Burnout in nurses and other healthcare workers has been an issue since well before the COVID-19 pandemic. Broadly speaking, burnout is a combination of exhaustion, cynicism, and perceived inefficacy resulting from long-term job stress.
It was first described in 1974 by the clinical psychologist Herbert Freudenberger, who often volunteered at a free clinic in the then drug-ridden East Village of New York City. Over time, Freudenberger observed emotional depletion and accompanying psychosomatic symptoms among the clinic’s volunteer staff. He called the phenomenon “burnout,” borrowing the term from drug-addict slang.
Freudenberger defined burnout as exhaustion resulting from “excessive demands on energy, strength, or resources” in the workplace, characterizing it by a set of symptoms including malaise, fatigue, frustration, cynicism, and inefficacy. In addition, Freudenberger noted that burnout often occurred in contexts requiring large amounts of personal involvement and empathy, primarily among “the dedicated and the committed.”1
Side effects of burnout
- Sadness, anger, or irritability
- Depressive thoughts
- Alcohol or substance abuse
- Musculoskeletal pain
- Vulnerability to illnesses
- Fatigue and insomnia
- Gastrointestinal issues
- Respiratory problems
- High cholesterol
- High blood pressure
- Type 2 diabetes
- Cardiovascular disease or disorder
In terms of how this translates to the workplace, these symptoms could increase absenteeism or detachment from work. But beyond that, burned out employees often experience:
- Job dissatisfaction
- Cynicism or highly critical thoughts about their position or the organization
- Difficulty concentrating
- Lack of productivity
Burned out workers are less effective than their more satisfied counterparts, and that can be a major drain on a company’s resources.
Burnout seems to be more of an issue since the start of the COVID-19 pandemic. A survey conducted by Mental Health America from June to September 2020 revealed that 76% respondents felt “exhaustion and burnout.” Beyond that, 93% of workers reported feeling stress, and 86% reported anxiety.3
Why should organizations address burnout in nurses?
There are many reasons as to why organizations should address burnout in nurses and other healthcare staff. The consequences of burnout are not limited to the personal well-being of healthcare workers; many studies have demonstrated that provider burnout is detrimental to patient care. For example, the number of major medical errors committed by a surgeon is correlated with the surgeon’s degree of burnout.4
Among nurses, higher levels of burnout are associated with higher rates of both patient mortality and dissemination of hospital-transmitted infections.5,6 High rates of physician burnout also correlate with lower patient satisfaction ratings.7 At an institutional level, burnout results in greater job turnover and increased thoughts of quitting among practitioners.8
While we are seeing strides toward ending the COVID-19 pandemic, such as vaccine rollout, we are not at the finish line yet. With that in mind, it is necessary to address staff burnout as soon as possible. Unfortunately, there is not much research or evidence on how to address this problem. Of the recent research available it seems that efforts at both the individual and organizational levels can prove effective with the best way forward likely involving a combination of the two.9
How to prevent burnout in nurses
So, what are some things that organizations can do to reduce burnout in nurses?
1. Understand potential causes
Before it can be addressed, it is important to understand the potential causes of nurse burnout. The best way to do this is to break it down into smaller, more easily addressed problems. According to nonprofit HelpGuide,10 some issues are:
- Poor workplace culture
- Lack of social support
- Lack of control
- Feeling overworked
- Feeling unchallenged
- Unclear job expectations
- Lack of recognition
By coming up with creative ways to address these problems, organizations should see a reduction of burnout.
2. Create a positive, supportive work culture
An effective way to fight or avoid burnout in nurses and other healthcare staff is to create and maintain a strong company culture that prioritizes transparency, respect, trust, and positive working relationships. Employees must feel comfortable coming forward with the problems or issues. If employees feel like their concerns will not be heard they tend to burnout more quickly.
3. Recognize staff and celebrate wins
Provide rewards and incentives for top-notch performance, whether you’re acknowledging the customer-facing team for praise received from customers or celebrating your group sales team for the best quarter yet. Sincere, timely recognition helps employees feel valued. Don’t keep it a secret, either: Let others know about jobs well done or major milestones.11
Other ways to do this involve celebrating the employee (not just the wins). Some ideas for this are:
- Make a big deal of birthdays with a monthly all-staff birthday celebration to honor anyone with a birthday during the month.
- Treat staff to an annual company dinner outside of the usual holiday gathering.
- Implement summer BBQ outings with kayaks and more at a favorite lakeside retreat.
- Take your collective knowledge on the road by organizing a trivia team.
- Give athletics a shot and form a sports league that meets regularly—designate teams or switch off for each game.
- Surprise employees with unexpected pizza, coffee, or ice cream breaks.
4. Do not overwork employees
In healthcare it can be difficult to slow down the pace. Depending on the healthcare setting and profession, there may be a shortage of employees and mandated over-time hours. While this may be necessary at times, it tends to lead to staff burnout. It is important to staff at necessary levels to avoid this problem.
5. Help staff find meaning in their work
We expect clinicians to find meaning in patient care, but it turns out that nonclinical staff also score highly on “activation,” or the amount of motivation or meaning they find in their work, according to the Harvard Business Review.12 High activation often means greater engagement, which helps fight burnout. Help staff connect the dots between the work they do with the quality care that’s being delivered to patients and the creation of a positive workplace for co-workers.
Long before the COVID-19 pandemic emerged, health care organizations and their staffs were dealing with burnout. The pandemic has accelerated this issue. By taking steps to combat it, both healthcare organizations and employees will benefit.
- Reith TP. Burnout in United States Healthcare Professionals: A Narrative Review. Cureus. 2018;10(12):e3681. Published 2018 Dec 4. doi:10.7759/cureus.3681
- Burnout and medical errors among American surgeons. Shanafelt TD, Balch CM, Bechamps G, Russell T, Dyrbye L, Satele D, Collicott P, Novotny PJ, Sloan J, Freischlag J. Ann Surg. 2010 Jun; 251(6):995-1000.
- Emotional exhaustion and workload predict clinician-rated and objective patient safety. Welp A, Meier LL, Manser T. Front Psychol. 2015;5:1573.
- Nurse staffing, burnout, and health care-associated infection. Cimiotti JP, Aiken LH, Sloane DM, Wu ES. Am J Infect Control. 2012;40:486-490.
- Linking physician burnout and patient outcomes: exploring the dyadic relationship between physicians and patients. Halbesleben JR, Rathert C. Health Care Manage Rev. 2008 Jan-Mar; 33(1):29-39.
- Why do surgeons consider leaving practice? Shanafelt T, Sloan J, Satele D, Balch C J. Am Coll Surg. 2011 Mar; 212(3):421-2.
- Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis. West CP, Dyrbye LN, Erwin PJ, Shanafelt TD. Lancet. 2016 Nov 5; 388(10057):2272-2281.