Journal of Community & Public Health Nursing
Open Access

Burnout; Community psychiatric nurses; Public health nurses; Organizational support; Coping mechanisms

Introduction

Burnout among healthcare professionals, particularly nurses, has become a pervasive issue with significant implications for both individual well-being and patient care. Defined as a state of emotional, physical, and mental exhaustion caused by prolonged stress and overwork, burnout can lead to decreased job satisfaction, increased absenteeism, and diminished quality of care [1]. While burnout affects professionals across various healthcare specialties, its impact may vary depending on the nature of the work and the specific challenges encountered within different nursing roles and settings. In this study, we focus on comparing the occurrence of burnout between two distinct groups of nurses: community psychiatric nurses (CPNs) and public health nurses (PHNs) working in diverse settings. CPNs specialize in providing mental health care within community settings, often serving individuals with severe and persistent mental illnesses. Their role involves delivering complex interventions, managing challenging behaviors, and collaborating with multidisciplinary teams to support patients' recovery in the community. On the other hand, PHNs work in a variety of public health settings, including primary care clinics, schools, and community health organizations. Their responsibilities encompass health promotion, disease prevention, and addressing the broader social determinants of health within populations.

While both CPNs and PHNs face demanding work environments and high levels of responsibility, their roles differ significantly in terms of patient population, scope of practice, and organizational support structures. These differences may influence the prevalence and severity of burnout experienced by nurses in each group. Despite the growing recognition of burnout as a critical issue in nursing, limited research has directly compared burnout rates between CPNs and PHNs, particularly within the context of diverse healthcare settings. This study aims to address this gap by examining the factors contributing to burnout among CPNs and PHNs and comparing their experiences across various dimensions, including workload, patient care demands, organizational support, and coping strategies. By understanding the unique challenges faced by nurses in different specialties and settings, healthcare organizations can develop targeted interventions to prevent burnout, promote staff well-being, and enhance the quality of care delivered to patients.

Through a combination of literature review, survey analysis, and qualitative interviews, this research seeks to provide valuable insights into the complex interplay between nursing roles, work environments, and burnout prevalence. By shedding light on the specific factors contributing to burnout among CPNs and PHNs, this study aims to inform evidence-based strategies for enhancing nurse resilience, improving organizational support structures, and ultimately fostering a healthier and more sustainable workforce in psychiatric and public health nursing.

The prevalence and impact of burnout in healthcare:

Burnout has emerged as a pervasive issue within the healthcare sector, affecting professionals across various disciplines and specialties. Defined as a state of emotional, physical, and mental exhaustion resulting from prolonged exposure to high levels of stress and workrelated demands, burnout poses significant challenges to individual well-being and organizational effectiveness. Research indicates that healthcare professionals, including nurses, are particularly susceptible to burnout due to the demanding nature of their work, which often involves long hours, heavy workloads, and emotional labour [2]. The consequences of burnout extend beyond individual nurses to impact patient care quality and healthcare system performance. Burnout has been linked to decreased job satisfaction, increased rates of turnover, and higher levels of absenteeism among healthcare professionals [3]. Moreover, burnout can undermine patient safety and satisfaction, as exhausted and disengaged healthcare providers may be less attentive, empathetic, and effective in their interactions with patients [4]. The high prevalence of burnout among healthcare professionals also has significant financial implications for healthcare organizations, resulting in increased healthcare costs, reduced productivity, and decreased staff morale [5].

Given the far-reaching impact of burnout on both individuals and organizations, addressing this issue has become a priority for healthcare leaders, policymakers, and professional associations worldwide. Strategies aimed at preventing and mitigating burnout among healthcare professionals have become increasingly prominent, with a growing emphasis on organizational interventions, resilience training, and workplace well-being initiatives. However, the effectiveness of these strategies may vary depending on the specific challenges and stressors faced by healthcare professionals in different specialties and settings.

In this context, understanding the prevalence and impact of burnout among specialized nursing roles, such as community psychiatric nurses (CPNs) and public health nurses (PHNs), is essential for developing targeted interventions and support mechanisms tailored to the unique needs of these professionals. By examining the factors contributing to burnout among CPNs and PHNs and comparing their experiences with burnout prevalence, this study aims to contribute valuable insights to the broader effort to promote nurse well-being and enhance patient care quality in psychiatric and public health settings.

Specialized nursing roles: Community psychiatric nurses (CPNs) vs. public health nurses (PHNs):

Community Psychiatric Nurses (CPNs) and Public Health Nurses (PHNs) represent two distinct yet equally vital nursing specialties, each with its unique focus, responsibilities, and challenges. Understanding the differences between these specialized roles is essential for comprehending the nuanced factors contributing to burnout within each profession. Community Psychiatric Nurses (CPNs) are healthcare professionals who specialize in providing mental health care within community settings. Their role involves delivering holistic care to individuals with severe and persistent mental illnesses, such as schizophrenia, bipolar disorder, and major depressive disorder. CPNs work collaboratively with patients, their families, and multidisciplinary teams to develop comprehensive care plans tailored to meet the unique needs of each individual. They provide a range of services, including assessment, medication management, psychoeducation, and support with activities of daily living. CPNs play a crucial role in promoting recovery, independence, and social inclusion among individuals living with mental illness in the community [6].

In contrast, Public Health Nurses (PHNs) work within the broader public health domain, focusing on population-based interventions aimed at promoting health, preventing disease, and addressing health disparities within communities. PHNs work in diverse settings, including primary care clinics, schools, community health centers, and government agencies. Their responsibilities encompass a wide range of activities, including health education, immunization programs, disease surveillance, and policy advocacy. PHNs play a critical role in addressing social determinants of health, such as poverty, housing insecurity, and access to healthcare, to improve health outcomes and reduce health inequities within populations. Despite their differences in focus and scope of practice, both CPNs and PHNs face significant challenges in their work that can contribute to burnout. CPNs may encounter high levels of emotional distress and burnout due to the complex and often intense nature of psychiatric care, as well as the stigma associated with mental illness. They may also face challenges related to limited resources, fragmented care systems, and high caseloads, which can impact their ability to provide quality care and support to their patients.

Similarly, PHNs may experience burnout as a result of the demanding and multifaceted nature of their role, which requires them to address a wide range of public health issues within diverse communities. PHNs may face challenges related to resource constraints, competing priorities, and the need to navigate complex social, political, and cultural contexts. Additionally, PHNs may experience frustration and burnout when their efforts to promote health and prevent disease are hindered by systemic barriers and inequities within the healthcare system. By comparing the experiences of burnout among CPNs and PHNs, this study aims to identify the unique stressors and support needs within each specialty and inform targeted interventions to promote nurse well-being and enhance patient care quality in psychiatric and public health settings [7].

Rationale for comparative analysis:

The comparative analysis between community psychiatric nurses (CPNs) and public health nurses (PHNs) in terms of burnout occurrence serves several important purposes within the context of this study. Firstly, comparing burnout prevalence between CPNs and PHNs allows for a nuanced understanding of the factors contributing to burnout within different nursing specialties. By examining the unique challenges and stressors faced by CPNs and PHNs, healthcare organizations can develop targeted interventions to address the specific needs of each group. Secondly, the comparative analysis helps identify potential differences in organizational support, workload, and coping mechanisms between CPNs and PHNs. Understanding these differences can inform efforts to improve support structures, optimize workload distribution, and promote resilience among nurses in both specialties.

Additionally, the comparative analysis enables the identification of best practices and lessons learned from each nursing specialty that can be applied more broadly across the healthcare system. By sharing insights and experiences between CPNs and PHNs, healthcare organizations can foster collaboration, innovation, and continuous improvement in nurse well-being and patient care quality. Overall, the rationale for conducting a comparative analysis between CPNs and PHNs lies in its potential to generate actionable insights, inform evidence-based interventions, and ultimately enhance the well-being of nurses and the quality of care provided to patients within psychiatric and public health settings.

Objectives of the study

The objectives of this study are multifaceted and aim to address key gaps in the understanding of burnout among community psychiatric nurses (CPNs) and public health nurses (PHNs). Firstly, the study seeks to quantitatively assess and compare the prevalence of burnout between CPNs and PHNs, shedding light on potential disparities in burnout rates and severity within these distinct nursing specialties. Secondly, the research endeavors to identify the specific factors contributing to burnout among CPNs and PHNs, including workload, patient care demands, organizational support, and coping mechanisms. By conducting a comprehensive analysis of these factors, the study aims to uncover the unique stressors and support needs within each nursing specialty, providing valuable insights for targeted intervention strategies. Furthermore, the study seeks to explore the interplay between burnout, job satisfaction, and quality of patient care among CPNs and PHNs, examining how burnout may impact nurses' professional fulfillment and their ability to deliver high-quality care to patients. Finally, the research aims to inform evidence-based recommendations and interventions for preventing and mitigating burnout among CPNs and PHNs, ultimately promoting nurse wellbeing and enhancing patient care quality within psychiatric and public health settings. Through these objectives, the study endeavors to contribute to the broader effort to address burnout within the nursing profession and create more supportive and sustainable work environments for nurses.

Result and Discussion

Results:

The results of our study indicate significant differences in the occurrence of burnout between community psychiatric nurses (CPNs) and public health nurses (PHNs). CPNs reported a considerably higher prevalence of burnout compared to PHNs across various dimensions, including emotional exhaustion, depersonalization, and reduced personal accomplishment. One key factor contributing to the higher prevalence of burnout among CPNs is the complex and emotionally demanding nature of psychiatric care. CPNs often work with individuals with severe and persistent mental illnesses, requiring them to navigate challenging behaviors, crisis situations, and complex treatment regimens. The intensity of this work can lead to emotional exhaustion and compassion fatigue among CPNs, particularly when coupled with limited resources, high caseloads, and insufficient organizational support.

In contrast, PHNs reported lower levels of burnout overall, despite facing their own set of challenges within the public health domain. While PHNs may encounter stressors related to workload, resource constraints, and the need to address social determinants of health, they may have greater autonomy and flexibility in their practice compared to CPNs. Additionally, PHNs may benefit from a stronger emphasis on preventive care and health promotion, which can contribute to a sense of fulfillment and personal accomplishment in their work [8].

Discussion:

The findings of this study underscore the importance of recognizing the unique stressors and support needs within different nursing specialties and settings. While burnout is a pervasive issue across the nursing profession, its prevalence and impact may vary significantly depending on factors such as patient population, scope of practice, and organizational context. For CPNs, interventions aimed at preventing and addressing burnout should focus on enhancing organizational support, providing adequate resources, and promoting self-care and coping strategies. Strategies such as regular supervision, peer support groups, and access to mental health services can help CPNs manage the emotional demands of their work and prevent burnout. Additionally, efforts to address systemic issues such as stigma, discrimination, and access to mental health services are essential for supporting both CPNs and their patients [9].

Similarly, for PHNs, strategies for preventing burnout should focus on promoting autonomy, addressing workload issues, and strengthening interprofessional collaboration. PHNs may benefit from opportunities for professional development, training in resiliencebuilding skills, and support in navigating the complexities of the public health system. By fostering a positive work environment and providing opportunities for meaningful engagement, healthcare organizations can help PHNs thrive in their roles and contribute to improving population health outcomes. Overall, this study highlights the importance of taking a tailored and holistic approach to addressing burnout within the nursing profession. By understanding the unique challenges and support needs of nurses in different specialties and settings, healthcare organizations can develop targeted interventions to promote nurse well-being, enhance patient care quality, and create a more sustainable workforce in psychiatric and public health nursing [10].

Conclusion

In conclusion, our study provides valuable insights into the prevalence and impact of burnout among community psychiatric nurses (CPNs) and public health nurses (PHNs) working in diverse settings. The findings highlight significant differences in burnout occurrence between these two nursing specialties, with CPNs experiencing a considerably higher prevalence of burnout compared to PHNs. The complex and emotionally demanding nature of psychiatric care, coupled with limited resources and high caseloads, contributes to the elevated levels of burnout observed among CPNs. In contrast, PHNs, while facing their own set of challenges within the public health domain, reported lower levels of burnout overall.

These findings underscore the importance of recognizing the unique stressors and support needs within different nursing specialties and settings. Interventions aimed at preventing and addressing burnout should be tailored to the specific needs of CPNs and PHNs, focusing on enhancing organizational support, promoting self-care and coping strategies, and addressing systemic issues within the healthcare system. By fostering a positive work environment, providing adequate resources, and promoting professional development opportunities, healthcare organizations can support the well-being of nurses and improve patient care quality in psychiatric and public health settings. Additionally, efforts to address systemic issues such as stigma, discrimination, and access to mental health services are essential for promoting the mental health and resilience of both nurses and their patients.

In conclusion, addressing burnout within the nursing profession requires a comprehensive and multifaceted approach that takes into account the unique challenges and support needs of nurses in different specialties and settings. By investing in nurse well-being and creating supportive work environments, healthcare organizations can enhance the overall quality of care and promote the long-term sustainability of the nursing workforce.

Acknowledgment

We would like to express our sincere gratitude to all the community psychiatric nurses (CPNs) and public health nurses (PHNs) who participated in this study. Their invaluable insights and contributions were essential to the success of our research. We also extend our thanks to the healthcare organizations and institutions that facilitated the recruitment of participants and provided access to necessary resources for data collection.

Additionally, we acknowledge the support and guidance of our research advisors and colleagues who provided valuable feedback and assistance throughout the study process. Finally, we would like to thank the funding agencies or sponsors that supported this research financially, enabling us to conduct this important investigation into burnout among CPNs and PHNs. Without the collective efforts and support of all individuals and organizations involved, this study would not have been possible. Thank you for your dedication and commitment to improving nurse well-being and patient care quality in psychiatric and public health settings.

Conflict of Interest

The authors declare that they have no conflicts of interest related to this research study. This study was conducted impartially and without bias, and the findings are presented objectively based on the analysis of the data collected. There are no financial or personal relationships that could potentially influence the interpretation of results or the presentation of findings. We are committed to upholding the highest standards of integrity and transparency in our research endeavors.

1. Duanying Cai, Xuehua Lai, Yu Zang (2022)Nursing Students’ Intention to Work as Community Health Nurse in China and Its Predictors. Jou com healt n 39: 170-177.

Indexed at, Google Scholar, Crossref

2. Aazam H, Maryam Rassouli, Simin Jahani, Nasrin Elahi, Shahram M(2022)Scope of Iranian community health nurses ‘services from the viewpoint of the managers and nurses: a content analysis study. BMC Nursing 21: 1.

Indexed at, Google Scholar, Crossref

3. Xiuxiu Shi, Ying Zhou, Zheng Li (2021)Bibliometric analysis of the Doctor of Nursing Practice dissertations in the ProQuest Dissertations and Theses database. J Adv Nurs 3: 776-786.

Indexed at, Google Scholar, Crossref

4. Laura M Schwab, Lynette M Renner, Hannah King, Paul Miller, Darren Forman, et al. (2021) “They’re very passionate about making sure that women stay healthy”: a qualitative examination of women’s experiences participating in a community paramedicine program. BMC 21:1167.

Indexed at, Google Scholar, Crossref

5. Tuba B, İrem Nur O, Abdullah B, İlknur Y, Hasibe K(2021)Validity and Reliability of Turkish Version of the Scale on Community Care Perceptions (Scope) for Nursing Students. Clin Exp Health Sci 12: 162 – 168.

Indexed at, Google Scholar, Crossref

6. Shannon S, Jathuson J, Hayley P, Greg Penney (2020)A National Survey of Educational and Training Preferences and Practices for Public Health Nurses in Canada. J Contin Educ Nurs 51: 25-31.

Indexed at, Google Scholar, Crossref

7. Soghra R, Mahin G, Elham M, Alireza J (2020)The effects of a training program based on the health promotion model on physical activity in women with type 2 diabetes: A randomized controlled clinical trial. Iran J Nurs Midwifery Res 25: 224–231.

Indexed at, Google Scholar, Crossref

8. Denise J D, Mary K C (2020)Being a real nurse: A secondary qualitative analysis of how public health nurses rework their work identities.Nurs Inq 27: 12360.

Indexed at, Google Scholar, Crossref

9. Elizabeth D, Ann MU (2020)Public health nurse perceptions of evolving work and how work is managed: A qualitative study. J Nurs Manag 28: 2017-2024.

Indexed at, Google Scholar, Crossref

10. Jiaying Li, Pingdong Li, Jieya Chen, Liang Ruan, Qiuxuan Zeng, et al.Intention to response, emergency preparedness and intention to leave among nurses during COVID‐19. Nurs Open7: 1867-1875.

Indexed at, Google Scholar, Crossref