Imagine being a nurse, working long hours, and having a high patient load. It is easy to see how you can become stressed, burned out, and perhaps even depressed. Research by the NIH analyzed more than 198,000 nurses for 11 years. It compared mental health burdens among nurses versus other different occupations and results reveal that this profession sees more dissatisfaction and burnout than any other.
Nurses are an important part of the healthcare industry. They are on the front lines looking after patients and this, in itself, is an extremely challenging and demanding role. Nurses are the primary caregivers in any healthcare setting. This means their health directly impacts the quality of patient care they provide and the health outcomes of the rest of the population.
What is burnout in nursing?
The World Health Organization defines burnout as occupational. It is a state of physical, mental, and emotional exhaustion that causes disengagement and detachment from your work. It is caused by long working hours, workplace stress, and the burden of quick decision-making. All professionals experience this phenomenon, but healthcare workers experience it the most due to the high-stress work environment.
The International Council of Nurses did a study and found that the burnout rate increased from 40% to 70% during the pandemic. These statistics rarely motivate change as burnout is considered personal. But a worrisome change that was observed was a dramatic increase in people seeking therapies and counseling. There has also been a drastic jump in enrollments in programs like MSW online and other psychiatrist degrees. The snowballing concerns of poor mental health that became prevalent during the pandemic have encouraged people to choose this career path and help nurses and others experiencing burnout.
Causes of burnout in nursing
The biggest contributor to burnout in nursing is the high-stress workplace environment. The pandemic further pushed the nurses over the edge, causing many nurses to quit their profession. The US Bureau of Labor Statistics has predicted a 12% increase in the demand for RNs by 2028. This indeed is an encouraging factor for fresh graduates. But unfortunately, this has caused an extreme workload on existing nurses as hospitals are understaffed.
A study by Marshall University has explained what causes prolonged stress in nurses. These are:
- Stressful specialties nurses like those in ER and ICU have the greatest burnout rate.
- The ideal nurse-to-patient ratio is 1:4. Nurses with more than four patients are at a higher risk of burnout.
- Nurses who work 10-13 hours compared to 8-9 hours experience burnout. Long shifts without any breaks can mentally and emotionally exhaust nurses.
- 25% of nurses have complained of lack of sleep due to long shifts and mental stress. A healthy adult needs at least 7-8 hours of deep sleep to function properly.
- Nursing is considered a thankless profession. Nurses experience workplace bullying by patients, physicians, and families.
- Establishing a healthy relationship with patients is known to boost health outcomes. But it becomes emotionally challenging when nurses are looking after terminally ill patients. The emotional letdown can cause depression.
Mental health and burnout
With the help of Mayo Clinic, the American Journal of Nursing conducted a study on occupational well-being, burnout, depression, and other mental health problems. The findings were extremely alarming. When incorporating factors like age, gender, relationship status, work hours, and workplace burnout, nurses were 38% more likely to have suicidal thoughts than workers of other professions. The worrisome thing is that this study was conducted before the pandemic.
Depression is also extremely common in nurses. The same study by the American Journal of Nursing stated that 35 to 45% of nurses in the US experience symptoms of depression. The questionnaire of the study included questions relating to seeking professional help. Unfortunately, the majority of the nurses with suicidal thoughts were hesitant to seek professional help.
Other than depression, studies found that nurses on the front lines of caring for covid-19 patients developed post-traumatic stress disorder (PTSD), anxiety, and sleep disorders. Healthcare workers were expected to work with minimal resources and very little clinical information to treat patients with coronavirus. The strict protocols of isolation and quarantine in hospitals had crept in, and the loneliness grew into severe depressive disorders.
Dangers of Nursing Burnout
Professional burnout, especially for nurses, is not just a personal matter. It is a major concern for administration, fellow doctors, nurses, and patients.
1. High turnover rate
The International Journal of Environmental Research and Public Health found that the high risk of burnout syndrome is directly linked to job dissatisfaction and nurses intending to quit. The healthcare industry is experiencing a high turnover rate and is facing difficulty finding replacements. This means the existing nurses are being overworked. And eventually, they’d experience burnout too.
The study by Marshall University stated the ideal patient-to-nurse ratio. If nurses are made to look after more than four patients, their ability to provide good quality of care and attention will drastically increase. This means there would be an increase of 7% in in-hospital mortality.
3. Poor quality of care
When nurses experience burnout, they become physically exhausted and feel disinterested in their work. The challenging nature of a nurse’s job is being vigilant. Nurses who are physically tired tend to make mistakes that can greatly compromise the quality of patient care. These mistakes cause discomfort, infections, patient-record errors, and death (in the worst case). These errors further add to the stress nurses are already under. The feeling of guilt makes them more depressed and anxious.
Nurses and healthcare professionals often work long hours, weekends, and holidays. This high-stress level with low relief could lead to burnout, which seems to be one of the healthcare industry’s biggest problems. If nurses are burned out, they might have a higher rate of mental illness, a much higher percentage than the average population. The effects of mental illness on patient care can be devastating. In some instances, it can even lead to death. If the staff cannot provide the quality care that a patient needs, then something must be done. Educating nurses on mental illness signs and symptoms may help reduce these rates. Similarly, the administration of hospitals can ensure the mental well-being of nurses is being looked after. These and other such measures can be taken to make hospitals a safe place for everyone.