Abstract
The content of this paper involves explanation and description of the issue of nurse burnout and the cost to the hospital across the United States from both ethical and cultural perspectives of enquiry. In that respect, the explanation gives insight into governing laws, ethical considerations, ethical theories, as well as cultural values and norms surrounding the issue of nurse burnout and the cost to hospital in the society.
Nurse Burnout and the Cost to Hospital
The categorization of burnout in nurses may involve emotional, mental and physical exhaustion. The description and understanding of nurse burnout are normally associated with disengagement unlike that of stress which is explained through over-engagement. There a higher likelihood that nurse burnout could lead to detachment and dulled emotions. In this regard, the focus is directed towards describing and explaining the issue of nurse burnout and the cost to the hospital across the United States from both ethical and cultural perspectives of inquiry. In evaluating, the ethical perspective of this particular healthcare issue, many research questions are considered namely what laws pertain to the issue? What ethical obstacles affect how the medical community addresses the issue? How do ethical theories apply to the issue? How do money, power, and control matters relate to the issue and its treatment? On the other hand, the exploration of the cultural perspective attempts to answer questions namely which include which cultural values and/or norms the issue influence? How is the issue addressed differently in varying cultural contexts and situations? Which cultures or societies are most affected by the issue? Which cultural traditions affect the treatment?
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Ethical and Cultural perspectives
On legal matters, some nursing associations that are state-based have, for a long time now, been involved in the pursuit of laws regulating overtime and the workload given to nurses in the course of discharging their professional duties. The general legal position is that healthcare centers and institutions are prohibited from forcing nurses to work beyond their regularly scheduled duration. Such legal measures are meant to prevent the instance of nurse burnout from taking place. By the end of the year 2018, at least 18 states in the United States had already passed a law meant to restrict employers from imposing the mandatory additional time and overtime on nurses. To that extent, some states have been able to introduce laws that prohibit additional compulsory working hours. However, pieces of legislation passed by other states have included restrictions on the required lengths of shifts and workload to be undertaken by nurses as legal measures toward addressing the issue of nurse burnout. Nonetheless, it is worth noting that these regulatory requirements are usually exempted in all the states that have passed them during situations characterized by disaster or emergency ( Fairchild, 2010).
The findings by Poghosyan et al. (2010) have led to the establishment of some ethical obstacles that tend to influence the manner in which the medical community addresses the concerns associated with the issue of nurse burnout. Nurses around the globe have always faced struggle related to ethical challenges. The proposal to regulate the working hours and working environment for nurses with the objective of reducing instances of nurse burnout has been widely criticized. Some of these criticisms have been based on the need to observe ethical considerations while administering healthcare to patients. In that respect, nurses are often charged with ethical duties of meeting the treatment needs of their patients without much consideration to their state of emotional, mental and physical wellbeing. Furthermore, the efforts by the medical community to regulate the working hours for nurses in an attempt to prevent nurse burnout has been met with sharp criticism from those who argue that it is unethical to limit the attention given to patients.
There are various ways through which ethical theories apply to the issue of nurse burnout. Gabel (2011) posits that the ethical theory of moral relativism advances the perspective that decisions regarding events, ideas, actions or issues always have an essential dependency upon a particular code of morality that is specific to culture, place and time. In addressing the factors that contribute to the issue of burnout in nurses, the ethical theory of moral relativism indicates that it is not easy to establish full criteria through which there may be an appraisal of the moral actions of nurses. A person who bases his or her decisions on historical, geographical, cultural or social data may be bound to accept the behavior of the nurse whenever they are experiencing burnout.
The views by Ulrich et al. (2010) indicate that the relationship-based theory or the ethical theory of care influences the process of deciding in a manner that deviates from paying attention to moral judgment. This theoretical approach to ethics ought to be demonstrated by nurses while experiencing burnout since it focuses on the being of the ethical requirements rather than the doing of ethical virtues. A decision-maker operating with ethics of care such as nurse often goes against absolute principles of morality and instead is involved in the promotion of respect for experience and promotion of situational sensitivity. The primary focus of this particular ethical theory of care is on sensitivity and empathy. Using virtues related to a character such as compassion, patience, wisdom, and compassion are prominent when considering the application of the theory of ethics of care on the behavior of nurses who experience burnout.
Money, power, and control matter a lot when it comes to the issue of nurse burnout and influence on the operations within a healthcare facility. In this regard, money would be critical when it comes to employing more nurses to ensure that the existing nurses are not overwhelmed by the workload at a particular healthcare facility. In turn, this would ensure that nurses are not physically, mentally or emotionally exhausted thus preventing them from experiencing burnout. It is noteworthy that this approach to avoiding burnout in nurses is associated with considerable costs to the hospital. Effective control of issues and operations at a healthcare facility by the nurses enable them to decide to take leave whenever they feel exhausted in a manner that helps them to prevent burnout ( Fairchild, 2010).
Several cultural norms and values may influence the issue of burnout in nurses. The application of cultural lens to the issue of nurse burnout by Gabel (2011) was able to reveal that different approach towards organization culture in a healthcare center could be associated with the exhaustion or nurses. The analysis of different levels and aspects of cultural values and norms in a healthcare organization indicates that various symbols and artifacts influence the social and physical work environments for nurses. To that extent, cultural environments in healthcare organizations determine the kind of working conditions that nurse can operate within thereby determining whether they are likely to become physically, emotionally or mentally exhausted. Varying cultural contexts often address the issue of nurse burnout differently depending on the prevailing situation.
According to Choi & Kim (2018), different cultural contexts are associated with a certain extent of relevance in the prediction and control of burnout in nurses. In this regard, culture may entail learned, transmitted or norms, beliefs, and values that influence the way of life led by a particular group of people. Cultural norms and values in any organization often affect the thinking and actions of the workers. Moreover, they help in setting the behaviors and conducts of workers such as nurses attending to patients in a healthcare facility. The nature of cultural values espoused in a given healthcare organization may extensively influence the kind of beliefs that are responsible for guiding the perception and thinking or nurses thereby determining their levels of exhaustion.
To that extent, cultural values and norms practiced in a healthcare environment have a considerable role to play in influencing the issue of burnout in nurses. A wide range of cultures and societies within the United States are affected by the issue of nurse burnout. Particularly, the modern societies where organization and management cultures within healthcare centers place more emphasis on the working hours by nurses as opposed to the quality of their productivity often expose nurses to burnouts. Cultural traditions that may affect the treatment of burnout in nurses include work practices and values that negate the importance of leisure and relaxation. Moreover, such traditions often put more focus on the duration spent by a working nurse rather than the quality of care given to the patients attended by that particular nurse ( Stimpfel, Sloane & Aiken, 2012).
Conclusion
Having been established that nurse burnout often arises from emotional, mental or physical exhaustion, some legal and regulatory measures have been established to address such concerns among the practitioners in the healthcare industry. Working for overtime as well as handling overwhelming workloads has been cited at some of the common factors that contribute towards the likelihood of nurses experiencing burnouts. Clearly, burnout can leave a nurse in a state of hopelessness after undermining his or her motivation. It is clear that nurses experiencing burnout are likely to consider every day at work as a bad one. Not only does burn out affect nurses, but it also tends to cascade onto the patients who are under their care. Previously, researchers have been able e establish the existence of a relationship between a higher probability of infections in patients and the occurrence of burnout in nurses. Healthcare centers with high rates of nurse burnout have a high tendency of lower overall satisfaction among parents.
References
Choi, S., & Kim, K. (2018). The Effects of Cultural Competence on Nurses' Burnout. Retrieved from http://onlinepresent.org/proceedings/vol47_2014/68.pdf
Fairchild, R. (2010). Practical ethical theory for nurses responding to complexity in care. Nursing Ethics , 17 (3), 353-362. doi: 10.1177/0969733010361442
Gabel, S. (2011). Ethics and Values in Clinical Practice: Whom Do They Help?. Mayo Clinic Proceedings , 86 (5), 421-424. doi: 10.4065/mcp.2010.0781
Poghosyan, L., Clarke, S. P., Finlayson, M., & Aiken, L. H. (2010). Nurse Burnout and Quality of Care: Cross-National Investigation in Six Countries. Research in Nursing & Health , 33 (4), 288–298. http://doi.org/10.1002/nur.20383
Stimpfel, A., Sloane, D., & Aiken, L. (2012). The Longer The Shifts For Hospital Nurses, The Higher The Levels Of Burnout And Patient Dissatisfaction. Health Affairs , 31 (11), 2501-2509. doi: 10.1377/hlthaff.2011.1377
Ulrich, C., Taylor, C., Soeken, K., O’Donnell, P., Farrar, A., Danis, M., & Grady, C. (2010). Everyday ethics: ethical issues and stress in nursing practice. Journal Of Advanced Nursing , 66 (11), 2510-2519. doi: 10.1111/j.1365-2648.2010.05425.x
