Incivility in nursing, or lateral violence, is widespread and appears to be more common in today's society. The nursing profession is a highly respected discipline among the general population, hence issues of incivility within the profession might seem misplaced. However, as much as the general public might not relate nursing with incivility, it frequently occurs. Nursing is a stressful career, and this is caused by the general work environment hence a key factor in lateral violence.
One aspect of lateral violence in nursing that is of critical importance is nursing burnout. Nursing burnout mostly affects newbie nurses in various departments in a healthcare centre and seasoned nurses. However, other nurses are not an exception to nursing burnout. Nursing burnout mostly results from both the physical and emotional toll emanating from the nature of the profession, and other external factors such as poor working conditions, management problems, lack of recognition for impact created, poor communication, strained work relationships, and inadequate staffing which results to overworking. Nursing burnout is an issue that should be critically watched for in nursing practice due to its adverse effects on both the healthcare team and the patients.
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Significance of the Nursing Burnout Issue
The significance of nursing burnout to me both as a professional in the medical field and as a person is deep rooted in the fact that it has adverse effects on myself as a nurse, my family, the patients and their families, and my colleagues in the emergency department. Therefore, given the weight of its effects, nursing burnout is an issue that everyone should treat as crucial especially for the sole reason of promoting a better healthcare environment for all. Nursing is a profession that involves long hours of working and an uncontrolled environment, therefore a burnout is likely to affect my ability to deliver quality services due to fatigue and emotional distress. Fatigue and emotional distress affect professional judgement and it is easy to make mistakes while at work such as drug overdosing and underdosing which is a violation of nursing ethics (Woodhead et al., 2016). Additionally, burnouts may lead to health deterioration and loss of weight, which are negative effects on personal health.
As a nurse, I have people that I care about and are mostly my family. Nursing burnout affects family in two ways: family can easily be frustrated and suffer emotionally due to lack of healthy and quality family time, and second due to the condition of their family member too. Family time is important in maintaining strong family ties. Since burnouts affects a professional mentally, it is possible for it to get in the way of their social life because most times these individuals will be too tired to have quality conversations with their families after work. The situation worsens if the family in question involves children and a marriage partner; the more it persists, the more intense the drift becomes and in extremities this may lead to divorce, separation, child custody law suits among other family problems. Second, after a stressful day at work it is possible to channel out the negative energy at home and this is often directed to the family members which might cause them emotional distress too. Negative energy towards children is likely to affect their psychology and general growth, which in most cases is difficult to reverse the damage caused unless through counselling.
Patients are the most affected by nursing burnouts: the patient’s condition is already critical by the time they get admitted in hospital, hence, additional distress tends to worsen their health and in extreme cases may lead to death for delicate patient cases. The effect of nursing burnout to patients is centered on how the professional reacts towards the patient: a nurse in distress is not capable to deliver proper care to patients which might result to further health complications. Also, a negative attitude by the nurse towards the patient might cause emotional torture to the patient.
Workmates and colleagues are also prone to effects of a nursing burnout if one among them is suffering from fatigue and emotional imbalance. Incidences of bullying and disrespect at work are common due to burnouts: affected professionals tend to vent out on their colleagues to feel better (Yom et al., 2017). Therefore, when there is disrespect and bullying, workmate relationships are adversely affected thus compromising work flow and quality of services rendered by the team to patients and the general public. Additionally, nurses who get bullied at work by their colleagues due to burnouts might retaliate by arrogance in some cases an in others disrespect in equal measure too, which ultimately costs the quality of work.
Why I am Interested in Solving Nursing Burnouts
The reasons why I am interested in solving nursing burnouts include the concern to curb toxic effects of burnouts to different groups involved in the healthcare industry, advocacy for upholding of nursing principles and ethical practice. I am also interested due to the concern for my personal wellbeing and that of people around me as well as the need to uphold public confidence in the profession.
There is a need to curb nursing burnouts due to its effects to various groups in the healthcare industry. Given the discussed effects of burnouts to nurses, patients, families belonging to both the nursing professionals and their patients, and colleague relations, it is essential to manage the issue. Otherwise, leaving it unattended to would lead to deteriorated services in healthcare institutions, family breakups, and destruction of lives in extreme casescases, which I feel should not happen within the nursing profession. I care about society and its well being. Therefore, at all times my desire would be to have a society that lives in harmony and in perfect mental and physical health. While these can be achieved through so many avenues such as eating a balanced diet, exercise, among others, preventing burnouts for nursing professionals would also go a long way in maintaining the same.
There is also need to uphold nursing principles and ethical practice, which have been the backbone of nursing over years since its existence. Nursing has six principles of ethics that define the profession: justice, autonomy, nonmaleficence, beneficence, fidelity, and integrity (Butts & Rich, 2019). Burnouts might compromise these ethical principles during practice which informs the reason why it should be resolved and my interest to do it. A nurse experiencing a burnout is likely to compromise ethical principles: bullying and disrespect go against the principle of beneficence which requires nurses to be compassionate and be involved in positive actions in practice while abusing patients violate the principle of fidelity. Ultimately, the violations to ethical standards demean the profession and no nurse whether in training or practice would want to witness that happening.
As an individual, my wellbeing affects my family, friends, and society in general while as a nurse, colleagues and patients are affected. Burnouts tend to affect nursing professionals both at work and off work. Therefore, to ensure that the wellbeing of people around me both at work and at home is taken care of, I need to ensure that mine is not affected by nursing burnouts. Therefore, this also ensures that I stay in perfect health both physically and mentally, hence enabling me effectively discharge my duties as a nurse and a social being.
The nursing profession has existed for centuries and has over time earned its respect for saving lives. The profession has created an image of love, care, and compassion which mostly are seen as attributes for all nurses by the general public. On the other hand, incivility and lateral violence are completely opposite from the attributes mentioned above. Therefore, associating the profession with incivility and lateral violence might not augur well with the public as much as incivility still happens in real life. Additionally, nursing burnouts may not be completely eliminated but efforts towards their elimination would help maintain the image of the profession, hence public confidence.
Why Nursing Professionals Face Burnouts
Nursing professionals face burnouts due to various reasons emanating from their work environment: poor working conditions, management problems, lack of recognition for impact created, poor communication, strained work relationships, and inadequate staffing which results to overworking. Due to the nature of the profession, nurses are more exposed to getting burnouts from any extra negative pressure from within or from external loci.
Poor working conditions trigger stress among nursing professionals, hence causing burnouts. In a healthcare setting, inadequacy of tools used for providing healthcare services such as gloves, syringes, drugs, hospital beds among others is likely to make nurses strain during discharge of duty, hence duress in the long term (Canadas-De LaFuente et al., 2015). There exists situations where nurses have to use one glove to attend to more than one patient, sterilize syringes and reuse them when they should actually be disposed, and minimize on the use of cotton and bandages due to shortages experienced in their work settings. Work relationships also form a huge part of working conditions in any work setting. Therefore, when such relations are in the red, whether due to personal or professional reasons, both the affected individuals and those not involved are exposed to lateral violence. A feud is highly likely to result to disrespect, bullying, and malice at work. Additionally, low remuneration and benefit packages which are also part of working conditions are likely to cause burnouts. Low remuneration against the amount of work done by nurses not only invokes mental pressure but also economically cripples the professionals: when nurses cannot meet minimum living standards due to low pays, they are prone to burnouts and frustration.
Management issues are also responsible for incidences of nursing burnouts to professionals. Toxic bosses at work are a major cause of emotional and mental torture to nursing professionals: supervisors setting unrealistic targets for nurses, structuring unhealthy work schedules for nurses, among other toxic arrangements which might inconvenience the welfare and lifestyle of nursing professionals. A schedule that has unfair shifts is likely to cause conflict because some nurses will feel unfavored for being allocated more nigh shifts than day shifts. In this case, the affected nurses are denied enough rest within a given period of time which ultimately affects their emotional and physical wellbeing thus causing burnouts. Scheduling problems also arise when nurses are not allocated enough leave time within a given period of time, say a year; annual leaves are essential to enable professionals unwind and reenergize. Therefore, an annual leave with only a few days of rest will disorient a professional, and in extreme cases where no leave is given due to understaffing, cause serious burnouts. Lack of recognition for achievements by nursing professionals in a department i also a result of poor management, and is likely to cause emotional distress to professionals. Additionally, an unstable leadership in a healthcare department may lead to team disorganisation hence making it prone to disrespect among colleagues which may result to burnouts after a given period of time.
Nursing in its nature involves long hours of working and sometimes a few hours of rest for emergency cases. Therefore, the amount of work handled by nurses is overwhelming and becomes even harder in situations where there is understaffing. Understaffing takes a toll on nursing professionals since they have to work for more hours to ensure wellbeing of the patients. The end result is that affected individuals experience fatigue both physical and mental, which affects the quality of work. Therefore, healthcare organizations should ensure that the ratio of nurses to patients almost meets the threshold stated by the World Health Organization or at least meets the number of patient cases administered in the hospital such that every patient gets maximum attention without straining only a small group of nurses. Mis-communication is also another factor that result to nursing burnouts among nurses: poor relay of information among colleagues or from the supervisor to the junior nursing staff might result to disrespect issues arising within a department.
Conclusion
Incivility in nursing might sound misplaced in the sense that as a respected profession, the public would not imagine lateral violence in nursing. Nursing is a profession that has existed for centuries and over years, has been faced with different challenges which have been resolved either entirely or are in the process of being resolved. Nursing burnouts have disastrous effects on both individuals and the profession as a whole. Based on the effects it has, it is important to note that leaving the problem unsolved is likely to cause more damage in the future. Resolving nursing burnouts requires understanding of the root causes which mainly revolve around the work environment. Therefore, maintaining a healthy and productive work environment ensures that such incidences are minimsed to low levels if not completely curbed. Maintenance of a healthy work environment is a responsibility to be owned by both the management of a healthcare facility and the nursing professionals in the facility. Going ahead, medical centres should establish department units equipped with both the personnel and equipment to assess emotional, physical and mental balance among nursing professionals. This strategy will help in curbing distress and fatigue from work in their early stages before they turn out to burnouts.
References
Butts, J. B., & Rich, K. L. (2019). Nursing ethics. Jones & Bartlett Learning.
Cañadas-De la Fuente, G. A., Vargas, C., San Luis, C., García, I., Cañadas, G. R., & Emilia, I. (2015). Risk factors and prevalence of burnout syndrome in the nursing profession. International journal of nursing studies, 52(1), 240-249.
Woodhead, E. L., Northrop, L., & Edelstein, B. (2016). Stress, social support, and burnout among long-term care nursing staff. Journal of Applied Gerontology, 35(1), 84-105.
Yom, Y. H., Yang, I. S., & Han, J. H. (2017). Effects of workplace bullying, job stress, self-esteem, and burnout on the intention of university hospital nurses to keep nursing job. Journal of Korean Academy of Nursing Administration, 23(3), 259-269.
