Using Health Information Technology as a Source of Evidence-Based Practice for Nurse Burnout
Burnout was first recognized as a psychological concept in the 1970s (Schaufeli and Enzmann 1998). Nurses are working longer hours and short staff. Burnout is thought to arise from a prolonged disparity between what the person gives and receives in the workplace (Maslach and Leiter 1997, Schaufeli and Enzmann 1998). This article explores strategies to help prevent nurse burnout and coping strategies for nurses to prevent job burnout. This article identified four key themes highlighting the fact that people with certain personalities traits have better coping skills, are less stressed and less likely to experience burnout. Also in this article there is a chart outlining problem-focused and emotional focused coping strategies. This chart indicates that how a person deal with stressful situations positive emotion focused coping or negative emotion focused coping will affect the outcome. For example, workplace guidance and support provides a sense of feeling valued and listened to, and can encourage the feeling of being better equipped to cope with and solve problems, restoring a sense of control over work (Bégat and Severinsson 2006, Jones and Cutcliffe 2009).
Emotional exhaustion results from feeling weighed down and emotionally overstretched (Maslach et al 2001, Maslach 2003). In this article Fearon states that a combination of both positive emotion-focused and problem-focused strategies may offer protection against the development of burnout. It is important to consider that these strategies will not change the organizational issues that lead to burnout in health care (Fearon, 2011). However, they can help nurses to cope better by encouraging them to respond more constructively to their own needs.
A review by the Department of Health on the health and wellbeing of nursing staff found that more than one quarter of staff absence was due to stress, depression and anxiety (Boorman 2009). This article explores strategies that nurses can use to protect themselves from burnout. Emotional exhaustion results from feeling weighed down and emotionally overstretched (Maslach et al2001, Maslach 2003).
I used health information technology to locate evidence-based practices that address this concern by using keywords such as burnout and nurse burnout and searching databases. Health information technology supports evidence-based practice by making best scientific knowledge with clinical expertise readily available to nurses.
Resources
Boorman, S. (2009). NHS Health and Well-Being Review Interim Report. Department of Health, London.
Fearon, C, Nicol, M (2011). Strategies to assist prevention of burnout in nursing staff. Nursing Standard, 26(14), 35-39.
Maslach C, Schaufeli WB, Leiter, M.P. (2001). Job burnout. Annual Review of Psychology. 52, 397-422.
Maslach, C. (2003). Burnout: The Cost of Caring. Malor, Cambridge MA.
Schaufeli WB, Enzmann D. (1998). The Burnout Companion to Study and Practice: A Critical Analysis. Taylor & Francis, London.
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Nursing is a profession that can be greatly enriched by health information technology (HIT). There are many ways we can use HIT to facilitate evidence-based practice. Nurses have many places where this knowledge can be acquired, such as: libraries, professional organizations, the media, available community resources, and the internet (McGonigle & Mastrian, 2012, p.463). As we are inundated with research and findings, we must be selective in what we choose to incorporate into practice. One of the best places to conduct research is within online professional databases (McGonigle & Mastrian, 2012, p.463). These databases can range from general to specific, they are exhaustive and comprehensive, and many have full text capabilities (McGonigle & Mastrian, 2012, p.463).
Mandatory overtime in nursing is of particular interest to me. I find it difficult to be required to work extra shifts while being a full time student, wife, and mother as well. As I felt I may not be alone in this, I decided to do research into overtime for nurses. A precursory Google search resulted in a lot of random opinionated postings, but not anything that would qualify as evidence based. I then searched within the Walden University Library databases, particularly within CINAHL. Using the search terms “nursing” and “mandatory overtime” and limiting the results to full text, peer reviewed, and within the last five years, I found three articles related to my topic.
The first article recognized that in order for hospitals to provide good care to patients, the physical health of the nurses is essential (Bae, 2012). However, long working hours and extra shifts lead to fatigue, insomnia, pain, and deficits in performance and reaction times (Bae, 2012). This puts both patient and nurse at risk. The rate of patient falls, medication errors and even patient mortality and nursing injuries are higher when the nurse is on overtime (Bae, 2012). In another article, the researchers found that thirty-seven percent of nurses who regularly worked overtime had a work-related injury within the previous year and forty-one percent had a work-related illness (Castro et al., 2010). Another article pointed out that mandatory overtime is the reason a lot of nurses choose to leave jobs (Kovner, Greene, Brewer, & Fairchild, 2009). This is a vicious cycle because as more nurses leave, more mandatory overtime becomes necessary, making more nurses leave… My facility is caught in this loop right now. As patients must be cared for, and unsafe nurse patient ratios are not a solution either, I do not know what the solution is that is in the best interest of both the nurses and patients. We are looking in to travel nurses currently as a temporary solution.
Ideally, I could present these articles to my nurse manager, she would then read them and understand how dangerous mandatory overtime is for nurses and patients, and she would take all overtime days off of our schedule. This would be an excellent example of HIT supporting evidence-based practice if this were to happen. As I know this will not, perhaps the HIT can support evidence-based practice by encouraging our manager to not schedule us too many days in a row. It is recommended that nurses work no more than sixty hours in a seven day period (Bae, 2012). I believe this knowledge, gained through HIT could be translated into evidence-based practice. Our schedules could easily be arranged to where we do not work more than sixty hours in any seven days.
Reference
Bae, S. (2012). Nursing overtime: Why, how much, and under what working conditions? Nursing Economics, 30(2), 60-72. Retrieved from the Walden University Library databases.
Castro, A., Fujishiro, K., Rue, T., Tagalog, E., Samaco-paquiz, L., & Gee, G. (2010). Associations between work schedule characteristics and occupational injury and illnesses. International Nursing Review, 57(2), 188-194. Retrieved from the Walden University Library databases.
Kovner, C., Greene, W., Brewer, C., & Fairchild, S. (2009). Understanding new registered nurses’ intent to stay at their jobs. Nursing Economics, 27(2), 81-98. Retrieved from the Walden University Library databases.
McGonigle, D., & Mastrian, K. G. (2012). Nursing informatics and the foundation of knowledge(Laureate Education, Inc., custom ed.). Burlington, MA: Jones and Bartlett Learning.
