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ORIGINAL ARTICLE |
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Year : 2021 | Volume
: 14
| Issue : 1 | Page : 80-83 |
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Burnout among nurses at a tertiary care hospital of South India
Anchu V Raju1, Aneeta Emmanual1, Dilty Shaji1, Mohammed Rithu Faizal1, Priya Reshma Aranha2
1 Yenepoya Nursing College, Yenepoya University, Mangalore, Karnataka, India 2 Department of Child Health Nursing, Yenepoya Nursing College, Yenepoya (Deemed to be) University, Mangalore, Karnataka, India
Date of Submission | 20-May-2020 |
Date of Acceptance | 20-Aug-2020 |
Date of Web Publication | 09-Feb-2021 |
Correspondence Address: Dr. Priya Reshma Aranha Department of Child Health Nursing, Yenepoya Nursing College, Yenepoya (Deemed to be University), Mangalore - 575 018, Karnataka India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/kleuhsj.kleuhsj_154_20
Background: Burnout is clearly identified as a problem in the area of human services that need to be addressed. Burnout negatively affects the health and personal lives if the employees experiencing it. Nurses are more prone for burn out in their day-to-day professional life. Objectives: The present study was conducted to determine the burnout among the staff nurses and to find association of burn out scores with selected demographic variables. Materials and Methods: A quantitative research approach with descriptive survey design was adopted for the study. The study was conducted in selected tertiary care hospital. The variables under study were burnout and demographic variables. Using nonprobability purposive sampling technique, 100 staff nurses were selected as study samples. Demographic pro forma and self-reported burnout inventory scale were used to collect data. The data were analyzed using descriptive and inferential statistics. Results: The study result showed that majority (83%) of the nurses had high level of burnout, 3% had very high level of burnout and 14% had moderate level of burnout. Conclusion: The study concluded that majority of the study participants had high level of burnout. Necessary action to be taken to reduce burnout among staff nurses to improve the quality care provided by them and also to have a conducive working environment for the staff nurses. Keywords: Burnout, hospital, nurses, patient care
How to cite this article: Raju AV, Emmanual A, Shaji D, Faizal MR, Aranha PR. Burnout among nurses at a tertiary care hospital of South India. Indian J Health Sci Biomed Res 2021;14:80-3 |
How to cite this URL: Raju AV, Emmanual A, Shaji D, Faizal MR, Aranha PR. Burnout among nurses at a tertiary care hospital of South India. Indian J Health Sci Biomed Res [serial online] 2021 [cited 2021 Mar 2];14:80-3. Available from: https://www.ijournalhs.org/text.asp?2021/14/1/80/308945 |
Introduction | |  |
Health-care industry is known to be very stressful as there is a lot demand from the health-care professionals. Among the health-care professionals nurses are highly prone for burnout due to their work pattern and long working hours as well. Nurses are the first line of contact in a hospital; they spend most of the time with the client and their accompanists. This makes them to have a continuous exposure to the emotional strains of dealing with the sick and dying. These stressors if not addressed may lead to burnout.[1],[2]
Freudenberger in 1974 for the first time coined the word burnout. Burnout describes the worker's reaction to chronic stress. It occurs in occupations involving multiple interactions with people.[3] Maslach et al. said that “the burnout is a syndrome of emotional exhaustion, depersonalization and reduced personal accomplishment.” Burnout has also been associated with working conditions in nursing.[4] In the current scenario, burnout syndrome can be considered as an epidemic across the world. It is a serious process that can impair in the worker's quality of life and can lead to serious damages of physical and mental health. The high incidence of this syndrome can be seen among professionals such as teachers, doctors, and nurses.[5]
Nursing is generally perceived as a stressful and demanding profession. Nurses deal with people who are suffering from major or minor health problems and life-threatening situations. To take care of these people is challenging, both physically and psychologically.[6] They also deal patients with loneliness, pain, agony, incapacity, disease, and death which increases their chance of getting burnout. Nurses care for the sick, provide presence, comfort, support, and help to patient around the clock. Nurses continuously are exposed to stressors at work and therefore they are vulnerable to burnout. The number of studies reported that burnout in nurses is linked with the time spent with patients, high work load, poor support, interpersonal conflict, death and dying, and inadequate preparation. Thus, nursing is an inherently stressful occupation and is at high risk of burnout.[7],[8],[9],[10],[11]
Burnout can affect the nurses' professional practice. It could also contributing to impairment in registered nurses assessment ability, errors in their judgment, as well as decrease in their job satisfaction and efficiency.[12] Since burnout impairs job performance, overall quality of patient care also may be affected.[13] Nurse burnout is a physical, mental, and emotional state caused by chronic overwork and a sustained lack of job fulfillment and support. Common burnout symptoms may include physical or emotional exhaustion, job-related cynicism, and a low sense of personal accomplishment.[14] Emotional exhaustion is the lower sense of competence and success in the profession, dissatisfaction with the work duties, feeling of failure, loss of judgment and understanding, sense of permanent oppression and exploitation, and decreased job performance, are different expressions of burnout. This syndrome negatively affects the individual's social, physical, and psychological life.[15] Burnout is associated with overthrowing ethics, impaired work performance, absence from work, and inappropriate contact with patients, and high number of job change.[16]
Job burnout among nursing staff is about 13%–27%, which is significantly higher than the general population due to the intense nature of occupational duties and high level of stress.[17],[18] A study has reported that among the nurses majority (84.2%) had moderate job satisfaction and nurses reported mostly low levels of personal achievements (39.5%), moderate levels of emotional exhaustion (38.8%), and low levels of depersonalization (72.4%).[19]
Nurses who experience burn out may have higher absenteeism rates, lower work satisfaction and are more likely to leave the organization. It was found that there is a negative effects of role stress on job satisfaction and commitment of nurses.[20] It was also seen that increase in role overload, role conflict, role ambiguity leads to an enhancement in disengagement and exhaustion.[21] It was also found that role ambiguity and role conflict were significantly correlated with burnout and role ambiguity was a stronger predictor of burnout. Moreover, role ambiguity, lack of power, and role conflict are linked to stress among nurses.[22] The number of studies suggest that patient outcomes and nurse burnout are both strongly associated with low staffing levels and poor practice environments.[23],[24],[25],[26],[27]
In general, burnout is a challenging health problem. This problem is harmful to humans and health systems. Therefore, in recent years, particular attention has been paid to research on burnout, especially among the nursing professions. The study was conducted to determine the burnout syndrome among the staff nurses and to find the associated of burnout scores with the selected demographic variables.
Materials and Methods | |  |
A quantitative research approach with descriptive survey design was adopted for the study. The study was conducted in a tertiary care hospital, which is a 1050 bedded multispecialty hospital. The variables under study were burnout and demographic variables. A total of 100 staff nurses having minimum 2 years of clinical experience were selected for the study. Staff nurses working in medical ward, surgical ward, intensive care unit, critical care unit, and emergency ward were selected for the study. Staff nurses working in outpatient department, laboratory and radiology department were excluded from the study. Based on the sample selection criteria, nonprobability purposive sampling technique was used to select the sample. The tool used for the study was demographic pro forma, and self-reported burnout inventory scale. The demographic pro forma consists of age, gender, religion, marital status, educational qualification, work experience, work areas, and monthly income of the staff nurses. The investigators have developed a self-reported burnout inventory scale comprising of 30 items. All the 30 items of the tool were measured across the five-point Likert scale indicating the frequency of the characteristics of symptoms from “1, Never” to “5, Always;” “2, rarely,” “3, Sometimes;” “4, Often.” Maximum possible score could be 150. Based on the scores, the grading of burnout is done. [Table 1] describes the arbitrary grading of the burn out.
The tool was validated and found reliable (r = 1). After obtaining the ethical clearance, informed consent was taken from the study participants. Then, the data were collected and analyzed using descriptive and inferential statistics. For the above project, ethical clearance obtained from Yenepoya University Ethics Committee 1. YEC-1/081/2019, dated 09/03/2019.
Results | |  |
Data in [Table 2] shows the demographic characteristics of sample. [Figure 1] shows the burnout among staff nurses. The study results showed that majority of the nurses (83%) had high level of burnout, 3% had very high level of burnout and 14% had moderate level of burnout. The study also showed that there is an association between burnout score and education of staff nurses (χ2 = 76.12, P < 0.05).
Discussion | |  |
The present study showed that majority (85.4%) of the study participants were female, majority (66.0%) were with B.Sc nursing degree, majority (29.1%) were working in medicine wards and surgery wards, majority (97.1%) were satisfied in work. This study finding is supported by our study where majority of the study participants were female (79.9%) majority had bachelor's degree in nursing (52%) majority (65.3%) were clinical nurses, majority (71%) were satisfied with the work.[28],[29],[30]
In the present study, majority (83%) of the study samples had high level of burnout, 14% had moderate level of burnout and 3% had very high level of burnout. These study findings are supported by a study which was conducted to assess the burnout among physicians and nursing staff working in the emergency hospital which showed that majority (66%) of the study participants had moderate level of burnout and (24.9%) had high level of burnout.[31],[32] Another study found that nurses experience burnout as moderate level.[33],[34] Some other studies also showed nurses burnout level was high.[33],[34],[35],[36]
The present study found the association between burnout scores and education of nurses. The previous studies[37],[38] did not find statistically significant difference between demographic profile and burnout level.
Conclusion | |  |
The study has provided an insight that majority of the nurses have high level of burnout. Nursing administrators need to take up necessary steps so as to reduce burnout among staff nurses and to improve the professional life of nurses as well as enhance quality of care.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
References | |  |
1. | Aiken LH, Clarke SP, Sloane DM, Sochalski JA, Busse R, Clarke H, et al. Nurses' reports on hospital care in five countries. Health Aff (Millwood) 2001;20:43-53. |
2. | Bloniasz ER. Caring for the caretaker: A nursing process approach. Creat Nurs 2011;17:12-5. |
3. | Jennings BM. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD). In: Hughes RG, editor. US: Agency for Healthcare Research and Quality; 2008. |
4. | Maslach C, Jackson S, Leiter M. The Maslach Burnout Inventory. 3 rd ed. Palo Alto, CA: Consulting Psychologist Press; 1997 p. 191-218. |
5. | Batista J, Batista P, Barros E, Lopes F, Medeiros G, Morais J. Burnout syndrome: Understanding of nursing professionals who work in the hospital context. J Nurs 2013;7:553-61. |
6. | Rosales RA, Rosales GL, Labrague LJ. Nurses' job satisfaction and burnout: Is there a connection. Int J Adv Nurs Stud 2013;2:1-10. |
7. | Bakker AB, Killmer CH, Siegrist J, Schaufeli WB. Effort-reward imbalance and burnout among nurses. J Adv Nurs 2000;31:884-91. |
8. | Peeters MC, Le Blanc PM. Towards a match between job demands and sources of social support: A study among oncology care providers. Eur J Work and Organ Psychol 2001;10:53-72. |
9. | Adali E, Priami M. Burnout among nurses in intensive care units, internal medicine wards and emergency departments in Greek hospitals. ICUs and Nurs Web J 2002;11:1-19. |
10. | Greenglass E, Burke RJ, Fiksenbaum L. Workload and burnout in nurses. J Community Appl Soc Psychol 2001;11:211-5 |
11. | Kirkaldy BD, Martin T. Job stress and satisfaction among nurses: Individual differences. Stress Med 2000;16:77-89. |
12. | Morse G, Salyers MP, Rollins AL, Monroe-DeVita M, Pfahler C. Burnout in mental health services: A review of the problem and its remediation. Adm Policy Ment Health 2012;39:341-52. |
13. | |
14. | Arab M, Rahimi A, Vali L, Ravangard R, Akbari Sari A. Study of the relationship between nurses' work environment indices and their burnout aspects in TUMS teaching hospitals. IOH 2012;9:39-51. |
15. | Shahnazdoust M, Maghsudi SH, Tabari R, Kazemnegad E. Relationship between nursing burnout and occupational support. J Guilan Uni Med Sci 2012;20:49-59. |
16. | Ferreira NN, Lucca SR. Burnout syndrome in nursing assistants of a public hospital in the state of São Paulo. Rev Bras Epidemiol 2015;18:68-79. |
17. | Abellanoza A, Provenzano HN, Gatchel RJ. Burnout in ER nurses: Review of the literature and interview themes. J Appl Biobehav Res 2018;23:e12117. |
18. | Abushaikha L, Saca-Hazboun H. Job satisfaction and burnout among Palestinian nurses. East Mediterr Health J 2009;15:190-7. |
19. | Arrigoni C, Caruso R, Campanella F, Berzolari FG, Miazza D, Pelissero G. Investigating burnout situations, nurses' stress perception and effect of a post-graduate education program in health care organizations of northern Italy: A multicenter study. G Ital Med Lav Ergon 2015;37:39-45. |
20. | Wen-Hsien Ho CS, Ying-Ling S, Rong D. Effects of job rotation and role stress among nurses on job satisfaction and organizational commitment. BMC Health Service Research 2009; 9:1-10. |
21. | Prasanjit D. Effect of role ambiguity, conflict and overload in private hospitals' nurses' burnout and mediation through self efficacy. J Health Manag 2012;14:513-34. |
22. | Eleni M, Theodoros CC. Sources of effects of work-related stress in nursing. Health Sci J 2010;4:210-6. |
23. | Aiken LH, Clarke SP, Sloane DM, Lake ET, Cheney T. Effects of hospital care environment on patient mortality and nurse outcomes. J Nurs Adm 2008;38:223-9. |
24. | Aiken LH, Clarke SP, Sloane DM; International Hospital Outcomes Research Consortium. Hospital staffing, organization, and quality of care: Cross-national findings. Int J Qual Health Care 2002;14:5-13. |
25. | Spence Laschinger HK, Leiter MP. The impact of nursing work environments on patient safety outcomes: The mediating role of burnout/engagement. J Nurs Adm 2006;36:259-67. |
26. | Leiter MP, Robichaud L. Relationships of occupational hazards with burnout: An assessment of measures and models. J Occup Health Psychol 1997;2:35-44. |
27. | Sasikala R, Ramu G. Occupational stress among nurses of tertiary care hospital Tiruvarur. Int J Sci Res Manag 2018;6:108-11. |
28. | Anish KA, Fatima D. Job satisfaction, burnout and quality of life of nurses from Manglore. J Health Manag 2016;15:91-7. |
29. | Guo YF, Luo YH, Lam L, Cross W, Plummer V, Zhang JP. Burnout and its association with resilience in nurses: A cross-sectional study. J Clin Nurs 2018;27:441-9. |
30. | Lahana E, Papadopoulou K, Roumeliotou O, Tsounis A, Sarafis P, Niakas D. Burnout among nurses working in social welfare centers for the disabled. BMC Nurs 2017;16:15. |
31. | Queiros C, Carlotto MS, Kaiseler M, Dias S, Pereira AM. Predictors of burnout among nurses: An interactionist approach. Psicothema 2013;25:330-5. |
32. | Cetinkaya F, Akbulut Z, Dur N, Eryalcin O, Korkmaz M. Analysis of job satisfaction and burnout level of nurses in different generations. Int J Caring Sci 2017;10:1507-13. |
33. | Abdo SA, El-Sallamy RM, El-Sherbiny AA, Kabbash IA. Burnout among physicians and nursing staff working in the emergency hospital of Tanta University, Egypt. East Mediterr Health J 2016;21:906-15. |
34. | Zhang LF, You LM, Liu K, Zheng J, Fang JB, Lu MM, et al. The association of Chinese hospital work environment with nurse burnout, job satisfaction, and intention to leave. Nurs Outlook 2014;62:128-37. |
35. | Metin O, Ozer FG. Determination of the level of nursing burnout. J Anatol Nurs Health Sci 2007;10:58-66. |
36. | Gunusen N, Ustun B. Determining the level of burnout in nurses working at a university hospital and affecting factors. J Ataturk Univ Nurs Sch 2008;11:48-58. |
37. | Akpinar A, Tas Y. A research to determine the relationship between level of burnout and job satisfaction of emergency services personnel. Turkish J Emerg Med 2011;11:161-5. |
38. | Akyuz I. Investigation of level of nurses' burnout and depression in terms of working conditions and demographic characteristics. J Bus Econ Stud 2015;3:21-34. |
[Figure 1]
[Table 1], [Table 2]
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