Practicum on Caregiver Role Strain and Nurse Burnout

HEALTH AND NURSING

Health and Nursing: Practicum on Caregiver Role Strain and Nurse Burnout

The role strain principally refers to the incompatibility of the social role that an individual has to face when expectations and obligations have to be met. A similar situation could occur in the nursing profession when patients’ expectations are not fulfilled when nurses feel stressed out emotionally and physically and experience a strain with their single social role towards society and humanity (Ndugbu & Uzoma, 2020). This paper aims to design the final comprehensive action planning and interdisciplinary team collaboration to address the selected clinical issue. 

Clinical Issue

It is common to be emotionally and physically burnt out at some point in life when a prolonged involvement in a job, which could be stressful, inflicts additional disengagement gradually. Nursing also experiences such feelings in their profession that directly impact the patient’s health outcomes, deeming it to be a major public health concern. Energy exhaustion creates a mental distance in terms of low motivation and reduced professional efficiency (Ndugbu & Uzoma, 2020). The issue certainly requires attention so that the risk to public health does not become an economic burden for the state. Patients receiving medical care from such nurses would be at risk of infection or aggravation of symptoms; hence, the clinical issue is of prime concern. 

Brief Description of the Proposed Change for the Issue

The proposed change could be addressed by implementing several minuscules but effective interventions discussed in the previous paper. For instance, two levels of interventions were suggested earlier. The first level was about building a strong community network, and the second was about providing support to the nurses with coping skills.

The second level included steps like listening to podcasts or music, having a better sleep in the nurse’s living room, mindful meditation, and chatting or sharing feelings with fellow nurses that could help reduce nurse burnout. Moreover, some interventions such as the bridge to home and teach-back even for home-care nurses. 

An important aspect of reducing nurse burnout is understanding the family dynamics, especially for culturally sensitive populations. It could be interpreted that African American families who have been facing racial discrimination for a long time need special attention, for which nurses should be extra careful. This extra carefulness might inflict an extra burnout, which could be tackled with technological intervention for better comprehension of cultural differences, credentials of the facilitators, and prominence of language preferences. 

Anticipated Benefits to the Nursing Profession and Clinical Practice Setting

The anticipated benefits to the nursing profession and within the clinical practice setting are an improvement in quality of life, better interpersonal relationships, and decreased stress leading to better job engagement and better patient outcomes with a reduction of risks for patient’s symptoms and their satisfaction levels (Dall’Ora et al., 2020). Research suggests that staffing inadequacy and the complexity of the nursing job’s psychological demands lead to higher nurse burnout. This emotional exhaustion could be reduced with the proposed changes through the interventions mentioned in the previous section. Intrinsic work motivation levels are expected to be higher once the personal accomplishments are perceived to be enhanced by the nurses with reduced levels of stress, consequently reduced burnout. Also, work collaborations would be upgraded with better work performance, which implies that improved nurse-physician and nurse-manager relations could diminish stress levels. 

Goals and Strategies to Address the Clinical Practice Issue

The goals include better burse work performance by reducing role strain, stress, and burnout to observe improved patient outcomes. Several patients come to the hospital with diverse health needs that create job complications for the nurses. It leads to work sensitivity and an overload of expectations from the nurses in their work environment. There might be an experience of lack of capacity from the nurses’ side that likely creates professional dissatisfaction. 

The strategies for addressing these clinical issues have been mentioned in intervention to prevent burnout from affecting their personality and productivity. 

SWOT Analysis, Practice Issue, and Evidence Summary

SWOT analysis of the caregiver role strain and nurse burnout has some strengths, weaknesses, threats, and opportunities for addressing the clinical issue. 

The strengths include: 

· The network resources and community support within the hospital in the form of fellow nurses and leadership/ managers. 

· Nurses’ self-efficacy: it is believed that those with stronger coping mechanisms and better self-efficacy are better at handling nurse burnout (Yao et al., 2018). 

· Population for whom the nurses are working and are willing to learn to grow

The weaknesses include:

· Decreased work performance that could lead to more patient errors

· Lack of employee resources for combating the clinical issue

· Absence of support from the leadership or managers

· Nurses’ reluctance to admit that they are experiencing a poor mental state

· Nurses fear that their societal image under burnout would impact their performance, hurting their strengths towards the population they are serving

The threats under caregiver role strain and burnout include: 

· Higher employee turnover 

· The bad image of the hospital where nursing care is offered due to higher nursing errors and lower patient satisfaction 

· The above factors lead to low participation of the population in the medical institution 

The opportunities for nurse burnout and role strain involve:

· Preparing for detecting nurse burnout on time so that the issue can be tackled before negative consequences show up

· Attracting an increased number of employees for helping them cope with the issue

· Attracting patients so that they do not get affected by any possible low-quality caregiving due to nurse burnout

The Nurses’ Roles and Responsibilities for Practice Change 

The nurses have to participate actively in the interventions for the practice change so that productivity can be enhanced. Research indicates that a higher level of optimism is one of the most effective attitudes that nurses could develop within themselves for coping with burnout (LaBelle, 2021). Additionally, maximizing the communication opportunities, either with fellow nurses or with top managers, could help solve the problems whenever they are sensed. Communicating with fellow nurses could help to reduce stress by making jokes. Humor attempts to cope with the stress by laughing and smiling amidst a wide variety of situations within the hospital, such as death, complexities of a patient’s disease, and dealings with hard-to-handle patients, could certainly assist in mitigating job stressors. 

Self-sufficiency and self-regulation of emotions is another responsibility in formulating a proactive approach by the nurses, depicting their responsibility towards their profession and service to humanity. Nurse burnout could be reduced when nurses express their concerns without fear so that creating solutions for the problems could be done on time (LaBelle, 2021). Handling their emotions and expression could help address the clinical issue under discussion here. 

Procedures

The steps and procedures that teach for the change process and reduce burse burnout would require interdisciplinary team collaboration. Emotionally exhausted clinicians have been reported to exhibit better productivity signs when cognitive-behavioral teamwork existed as clinician-rated patient safety maximized (Welp, Meier & Manser, 2016). The major step in this direction would be consistent support and trust among the team workers and the lead people so that contributions towards common goals lessen the burden. The interpersonal quality of teamwork would magnify professionalism; ultimately, the patient results in their satisfaction with the caregivers’ service quality and lesser clinical errors.

Another step could be suggested based on a multi-pronged approach: an unending chain of measures, interdependent on one another. Forming a team and helping to work as a team would be highly reliable because each team member knows how to deal with nurse burnout, creating resilience on their own. For this, ‘three good things have been a tried and tested effective intervention (Bruschwein & Gettle, 2020). In this method, the involved step would be to ask each team member to record three good things that happen to them daily, at least for two weeks. 

Resources Required

The resource required to measure burnout among nurses is the Oldenburg Burnout Inventory (OLBI). It is a useful tool for identifying exhaustion through certain statements within the survey that would reflect the exhaustion and the vigor for the nurses’ role. The role strain could be best measured with this assessment by presenting the participants with 16 statements only for which they would state whether they agree or disagree (Mbanga et al., 2018). The responses would be gauged over two sub-scales and two types of sub-totals: disengagement items (specified by odd numbers from 1 to 15) and exhaustion items (specified by even numbers from 2 to 16). The disengagement to dedication spectrum is easy to discern with this tool, especially for nurses facing burnout or high job commitment. 

Cost: No apparent costs are required since the survey could be sent via email. 

Participants: There would be 4 participants

Physical space: No physical space is required as assessment could be done online. The survey of 16 statements could be sent via email to the participants and could be filled and sent back. This is a remote job. Interventions could be done remotely too. 

Tools: The pre-and post-evaluation forms could assess whether OLBI served as an effective method for spotting disengagement and dedication among the nurses and discovering improvement areas where the interventions could be applied. The learner evaluation form could be gauged for the factors such as better communication among nurses, better focus, improved motivation, self-reliance and self-resilience, greater involvement, enhanced leadership support, reduced patient errors, and greater patient satisfaction levels, etc. The scales that could be used for gauging inculcate ‘performance above expectation,’ ‘at expectations,’ ‘needs refinement,’ and ‘unsatisfactory result.’ 

Anticipated Barriers and Strategies to Overcome

The possible barriers that could hinder the way of handling nurse burnout and role strain could be less support from the leadership, diminished teamwork, and availability of resources (Anderson et al., 2021). Workplace well-being is a chief facilitator in nurse burnout, which teaches leadership support and community networking with peers. If all of the burdens fall upon one nurse, the emotional exhaustion would be high. The nurses would also feel frustrated when resources are scarce, especially handling a difficult patient or one with complicated medical conditions. 

The strategies to overcome such limitations could include encouragement from the leadership and managers so that nurses feel valued and put their constant efforts into serving the patients with stamina and enthusiasm (Anderson et al., 2021). Verbal boosting works wonders from time to time. Improving resources with possibly greater staff and fewer pressures to fulfill the assigned tasks could also help.