NUR-300-H4098 7-2 FINAL PROJECT
1. The final project for this course is a scholarly written formal paper that addresses a professional nursing practice issue of your choosing. You will use evidence based, peer-reviewed resources to support the multiple aspects of healthcare that connect to your nursing issue.
2. Evidence-based resources should also be used to connect a conceptual model or theory, inter professional collaboration, patient care outcomes, and recommended solutions to the issue. Databases within the Shapiro Library are excellent resources to identify current information on the issue.
Nursing Practice Issue
As a professional nurse, offering nursing care consistent with professional standards and principles is paramount. However, various professional nursing practice issues can impact nurses’ ability to provide high-quality care. The nursing practice issue I have chosen to investigate is the increasing incidence of nurse burnout in healthcare settings.
Nurse burnout is a state of emotional, physical, and mental exhaustion resulting from prolonged and excessive stress in the workplace. Nursing is a difficult and challenging profession and can be particularly demanding due to the long hours and high-pressure environments in which nurses work (Jun et al., 2021). As a result, nurses are increasingly experiencing burnout, which harms their physical and psychological health, job performance, and ultimately their ability to provide quality care to their patients, including compromised patient safety (Jun et al., 2021). Thus, it is important to address the potential barriers to nursing development caused by nurse burnout.
Validation of Rationale
According to a cross-sectional study by Shah et al. (2021), burnout is a major concern for the healthcare profession in the US. It has been identified as a key factor in the development of a healthy and effective especially for nursing workforce. According to the study, nurses are the frontline healthcare workers, and any negative aspect that affects their profession is detrimental to the healthcare sector. Therefore, it is important to deal with the issue of nurse burnout to maximize positive patient outcomes and job satisfaction. Shah et al. (2021) add that a poor staff-patient ratio is the major cause of nurse burnout.
Burnout can negatively affect a nurse’s effort to offer exceptional care, leading to increased absenteeism, decreased job satisfaction, and even depersonalization (Jun et al., 2021). Furthermore, burnout can adversely affect patient outcomes and satisfaction, decreasing patient satisfaction and increasing healthcare costs. Burnout is also associated with adverse organizational effects due to reduced commitment, leading to reduced productivity (Jun et al., 2021). As such, the nursing profession must address the nursing issue to ensure the health and well-being of nurses and the quality of care they can offer.
Resource Appraisal
A systematic review by Jun et al. (2021) examined the relationship between nurse burnout and its effects on organizational and patient outcomes. The review utilized primary studies about nurse burnout in hospitals; twenty were included. The review is related to the nursing issue being addressed because it tries to determine how the organization and patients are affected by nurse burnout. Some of the findings pointed out by the authors are that nurse burnout is related to negative effects such as decreased patient satisfaction, poor quality of care and patient safety incidents, and diminished commitment of nurses towards their responsibilities (Jun et al., 2021). It was also associated with several negative organizational outcomes, such as turnover intention and absenteeism.
A study conducted by Shah et al. (2021) tried to examine the prevalence and factors associated with nurse burnout in the United States. The findings showed that nurse burnout was high, with 34.1% of nurses reporting high emotional exhaustion, 31.5% reporting high depersonalization, and 43.8% reporting low personal accomplishment. The authors identified several factors significantly associated with burnout, including job demands, lack of autonomy, and inadequate supervisor support.
Scope and Standards of Professional Nursing Practice
The scope and standards of professional nursing practice are directly associated with the issue of nurse burnout. Assessing the scope and standards of professional nursing practice reveals that nurse burnout needs to be consistent with the ANA’s Code of Ethics and Standards of Practice. The nursing scope defines what nurses are expected to do and who they are in healthcare (ANA &AHNA, 2019). They are expected to provide holistic care to the clients putting into consideration self-care. Self-care about burnout is important in reducing the rate of low patient satisfaction.
The Code of Ethics emphasizes providing safe, compassionate, and competent care. At the same time, the Standards of Practice outline the expectations for professional nursing practice, including maintaining a healthy work environment and engaging in ongoing professional development (ANA &AHNA, 2019). Additionally, nurses are expected to provide quality patient care, which is part of the standards of practice not availed when they experience burnout. Therefore, addressing nurse burnout is critical to upholding professional nursing practice standards.
References
American Nurses Association, & American Holistic Nurses’ Association (Eds.). (2019). Holistic nursing: Scope and standards of practice. American Nurses Association. https://samples.jbpub.com/9781449651756/45632_ch02_pass1.pdf
Jun, J., Ojemeni, M. M., Kalamani, R., Tong, J., & Crecelius, M. L. (2021). Relationship between nurse burnout, patient and organizational outcomes: Systematic review. International Journal of Nursing Studies, 119(103933), 103933. https://doi.org/10.1016/j.ijnurstu.2021.103933
Shah, M. K., Gandrakota, N., Cimiotti, J. P., Ghose, N., Moore, M., & Ali, M. K. (2021). Prevalence of and Factors Associated With Nurse Burnout in the US. JAMA Network Open, 4(2), 1–11. https://doi.org/10.1001/jamanetworkopen.2020.36469
HERE IS THE SECOND MILESTONE:
Nurse Burnout
Nurse burnout is the mental, physical, and emotional exhaustion that nursing practitioners experience in the line of work. Burnout is a significant concern in the US healthcare system, affecting clinical outcomes and job satisfaction. Therefore, there is a need to explore the various implications of the issue on legal and ethical matters, finance, patient care, and nursing safety.
Legal Implications of Burnout on Licensure and Professional Nursing Practice
Burnout increases the chances of nurses committing critical errors during care delivery. Thus, the affected patients or their families can sue individual nurses or organizations for these errors. The result could be the revocation or suspension of the nurses’ licenses. Therefore, burnout affects nursing practice since caregivers must employ various strategies to mitigate errors, even if nurses are experiencing burnout. Alternatively, they can mandate a minimum off-duty period to ensure sufficient relaxation. Thus, burnout has impacted nursing practice by raising more awareness of the nurses’ physical, mental, and emotional well-being.
Ethical Implications
Burnout’s ethical implications revolve around the principle of non-maleficence. Care providers, including individuals and organizations, should not do anything that can conceivably harm healthcare recipients (Richemonde et al., 2022). Therefore, an employer who allows burned-out nurses to keep working is liable for breaching non-maleficence, resulting in ethical liability. Similarly, a caregiver who fails to report burnout poses a risk to colleagues and patients. Therefore, ethically, nurses owe themselves the same duty of care they do their patients. Neglecting this duty amounts to ethical liability, which could negatively affect one’s career.
Finance and Burnout
Nurse burnout and healthcare finances relate in several ways. First, since burnout increases turnovers and turnover intentions (Kelly et al., 2021), healthcare organizations incur additional costs in replacing employees. This extra expenditure impedes the healthcare system’s sustainability. The legal and arbitration fees that the healthcare system spends to resolve conflicts arising from burnout are also high. These funds could have been useful in direct care delivery, enhancing the system’s efficacy. Lastly, burnout affects consumers’ finances. When burnout impedes care delivery, patients generally have to spend more money due to corrective therapies and longer hospital stays. Hence, these additional costs make healthcare more expensive, reducing its accessibility.
Care Quality
Overall, burnout impedes care quality by increasing errors and suppressing empathetic care. Burnout hinders proper decision-making among caregivers. Consequently, errors in medication administration, communication, and other aspects of care delivery occur, resulting in poor quality outcomes. On the other hand, burnout contributes to compassion fatigue, which manifests through nurses not being empathetic toward their patients (Kelly, 2022). Consequently, they fail to address patients’ clinical and non-clinical needs, resulting in low-quality patient experiences.
Nursing Safety Challenges
Lastly, burnout presents various nursing safety challenges. First, it enhances the risk of developing severe mental illnesses. According to Janeway (2020), nurses are twice as likely as other caregivers to develop depression. When such conditions arise, the nurses are vulnerable to long-term mental health concerns. Burnout also increases the risk of workplace violence, which creates an unconducive work environment. The risk of physical and emotional abuse affects nurses’ confidence in their work, resulting in low morale to deliver high-quality care.
Conclusion
In conclusion, burnout has negative implications in most aspects of healthcare delivery. Stakeholders’ awareness of the risk is important to ensure the commencement of timely strategic, policy-driven interventions. In so doing, burnout’s prevalence and severity will decrease, resulting in more conducive healthcare experiences for both nurses and healthcare consumers.
References
Janeway, D. (2020). The role of psychiatry in treating burnout among nurses during the Covid-19 pandemic. Journal of Radiology Nursing, 39(3), 176–178. https://doi.org/10.1016/j.jradnu.2020.06.004
Kelly, L. (2020). Burnout, compassion fatigue, and secondary trauma in nurses: recognizing the occupational phenomenon and personal consequences of caregiving. Critical Care Nursing Quarterly, 43(1), 73–80. https://doi.org/10.1097/CNQ.0000000000000293
Kelly, L. A., Gee, P. M., & Butler, R. J. (2021). Impact of nurse burnout on organizational and position turnover. Nursing Outlook, 69(1), 96–102. https://doi.org/10.1016/j.outlook.2020.06.008
Richemonde, D., Needham, M., & Jean, K. (2022). The effects of nurse burnout on patient experiences. Open Journal of Business and Management, 10(5), 2805-2828. https://doi.org/10.4236/ojbm.2022.105139
HERE IS THE THIRD MILESTONE: Nurse Burnout
Nurse burnout is a major concern in the modern healthcare sector since mentally exhausted caregivers deliver suboptimal care services. Research on the best ways to address the problem is ongoing as practice leaders explore the ever-growing literature to find suitable and effective solutions to the problem in their clinical settings. Therefore, the current paper explores some known approaches, theories, and conceptual frameworks to enhance awareness among nursing practitioners and stakeholders.
Interprofessional Collaboration
Interprofessional collaboration could provide beneficial opportunities to address the issue. First, collaboration eases the burden of caring for individual team members (De Sutter et al., 2019). Thus, the shared emotional load is easier to address. Interprofessional teams also facilitate the exchange of ideas on coping mechanisms. Therefore, nurses can learn about diverse ways that professionals from other fields have adopted to deal with accumulating stress. Lastly, interprofessional collaboration enhances job satisfaction (Al Sabei et al., 2022). The more positive outcomes arising from teamwork reduce the feelings of negativity that nurses would normally feel after achieving poor patient outcomes. Hence, increased job satisfaction through interprofessional collaboration could alleviate burnout.
External Theory
The conservation of resources theory could be applicable to nurse burnout. Prapanjaroensin et al. (2017) explored it and found that its concepts can explain the “etiology, progression, and consequences of nurse burnout.†The theory posits that individuals develop stress when they perceive the potential loss or experience the actual loss of four resources. The first resource, objects, refers to the economic benefits. Thus, nurses who think they may get fired are more likely to experience burnout. The second resource, conditions, includes health and social relationships. Again, the threat or actual loss of these resources contributes to burnout. Thirdly, personal characteristics, such as coping mechanisms, make nurses resilient despite work-related stresses. Their loss can, therefore, make a caregiver more susceptible to burnout. Lastly, energy resources, most significantly time, influence the stress that a nurse experiences. Hence, if the workplace is always short on time, burnouts are likely to develop. Thus, the theory offers an external perspective, enhancing creative thinking in developing solutions.
Nursing Theory
Meanwhile, nursing theories still offer fundamental ideas on how to address the issue. For instance, Sister Callista Roy’s adaptation model of nursing provides a framework for burnout prevention and management. The model contains four key pillars: nurses’ self-care, community interdependence, professional practice, and improved patient outcomes (Browning, 2020). Under self-care, the theory posits that nurses should learn how to identify and address their psychological and physiological needs. Meanwhile, nurses can create an interdependent community by having shared values and collective responsibility in achieving their goals. Nurses should also ensure their professional practice clearly defines their individual and shared identity. Lastly, the theory proposes that one can address nurse burnout by improving patient outcomes, thereby reducing the stress and psychological torture that nurses face. Therefore, the theory would be useful to a nursing leader seeking to implement integrated solutions to address burnout.
Nursing Metaparadigm Concepts
The four concepts inform clinical solutions for burnout. For instance, a conducive work environment eases nurses’ pressure in care delivery, lowering the risk of burnout. Meanwhile, having sufficient nursing personnel will ensure shared responsibility and adequate skill mix to share clinical duties. The reduced workload will, in turn, alleviate stress and burnout prevalence. Thirdly, healthy relationships with patients will enhance nurse-patient communication. Therefore, nurses will have fewer conflicts with the patient and their families (the person) and less work-related stress. Lastly, nurses’ physical and psychological health is an important consideration in assigning duties. Therefore, leaders should ensure they do not delegate duties to nurses without considering various health factors, such as age, disability, trauma, or chronic illness.
EBP-Recommended Solutions
Some evidence-based-recommended solutions for burnout include better workplace management and psychological interventions. Workplace management entails adequate communication, and teamwork, among other solutions to improve the workplace experience. According to Aryankhesal et al. (2019), these interventions are popular in care settings and offer significant improvements. Meanwhile, psychological interventions, such as meditation and Yoga, enhance individual nurses’ resilience, making them less susceptible to developing burnout (De Oliveira et al., 2019). Thus, integrating these solutions in the workplace could offer individual and collective success in alleviating burnout.
Conclusion
While burnout has been a menace in the nursing sector, there are potential solutions to the problem. The two theories discussed in the paper provide useful insights into the issue, as does the exploration of the nursing metaparadigm. Lastly, current literature provides practical solutions which leaders can assess to determine their applicability to address nurse burnout in their workplaces.
 
References
Al Sabei, S. D., Labrague, L. J., Al-Rawajfah, O., AbuAlRub, R., Burney, I. A., & Jayapal, S. K. (2022). Relationship between interprofessional teamwork and nurses’ intent to leave work: The mediating role of job satisfaction and burnout. Nursing Forum, 57(4), 568–576. https://doi.org/10.1111/nuf.12706
Aryankhesal, A., Mohammadibakhsh, R., Hamidi, Y., Alidoost, S., Behzadifar, M., Sohrabi, R., & Farhadi, Z. (2019). Interventions on reducing burnout in physicians and nurses: A systematic review. Medical journal of the Islamic Republic of Iran, 33, 77. https://doi.org/10.34171/mjiri.33.77
Browning, C. A. M. (2020). Application of the Roy Adaptation Theory to a care program for nurses. Applied Nursing Research, 56, 151340. https://doi.org/10.1016/j.apnr.2020.151340
De Oliveira, S. M., de Alcantara Sousa, L. V., Vieira Gadelha, M. D. S., & do Nascimento, V. B. (2019). Prevention actions of burnout syndrome in nurses: An integrating literature review. Clinical Practice and Epidemiology in Mental Health, 15, 64–73. https://doi.org/10.2174/1745017901915010064
De Sutter, M., De Sutter, A., Sundahl, N., Declercq, T., & Decat, P. (2019). Inter-professional collaboration reduces the burden of caring for patients with mental illnesses in primary healthcare. A realist evaluation study. The European Journal of General Practice, 25(4), 236–242. https://doi.org/10.1080/13814788.2019.1640209
Prapanjaroensin, A., Patrician, P. A., & Vance, D. E. (2017). Conservation of resources theory in nurse burnout and patient safety. Journal of Advanced Nursing, 73(11), 2558–2565. DOI:10.1111/jan.13348