Articulating the Issue
Nursing professionals are a crucial element of the healthcare system. They administer medications for treatment of health complications, handle medical emergencies such as strokes and heart attacks, assist physicians in medical procedures and also evaluate and record the symptoms of patients. However, as they go about doing their job, nurses are exposed to various psychological and social risk factors that can result in work stress and burn out that is caused by physical exhaustion, mental exhaustion, and emotional exhaustion. This compromises the quality of service they provide. Nurses are responsible for delivering high-quality care for all the patients they take care of. There are various ethical rules and guiding principles that dictate their decision making process and work performance to guarantee that they provide quality healthcare services. Despite this, there have been increased incidences of nursing burn out all over the world that are raising concern amongst many researchers. Berry and Curry (2012) opine that the nurses are going into burnout at unprecedented levels. The authors further suggest that as a result of the exhaustion, the nurses fail to fulfill the professional obligations, as well as the ethical and legal requirements they owe their patients and the patients’ families. There is, therefore, a need to carry out investigations to determine the root causes of nursing burnout and ascertain the effects that it has on patient healthcare.
According to Maslach and Leiter (2005), Burnout Syndrome or Burnout is a prolonged reaction to stress factors that physical or emotional which leads one to feel exhausted, become overwhelmed, have self-doubt, develop anxiety as well as feel bitter, cynical, and inefficient. It majorly occurs amongst caregiving professions where it is requisite of professionals to closely work with people where high levels of emotions are involved (Spooner-Lane & Patton, n.d). The professionals acquire negative attitudes and feelings toward the people that they work with and as well as their professional role (Maslach &Jackson, 1989). It is, therefore, a response to chronic work stress. The effects of nursing professional burnout consist of reduced productiveness, absenteeism, deficiency of motivation, musculoskeletal complications, increased endangerment of cardiovascular diseases, and psychological fatigue (J. Chang & Y. Chang, 2013; Suñer-Soler et al., 2012; L.Wang, Liu & S.Wang, 2015). In the past few years, there have been growing concerns about Burnout in the nursing profession. A reduction in the quality of the healthcare services provided by the nurses can only be blamed on nursing burnout which is brought about by staffing issues and not just on the independent actions of the nurses.
Analysis of the Issue
Staffing is a significant contributor to nursing Burnout in the healthcare system. Increase in nurses staffing in hospitals has been associated with a reduction in mortality rates (Harless & Mark, 2010). According to the 2010 Workforce Profile of Registered Nurses in Canada (2012), the number of registered nurses (RNs) in Canada, including nurses practitioners in the year 2010 was 287,344 yet only 93.4 percent of these were employed in nursing. The author further argues that the ratio of employed RNs to the population of Canada in 2010 was one registered nurse for every 127 people. This coupled by the fact that nurses are on call 24/7 goes to show that nurses are arguably overworked. Nurses provide some services on a typical day such as administering medications for treatment of health complications, handling medical emergencies such as strokes and heart attacks, assisting physicians in medical procedures and also evaluating and correctly recording the symptoms of patients. At any time of the day, their work may increase due to the occurrence of unexpected events such as floods and earthquakes. Overstretching of nurses sometimes makes them skip lunches and breaks and leaves them feeling exhausted both physically and emotionally when the day comes to an end (Maslach & Leiter, 2005). Work-related pressures which lead to an increment in the load of effort needed to perform work are a significant cause of fatigue (Cordes et al. 1997). Altun (2002) suggested that Burnout is the result of unmanaged work stress. According to Aiken, Clarke, Sloane, Sochalski, and Hiber (2002), every additional patient that is given to an overloaded nurse causes an increment of 23 percent in the probability of the nursing professionals suffering from burnout and a 15 percent increment in the chance of discontentment with their job. Ottawa, Ontario
Poghosyan, Clerke, and Aieken (2010) opine that high levels of nurses’ burnout are directly linked to a reduction in the quality of care they give. This is brought about by the feelings of emotional exhaustion, perceptions of the inefficiency of work and keeping a distance from patients that nursing professionals are going through burnout experience. Nurses spend most of their time taking care of their patients and their families. Thus they are quite vulnerable to several risk factors that lead to burnout therefore directly affecting the quality of care they deliver, and this becomes worse when the nurses are overburdened with work. According to the Aiken, Clerke, Sloane, Sochaslaki, and Hiber (2012), the rate of mortality of patients increased by 7 percent for each surgically treated patient that was added to an average nursing workload. Maslach and Jackson (1989) opine that Burnout can be detrimental to the people suffering from it and those they interact with, like the patients under nursing care since people enduring burnout don’t see a way out of their situation. The components of the burden of work in the nursing profession contribute to exhaustion which leaves them susceptible to adverse health outcomes and eventually affects their performance and their quality of care they provide ( Aiken, Clerke and Sloan, 2002; Gunnarsdottir, Clerke, Refferty & Nutbean, 2009). Research has seen Burnout be conceived as a mental syndrome that is consist of emotional exhaustion, a propensity to objectify the clients that one comes up, and a reduction in the sense of personal accomplishment (Maslach, 1982). Burnout, therefore, has a negative influence on job performance and contributes to the action of nurses undermining the due care professional attention they are supposed to give to their client as is ethically required of them.
However, there is a school of thought that argues that there are several other factors that leads to a reduction in quality of healthcare that nurses provide to their patients and therefore nurses must uphold the ethical standards that are required of them under the law. The ethical standards of nurses are informed by seven relatable primary values in Part I of the Canadian Nurses Association (CNA) Code of Ethics for registered nurses which constitute principles of ethics that date back as far as 1780 B.C.( Keatings& Smith 2012). These values include the provision of competent, compassionate, safe and ethical care, promotion of health and well-being of people, preserving dignity, and being accountable (Code of Ethics for Registered Nurses, 2017). Despite the argument that nurses who experience burnout may be unable or unwilling to provide quality healthcare to patients and their families due to emotional and psychological distress, working in an environment where the quality of healthcare provisions low, for example, due to lack of critical medical facilities may as be the cause of emotional distress and disengagement. Some researches indicate that burnout only mediates the connection between staffing of nurses and the described quality care of nurses (Bogaert, Meulemans, Clerke, Vermeyan & Heyning, 2009). Therefore, Burnout and the perception of poor quality care by the nurses may be due to the subjective negative assessment or discontentment with their working environment.
All in all, the issues discussed in this essay clearly show that staffing is a significant contributor to nursing Burnout which consequently compromises the quality of work provided by the nursing professionals. Burnout is common in the nursing profession since it is mainly found in caregiving professions where it is requisite of the professionals to closely work with people where high levels of emotions are involved. The issue of nursing burnout has therefore attracted great some researchers who dive deep into the factors surrounding it. However, since it is a continuous problem that is bound to change with the fast-changing global and national environments, and given the increase in some incidences of burnouts in healthcare nursing, continuous research needs to be carried out to determine emerging issues surrounding this subject to implementing appropriate proactive measures.
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