Preventing Nurse Burnout

1. Preventing  Nurse Burnout By: Gurjinder Binapal and Sandeep Nijjer

2. Burnout Burnout is a condition that evolves slowly over a period of prolonged stress. It wears down and wears out energy exhaustion due to excessive demands which may be self-imposed or externally imposed by families, jobs, friends, value systems or society. This depletes one's energy, coping mechanism, and internal resources. It leads to a feeling state that is accompanied by an overload of stress, and eventually impacts one's motivation, attitudes, and behaviours. (Smith, Jaffe-Gill &Segal, 2007)

3. Who is at Risk for Burnout? You may be more likely to have job burnout if: You identify so strongly with work that you lack a reasonable balance between work and your personal life. You try to do everything for everyone. Your job is monotonous. You work in a helping profession, such as health care. You feel you have little or no control over your work environment. (Smith, Jaffe-Gill &Segal, 2007)

4. Signs and Symptoms of Burnout Being more cynical, critical and sarcastic at work. Lose the ability to experience joy at work. Feeling like you have to drag yourself into work and have trouble getting started once you arrive. Becoming more irritable and less patient with co-workers or clients. Feeling that you cannot overcome barriers at work. Lacking the energy to be consistently productive. No longer feeling satisfied from your achievements. Co-workers asking you if you're OK. Feeling disillusioned about your job. Self-medicating by using food, drugs, or alcohol to feel better or to simply not feel. Changes in sleeping habits or appetite. Having unexplained headache, neck pain, or lower back pain. (Smith, Jaffe-Gill &Segal, 2007)

5. Causes of Burnout Nursing Shortage Lack of autonomy and respect Government funding cuts Aging population (CBC News, 2006)

6. Effects of Burnout on Nurses Increased Workload Exhaustion Limited support from colleagues and administration. Increased sick calls. Physical and psychological illnesses. (Greco, Laschinger, & Wong, 2006)

7. Strategies to Reduce Burnout Communicate openly and clearly with coworkers and management. Join support groups Know your job limits and rights. Relaxation techniques ie: massage therapy, exercise, yoga, etc. Attend seminars related to stress management and job burnout. Healthy Diet (Greco, Laschinger, & Wong, 2006)

8. Statistics Nearly half of all health care providers in�2003�suffered a high degree of work stress, with nurses, doctors and lab technicians reporting the highest levels, according to a new study. Among health care providers, 45, reported that most days at work were "quite" or "extremely" stressful. By comparison,�31% of all other employed people reported this level of stress. Two-thirds, or 67%, of head nurses and nurse supervisors reported high work stress, among the highest of the health care occupations, the study found. In registered nurses high work stress ranged from 58% to�64%. Even when influences outside the job were taken into account, nurses and physicians were significantly more likely to report high work stress than all other health care workers. Among health care workers who reported high levels of stress in their daily lives,�78% also reported high work stress. Similarly,�75% of health care providers who reported being "dissatisfied" or "very dissatisfied" with their lives reported high work stress. There was no statistically significant difference between the proportions of men and women in health care occupations who reported high work stress. Age was a factor, however, with about half of health care providers aged�35�to�54�reporting high work stress, the highest among age groups. In comparison, the proportions were lower, at�41%, among those aged�55�to�75, and�31% among those younger than�25. Health care providers who worked�35�or more hours per week were much more likely than those working fewer than�35�hours per week to report high stress. As well, those who had a schedule other than a regular daytime shift were more likely to report high work stress. (Statistics Canada, 2007)

9. Driving and Restraining Forces Driving Forces More Staff Decrease Costs Increase Staff Productivity Less Sick Calls Reduced Stress Satisfied Individual Needs Reduced Workload Improved Job Satisfaction Restraining Forces Less Staff Increased Costs Exhaustion Increased Workload Time limitation Lack of Communication More Sick Calls Poor Judgement

10. Kurt Lewin�s Change Theory Kurt Lewin describes change as a three-step process. The 3 stages include: Unfreezing Moving to a New Level Refreezing (Ritchie, 2006)

11. Unfreezing Involves accepting that change is necessary, and breaking down the existing status quo before building a new way of operating. Strategies: Interview nurses and use surveys to assess the cause of burnout and the increased workload. Present the problem to the government using the media to show awareness of the issue. Empower nurses to feel more involved and to have control over their work environment. (Ritchie, 2006)

12. Moving to a New Level Involves a change in the way an individual or organization thinks, feels, and behaves. Strategies: Provide sufficient resources for questions that may arise. Evaluate and obtain feedback from staff regarding work related issues. Organize in services on managing burnout. Ensure the government is aware of the burnout rate and staff shortage. Discuss work related concerns regularly through open communication ie: group meetings, surveys, interviews Appoint a liaison between staff and management regarding work obstacles Use trial and error procedures to measure effective and ineffective strategies. (Ritchie, 2006)

13. Refreezing Involves stabilizing the new equilibrium resulting from the change by balancing both the driving and restraining forces. Strategies: Continuously monitor staff effectiveness to reduce burnout. Assess, observe, and ask staff about stress in the work environment, so that problems can be resolved promptly if they arise. Continue doing surveys and interviews to assess needs and to make changes as applicable. (Ritchie, 2006)

14. Conclusion Overall Goals: Improved Staffing Levels Enhanced Job Satisfaction Decreased Workload Reduced Burnout and Stress Levels

15. References CBC News. (2006). Nurses report high levels of abuse, stress. Retrieved October 24, 2008, from http://www.cbc.ca/canada/story/2006/12/11/nurses-survey.html Greco, P., Laschinger, H., & Wong, C. (2006). Leader empowering behaviours, staff nurse empowerment and work engagement/burnout. Canadian Journal of Nursing Leadership, 19(4), 41-56. Retrieved October 21, 2008, from http://www.longwoods.com/product.php? productid=18599 Ritchie, B. (2006). Lewin�s change management model: Understanding the three stages of change. Retrieved October 19, 2008, from http://www.consultpivotal.com/ lewin% 27s.htm Smith, M., Jaffe-Gill, E., & Segal, J. (2007). Understand prevent and resolve life�s challenges. Retrieved November 1, 2008, from http://www.helpguide.org/mental/burnout_signs_symptoms.htm Statistics Canada (2007, November 13). Study: Work stress among health care providers. Retrieved November 1, 2008, from http://www.statcan.ca/Daily/English/071113/d071113a.htm