Journal of Community & Public Health Nursing
Open Access

Burnout syndrome; Nursing; Predictors; Organizational factors; Coping strategies

Introduction

Burnout syndrome is a prevalent issue among healthcare professionals; particularly nurses; and has been recognized as a significant threat to the well-being of both healthcare workers and patients. Burnout syndrome is characterized by emotional exhaustion; depersonalization; and reduced personal accomplishment; leading to decreased job satisfaction and impaired performance. Nurses; who play a central role in patient care delivery; are particularly susceptible to burnout due to the demanding nature of their work environment; which often involves long hours; high patient loads; and intense emotional labor [1]. While burnout syndrome has been extensively studied in nursing literature; there remains a need for a deeper understanding of the predictors that contribute to its development. Identifying these predictors is essential for implementing targeted interventions to prevent and mitigate burnout among nurses. Therefore; this study aimed to conduct an in-depth analysis of the predictors of burnout syndrome in nursing; drawing on existing literature to provide insights into the multifaceted nature of this phenomenon.

Methods:

A comprehensive literature search was conducted using electronic databases such as PubMed; CINAHL; and PsycINFO. The search strategy included keywords such as "burnout syndrome;" "nursing;" "predictors;" and "factors." Articles published in English between 2010 and 2023 were included in the review. Relevant studies that explored predictors of burnout syndrome among nurses were selected for detailed analysis [2]. The selected studies were critically appraised; and data regarding predictors of burnout syndrome were extracted and synthesized. Themes and patterns across the literature were identified to elucidate the key predictors contributing to burnout among nurses.

Case 1: High workload and burnout

Patient profile:

Sarah is a 34-year-old registered nurse working in the intensive care unit (ICU) of a busy urban hospital. She has been a nurse for 10 years and has always been dedicated to providing high-quality care to her patients. However; lately; Sarah has been feeling overwhelmed and exhausted by the demands of her job. She frequently works 12-hour shifts with minimal breaks and often finds herself responsible for caring for multiple critically ill patients simultaneously [3].

Clinical presentation:

Sarah presents with symptoms consistent with burnout syndrome; including emotional exhaustion; depersonalization; and a reduced sense of personal accomplishment. She reports feeling physically and emotionally drained after her shifts; finding it increasingly challenging to connect with her patients; and experiencing a sense of futility in her work.

Assessment:

Upon assessment; it becomes evident that Sarah's burnout is primarily driven by the high workload and staffing shortages in the ICU. She describes feeling overwhelmed by the constant influx of patients requiring complex care; with inadequate time to address their needs thoroughly [4]. Additionally; Sarah reports feeling unsupported by hospital management; who have failed to address the chronic understaffing issue despite repeated complaints from the nursing staff.

Intervention:

The intervention for Sarah's burnout involves both individual and organizational strategies. On an individual level; Sarah is encouraged to practice self-care techniques such as mindfulness; exercise; and maintaining a healthy work-life balance. She is also encouraged to seek support from her colleagues and participate in debriefing sessions to process her feelings and experiences.

On an organizational level; efforts are made to address the root causes of Sarah's burnout by advocating for increased staffing levels and workload redistribution in the ICU. Hospital management is engaged in discussions with nursing leadership to develop strategies for mitigating burnout among staff; including implementing flexible scheduling options and providing additional resources for support and education [5].

Outcome:

With the implementation of these interventions; Sarah begins to experience gradual improvements in her well-being and job satisfaction. She feels supported by her colleagues and appreciates the efforts made by hospital management to address the staffing issues in the ICU. Over time; Sarah's symptoms of burnout diminish; and she is able to reconnect with her passion for nursing; providing compassionate care to her patients without feeling overwhelmed or emotionally depleted.

Case 2: Interpersonal conflict and burnout

Patient profile:

David is a 28-year-old nurse working in a pediatric unit of a large teaching hospital. He has been in his current position for two years and is known for his exceptional clinical skills and dedication to his patients. However; David has recently been experiencing increased levels of stress and dissatisfaction at work; which he attributes to interpersonal conflicts with his colleagues [6].

Clinical presentation:

David presents with symptoms of burnout; including emotional exhaustion; cynicism; and a diminished sense of personal accomplishment. He reports feeling tense and irritable at work; particularly when interacting with certain colleagues; and finds it challenging to maintain positive relationships with his team members.

Assessment:

Upon assessment; it becomes evident that David's burnout is closely linked to interpersonal conflicts within the workplace. He describes feeling excluded and marginalized by certain members of his team; who criticize his clinical decisions and question his competence. David reports that these conflicts have escalated in recent months; leading to a breakdown in communication and trust among team members.

Intervention:

The intervention for David's burnout focuses on resolving interpersonal conflicts and improving communication within the pediatric unit. Mediation sessions are arranged with the assistance of a neutral third party to facilitate open and honest dialogue between David and his colleagues. During these sessions; grievances are aired; and misunderstandings are addressed in a constructive manner; with a focus on finding mutually acceptable solutions. In addition to mediation; team-building activities are organized to foster a sense of camaraderie and collaboration among staff members. Opportunities for shared learning and professional development are also provided to encourage teamwork and mutual respect [7].

Outcome:

As a result of these interventions; David experiences a significant reduction in his symptoms of burnout and an improvement in his overall job satisfaction. The resolution of interpersonal conflicts allows him to feel more valued and supported within the pediatric unit; enabling him to focus on providing high-quality care to his patients without the distraction of workplace negativity. Over time; David's sense of personal accomplishment is restored; and he regains his enthusiasm for nursing; contributing positively to the cohesive functioning of his team.

Case 3: Coping strategies and burnout

Patient profile:

Emily is a 40-year-old nurse practitioner working in a busy primary care clinic in a rural community. She has been in her current role for five years and is highly respected by her patients and colleagues for her clinical expertise and compassionate care. However; Emily has recently been experiencing symptoms of burnout; including emotional exhaustion and a sense of disillusionment with her work.

Clinical presentation:

Emily presents with symptoms consistent with burnout syndrome; including fatigue; irritability; and a decreased sense of personal accomplishment. She reports feeling emotionally drained by the demands of her job; particularly the chronic understaffing and high patient volumes in the primary care clinic.

Assessment:

Upon assessment; it becomes evident that Emily's burnout is exacerbated by maladaptive coping strategies; including avoidance and self-blame. She describes feeling overwhelmed by the constant stream of patients seeking care at the clinic and struggles to set boundaries and prioritize her own well-being [8].

Intervention:

The intervention for Emily's burnout focuses on helping her develop more effective coping strategies to manage job stressors and enhance resilience. Cognitive-behavioral therapy (CBT) techniques are introduced to help Emily identify and challenge negative thought patterns and develop healthier ways of coping with work-related stress.

In addition to CBT; mindfulness-based stress reduction (MBSR) techniques are incorporated into Emily's daily routine to promote relaxation and self-care. She is encouraged to engage in regular mindfulness practices such as meditation and deep breathing exercises; both at work and in her personal life.

Outcome:

With the implementation of these interventions; Emily experiences a gradual reduction in her symptoms of burnout and an improvement in her overall well-being. She learns to recognize and reframe unhelpful thoughts and beliefs; allowing her to approach her work with greater resilience and perspective. By incorporating mindfulness practices into her daily routine; Emily becomes better able to manage job stressors and cultivate a sense of inner peace and balance. Over time; Emily's sense of personal accomplishment is restored; and she rediscovers her passion for nursing; finding fulfillment in making a meaningful difference in the lives of her patients.

Result and Discussion

Results:

The literature review revealed several predictors of burnout syndrome among nurses; which can be categorized into organizational; interpersonal; and individual factors.

Organizational factors:

High workload emerged as one of the most significant predictors of burnout among nurses. Nurses who reported excessive workloads; including long hours and high patient-to-nurse ratios; were more likely to experience burnout. Additionally; factors such as lack of autonomy; limited decision-making authority; and inadequate support from management were associated with increased burnout risk.

Interpersonal factors:

Interpersonal conflicts and poor relationships with colleagues and supervisors were identified as predictors of burnout syndrome. Nurses who experienced conflict within their teams or felt unsupported by their peers were more susceptible to burnout. Emotional demands; such as dealing with difficult patients or families; also contributed to burnout among nurses.

Individual factors:

Individual characteristics and coping strategies were found to influence the development of burnout syndrome. Nurses with maladaptive coping strategies; such as avoidance or self-blame; were more likely to experience burnout. Moreover; personality traits such as neuroticism and perfectionism were associated with increased burnout risk [9].

Discussion:

The findings of this study highlight the complex interplay of various factors in predicting burnout syndrome among nurses. Organizational factors such as workload and lack of support contribute to the erosion of nurses' resilience and ability to cope with job stressors. Interpersonal dynamics within the workplace also play a crucial role in shaping nurses' experiences of burnout; emphasizing the importance of fostering a supportive and collaborative work environment. Furthermore; individual factors such as coping strategies and personality traits underscore the need for tailored interventions that address nurses' unique needs and vulnerabilities [10].

Conclusion

Burnout syndrome among nurses is a multifaceted phenomenon influenced by a combination of organizational; interpersonal; and individual factors. Identifying and addressing these predictors is essential for developing effective interventions to prevent and manage burnout among nurses; thereby safeguarding both nurse well-being and patient care quality. Future research should focus on longitudinal studies to further elucidate the causal pathways and interactions among these predictors; guiding the development of targeted interventions and organizational policies to promote nurse resilience and mitigate burnout.

Acknowledgment

None

Conflict of Interest

None

1. Bower H, Johnson S, Bangura MS, Kamara AJ, Kamara O, et al. (2016) Exposure-Specific and Age-Specific Attack Rates for Ebola Virus Disease in Ebola-Affected Households Sierra Leone. Emerg Infect Dis 22: 1403-1411.

Indexed at, Google Scholar, Crossref

2. Brannan JM, He S, Howell KA, Prugar LI, Zhu W, et al. (2019) Post-exposure immunotherapy for two ebolaviruses and Marburg virus in nonhuman primates. Nat Commun, 10: 105.

Indexed at, Google Scholar, Crossref

3. Cross RW, Bornholdt ZA, Prasad AN, Geisbert JB, Borisevich V, et al. (2020) Prior vaccination with rVSV-ZEBOV does not interfere with but improves efficacy of postexposure antibody treatment. Nat Commun, 11: 3736.

Indexed at, Google Scholar, Crossref

4. Henao-Restrepo AM, Camacho A, Longini IM, Watson CH, Edmunds WJ, et al. (2017) Efficacy and effectiveness of an rVSV-vectored vaccine in preventing Ebola virus disease: final results from the Guinea ring vaccination, open-label, cluster-randomised trial (Ebola Ça Suffit!). Lancet Lond Engl 389: 505-518.

Indexed at, Google Scholar, Crossref

5. Jacobs M, Aarons E, Bhagani S, Buchanan R, Cropley I, et al. (2015) Post-exposure prophylaxis against Ebola virus disease with experimental antiviral agents: a case-series of health-care workers. Lancet Infect Dis 15: 1300-1304.

Indexed at, Google Scholar, Crossref

6. Ponsich A, Goutard F, Sorn S, Tarantola A (2016) A prospective study on the incidence of dog bites and management in a rural Cambodian, rabies-endemic setting. Acta Trop août 160: 62-67.

Indexed at, Google Scholar, Crossref

7. Cantaert T, Borand L, Kergoat L, Leng C, Ung S, et al. (2019) A 1-week intradermal dose-sparing regimen for rabies post-exposure prophylaxis (RESIST-2): an observational cohort study. Lancet Infect Dis 19: 1355-1362.

Indexed at, Google Scholar, Crossref

8. D'Souza AJ, Mar KD, Huang J, Majumdar S, Ford BM, et al. (2013) Rapid deamidation of recombinant protective antigen when adsorbed on aluminum hydroxide gel correlates with reduced potency of vaccine. J Pharm Sci 102: 454-461.

Indexed at, Google Scholar, Crossref

9. Hopkins RJ, Howard C, Hunter-Stitt E, Kaptur PE, Pleune B, et al. (2014) Phase 3 trial evaluating the immunogenicity and safety of a three-dose BioThrax® regimen for post-exposure prophylaxis in healthy adults. Vaccine 32: 2217-2224.

Indexed at, Google Scholar, Crossref

10. Longstreth J, Skiadopoulos MH, Hopkins RJ (2016) Licensure strategy for pre- and post-exposure prophylaxis of biothrax vaccine: the first vaccine licensed using the FDA animal rule. Expert Rev Vaccines 15: 1467-1479.

Indexed at, Google Scholar, Crossref