Strategies to assist prevention of burnout in nursing staff Christina Fearon and Maggie Nicol

This article explores strategies that nurses can use to protect themselves from burnout. This is an article that is a literature review of other articles. The use of problem-focused strategies and emotion- focused strategies, such as reflection, may offer some protection against burnout. There is evidence that improving nurses’ wellbeing results in better patient care. Introduction

What is burnout? Burnout is specifically connected to the work environment and occurs when the individual feels ineffective in their workplace, resulting in the loss of purpose and the meaning that was once attached to his or her work.

Review Psychological concept EMOTIONAL EXHAUSTION DEPERSONALIZATION The Maslach Burnout Inventory was conceptualized in the 1970’s. It is defines burnout according to three characteristics: EMOTIONAL EXHAUSTION DEPERSONALIZATION REDUCTION IN PERCEIVED PERSONAL ACCOMPLISHMENT

Emotional Exhaustion Emotional exhaustion results from feeling weighted down and emotionally overstretched.

Depersonalization Depersonalization occurs when you try to protect yourself psychologically from further strain by becoming overly detached.

Reduced Perceived Personal Accomplishment Reduced perceived personal accomplishment constitutes dissatisfaction in achievement and in productivity at work.

Work-life Workload Control Reward Social support Fairness Values Literature identified six work-life areas that are particularly important to prevent burnout. Workload Control Reward Social support Fairness Values

Four key themes to help cope with burnout were identified from the literature: Problem-focused and emotion-focused coping Self-awareness and emotional intelligence Lifestyle and coping styles Clinical supervision Nursing Databases Literature from 1975 onward recognized burnout as a psychological concept and was identified using psychology and nursing databases.

Problem-focused Coping Also known as task-orientated. Associated with experiencing less stress and is ‘directed at managing or altering the problem’. Coping strategies for problem-focused coping are: Time management Organizational skills Seeking advice Discussion with others

Problem-focused Coping The key to this type of coping is exerting control over situations. This kind of coping has been linked to a reduction in the extent to which individuals tend to be affected by stress, not in lowering rates of burnout.

Emotion-focused Coping Directed at regulating the emotional response to the problem. Literature reviewed showed that emotion-focused coping was associated with higher rates of stress and burnout. There are 2 kinds of emotion focused coping – negative and positive. Negative Coping Positive Coping Hostility Reflection Self-delusion Self-awareness Avoidance Counciling Escapism

Emotional Intelligence Because nurses are continually exposed to emotionally charged situations, it can lead to damaging coping strategies. Self-awareness is a key concept in emotional intelligence. Studies show that various health professions (such as nurses, OT, PT, CAN’s) caring for patients with advanced disease processes used ‘distancing’ to cope with and manage difficult situations.

How many of you have distanced yourself emotionally while at work to cope with difficult situations?

Emotional Intelligence The authors reviewed for this article found a link between distancing coping mechanism and burnout. Clinical supervision can aid as a preventative strategy because of its supportive and reflective elements.

Lifestyle And Coping Style The promotion of a healthier lifestyle to improve wellbeing and protect against burnout is a common topic in burnout literature, with advice on Diet Exercise Relaxation Decompression routines.

Lifestyle And Coping Style A link between higher levels of emotional intelligence and healthier lifestyle choices has been identified in literature. Individuals with higher emotional intelligence tend to have a combination of different coping strategies. Individuals with lower emotional intelligence were more likely to have less coping strategies and were more likely to adopt unhealthy lifestyle choices such as alcohol consumption and smoking.

Clinical Supervision The literature highlights some consistency in the relationship between receiving effective clinical support and lower levels of burnout. It is perhaps a sense of investment in individuals that explains how clinic supervision may be useful in reducing burnout. Workplace guidance and support provides a sense of feeling valued and listened to.

Implications For Practice Ways to decrease workplace emotional stress: Supportive clinical supervision Feeling valued Sufficient time to engage with supervision and peers Helping nurses to use reflection as a positive emotion-focused coping strategy could promote wellbeing and reduce the risk of burnout. Reflection is a valuable strategy in managing problems because it can address those that are not necessarily solvable.

Conclusion A combination of both positive emotion- focused and problem-focused strategies may offer protection against the development of burnout. It is important to understand that these strategies will not change the organizational issues that lead to burnout in healthcare. They can, however, help nurses cope better.

Reference Feron, C., RN, & Nicol, M. (2011). Strategies to assist prevention of burnout in nursing staff. Nursing Standard, 26(14), 2011th ser., 35-39.

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