Intensive Care Unit Nursing Staff Job Stress and Burnout

Job Stress and Burnout among Intensive Care Unit Nursing Staff
In the last few centuries, we have witnessed major transformations in the health and nursing sector, especially regarding the scope of job and technological advances. The drastic change has not been without difficulties, the most notable of which is emotional stress. Such stress can compromise the safety of the patients and the health of the health care providers (Aiken et al., 2012). Stress can be defined as an internal or environmental event that an individual or social system can no longer adapt to. Stress comprises both psychic and organic changes that are of importance to the cognitive system. When confronted with stress, the human body automatically employs strategies in a bid to alleviate the damning effects of the situation. When these strategies fail, the result may be a burnout syndrome. This is basically the emotional exhaustion that comes as a result of physical exhaustion (Andolhe, Barbosa, Oliveira, Costa & Padilha, 2015).
A person experiencing burnout normally has little or no emotional strength. He seems not to value the other persons he may be living with. The person also loses general interest in life, and this leads to poor job performance. This is quite dangerous, to say the least. Burnout is especially common with health care providers because of the many hours they have to work, as they struggle to save humanity from illnesses. Failure to manage such work related stress is what leads to burnout. The most easily seen effects include absenteeism, high work turnover, poor interpersonal relationships, and decreased personal achievement and productivity (Tucker, Cutshall, Rhudy & Lohse, 2012).
All health care workers can experience burnout, but this again depends on the specialization of the worker. Those who work in the Intensive Care Units (ICUs) and the emergency department (ED) are the most vulnerable health care workers. Their job routine is normally hectic and stressful. Their work is characterized with poor working conditions, high death rates, critical patient care, and inadequate time to care for patients, among others. A typical nurse may report to work and work for up to sixteen hours with no break. Some surgical operations really take time and the nurses cannot dare take their eyes off the patient because of their delicate situation. When they get to a point they can no longer cope, high rate of absenteeism ensues, which greatly compromises the quality of care given to patients. For the over 50 years nursing has been recognized as a profession, it has been noted as a very stressful occupation. A remarkable number of investigations have been done on the stress situation in the nursing field, but there is still more to be done, considering factors such as regional differences impacting the health care system, and other peculiarities of nursing in relation to other professions (Bakker, Le Blanc & Schaufeli, 2005).
A burnt out nurse will be less effective at work and his commitment to the job or that particular organization will decrease. The nurse will constantly desire to leave the job for another one. This was confirmed by a recent french study, where about 60 % of nurses working in ICUs expressed their longing to leave the job. Most French nurses working in ICUs have exhibited symptoms of depression and low quality of private life, as measured by the Center for Epidemiologiccal Studies Scale for Depression. Shanafelt et al conducted a study on internal medicine residents and discovered how low quality patient care was related to depersonalization. He also noted rising levels of patient dissatisfaction as a result of the burnout syndrome. Personal conflicts among the colleagues were also recorded, with the resultant effect of interrupting job tasks (Maslach, Schaufeli & Leiter, 2001).
Annotated Bibliography
1. Andolhe, R., Barbosa, R., Oliveira, E., Costa, A., & Padilha, K. G. (2015). Stress, coping and burnout among Intensive Care Unit nursing staff: Associated factors. Journal of School of Nursing, 49, 57-63. Doi:10.1590/S0080-623420150000700009
Andolhe, Barbosa, Oliveira, Costa and Padilha carried out a research on health psychology in 2015. They investigated the burnout syndrome among the nurses in relation to the working conditions in the ICUs. They pointed out two major factors that stress out nurses. These are: exposure to adverse environments; and critical condition of patients. The study was done in Sao Paulo, Brazil and it spanned across eight ICUs. The data gathered included, biosocial data, level of occupational stress, level of occupational coping, and the symptoms and signs of stress. The study also employed the Maslach Burnout Inventory. Two hundred and eighty seven nurses were investigated, most of which were women having spouses and kids. It was found out that 74.47% of the nurses had moderate stress levels and 79.93 % of these could cope with the stress. 12.54% of the nurses under investigation experienced the urnout syndrome. The major cause of stress among the nurses was related to the adverse working conditions. Those who had little or no stress attributed their stability to having a supportive partner and the mere fact of liking their work. They also reportedly had adequate sleep each day. This is a personal decision as is also controlling the work environment, and they have been proven effective in alleviating occupational stress. These findings are very vital regarding the safety of patients and health of the nurses.
2. Cishahayo, E. U., Nankundwa, E., Sego, R., Bhengu, R. (2017). Burnout among nurses working in critical care settings: a case of a selected tertiary hospital in Rwanda. International Journal of Research in Medical Sciences, 5(12), 5121-5128.
Cishahayo, Nankundwa, Sego and Bhengu concentrated their research on nurses serving in the ICU and ED. They sought to determine the factors associated with these nurses working in the emergency department and Intensive care units. They identified the major risk factors for burnout: gender, age, work load, years of experience, working shift, ethical issues, and patient-related decision making, among others. They also attempted to derive the associations between socio-demographic factors and burnout. They used the descriptive cross-sectional design. For instance, they used a sample of 60 nurses for the study from the total population. They then designed and administered a questionnaire to each of the nurses. They employed the Maslach Burnout Inventory Human Service Survey to collect the data. 61.7 % of the nurses under study recorded serious cases of burnout. This was directly related to the heavy workload the nurses were subjected to each day, which subsequently made them curious to leave thye job. 48.3 % had high Emotional Exhaustion (EE of 29), 25 % had high Sepersonalization (DP of 15) and 30 % of the nurses had low Personal Accomplishment (PA of 30). They concluded that these high levels of burnout were as a direct result of the unbearable workload the nurses working in the emergency department and the ICU are subjected to, and thus most intend to leave their job within 12 months.
3. Elshaer, N., Moustafa, M., Aiad, M., & Ramadan, M. (2018). Job stress and burnout syndrome among critical care healthcare workers. Alexandria Journal of Medicine, 54(3), 273-277. doi: 10.1016/j.ajme.2017.06.004
According to Elshaer, Moustafa, Aiad and Ranadan, nurses working in the critical care department have one of the most stressful jobs ever. They defined the burnout syndrome as that long feeling of exhaustion and declining interest while at work. The health care technicians and nurses working in the Intensive Care Unit and Emergency Department have a high risk of suffering the burnout syndrome because of the job-related stress they are subjected to. Factors such as high death rates, improper working environment, critical patient care, and inadequate time to meet the needs of the patients were identifies as the major ones that lead to burnout. This study was carried out at the Alexandria University Hospital. They sampled out eighty two healthcare technicians and nurses for the research. They designed and administered questionnaires to the nurses. The data was collected using selected subscales of the NIOSH Generic job stress questionnaire. The Maslach Burnout Inventory model was also employed. They carried out multivariate and bivariate analyses to examine the relationship between burnout syndrome and job stress. 80 % of the participants reported high emotional exhaustion. Less than 30% of the participants reported either high depersonalization levels or low low personal accomplishment. These three criteria are used to measure the intensity of the burnout syndrome. After carrying regressional analysis, they could identify some effects of the burnout syndrome as underutilization of skill, poor performance at work, interpersonal conflict. On the positive side, the burnout syndrome led the health care workers to take better charge of their own lives and be satisfied with their job. They concluded that burnout syndrome can be reduced by addressing interpersonal conflicts, utilizing the workers skills more, and generally raising the job satisfaction levels of the workers. The critical health care workers also need also need enough moral support for them to remain stable.
References
Aiken, L. H., Sermeus, W., Van den Heede, K., Sloane, D. M., Busse, R., McKee, M. (2012). Patient safety, satisfaction, and quality of hospital care: Cross sectional surveys of nurses and patients in 12 countries in Europe and the United States. BMJ, 344, 1717
Andolhe, R., Barbosa, R., Oliveira, E., Costa, A., & Padilha, K. G. (2015). Stress, coping and burnout among Intensive Care Unit nursing staff: Associated factors. Journal of School of Nursing, 49, 57-63. Doi:10.1590/S0080-623420150000700009
Bakker, A.B Le Blanc, P.M., & Schaufeli, W.B. (2005). Burnout contagion among intensive care nurses. J Adv Nurs, 51(3), 276-287.
Maslach, C., Schaufeli, W. B, & Leiter, M. P. (2001). Job burnout. Annu Rev Psychol, 52, 397–422.
Tucker, S. J., Weymiller, A. J., Cutshall, S. M., Rhudy, L. M., & Lohse, C. M. (2012). Stress ratings and health promotion practices among RNs: A case for action. JONA, 42(5), 282-92.