for each nurse. There are steps individual nurses can take to prevent burnout for themselves. These steps include:¹⁰

Developing strong relationships. Close relationships in the workplace and at home can help combat nurse burnout. These relationships provide a safe space for nurses to vent about their emotional distress. A balance between work and personal life can also be beneficial when dealing with high-stress situations.¹⁰
Setting boundaries. Nurses should leave any thoughts or feelings regarding work at work and focus on family, friends, and enjoyable activities outside of work. Remaining present and mindful can help reduce burnout. ¹⁰
Getting adequate sleep. Sleep is essential for nursing professionals who want to avoid burnout. Nurses may need to adjust their sleep schedule to ensure they are getting at least eight hours of sleep each day or night. Getting enough sleep can foster alertness, concentration, stamina, mood, and motivation.¹⁰
Maintaining Physical and Mental Health. Regular exercise and a healthy, well-balanced diet can help to reduce stress. Nurses should exercise at least 30 minutes a day to feel rejuvenated and take a mental break. It is also essential for nurses to take time off when needed to prioritize their mental health, reduce burnout, and remain effective in the workplace.¹⁰
Utilizing Therapy and Assistance Programs. Nurses should take advantage of any therapeutic or counseling services their institution offers. If they are not available in the workplace, it may be wise to seek counseling or therapy outside of work.¹⁰