Nurses are feeling more stressed than ever before. In the two years following the pandemic, healthcare workers have suffered declining mental health and rising rates of nurse burnout. What starts as discontentment or job dissatisfaction can lead to more serious problems. In this blog, we will explain the causes, symptoms, and prevention strategies for nurse burnout.
Nurse dissatisfaction leads to burnout
In a study conducted by nursing faculty at the University of Pennsylvania’s School of Nursing, researchers found that a large number of nurses are unhappy. According to the study, nursing dissatisfaction stems from undesirable working conditions, including,
- Work environment
- Staffing levels
- Benefit packages
In fact, the lack of benefits seems to be a focal point of nurse dissatisfaction.
Nurse unhappiness is nothing to take lightly. Nursing professionals administer 90 percent of the world’s health care. Furthermore, the study has linked nurse dissatisfaction with poor patient outcomes. The study’s abstract reads:
Patient satisfaction levels are lower in hospitals with more nurses who are dissatisfied or burned out—a finding that signals problems with quality of care. Improving nurses’ working conditions may improve both nurses’ and patients’ satisfaction as well as the quality of care…More than one-third of patients report that they would not recommend their hospital to family and friends, and the quality of nursing home care has been a concern to families for a long time.
That’s a problem. With the passing of the Affordable Care Act, hospital emphasis has turned to patient satisfaction, which is great for us. But nurses are struggling to adjust. Their dissatisfaction manifests itself.
According to the study, nurses have long reported that their work conditions are not conducive to providing patient-centered care that is safe and of high quality. The relationship between nurses’ working conditions and patient safety was recognized by the IOM report Keeping Patients Safe: Transforming the Work Environment of Nurses. Indeed, researchers have suggested that the work environment and staffing levels for nurses affect both nurse burnout—which is characterized by feeling extremely overextended and depleted of one’s emotional and physical resources in response to chronic job stressors—and job satisfaction, and are also associated with patients’ satisfaction with care.
The study goes on to segment nurse satisfaction by setting. The following are the types of nurses (providing direct patient care) surveyed and the percentage of nurses dissatisfied:
- Hospital – 24 percent dissatisfied
- Nursing Homes – 27 percent dissatisfied
- Other Settings – 13 percent dissatisfied
There’s much more data worth exploring in the study, which you can read in its entirety here. The fact is, nurse satisfaction is critical to patient satisfaction. Which means that you and I are a lot safer when our nurses are happier.
On the other hand, nurse dissatisfaction can lead to a much more serious issue, nurse burnout. In a survey of registered nurses working in New York and Illinois from December 2019 through February 2020, more than 40% reported high burnout. One in four were dissatisfied with their jobs. The prevalence of burnout is higher now, in the post-pandemic era of healthcare.
Research shows that healthcare workers, particularly nurses, have experienced high levels of burnout since the COVID-19 pandemic. At the height of the public health emergency, many nurses found themselves working in facilities with inadequate resources, increased workloads, and dying, quarantined patients. One study on nurses’ mental health during the pandemic highlighted these disturbing trends:
- 80.1% of nurses reported moderate stress
- 43% of nurses reported moderate to severe anxiety
- 26% of nurses reported moderate to severe depression
These alarming stats show just how much the profession has struggled in the past few years. Job stress that is not dealt with, or mismanaged, can lead to more serious matters.
What is nurse burnout?
Nurse burnout is a state of exhaustion caused by chronic work stress that is ineffectively managed. It is a widespread phenomenon characterized by a reduction in nurses' energy and may lead to reductions in work efficacy.
The three hallmarks of the nursing burnout syndrome are:
- Emotional exhaustion
- Cynicism or depersonalization
- Low sense of personal accomplishment
The process can develop slowly. And at first, the feelings may be subtle. Yet over time, stress compounds, until eventually burnout syndrome develops.
Nurse burnout can feel intense. It is a personal experience and a social problem, caused by the workplace. Its effects are often work-related.
What triggers or causes nurse burnout?
According to the World Health Organization, healthcare workers face unique challenges in the workplace that contribute to high stress. Some of these nursing-related stressors include:
- The intrinsic demands of the job
- Hospital nurse staffing shortages
- High nurse to patient ratios
- Excessive workloads
- Workplace bullying
- Compassion fatigue
These factors can trigger or cause nurse burnout over time if they aren’t managed effectively.
In addition to the nurse’s work life, factors in their personal life, such as lifestyle, habits, and choices may also be causes or triggers. For example, inadequate sleep can make a nurse more prone to burnout. Likewise, nursing professionals who do not have a strong support system may find it harder to manage job stress, and may succumb to it more easily.
Some research suggests that working more than 40 hours per week and working longer shifts are strongly correlated to increased reports of burnout.
Symptoms of nurse burnout
When you know the symptoms of nurse burnout, you can better identify problems and act early to address the causes before it escalates. Common symptoms associated with nurse burnout include:
- Malaise and fatigue
- Difficulty concentrating or focusing at work
- Feelings of dread or anxiety about going to work
- Trouble sleeping
- Change in appetite, eating more or less than normal
- Disinterest in helping others
- Frequent self-doubt
- Headaches and muscle pains
- Nausea or upset stomach
- Physical aggression
Each nurse’s personality characteristics, coping skills, and support systems will affect how nurse burnout is expressed. In other words, overwhelming exhaustion will look and feel different from one nurse to the next.
If you suspect that you or someone you know is heading down the spiral of burnout, face the issue head on with gentleness, compassion, and respect. If left unchecked, nurses will only grow more weary and may face dire consequences in their nursing careers.
Eventually, they can suffer from serious mental, physical, or professional effects.
Perils of nurse burnout
Nurse burnout results in adverse consequences both for individuals who suffer, and the organizations in which they work.
Psychologically, burnout affects cognitive and emotional function. Studies have shown that burnout is associated with anxiety, depression, low self-esteem, increased alcohol and tobacco use, and irritability.
Physical consequences of stress and exhaustion affect all of the body systems. Research demonstrates that workers who are burned out are more likely to suffer musculoskeletal pain, gastrointestinal upset, cardiovascular disorders, headaches, increased vulnerability to infections, and insomnia.
Within health care facilities, nurses who are burned out influence the rest of the organization, causing a ripple effect that leads to a bad work environment. Perils of nurse burnout within a facility can include:
- High staff turnover
- Reduced patient satisfaction
- Increased medical errors
Ultimately, everyone suffers when nurses become run down and worn out.
How nurses can prevent burnout
Fortunately, these problems are preventable. To prevent nurse burnout, individuals and organizations can assess their wellbeing and take action to reduce stress and improve job satisfaction.
How can we improve nurse satisfaction? We can start by addressing the nation’s nursing shortage. Remedies like international staffing and travel nursing are both a safe recourse for hospital administration to consider. According to a recent USA Today article, travel nursing demand has reached a 20-year high.
Providing better benefits is also a good way to improve nurse satisfaction. Benefit packages will vary by hospital system, but international and travel nurses can secure incentives for themselves based on which agency they choose. For example, Health Carousel Travel Nursing offers exceptional benefits.
There’s a reason that the demand for travel nurses has reached a 20-year high. The nursing shortage is taking its toll on nurses who are knee-deep in the trenches, working longer shifts and playing multiple roles to meet unprecedented work demands. Nursing professionals need help by way of reform. And until that happens at an institutional level, nurses should consider all of their options.
The study would suggest as much, ending with “It may be possible to improve patient satisfaction and avoid other adverse patient outcomes while also improving nurse satisfaction and retention by improving working conditions for nurses.”
While there is still a lot of work to do to restore nurse satisfaction and combat nurse burnout, working conditions can be improved by addressing the staffing shortage. One way hospitals can do this is by using alternative staffing methods like international and travel nursing.
Also full-time nurses enduring overly-stressful work environments might consider a change to travel nursing. Instead of feeling stuck in a rut of prolonged poor conditions and inner-hospital politics, travel nurses enjoy new scenery, make new friends, and enjoy the freedom to explore their nursing passions. They also earn excellent pay with matchless benefits. Click the button below to learn why nurses like you start traveling!
What is the treatment for burnout?
The best treatment for burnout is relief from the stressors. Once you remove yourself from the environment that is aggravating your physical and mental health, you can manage nurse burnout by treating the symptoms. These can include headaches, muscle aches and spasms, stomach issues, and fatigue. Self care including rest, hydration, nutrition, and light exercise will encourage physical and mental health.
How can nursing burnout be prevented?
Nurses can take steps to reduce stress and prevent personal burnout through awareness and education. Talking about coping techniques and stress management can empower nurses with tools to beat burnout. Talking about it openly can help remove some of the stigma that nurses may feel when they just can’t handle the feelings of emotional and mental exhaustion.
Which nursing specialty is more prone to burnout?
It stands to reason that nursing positions that are high stress and where nurses may feel inadequate, unprepared, or ineffective are prone to burnout. One survey among nurse practitioners, nurse managers, and emergency department (ED) nurses found that ED nurses experienced burnout the most. They also had less control of their environment. Nursing professionals with advanced nursing degrees were at lower risk. Other studies have found that healthcare providers in the most acute hospital settings (e.g. the ER, ICU, CCU) where patient mortality is higher are the most vulnerable.
Who is at risk for nurse burnout?
All nurses are at risk since nursing can be stressful. Yet, some are at higher risk than others. Nursing students and new nurse graduates are at increased risk because they may find the job more difficult and might not have the tools to deal with challenges.
What are the five stages of burnout?
Dr. Robert Veninga and James Spradley qualified five stages of burnout in their 1981 book called “The work/stress connection: How to cope with job burnout.” The five stages of burnout are:
- Stage 1: Honeymoon Phase- a time of job satisfaction, commitment, and creativity before stress
- Stage 2: Balancing Act - awareness of job stress, job dissatisfaction, inefficiency, and fatigue
- Stage 3: Chronic Symptoms - intensification of stage 2, marked by physical illness, anger, or depression
- Stage 4: Crisis - symptoms become critical
- Stage 5: Enmeshment - symptoms become embedded in life and you become labeled as having a mental or physical problem, you are a “burnout case.”