Managing Stress in the Professional Nurse to Prevent Burnout

Currently, the health care settings are faced by increased patient acuity yet there is a worsening shortage of nurses. This high-pressured circumstance in which fewer nurses are available to take care of the ever increasing patients with complicated situations exposes the nurses to high workload and stress magnitude. Moreover, the scope of the nurses’ roles is expanding over the years and thus nurses are involved in more work than before. If this situation is left unchecked, nurses are at risk of burnout.

Burnout among the nurses is a serious devastating condition and threatens both the nurses’ and patients’ health. There is need to prevent burnout among the nurses as their presence in care matters is of significance. Burnout can be prevented through identification of stressors and applying stress management strategies. This paper presents information on stress management and how it should be applied to prevent burnout in the professional nurse. Credibility of the information is ensured through reviews of professional nursing journals concerning the subject. Literature Review

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Definition of Burnout Burnout has been described as a psychological syndrome characterized by excessive exhaustion, inefficacy, and cynicism which occur in response to chronic occupational stressors (Laschinger & Finegan, 2008). Billeter-Koponen and Freden (2005) describes burnout as pathological or unusual tiredness. However, as much as burnout in the nurse professional has always been associated with job-related stress factors, there are speculations that personal stressors also contribute to burnout which affects the occupational life (Laschinger & Finegan, 2008).

Effects of Burnout Burnout results to poor states of both the mental and physical being of the professional nurses. According to Billeter-Koponen and Freden (2005) continual stress is the leading cause of burnout as stress hormones such as cortisol are secreted in the blood and these lead to fatigue, sleep disorders and even cardiovascular diseases. Laschinger and Finegan (2008) assert that as much as burnout occurs as a multidimensional state, the emotional exhaustion aspect is the core element from which inefficacy occurs.

Consequently, the quality of work of the nurse also deteriorates and this means that the patient will not be cared for, as expected. Nurses believe that the patient outcome is the most significant aspect of care, and although stressed nurses are still willing to make it happen, burnout causes powerlessness to achieve the outcome (Billeter-Koponen & Freden, 2005; Vinje and Mittlemark, 2007). Laschinger and Finegan (2008) and Billeter-Koponen and Freden (2005) report that burnout is prominent in health professionals and is mostly associated with turnover, absenteeism related with illnesses, and patients’ outcome.

. Managing Stress and Preventing Burnout Long lasting stress and burnout is common among professional nurses (Billeter-Koponen, & Freden, 2005). To prevent burnout, there needs to be ways in which stress among the professional nurses can be managed. Stressful events jeopardize the quality of work of professional nurses as well as their own health, and thus, the employer should incorporate stress management models in the work cycle of nurses. Laschinger and Finegan (2008) carried out a time lagged analysis to study the situational and disposal predictors of burnout in nurse managers.

The situational predictor studied was effort-reward imbalance while the dispositional predictor studied was core self-evaluation. The study conducted was a longitudinal survey that was dome on 134 nurse managers over a one year period. It was revealed that both dispositional and situational factors influenced the burnout levels in the nurses over the one year period. The study implicated that both personal and contextual factors must be considered by managers when creating work environments that prevent burnout and enhance positive health among the working nurses.

Laschinger and Finegan (2008) identify situational stressors that require managerial intervention for the purpose of preventing burnout. These include workload, control, community, fairness and value congruence. Billeter-Koponen and Freden (2005) carried out a study to find out how nurses experience stress and burnout. A grounded theory approach was followed through using open questions to interview 10 participant nurses between ages 30 and 61. Key findings revealed that both the professionalism of the nurse and the patient relationship are affected by stress and burnout.

Vinje and Mittlemark (2007) performed a qualitative analysis in which 11 community health nurses were interviewed for the purpose of finding out whether job engagement was connected to the nurses’ health and functioning. The findings revealed that burnout was responsible for the nurses’ failure to engage wholly in community work. The study concluded that job engagement is can promote either thriving on the job or negative processes that lead to poor functioning. • Stress management through rewarding effort

Little or lack of rewarding effort has been associated with stress and negative feelings (Laschinger and Finegan, 2008). In the work environment, efforts need to be appreciated to ensure that the professional nurses retain feelings of self esteem and self efficacy which in turn eliminates distress. Reward can be in form of money, status control through job security and promotion prospects, and esteem. On the other hand, effort-reward imbalances can lead to stressful situations and subsequent poor health outcomes in the professional nurses.

Job instability and lack of promotional prospects can lead to emotional distress characterized by reactions from autonomic arousals, for instance anger, depression or threatened feelings. • Stress management through core self-evaluation Core self evaluation is a personal dispositional component in which a person evaluates the individual’s self worth as a whole (Laschinger and Finegan, 2008). This is an important predictor of how the nurses can interpret the events in their work life.

Core self evaluation entails self esteem, locus of control, emotional stability, and the general self efficacy. Through self esteem an individual places value on the self while the locus of control enables the individual to posses the belief that they have control of the experiences in their lives. Emotional stability can enable the nurse to be confident and secure despite the weight of situations while through general self efficacy the individual’s ability to cope, perform or achieve is determined.

Core self evaluation is associated with psychological empowerment, quality performance at work and general job satisfaction (Laschinger and Finegan, 2008). Nurses with high core self evaluation have lower job stress and experience les job strain. Instead, they are able to seek out more challenging task and are able to balance both the work and personal aspects of their lives. Additionally, the nurse’ core self evaluation is significantly related to healthy relationships between the professional nurses and their supervisors and employers.

A positive relationship enhances communication and this can assist both the nurses and the managers to make best decisions regarding the nurse’ work experience and environment (Billeter-Koponen & Freden, 2005). According to Vinje and Mittlemark (2007), nurses have a certain attachment to their work and work engagement is achieved through the nurse’ deep feeling that his/her profession is a calling, and that such nurses have a deep sense of duty and strict self demand as far as expectations on the level of performance is concerned.

Nevertheless, burnout can cause the nurses to fail to achieve these expectations. This therefore demands for core-self evaluation which will help an individual know how to balance the life and work aspects, with the aim of eliminating stress and preventing burnout. Application of Clinical Example This information is practical for clinical application because as a practical nurse, cases of job-related stress are many. As a nurse it is important to identify stressors that contribute to burnout moments and learn how to deal with the rout causes.

This includes having well defined and realistic career goals in care giving as well, as relating well with management and pushing for better working environments. A nurse should always strive for a balance between giving care that guaranteed better patient outcomes as well as ensuring that she remains healthy both in mind, body and spirit. Conclusion Stress reduces the quality of work as well as affects the health of the nurse. Continual build up of stress and lack of a channel to reduce the build-up pressure or prevent stress all together leads to burnout.

Burnout is a serious pathological condition characterized by shortcomings in the psychological and physical states. With such conditions nurses cannot perform their duties well and this leads to poor patient outcomes as well as poor health. Burnout is an increasing condition among care givers in the health settings and thus there is need to manage stress which leads to this burnout. Self-evaluation methods and management policies at work can be combined effectively in stress management and thus the prevention of workers’ burnout.

References Billeter-Koponen, S. , & Freden, L. (2005). “Long-term stress, burnout and patient-nurse relations: Qualitative interview study about nurses’ experiences,” Scandinavian Journal of Caring Sciences, 19: 20-27. Laschinger, H. S. , & Finegan, J. (2008). “Situational and dispositional predictors of nurse manager burnout: A time lagged analysis,” Journal of Nursing Management, 16: 601- 607. Vinje, H. F. , & Mittlemark, M. (2007). “Job engagement’s paradoxical role in nurse burnout,” Nursing and Health Sciences, 9: 107-111.


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