Managing Stress: The Prevention of Burnout Heather A. Ingalls Chamberlain College of Nursing NR 351: Transitions in the Professions Summer A 2010 Managing Stress: The Prevention of Burnout Farrington (1997) stated “Stress has been identified as possibly the greatest reason why so many qualified nurses give up nursing” (p. 44). Stress leads to burnout which leads to nurses no longer being nurses either by personal choice or by some incident that happened that has caused this nurse to no longer practice.
This paper will discuss and define stressors for the professional nurse and explain burnout as well as strategies to manage the stress and prevent burnout. Lastly it will go over a case study and discuss some examples the nurse used to decrease stress and prevent his or her burnout. Definition of Stressors and Burnout Stressors can be thought of as physical, psychological, or social force that puts real or perceived demands on the body, emotions, mind, or spirit of an individual. Nurses can have personal stressors and stressors brought on by the company they work for.
Examples of personal stressors would include marital problems, financial concerns, and possibly problems with children just to name a few. Company stressors are “professional latitude and role problems such as inconsistencies in patient care, conflict, clinical demands and workload” (Farrington, 1997, p. 44). This could include the nurse to patient ratio, mandatory overtime, and working within strict budget, limiting the care a nurse is able to provide, and dealing with the emotions that come when a patient is unable to be saved.
Taormina and Law (2000) describe “burnout as a state of physical, emotional and mental exhaustion found in people who work intensively with other people in emotionally demanding situations” (p. 89). Van Den Tooren and De Jonge (2008), conducted a study in a Dutch Nursing Home and found the top three reasons for burnout were emotional exhaustion, depersonalization, and a decreased feeling of personal accomplishment. The study showed that correlation that high physical and mental demands when associated with low physical and mental resources put the nurse at the greatest risk for emotional exhaustion and burnout.
Management of Stressors With the appropriate management of stressors, negative stressors can turn positive, burnout can be prevented, and the entire circumstance can become a learning experience. A nurse who can learn to manage personal stressors can be more equipped to manage stressors at work. The same holds true for a nurse who learns to manage stressors at work is more prepared to manage stressors at home. Training is the most important way to teach a nurse to manage stress. Personal stress management programs include the development of interpersonal skills, self management skills, and psychological preparedness.
Stress management programs are designed to aid in gaining interpersonal skills (Taormina and Law, 2000). These skills are so important to nursing. Through learning the skill of intereacting with others, a nurses overall stress level is decreased. “Such skills involve creating relaxed interactions with others while maintaining one’s ability to refuse a request that is too burdensome” (Taormina and Law, 2000, p. 90). The more developed interpersonal skills a person has, the less depersonalization and emotional exhaustion occur.
Self management skills are used by people to learn to manage their stressors through a positive release of negative energy. Some examples of this include relaxation techniques, breathing techniques, reading a book, exercising, and even just sitting by oneself and meditating. These skills help reduce the negative effects on stress and teach the person to more effectively manage their lives personally and professionally. Just as with the interpersonal skills, developed self management skills decrease depersonalization and emotional exhaustion (Taormina and Law, 2000). Finally psychological preparedness needs to be established.
Nurses and other healthcare providers who follow patients through their disease processes can feel the strain the patients are going through as well. Taormina and Law (2000) stated “that defending oneself with psychological skills and realistic expectations can help people deal more effectively with stressful situations” (p. 90). Training nurses in counseling skills will help alleviate burnout and emotional stress. Aan organizational approach focusing on the work environment to include training, coworker support, and an awarding system will reduce stress and prevent burnout.
Training personnel will develop their skills to improve quality care for patients and also increase the nurses’ self confidence in the quality of care they provide. To prevent burnout a hospital that expects a high quality of care needs to provide the nurse with the means to complete the tasks and provide good training in job specific areas. Nurses feel more personal accomplishment and suffer less emotional exhaustion when they receive high quality training (Taormina and Law, 2000). Coworker support accomplishes a few ideas. Having coworker support aids in interpersonal skills, helps build a community, and provides emotional support.
Coworkers are the people that can relate best to what another coworker is going through and offer up advise that they have learned from to assist that other person. The coworker support will also prevent depersonalization by giving that nurse or healthcare worker the ability to ventilate emotions (Taormina and Law, 2000). Having some type of award system in the hospital helps motivate all workers. A nurse that is able to manage stress is often provided with opportunities for promotion, pay increases, and recognition for hard word. Conceptually, nurses with a positive view of their future, such as anticipated rewards from their organization feel encouraged, and thus be less susceptible to emotional strain” (Taormina and Law, 2000, p. 92). Case Study The following case study describes life and career stressors experienced by a registered nurse and how these stressors were managed to prevent the nurse from developing burnout. Nora is a 32 year old RN. She is feeling overwhelmed lately. At home she is fighting with her husband because she is working too many hours at the local hospital.
Her two children have not been listening well because she is not the one at home watching them normally and are only listening to her husband. Financially she and her family are doing alright. Nora has worked at the local hospital for almost eight years now. For the past two months Nora has been working almost an hour into the next shift and weekly it seems that there are not enough nurses to cover the next shift so she is asked to stay through half the shift and the night nurse is coming in early to cover the other half of the shift. Nora is taking care of five patients, one or two of which need a treatment that Nora is unfamiliar with.
Unfortunately the rest of the staff is stressed and unable to help Nora. She knew that she was about to explode physically and mentally if she did not do something about it. Nora went and spoke to her supervisor and took a week off work and spent quality time with her family. Upon returning to work Nora’s supervisor had set up inservices throughout the month to cover procedures that were not common to that ward and the co-workers had set up weekly pot lucks to increase the morale and give the nurses a chance to talk with each other. By taking some time to herself, Nora was able to recognize her increased level of stress and potential burnout.
She wa able to work on interpersonal skills and self management skills during her time off. Because Nora shared her concerns with her supervisor, the supervisor realized the concerns were also shared by other staff members. As a result, training was implemented and wime was set aside for the nurses to establish a community for openly discussing their concerns and frustrations. Conclusion Although some stress is inevitable, the majority of stress can be reduced making the stress that exists a positive thing that motivates the nurse to work compassionately and efficiently. Stressful events may be perceived as either challenges that lead to positive growth or threats that can lead to negative consequences” (Hood, 2010, p. 200). It is the responsibility of the organization and of the nurse to notice when there is an increase in stress and use the appropriate means to manage it to prevent burnout. Between the shortage of nurses and the effort put forth by nursing students it is too much to waste to be burned out too quickly and decide to leave the practice. References Farrington, A. (1997). Clinical management.
Strategies for reducing stress and burnout in nursing. British Journal of Nursing, 6(1), 44-50. Hood, L. (2010). Leddy and Pepper’s Conceptual Bases of Professional Nursing. (7th ed. ). Philadelphia, PA: Lippincott Williams & Wilkins. Taormina, R. , & Law, C. (2000). Approaches to preventing burnout: the effects of personal stress management and organizational socialization. Journal of Nursing Management, 8(2), 89-99. Van Den Tooren M, & De Jonge, J. (2008). Managing job stress in nursing: what kind of resources do we need? Journal of Advanced Nursing, 63(1), 75-84.