Marie Desire

ENG 1121

Professor Cipriani

10 May 2023

Revised Annotated Bibliography

Research Question: With the current nursing shortage, how can we identify and address the causes of nurse burnout to improve the retention of nurses at the bedside?

Introduction

            The healthcare industry is a conglomerate of different sectors, including healthcare providers, nurses and doctors, insurance agencies, and pharmaceuticals. One area in particular, the nursing industry, is amid a crisis. Currently, there is a worldwide shortage of nurses. There has always been a shortage of nurses throughout history, but the recent COVID-19 pandemic has exacerbated the situation. Due to the lack of nurses, many nurses in the field are experiencing burnout, worsening the current situation as well. But is that the only cause of nurse burnout? Working in the healthcare industry as a licensed practical nurse and experiencing the problem firsthand, I know that many other factors contribute to the increased number of nurses experiencing burnout. Hence, the purpose of this research has three parts. The first is to identify the factors that contribute to nurse burnout. The second is to find possible solutions to mitigate the impact of said contributors of nurses. The last part explores how suggested interventions worked to help decrease burnout in nurses and influence the retention of bedside nurses. The goal of this research is to find reasonable solutions to a problem that affects many people around me daily with the intent of formulating a plan to bring to the administrators of my workplace that they could implement.

Source Entries          

Source One:

Citation

Abuzeid, Iman, and Sharon Pappas. “How Emory Healthcare’s Chief Nurse Executive Improves Nurse Retention and Resilience.” YouTube, YouTube, 17 June 2021, https://www.youtube.com/watch?v=fCisbwmVL3Q.

Summary

In a webinar hosted by the founder of Incredible Health, Iman Abuzeid, and the Chief Nursing Executive of Emory Healthcare, Sharon Pappas, the interventions applied to reduce nurse burnout and improve retention are discussed. The agenda included exploring the ability of healthcare workers to pivot and rebuild, the importance of interprofessional leadership, building resilience, improving retention, and tips for recruiting and hiring. At one point, Pappas highlights, various articles reviewing burnout and its relationship with workplace satisfaction. Pappas used the World Health Organization’s definition of clinical “burnout as a problem associated with chronic workplace stress” encompassing “emotional exhaustion, also known as overextension; depersonalization, also known as cynicism; and low professional efficacy, also known as the inability to see your own personal accomplishment” (Abuzeid and Pappas). Pappas details many of the tactics Emory employed to foster unity among their staff across disciplines. The video concludes with Abuzeid discussing how Incredible Health could help fill those vacant positions, which would lessen the burden nurses face by lowering the nurse-to-patient ratio and, in turn, help prevent burnout.

Analysis

Overall, this webinar was an excellent resource that provides context on implemented practices by a magnet hospital that worked to help reduce nurse burnout. Pappas reported that pre-pandemic, the turnover rate at Emory was 12.5% (Abuzeid and Pappas). During the pandemic, it rose to 20% (Abuzeid and Pappas). Due to changes implemented, it has fallen to 16% (Abuzeid and Pappas). The numbers are shocking, but I’m glad to see that what they are doing is helping to improve the situation. From what is mentioned in the video, burnout is the determining factor for the increase in the turnover rate. During the discussion, the intended audience is healthcare administrators with the power to make changes to improve their workplace. But it could also be targeted to the staff who can band together to draft a plan of action to improve their working conditions. This video helped to broaden my scope of understanding of what administrators must consider when formulating a plan to make changes in the workplace. Now that I can see interventions that work, I can use them to help construct a plan of action for my workplace. 

Source Two:

Citation

Alenezi, Atallah, et al. “Burning out Physical and Emotional Fatigue: Evaluating the Effects of a Programme Aimed at Reducing Burnout among Mental Health Nurses.” International Journal of Mental Health Nursing, vol. 28, no. 5, Oct. 2019, pp. 1045–55. EBSCOhost, https://doi-org.citytech.ezproxy.cuny.edu/10.1111/inm.12608.

Summary

            The article discusses the current problem with employing and keeping nurses, particularly in the mental health nursing sector. The report identifies that mental health professionals experience burnout at a rate “between 20% and 67%” predominantly “at the early stage of their career” (Alenezi, Atallah, et al. 1045-46). The article identified that the primary influencing factor for burnout is increased stress. Burnout is defined as a “psychological symptom of stress, having a tri-dimensional set of symptoms; depersonalisation (DP) and emotional exhaustion (EE), common in the work situation, and lack of personal accomplishment (PA), an inability to accomplish or complete tasks” (Alenezi, Atallah, et al. 1046). The article highlights a study conducted among Saudi Arabian nurses that sought to identify the prevalence of burnout and the effect of implementing a program centered on educating nurses about burnout prevention in stress reduction. The study consisted of a sample of 296 nurses, of which 154 were in the intervention group, and 142 were in the control group. The participants were assessed at one-, three-, and six-month intervals after the intervention. The research concluded that the program was more effective immediately after the intervention. While the burnout rates did not return to the baseline, an increase in burnout was noted at the six-month assessment. The research concluded that nurses would benefit from intervention regularly.

Analysis

            Overall, this article was an interesting read. While not based in the United States, the research question is almost identical to mine. It should not be surprising, but I was still stunned to see how much of a problem burnout is worldwide. This article is trustworthy because the article was published in the International Journal of Mental Health Nursing, and research was conducted on mental health nurses. The intended audience is clear to be those within the field of mental health nursing. Still, the report could interest others besides nurses in mental health, students, and nursing administrators. I found the article to be a wealth of information. The idea to provide mandated education to staff regarding identifying burnout and how to reduce stress has merit. I applaud the researchers for recognizing that this could not be a one-time intervention, but must be conducted routinely. I suggest having the course every three to four months to ensure the material introduced is retained and new tactics can be presented as they are found. Because this study tested an intervention, this source helps to enhance my research and show it if I so choose as “high level of job satisfaction among nurses has been associated positively to remain in employment, and negatively with increased turnover rates” (Alenezi, Atallah, et al. 1046).

Source Three:

Citation

Dall’Ora, Chiara et al. “Burnout in nursing: a theoretical review.” Human resources for health vol. 18,1 41. 5 Jun. 2020, doi:10.1186/s12960-020-00469-9

Summary

            The purpose of this article was to present a comprehensive overview of what is understood about burnout, the factors that contribute to it, and the impact it has on the nursing field. The researchers explored various databases, including MEDLINE, CINAHL, and PsycINFO, to obtain the information presented in the article. The article includes information from ninety-one peer-reviewed articles that included nursing and burnout from twenty-eight countries. The report found that eighty-one studies utilized the “Maslach Burnout Inventory Scale…which comprises three subscales reflecting the theoretical model: Emotional Exhaustion, Depersonalisation, and reduced Personal Accomplishment” (Dall’Ora, Chiara et al. 5). The results of the research also detailed six main areas influencing burnout including,

“Working patterns and shifts working (n = 15), Features inherent in the job such as psychological demand and complexity (n = 24), Job support from working relationships and leadership (n = 39), Hospital or environmental characteristics (n = 28), Staff outcomes and job performance (n = 33), Patient outcomes (n = 17), [and] Individual attributes (personal or professional) (n = 16)” (Dall’Ora, Chiara et al. 7).

The research concluded that the articles on the topic consistently report the adverse effects of burnout on workplace features and personally affecting the staff and patients. It was also noted that there needs to be more research on the relationship between burnout and retention rates.

Analysis

The article was well constructed and presented the information in a way that anyone who reads it could understand. Additionally, the report is a literature review of the information available regarding nurse burnout. Published in Human Resources for Health, the paper meets the requirements to be considered peer reviewed and essentially a trustworthy source. The report targets those like me interested in researching nursing burnout. One aspect of the article that I like is the use of a graph to depict the various factors that impact burnout. One question I have is if job security was observed with low quality because of the lack of supporting evidence or for another reason entirely. This article is an excellent source as it conducted my research. It presents all the information I would need if I were to write a paper and list the information where I can get further detail regarding a specific idea should I choose to. This is likely due to this source being a literature review.

Source Four:

Citation

“5 TELL TALE SIGNS OF BURNOUT.” Australian Nursing & Midwifery Journal, vol. 25, no. 5, Nov. 2017, pp. 22+. Gale OneFile: Nursing and Allied Health, link.gale.com/apps/doc/A518337814/PPNU?u=cuny_nytc&sid=bookmark-PPNU&xid=03b73d3d. Accessed 8 Apr. 2023.

Summary

            The article details the five critical indications of nurse burnout. They include “Fatigue,” “Loss of motivation,” “Irritability and cynicism,” “Mistakes,” and “Detachment” (“5 TELL TALE SIGNS OF BURNOUT” 22). For each sign, an explanation of how it manifests and its consequences are provided. The article then includes a section on managing burnout which highlights a nurse Linda and her experience with burnout. Another area included providing suggestions on prioritizing health from Carolyn McDonald, a registered nurse. “To deal with burnout,” McDonald “encourages nurses and midwives to take time out immediately if required” (“5 TELL TALE SIGNS OF BURNOUT” 23).

Analysis

            As a healthcare worker, I agree 100% with the article’s indicators for burnout. The number of people I have heard perform preventable mistakes due to increased fatigue and needing to be more motivated is ridiculous. I agree with McDonald’s idea to take time away before it becomes too much, but for that to happen, people need to be able to identify the signs in themselves and others. The article was published in the Australian Nursing & Midwifery Journal and is more of an opt-ed that addresses healthcare professionals specifically. This source reinforces my knowledge of burnout and reiterates the importance of self-awareness and seeking help from an outside source if necessary. What I liked about this article is the image of a burning match at different stages to reflect the worsening of burnout.

Conclusion

            My research aims to identify how the nursing shortage is influenced by nurse burnout. First, it is necessary to define what burnout is and how we can identify burnout in ourselves and others. Next, it is to explore how burnout impacts retention rates and what intervention can help to mitigate the effects. From my research, burnout is a consequence of stress in the workplace due to excessive demands from the workplace. Signs of burnout include extreme fatigue, detachment, increased mistakes, irritability, and lack of motivation. Some interventions that were found to work to help mitigate burnout are improved staffing to reduce nurse workload and education about the signs of burnout and stress coping mechanisms. The people who need to be aware of my research are precisely those who work in healthcare, primarily nurses and their managers. Nurses so that they can understand what is happening to them and those around them and come up with a plan or use one that has already been created. And manages so that they can put the suggested intervention into effect.

Works Cited

Abuzeid, Iman, and Sharon Pappas. “How Emory Healthcare’s Chief Nurse Executive Improves Nurse Retention and Resilience.” YouTube, YouTube, 17 June 2021, https://www.youtube.com/watch?v=fCisbwmVL3Q.

Alenezi, Atallah, et al. “Burning out Physical and Emotional Fatigue: Evaluating the Effects of a Programme Aimed at Reducing Burnout among Mental Health Nurses.” International Journal of Mental Health Nursing, vol. 28, no. 5, Oct. 2019, pp. 1045–55. EBSCOhost, https://doi-org.citytech.ezproxy.cuny.edu/10.1111/inm.12608.

Dall’Ora, Chiara et al. “Burnout in nursing: a theoretical review.” Human resources for health vol. 18,1 41. 5 Jun. 2020, doi:10.1186/s12960-020-00469-9

“5 TELL TALE SIGNS OF BURNOUT.” Australian Nursing & Midwifery Journal, vol. 25, no. 5, Nov. 2017, pp. 22+. Gale OneFile: Nursing and Allied Health, link.gale.com/apps/doc/A518337814/PPNU?u=cuny_nytc&sid=bookmark-PPNU&xid=03b73d3d. Accessed 8 Apr. 2023.