In nursing how does stress management compared to no stress management affect turnover and burnout

In nursing how does stress management compared to no stress management affect turnover and burnout

Description of the problem

            Burnout refers to the stress that is chronic related and comes in the workplace a result of excessive work or unpleasurable conditions in the workplace. It has become an increasingly concerning and prevalent problem in healthcare and other organizational employees.  The people working in healthcare are exposed to stress and are therefore quite prone to burnout because of the overwhelming demands and excessive efforts that are required in nursing.  Nursing field required the nurses to deliver daily a continuously are quite exposed to cases of burnout and eventual turnover. Nurses are working in continuously stressful places that continuously dead the physical, emotional and mental strength. Healthcare personnel are always at risk of burnout and can quit their jobs because of this continuous stress. The constant work in stressful and needs concentration all the time has led to numerous individuals quitting and is becoming a concern within healthcare. High level of stress has also led to a decrease in the quality of service delivery together with other problems such as reduced satisfaction from the patients. The nursing profession has received negative reviews because of the passion that has reduced in the field. Because of these problems, there is a need for continuous improvement in service delivery through interventions that can decrease nurse burnout and turn over.

This research will explore articles from databases that examine the methods that can be used to avoid burnout as well as methods to cope with the problem identified and to prevent it completely. This is significant as it will benefit numerous nurses together with other healthcare professionals in identifying numerous risk factors that lead to this problem. Additionally, they will learn about methods that can be used to manage the problem and eventually prevent burnout and turnover. Quality of patient care can also allow the nurses to experience job satisfaction and therefore lead to a positive outlook of the healthcare sector.




In regards to the PICOT question, The PICO question was, “In nursing how does stress management compare to no stress management affect turnover and burnout?” the question asks how stress management compares to known stress management situations and how this management can give differences in master and avoid burnout.

Literature search

To find the most appropriate information in regards to the PICOT question addressed in this research, there is the need to perform a literature search from the database. The database searches that are used include the PubMed database, CINAHL database, and  Cochrane Database. Others include google scholar among others. The search terms that have been used here include; “personnel turnover”, “nurse burnout”, “professionalism”, “nurses”, “petitioners”, “medical professionals”. Filters were used in narrowing research articles including those that dealt with the following terms: Human species, research articles, in English, adult participants above the age of 19. Generally, the timeline for the articles was limited to 100 years and several other exemptions including the relevance to the topic. Some articles were extracted indirectly from PubMed. These were found from PubMed and sought through the other means. It is this reason why these articles are predating the searched years. There was also a total of 50 articles together with two sites  the search engines as shown in the table below.  There is one textbook reference that is used for the paper and can be seen in the references.


Databases searched Search term


Years reached The total numbers of the identified studies The total  included articles number The total number of articles that have been excluded
PubMed MeSH

“Burnouts, professionals” with the subheadings:

•       “nursing work.”

•       “educational”

•       “prevention methods and controls.”

2009-2014 158 23 135

“Walking methods” with the used  subheadings:

•       “education, learning”

•       “psychology”

•       “trend”

2009-2014 320 12 308

“Nurse Turnover”AND “Nurse”

AND “Cost and Costs Analysis”

2005-2014 12 4 8
CINAHL Generalisation 2009-2014 280 0 280
  “Burnout” with subheadings:

•       “nursings”

•       “educations”

•       “preventions and control”


“Nursing student and stressers”

2009-2014 8 4 4
The Cochrane Database for review General

“Nursing burnouts”

2005-2014 2 0 2

“WalksAND moods”

2005-2014 124 0 124
Scopus General

“Walking AND stressers”

2009-2014 737 3 734
Google Scholar General

“Walking programs and nursing students”

2005-2015 17,000 4 16,996
Search engines/websites searched Search term


Years searched Number of sites identified Number of sites included   Number

of sites excluded

http://www.aacn.nche.ed u/medias-relations/factsheets/nursing-shortage n/a n/a 1 1   0


Critical literature review


The 26 articles out of the fifty articles that had been obtained and examined based on the potential of their contribution to guideline development. The findings of the study are organized through the articles used and those that will be described. A more focused review of the relationship between these studies together with their similarities is then presented later on.


Major themes

Several themes are identified in the articles that have been presented that relate to the prevention of burnout in nursing and turnover. They relate to the implementation of the programs such as a walking program that can allow the nurses to relax and eliminate the stress. The major topics are the factors involving burnout for the nursing students and how to cope up with a burnout thereby maximizing the potential benefits of stress relief exercises. Through understanding methods that can be used to differentiate between performing and assess and whether the nurses under stress management perform better than those that do not go under stress management this far determines the outcome of the articles. Understanding of these themes enables us to assess how to assess the differences and whether the nurses under stress management are performing better than those that do not perform under stress management.

Description of the used Studies

The researchers in the first study conducted cross-sectional research that states that burnout in nurses is one factor that is influenced by certain personality traits. That is also influenced by personal accomplishments together with variables that depend on each nurse. This research had questions that were asked based on the risk factors that cause nurses to burn out and concluded that personality was a massive factor (Cañadas-De la Fuente, Vargas, San Luis, Garcia, Cañadas, and De la Fuente, 2015). The purpose of this study was to identify various risk factors that lead to burnout and whether they were ways that could be used to intervene at the managing stress levels to reduce burnout.

Sallon, Katz-Eisner, Yaffe, and Bdolah-Abram, 2017 looked to find the impacts of interventions for the nurses. The research used 97 participants compared to 67  participate in the research where 66% of them had an average age of 44.5 years. The participants selected were all professional nurses that gave total patient care. The participants were also selected from different public hospitals (Chang, and  Chan, 2015).

Gómez-Urquiza et al., 2017 wanted to determine the prevalences about the burnout and how it affects the nurses. In this study, the participants were given questionnaires that would be used to assess the level of burnout. Apart from this, they were supposed to fill up personal treats together with their demographics in 1 hour. The tool that was used for the study if the personality was known as revised NEO ( neuroticism characteristic, extraversion characteristic, openness characteristic). Personal inventory was made up of five different dimensions and five-factor theories of neuroticism, extraversion, and openness together with experiences, agreeableness experience, and consciousness. The other tool that was used in this study is Maslach burnout inventory that was made up of the three dimensions such as emotional exertion, depersonalization, and personal accomplishment.

Analyzing these data required understanding the differences that existed between the different scores from the MBI and the NEO personality traits test and the variations to be analyzed. When a variance is not determined, the approach used is the welch approach that has to be conducted to understand the differences.

Limitation: The main limitation in these studies is that the research design as the nature of the research did not allow the authors to perform procreation on vanoss test analysis. Apart from this, the sample that was used was not randomized. Nonetheless, the size of the sample used in different health centers helps in counteracting this limitation. When it comes to the pico question, the study showed that risk factors associated with nurse burnout could be managed and then those who can manage the stress better in the nursing profession had limited chances of experiencing burnout. For those who did not manage burnout factors, it was difficult for them to manage fan art and most of them eventually left the profession.

Concerning the PICOT question, the study showed that risk factors that are associated with nurse burnout and they help in determining specific stress management that can address the factors that lead to nurse burnout eventually. The question is, In nursing how does stress management compare to no stress management affect turnover and burnout?” this study revealed that there are risk factors that result in an increased level of burnout in case there are no interventions or management strategies to reduce the risk factors for stress, and therefore the study supports this PICOT question.






After a review of this literature, it can be revealed that numerous demographics play an important role in development. Some of these include gender age and marital status as well as the level of education. Personality traits and the environment where people working are also important factors together with the social support and the word experience that massively contribute to burnout(Cañadas-De la Fuente, Vargas, San Luis, Garcia, Cañadas, & De la Fuente, 2015). Nonetheless, despite these relevant factors, it is important to practice the best and most effective stress management strategies to cope up with the possible burnout and reduce the levels of analysis. One of the strategies that have been used in this study is having a positive attitude and involving nurses in production practices. They are nurses who are optimistic and have positive aspects of life. Such nurses stay motivated in life, and they can manage their stress level in a better way. Strong social connection and spirituality are important in nurses’ life as they reduce the level of burnout in nurses.

The other study, maintaining a positive attitude and having a strong social network and massively reduce emotional exhaustion and depersonalization. This ultimately reduces burnout in nurses, and it’s helpful to the general health as it reduces nurse turnover.

Besides the establishment for positive attitude together with a strong connection with the fellow workers, nurses and other activities are likely to relieve stress as they find their jobs enjoyable and stress-free. Activities include physical activities like running on the treadmill having a peaceful time with others and having activities that promote health such as mental health and spiritual well-being. Auditing findings from further research show a strong relationship between stress management and I reduce the shown in burnout levels through the practice of coping mechanisms and coworkers who support the exercise or physical activity. Family support also has a  positive impact on the nurses and help them relieve stress.



Recommendations of the research and its Implications

This review revealed that stress management is one of the most significant issues in healthcare as it helps in reducing burnout and turnover. Stress management has implications of their policies can help in reducing burnouts. Risk factors include personal traits and the environment. Personality is a massive factor that contributes to burnout and has to be taken into consideration when controlling personality. There is a massive impact of working conditions and shift hours together with the effectiveness of role changes in preventing burnout. Healthcare givers in the current conditions have to assess the risk that the nurses are exposed to and that they play based on their nurse-patient. It is important to have the right number of nurses who take care of their patients.

wWhen it comes to recommendations, studies have identified strategies that can be used to cope with trauma programs that the nurses are involved in. The recommendations include acknowledging the reality that fatigue exists and that burnouts are present in the nurse profession. It is recommended that they should be educated on ways of recognizing the symptoms that lead to fatigue and burnout. It is important to portray professional coping skills and team support in the hospital. The nurses should be engaged in discussions and teamwork to cope effectively with the schedule in meetings.

Application to practice


The findings from this research are important because of the growing concern with nurse burnout and turnover. Acknowledging the effectiveness of stress management skills can help nurses to provide better care and improve patient outcomes. Management also leads to job satisfaction and recommendations from the patients. The findings cannot be applied to practice settings in management source to promote positive environmental and behaviors that can assist in improving performance. Educational practices that can help the nurses to cope with stress and can help the nurses to become more knowledgeable and prove the effectiveness in stress management.



Further Research


Further studies are needed by researchers to conduct longitudinal design on research to determine the long-term benefits are the burnouts and practices that can help in burnout including performing yoga. The relationship between these initiatives of reducing burnout and another professional career should also be examined. It is also suggested that investigation on the relationship between traits and burnout among the nurses should be recommended.




Gómez-Urquiza, J. L., Emilia, I., Albendín-García, L., Vargas-Pecino, C., Ortega-Campos, E. M., & Cañadas-De la Fuente, G. A. (2017). Prevalence of burnout syndrome in emergency nurses: A meta-analysis. Critical care nurse37(5), e1-e9.

Sallon, S., Katz-Eisner, D., Yaffe, H., & Bdolah-Abram, T. (2017). Caring for the caregivers: results of an extended, five-component stress-reduction intervention for hospital staff. Behavioral Medicine43(1), 47-60.

Cañadas-De la Fuente, G. A., Vargas, C., San Luis, C., García, I., Cañadas, G. R., & De la   Fuente, E. I. (2015). Risk factors and prevalence of burnout syndrome in the nursing profession. International Journal of Nursing Studies, 52(1), 240-249. doi:10.1016/j.ijnurstu.2014.07.001. Chang, Y., & Chan, H. (2015). Optimism and proactive coping about burnout among          nurses. Journal of Nursing Management, 23(3), 401-408. doi:10.1111/jonm.12148.