Burnout, the Literature, and Understanding

A discussion of burnout, research, and possible preventative actions to be taken to resolve burnout. Nurses Announcements Archive

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Preventative Measures

Burnout has been a topic well researched starting with Maslach, Jackson, Leiter, Schaufeli, and Schwab (1986). As someone who has been reading literature and spending a tremendous amount of time over the past few years thinking about burnout, I have often been asked what is the cure or the preventative actions. The research is consistent in establishing the existence of burnout and the all too commonality of it.

In my reading, I found articles reporting nursing student burnout. Recent research is attempting to pinpoint where it begins for nurses, before graduation during the educative process? Or as a graduate nurse? The article I wrote recently and published here in allnurses.com titled "Are Nursing Students Burned Out Before or After They Graduate?" (2020) does delve into the topic with much greater depth. Currently, there are many more questions about student nurses and burnout than answers.

Change in Mindset?

Another nurse posted a question in allnurses.com (Destin293, March 17, 2019) "Burnout...what to do about it" had a respondent that stated “There is nothing wrong with YOU or your very reasonable feelings about this. Burnout is not the appropriate label for it. Chin up. Put your confidence and self-worth back in order, as this weight is not yours to bear. You have no professional duty to imposed nonsense. Instead be impowered. Formulate plan B and put it into action” (JKL33, March 17, 2019). A response that is well-meaning but not helpful. If burnout is the perceived experience, it is the individual’s state of being. And the description of burnout as put forth by Maslach et al. (1986) is one the encompasses an individual incapable of self-directed action as described by the respondent above.

However, the respondent that posted the above comment is not alone, many believe that burnout can be defeated with a positive attitude or thinking, pulling oneself up by bootstraps or change of outlook. Maslach et al.’s (1986) beginning and subsequent work along with a plethora of other researchers have established the construct of burnout as valid with many different mediating factors. Little research has found burnout to be mediated simply by a change in mindset.

Self-Care and Mindfulness

Some recent study, however, has explored the impact of preventative measures for nursing students e.g. self-care (Nevins et al., 2019) and mindfulness for nurses Montanari, Bowe, Chesak & Cutshall, 2019). Nevins et al. (2019) reported that an increase in exercise and hydration in baccalaureate nursing students did increase students’ described levels of wellness. Montantari et al. (2019) found that nurses’ use of mindfulness “positive implications for the well-being of nurses” to stress and burnout (p. 175). Increased resilience in nurses mediated burnout (Guo et al., 2019). All increase my hopefulness that research is on track to illuminate a burnout preventative pathway.

Faculty Burnout

Additionally, my literature reading has included the topic I plan to research, nursing faculty member burnout. Aquino, Young-Me, Spawn, and Bishop-Royse (2018) found in their descriptive survey study of doctorate nursing faculty members’ intent to leave their academic position that degree type, age, and burnout were significant predictors. Their recommendations in addressing the nursing faculty member shortage as “critical to creat[ing] supportive and positive work environments to promote the well-being of nursing faculty” (p. 35).

I have found the reading and contemplating burnout and nursing faculty members’ possible experience of it as interesting. The plethora of burnout research mentioned previously consists primarily of educators and healthcare providers as subjects. Little burnout research is of nursing faculty members despite the “great demands placed on many nursing faculty” (Aquino, Young-Me, Spawn & Bishop-Royse, 2018, p. 35).

My doctorate topic is nursing faculty member burnout. I plan to offer qualifying allnurse.com members access to a survey. The qualifications include current full-time employment and one year of experience as a nursing faculty member. Interested? It is coming soon.

1 hour ago, PamtheNurse said:

"I would be interested to know if the rate of burnout is higher in student nurses/nurses whose primary motivation for becoming a nurse is money, job security/status, family pressure, etc., versus those who are primarily motivated by wanting to care for sick people."

Susie2310,

Thank you for your question. I can imagine that a study of such would be fascinating. However, the difficulty would be in determining the population that would represent those nurses that are in the profession for the monetary gain only. Thoughts?

PamtheNurse

Thank you for your reply PamtheNurse. I will post back with my thoughts as soon as possible.

Specializes in SCRN.
On 6/20/2020 at 2:09 AM, Arafelle said:

Part of what burns me out is that, living in the Seattle area, ADN's are being progressively relegated in the hospital setting in lieu of BSN prepared nurses. I haven't even graduated my ADN program yet, and I already feel like I made a mistake and should have just gone for a BSN program or a different career altogether. Moving isn't an option for me.

If you can get into the hospital with ADN ( and you will ), the employer will pay for your way yo BSN. You save money, big time. Hang in there.

Specializes in SCRN.
On 6/19/2020 at 11:02 AM, PamtheNurse said:

Faculty Burnout

Preceptor burn out!

I just finished with precepting 2 nurses back to back. I had no flexibility to trade shifts and do it my way for 3 months! my solution? no more until end of the year.

18 hours ago, PamtheNurse said:

"I would be interested to know if the rate of burnout is higher in student nurses/nurses whose primary motivation for becoming a nurse is money, job security/status, family pressure, etc., versus those who are primarily motivated by wanting to care for sick people."

Susie2310,

Thank you for your question. I can imagine that a study of such would be fascinating. However, the difficulty would be in determining the population that would represent those nurses that are in the profession for the monetary gain only. Thoughts?

PamtheNurse

My idea is the following: The goal of the study would be to determine whether burnout is present in higher degrees in nurses who became nurses PRIMARILY for the monetary reward; social status; job security; family pressure; etc., versus those who became nurses PRIMARILY because they wanted to take care of sick people.

The population would be licensed nurses. One could, of course, make student nurses the population. For example, it would be possible to take a Simple Random Sample of nurses using an appropriate sample size, and ask the nurses to complete a questionnaire that describes the purpose of the study, including the definition of burnout in nurses, and ask the nurses to indicate whether their PRIMARY motivation for becoming a nurse was the monetary reward/social status/job security/family pressure, etc. (indicate which), or taking care of sick people, and also ask the nurses to indicate their degree of burnout and the number of years they have been practicing. This data would then be analyzed. The anonymity of the nurses taking part would of course be preserved.

Specializes in Education.

Susie2310,

You have certainly piqued my interest. I could see the possibility of this study. For a quantitative study: demographics questions could include those that would indicate the monetary motivation and number of years in nursing. The best bet for a validated tool would be the Maslach Burnout Inventory, which would indicate the degree of burnout. Your thoughts on variables? Or would a qualitative study be best?

PamtheNurse

Specializes in Education.

Faculty Burnout

Preceptor burn out!

I just finished with precepting 2 nurses back to back. I had no flexibility to trade shifts and do it my way for 3 months! my solution? no more until end of the year.

RN to BSN,

You have me thinking. I have an interest in nursing faculty members and burnout, however, I hadn't thought about preceptors. Would doing it your way have prevented or preempted the burnout?

PamtheNurse

18 minutes ago, PamtheNurse said:

Susie2310,

You have certainly piqued my interest. I could see the possibility of this study. For a quantitative study: demographics questions could include those that would indicate the monetary motivation and number of years in nursing. The best bet for a validated tool would be the Maslach Burnout Inventory, which would indicate the degree of burnout. Your thoughts on variables? Or would a qualitative study be best?

PamtheNurse

PamtheNurse,

I will reply as soon as I have the chance to consider the above.

Specializes in Stepdown . Telemetry.
On 6/21/2020 at 5:35 AM, JKL33 said:

Well hello there.

I'm disappointed that you did not reach out to give me an opportunity to explain my perspective on burnout before labeling my words unhelpful. I, too, have a lot of thoughts about it, and I'm pretty sure I've even previously posted some explanations of why I feel the way I do.

If I have time I might read what Maslach said 34 years ago. I was not in the workforce back then, but I'm guessing it's safe to say the backdrop has changed significantly. Nurse treatment has devolved even since I've been a nurse (in my own opinion). My consistent philosophy has been that it is wrong and unethical to treat people poorly and then have the focus be on them and their altered responses to the poor treatment -- as if they're the ones with the problem or there is something inherently wrong with them. The ones with the problem are those who disparage nurses, seek to rob them of all autonomy, make them dime-a-dozen "workers" and treat them with disdain while constantly nitpicking and being generally meddlesome. Then nurses get to read articles about doing yoga or spending time with loved ones in order to not feel "burned out." Any of my comments on the topic will hinge upon my philosophy that descriptions of the problem are misfocused.

 Forgive the simple comparison but this whole topic is akin to kicking a dog repeatedly and then seeking to find out why he cowers and doesn't enjoy it and researching what he can do to develop healthy coping--instead of asking why the **** people need to keep kicking him and asking what is wrong with them.

There you have it. Thank you.



OMG thank you for saying exactly what I was about to try to articulate! Much research in the nursing literature exists that studies the CAUSES of burnout: management, work environment, etc. So if we have empiric research on the causes why would the solution be for US to cope with it! That is the problem with the whole mindfulness BS. There is actually (somewhere on the inter web) a solid critique of the “mindfulness movement” in the general workforce that it was created by business interests to get workers to decide its their problem and never to question the system that puts them in awful situations.

Another great point you made was the fact that the OP’s researcher cited was from 30 years ago. Things are dramatically different now. Actually 30 years ago was a turning point: for 200 years up until 1970, basically the start of this capitalist system) real wages rose every single year across the country. People from 1770 to 1970 were realizing the American dream. Then in 1970, real wages flattened, and ever since Americans became overworked and in severe debt and profits boomed at the top.

So my point is, that no, something discussing working conditions 30 years ago is not going to be the same conditions of today. Not even close.

Thanks again for the great summary of the ACTUAL problem.

2 hours ago, PamtheNurse said:

Susie2310,

You have certainly piqued my interest. I could see the possibility of this study. For a quantitative study: demographics questions could include those that would indicate the monetary motivation and number of years in nursing. The best bet for a validated tool would be the Maslach Burnout Inventory, which would indicate the degree of burnout. Your thoughts on variables? Or would a qualitative study be best?

PamtheNurse

PamtheNurse,

For the study idea I put forth, the data collected would be qualitative, not quantitative, as it has to do with human responses and is not numeric data.

I'm not qualified to advise you on study design or statistical procedures, but if you are serious about doing a study and are seeking qualified input, if you have not already done so, I would respectfully suggest considering seeking the advice of a statistician in order to obtain information about the choice of statistical procedures and study designs that are appropriate for the goal of your study/question you want to answer and type/s of data you want to collect.

Best wishes to you.

Specializes in Education.

Susie2310,

I have my own research I am attending at the moment. My topic is nursing faculty member burnout. Variables are perceived organizational support and self-efficacy.

However, is this a study topic one you would want to pursue? You certainly have a grasp of the idea. A qualitative study would be an interesting one. Deciding design and analysis procedures is a bit down the road. First, a discussion of possible variables and then an investigation of previous research would give insight on proceeding.

I am happy to be involved in the discussion of the possible variables. Your thoughts?

PamtheNurse

Specializes in Med Surg, Tele, Geriatrics, home infusion.
On 6/21/2020 at 11:48 PM, JKL33 said:

To me, being personally burned out on something requires that there be nothing inherently wrong with that thing; rather, the one burned out is just tired of it and ready for something new.

Example I have posted before: If I have a fresh and nutritious salad every day at lunch for 10 years, there might come a point where I say, "Meh, I'm pretty burned out on salad for lunch. I think I need to find something else for awhile." On the other hand, if I am upset that someone expects me to happily eat a sh*t sandwich....that isn't burnout. That's just being intolerant of poor treatment.

***

Do you have a theory about it?

My theory would be that those who are in it for money or job security will be shown to fare much better with regard to "burnout" [a concept whose application to nursing is misfocused]. Those who wanted to serve others' needs, take care of sick people and provide excellent nursing care are in for a world of hurt in our current system. It would not surprise me in the least to hear that this latter group has a more difficult time with the dog and pony shows that are championed as representing good care.

THIS. I share your theory. The more you care, the more the healthcare system will exhaust and disillusion you. It's almost as if healthcare should not be for profit...

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