Nursing is not for everyone. It takes a very strong, intelligent, and compassionate person to take on the ills of the world with passion and purpose and work to maintain the health and well-being of the planet. No wonder we’re exhausted at the end of the day!’ (Donna Wilk Cardillo).
Select a Concept
When hearing about nursing caring, empathy, compassion, and medication administration come in mind but burnout is the cost of caring that weighs down on nurses. Nurses work in very demanding environments, long hours, constantly pulled in different directions, and understaffed thereby increasing the workload to a nurse. Working in a Long-term care (convalescent home), nurses have continued to bear more tasks, don’t have enough time to recuperate, work extra hours, and have been left to handle things without help. All these extra stressors cause exhaustion at the end of shift. Nurses going home at the end of eight-hour or twelve-hour shift are very tired and exhausted the author called these feelings Burnout.
Aim of Concept Analysis
The purpose of this paper is to expand the understanding of the concept of burnout in the nursing profession but mostly in long-term care. Burnout has so many negative implications for nurses both in their personal life and at a professional level. Personally, burnout can create a hindrance to the nurse-client relationship. It can cause exhaustion, anxiety, change in appetite, feeling of helplessness, lack of motivation, detachment, etc. Professional level, burnout can cause an increase in medication error, poor judgments, not following policies, etc.
Presently, at the Long-Term care, there has been an increase in falls, bedsore (pressure ulcers), medication errors, and shortage of staff. All these factors indicate a significate side effect of an increased burnout among nurses. It has been noted that most nurses stay beyond their scheduled shifts just to be able to catch up with their daily tasks. There are several ways burnouts can be fixed. First, the management should consider rearranging the patients on each unit to avoid having heavy and/or difficult clients in one unit. Secondly, whoever oversees the scheduling of the nursing staff should make sure that there is adequate staffing for both nurses and nurse’s aides. Finally, the nursing directors should have a quarterly in-service on how to manage work-related stress.
Current uses and Historical Perspectives:
Burnout is an exhaustion of physical or emotional strength or motivation usually as a result of prolonged stress or frustration (Merriam-Webster’s online dictionary, n.d).
HelpGuide defined burnout as the feeling of extreme physical and emotional exhaustion that often affects doctors, business executives, and first responders.
Psychology Today defined burnout as a state of emotional, mental, and often physical exhaustion brought on by prolonged or repeated stress—is not simply a result of working long hours.
Mayo Clinic defined it as a state of physical or emotional exhaustion that also involves a sense of reduced accomplishment and loss of personal identity. The concept of burnout in nurses are found in numerous works of literatures. Burnout is generally viewed as a psychological phenomenon that emerges from a prolonged response to chronic interpersonal job-related stressors (Maslach, Schaufeli, & Marek, 2017).
Emotional exhaustion is considered the central factor of burnout syndrome. It is characterized by a feeling of exhaustion lack of energy and physical and emotional overload (Leiter & Maslach, 2004).
Stressful events, especially in this type of acute clinical environment, occur with some regularity. The inability to process the information leaves stress unchecked. That type of unresolved stress can layer upon previous experiences and progress over time from an acute issue to chronic fatigue and eventually lead to burnout (Waddill-Goad, 2016).
Defining Attributes of Concept
Concept analysis allows nursing scholars to examine the attributes or characteristics of a concept. Examining the attributes of a concept is the best approach to recognize and differentiate it from another concept (Walker and Avant (1995),
Exhaustion is an attribute of burnout because it is found in all definition of burnout. However, in the literature review, the word exhaustion was found to be an important concept that will help in understanding the sensational effect in the concept of burnout. Exhaustion is said to be the state of feeling depleted of an employee’s emotional and internal resources. It makes an employee feel like that there is nothing more to give to the job because there’s nothing left to give.
Physical exhaustion is one of the attributes found in all works of literature and is also found in the definition of burnout. It comes when a nurse develops overexertion due to inadequate rest periods. The nursing profession is a physically demanding job that requires nurses to be on their feet most of the time. When adequate rest periods are not observed, the nurse will develop physical and emotional exhaustion leading to burnout.
The best remedy for burnout is more rest periods, adequate staffing, working equipment, and strong leadership. A strong leader should be the one that will be proactive in the well-being of the nursing staff, extra time off, and rearranging each unit to help ease the workloads on nurses. The nursing scheduler must make sure that when a nursing staff calls out, that there will be a replacement before the next shift starts.
Burnout is a very unpleasant situation for nurses and imposes a high risk to clients or patients or residents, families, staff, and the organization. It is the emotional, physical, and mental exhaustion that affects nurses, directly and indirectly, the patients, families, and finally to the organization as well. When all situations that are responsible for causing burnout are corrected, it is then there will be a great harmony within each nurse that will result in giving excellent care to their patients and families.
When all attributes of a concept are utilized, it is an example of a model case (Walker & Avant 2011). Mercy, a Licensed Practical Nurse (LPN) in long-term care, begins her eight-hour shift at 0700. She is an excellent nurse, pays attention to her patients, but the facility isn’t staffed appropriately. The smile on her face is electrifying. After morning report, she will brief her aides on the expectation for the shift, and she assigns patient assignments to them. She found out that four patients were admitted to her unit the previous day. On assessing new patients, she noted that three of the patients have very extensive wounds, and two of the patients are on bolus tube feeding. Her medication pass (administration) was very extensive she is always careful to avoid any medication error. She was called into a room by one of the nurses’ aides to assist with a transfer of a patient to a wheelchair because one of the aides was on a breakfast break. When getting back to the mediation cart, a family member was waiting for her to ask questions.
By noon, she hasn’t finished her medication pass or take any break to refuel for the remaining of the shift. She became very exhausted in taking so many roles. She was physically drained, exhausted, frustrated, and was found in her medication room crying. She went to her nursing manager, tabled her dilemma, and demand that something must be done before she makes a serious mistake. The manager called-in extra nurses’ aide to assist other aides. She requested that the infection control nurse and wound nurse assist Mercy in making sure that the rest of the shift is uneventful. With that little change, she had a few minutes break for a snack and finished her work in time with a smile.
A contrary case is the opposite of the concept, the one that omits all the defining attributes (Walker & Avant 2011). Edward is a male registered nurse (RN), who works in a medical-surgical unit. Normal working hours are twelve hours shift per day for three days a week. He normally begins his shift at 0700 and ends in 1900. On this given day, he came to work and found that his unit is full, well-staffed both nurses and nurses’ aides are present. His assignment doesn’t have a heavy load of patients. He has multiple breaks, assisted other nurses and aides. He finished his twelve-hour shift without been exhausted or emotionally drained.
The antecedents that must occur prior been burnout includes being a nurse either RN or LPN, work in a hospital or long-term care facility, shortage of staff and equipment, having patients with a complicated issue, and/or difficult families. A nurse either RN or LPN cannot be burnout unless all this antecedent exists regardless either in the hospital or long-term care facility.
Empirical referents are classes or categories of actual phenomena that by their existence or presence demonstrate the occurrence of the concept itself. Empirical referents are the criteria used to evaluate the existence of the defining attributes (Walker & Avant, 2011). Being physically drained, exhausted, and found in a corner crying are all measurable components of the concept.