Cap 401 week 7

1

Signature Assignment Paper: Culminating Argument

Greter Pacios

West Coast University

2

Abstract

Burnout is a major issue in the United States as it is a prevalent problem in hospitals across the

country. It is important that this issue is addressed as burnout has negative implications for both

patients and nurses. Organizations need to acknowledge that this is a problem. There are several

different interventions and strategies that can be used to prevent burnout among nurses. The

interventions and strategies that will be outlined in this paper are all evidence-based and

supported by research. To answer the research questions that have been posed, the student has

conducted a comprehensive review of the literature to acquire evidence. The student was able to

answer each research question. The student used various databases provided by the university’s

library system to search for sources. After reviewing the literature, the student was able to learn

more about burnout prevention. There are various interventions and strategies that can be used to

help nurses prevent burnout. Among the interventions that can be used prevent burnout include

yoga and hardiness education. Based on the research that has been acquired, the student proposes

a solution that calls for the implementation of a burnout prevention program. Organizations

should develop and implement a burnout prevention program that comprises the interventions

and strategies that have been discussed in this paper.

3

Signature Assignment Paper: Culminating Argument

There are several issues within the nursing profession that affect nurses’ ability to

provide patients with safe, high-quality care. These issues that are present within the nursing

profession also affect the health and well-being of nurses. One can make the argument that one

of the most significant issues is burnout. Burnout is considered to be a serious issue. The latest

statistics regarding the prevalence of burnout among nurses show that nearly one-third of nurses

in this country have experienced burnout (Reith, 2018). This figure applies to nurses who work

in hospitals. There is research that shows that nurses who are employed in the intensive care unit

(ICU) are more prone to burnout than nurses who work in other hospital units or departments.

The numbers are very alarming. Statistics indicate that as much as 80% of nurses who work in

the ICU are prone to burnout (Mealer, 2015).

This is an issue that merits more attention as a result of its implications for both patients

and nurses. Nurses who are burned out are not fit for practice as they have a higher likelihood of

committing medical errors that can pose a threat to patient safety and well-being. In order to

learn more about this issue, the student has conducted a comprehensive review of the literature to

obtain peer-reviewed journal articles relevant to the topic. The student has developed a series of

research questions that focus on the Scientific, Mathematical/Analytical, Cultural, and Ethical

Perspectives of Inquiry. The research questions that have been developed will be answered with

the research that has been acquired from the literature. It is the student’s goal to learn more about

burnout. With the research that has been gathered, the student hopes to provide a

recommendation for organizations to consider if they are to address this issue. The student would

like to recommend a set of interventions and strategies that can comprise a burnout prevention

program that is based on evidence-based practice.

4

The Scientific Research Questions

What systems of the body are affected by burnout?

The first question that was developed for the scientific perspective is the first level

question. This question asks if any systems of the body are affected by burnout. As noted,

burnout can affect the health and well-being of nurses. It is important to understand the effects of

burnout on nurse’s body. The evidence regarding this question is clear. There is a substantial

amount of evidence that demonstrates that different systems of the body can be affected by

burnout. One of the systems of the body that can be affected by burnout is the sympathetic

nervous system. When a burned out nurse’s sympathetic nervous system is affected, there is a

high likelihood that the nurse can experience different effects such as an increase in the heart

rate. Furthermore, it is possible for a nurse who is burned out to experience a rise in blood

pressure as well as other chronic conditions (Rozo, Olson, Thu, & Stutzman, 2017).

It should be noted that stress is associated with burnout; therefore, it is important that

nurses seek to manage their stress in an effective manner. If there is a high level of stress, a

nurse’s likelihood of experiencing burnout increases. There is research that shows that nurses

who have a high amount of stress and are burned out can experience different health issues such

as muscle tensions and aches in different parts of the body (Heinemann & Heinemann, 2017).

Nurses who are burned out and are being affected by any of the aforementioned health issues

should seek help. If help is not sought, nurses risk doing more harm to their health and well-

being, which can lead to the deterioration of their quality of life.

How are psychological effects impacting the physiological systems?

It is clear that burnout can lead to different effects on various systems of the body. It is

important to determine if burnout can lead to psychological effects on a nurse. The second level

5

scientific question asks whether there are psychological effects in nurses who are burned out. In

a research study conducted by Papathanasiou (2015), there was evidence that demonstrated that

nurses who are burned out experience psychological effects. The researcher conducted the

research study to learn how a burned out nurse’s mental health is affected by this issue. For the

research study, the researcher recruited a group of nurses who were found to have moderate-level

burnout. The nurses were asked to complete the Symptoms Rating Scale for Depression and

Anxiety (SRSDA) questionnaire, which is an assessment tool that is used to assess for severity of

depression and anxiety. Based on the data that was collected, the researcher concluded that

burnout could lead to the onset of anxiety as well as depression. The data also showed that many

of the nurses who were part of the research study had irritable mood.

There are other research studies that yielded similar results. Cheung and Yip (2015)

conducted a cross-sectional study in which nurses who were burned out were asked to complete

the Depression Anxiety and Stress Scale (DASS 21), which is an assessment tool that is used to

assess for three domains: anxiety, depression, and stress. Per the data, all of the nurses who

participated in the study had a high level of stress. About 36% of nurses were found to have

depression. Roughly 37% of the nurses were found to have anxiety.

Salvagioni et al. (2017) conducted a comprehensive review of the literature to find

evidence that shows what psychological effects are associated with burnout among nurses. The

authors found that depression is among the most prevalent mental health issue that affects burned

out nurses. Furthermore, the authors learned that nurses who are burned out may experience

irritability and hopelessness, which can deteriorate their mental health and lead to other mental

health issues. To protect the mental health of nurses, organizations need to recognize that it is a

major issue.

6

The Mathematical/Analytical Research Questions

Do statistics indicate that burnout is a major problem?

One of the things that the student wanted to confirm was the whether burnout is a major

issue in the nursing profession. To determine the severity of this issue, the student reviewed the

literature to gather statistics. According to Reith (2018), roughly 40% of nurses in the United

States reported that they experience symptoms related to burnout. This is figure is alarming

considering that it indicates there is a high prevalence of burnout in the United States.

There is data that shows that the prevalence of burnout is much higher in the intensive

care unit (ICU). Statistics indicate that as much as 80% of nurses in the United States who are

employed in the ICU have experienced burnout (Reith, 2018). These nurses are the most prone to

this issue.

What economic issues are associated with burnout?

For the second level research question related to this domain, the student wanted to know

if there are any economic issues related to burnout. Research shows that organizations who have

nurses who are burned out must often deal with high turnover rates, leading to high financial

costs as the organizations have to hire and train new nurses to replace the ones that have left

(Halter et al., 2017).

Cultural Research Questions

What cultural values and/or norms contribute to the high rate of burnout?

The first level cultural research questions ask if there are cultural values and/or norms

that are associated with the burnout rate in the United States. The student developed this research

question because she wanted to know what factors can contribute to burnout. While there may be

various factors that are clearly shown to contribute to the high rate of burnout among nurses,

7

there are some factors that are implicit; therefore, it is important to identify these factors so that

one is able to address them.

For the first level cultural research question, the student determined that the best

approach was to identify the cultural values and norms associated with the topic. The student

reviewed the literature but was not able to gather an adequate amount of research. As the

student’s goal was to acquire research published within the last five years, the student was only

able to find a limited number of research articles associated with this cultural research question.

The student decided to extend the publication data to 10 years in the hope that he would be able

to acquire relevant research article. While the student was able to acquire five research articles

related to this cultural research question, he found that only one of the research articles was

relevant as it was published in the United States.

Research has shown that there is one factor that can contribute to the high rate of burnout

in the nursing practice. Per the research of Matin and colleagues (2014), there is a sociological

concept known as cultural capital that plays a role in the contribution of the high rate of burnout.

The researchers define this sociological concept knowledge and skills that is used to mobilize

groups. These assets need to be present in order for a nurse to have a higher likelihood of being

to prevent burnout. If nurses possess the knowledge and skills needed to manage stress, they are

less prone to burnout.

The data yielded from the research study conducted by Matin and colleagues (2014)

demonstrates how cultural capital can aiding in the prevention of the burnout among nurses. For

this research study, 385 female nurses were recruited for participation. All participants were

instructed to complete a questionnaire in which they answered questions related to the cultural

capital assets that they possessed. After completing the questionnaire, the participants were

8

assessed for burnout using the Maslach Burnout Inventory. The data showed that nearly half of

the participants had low cultural capital, thus being more prone to burnout (Matin et al., 2014).

How is burnout addressed in different organizations across the United States?

The second level cultural research question aims to explore the interventions and

strategies that organizations throughout the United States utilize to help prevent burnout among

nurses. After conducting an ample review of the literature, the student was able to acquire a

substantial amount of research that discussed various interventions and strategies that can be

used for this purpose. One of the interventions that has proven to be effective is yoga. Alexander

et al. (2015) conducted a randomized controlled trial in which they recruited a group of nurses

who were asked to participate in a yoga-based program. After completing the eight-week yoga

intervention the nurses were assessed for burnout using the Maslach Burnout Inventory. Per the

data, the nurses who practiced yoga had less emotional exhaustion and improved self-care which

reduced their likelihood of being burned out.

Research has shown that mindfulness is an intervention that can be used to prevent

burnout among nurses. There is a substantial amount of evidence that shows that mindfulness

training is an effective intervention (Motaghedi, Donyavi, & Mirzaian, 2016). Nurses should be

provided with mindfulness training. This can help them build resiliency which can help them

manage stress.

Ethical Research Question

How do money, power, and control matters relate to burnout and its prevention?

The student wanted to learn if money, power, and control were factors that could help

prevent burnout among nurses. Unfortunately, organizations often find themselves having to

make tough decisions. Given various factors related to costs and the allocation of resources,

9

many organizations fail to take action to address this issue. While some organizations understand

that burnout is a major issue, many are unable to or choose not to provide nurses with the

knowledge and resources needed to prevent burnout. This may be an issue for organizations that

do not have the budget to implement a burnout prevention program.

Leadership plays a major role in the prevention of burnout. Nurse leaders who are in

power can help to address this issue. Nurse leaders can advocate on behalf of their followers to

ensure that they have the knowledge and resources needed to prevent burnout (Mudallal,

Othman, & Al Hassan, 2017). Nurse leaders need to intervene if there are issues that can

contribute to burnout. Nurse leaders can use their communication and advocacy skills to speak

up on behalf of their followers. In case in which the organization does not have a plan in place to

prevent burnout, it essential that nurse leaders meet with stakeholders to present them with the

evidence they need to support the implementation of interventions that can help to prevent

burnout.

How can organizations prevent burnout?

It is important to explore how organizations can prevent burnout. This should be explored

from the perspective of policy and other factors from an ethical perspective such as mandated

overtime and patient ratios. There are various organizations that are mandating their nurses to

work overtime in order to ensure that care is provided to patients. This is can lead to nurses

becoming burned out as they are mandated to work more hours than they can handle.

Organizations need to understand that mandatory overtime can contribute to a high rate of

burnout. To prevent burnout, organizations should not mandate nurses to work overtime. Instead,

organizations should look for alternative options that reduce the likelihood of nurses being prone

to burnout.

10

Another policy that can contribute to a high rate of burnout is inadequate patient ratios.

This is an issue that various nurses have to deal with given the nursing shortage and other factors

that require organizations to give nurses more patients to care for. Nurses should be assigned an

appropriate number of patients. Given the various responsibilities and roles that nurses have to

undertake, many can become overwhelmed by having to provide care to an excessive number of

patients. This can cause stress which can then lead to burnout.

Conclusion

There is no denying that burnout is a major issue within the nursing profession. The

prevalence of burnout is very high, in particular in the ICU. There is a lot of evidence that shows

that burnout is associated with different problems. Burnout can cause nurses to experience

various health issues. Burnout can also add financial issues. It is important that this issue is

addressed. As noted, the student’s goal is to identify a solution to this problem. By completing

this paper, the student has been able to acquire a substantial amount of data that can be used to

make a recommendation. The student would like to extend this recommendations to

organizations across the United States.

11

References

Alexander, G. K., Rollins, K., Walker, D., Wong, L., & Pennings, J. (2015). Yoga for self-care

and burnout prevention among nurses. Workplace Health & Safety, 63, 462-470. doi:

10.1177/2165079915596102

Cheung, T., & Yip, P. (2015). Depression, anxiety and symptoms of stress among Hong Kong

nurses: A cross-sectional study. International Journal of Environmental Research and

Public Health, 12, 11072–11100. doi: 10.3390/ijerph120911072

Halter, M., Boiko, O., Pelone, F., Beighton, C., Harris, R., Gale, J., … Drennan, V. (2017). The

determinants and consequences of adult nursing staff turnover: A systematic review of

systematic reviews. BMC Health Services Research, 17, 824. doi: 10.1186/s12913-017-

2707-0

Heinemann, L. V., & Heinemann, T. (2017). Burnout research: Emergence and scientific

investigation of a contested diagnosis. Sage Open, 2017, 1-12. doi:

10.1177/2158244017697154

Mealer, M. (2015). Burnout syndrome in the intensive care unit. Future directions for research.

Annals of the American Thoracic Society, 13(7), 997-998.

https://doi.org/10.1513/AnnalsATS.201604-280ED

Motaghedi, H., Donyavi, R., & Mirzaian, B. (2016). Effectiveness of mindfulness based

cognitive therapy on the distress tolerance of nurses and job burnout. Journal of Nursing

and Midwifery Sciences, 3(4), 3-12.

Mudallal, R. H., Othman, W. M., & Al Hassan, N, F. (2017). Nurses’ burnout: The influence of

leader empowering behaviors, work conditions, and demographic traits. Inquiry, 54, 1-10.

doi: 10.1177/0046958017724944

12

Papathanasiou, I. V. (2015). Work-related mental consequences: Implications of burnout on

mental health status among health care providers. Acta Informatica Medica, 23, 22–28.

doi: 10.5455/aim.2015.23.22-28

Reith, T. P. (2018). Burnout in United States healthcare professionals: A narrative review.

Cureus, 10(12), e3681.

Salvagioni, D. A., Melanda, F. N., Mesas, A. E., Gonzalez, A. D., Gabani, F. L., & de Andrade,

S. M. (2017). Physical, psychological and occupational consequences of job burnout: A

systematic review of prospective studies. Plos One, 12(10), e0185781. Retrieved from

https://doi.org/10.1371/journal.pone.0185781