The nursing profession is a highly demanding job that takes a huge toll on a person’s emotional and physical status. The task gets even more daunting to those deployed to intensive care units (ICU) and emergency rooms (ER). Mazurenko, Gupte and Shan (2015) noted that the two environments (ER and ICU) deal with patients that are usually critically injured and ill, requiring a lot of patience, high task precision and specialized care. Thus, the extra demand makes the job even more complex. According to the NCBI ( National Center for Biotechnology Information ) burnout is the prolonged response to interpersonal and emotional stress at work caused by spending excessive effort and time at work while having limited recovery time. Thus, nurses that work in a stressful work environment are highly susceptible to burnout ( Mazurenko et al., 2015) . Burnout is detrimental to safety of patients since it negatively influences quality of medical care offered. The paper will conduct an in-depth analysis of how burnout affects ICU and ER nurses.
Level 1 Research Question/Writing Prompt
Scientific Perspective of Inquiry
Researchers argue that there is strong link between burnout and anatomical problems. For instance, majority of nurses that suffer from burn out complain of musculoskeletal disorders (MSD) which is the most frequently occurring and the costliest. It is usually characterized by swelling, stiffness, soft tissue pain, discomfort, par aesthesia, loss of function due to exposure to work and body weakness (Mazurenko et al., 2015). Nurses, especially the ones working in the ICU and ER have to put up with repetitive vibrations and movement, handling and attending to patients and other physical demands. The risk of nurses developing MSD is particularly high since they are required to engage in tedious physical work, which includes operating hazardous equipment, transferring of patients, maintaining awkward postures sometimes for extended periods, bending and lifting of loads. Work burnout of nurses is also closely associated with some physiological factors such as depressive symptoms, insomnia, anxiety and overreliance on medication. Moreover, burnout by itself is regarded as a pathological syndrome in which maladaptive and emotional depletion lead to chronic occupational stress.
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Burnout among nurses working in the ICU and ER is also known to affect a number of body systems. The cardiovascular system is usually the most prevalent and is mainly characterized by three major symptoms; reduced feelings of personal accomplishment, depersonalization and emotional exhaustion (Lee & Rhee, 2017). The three symptoms are a recipe for work-related mental stress disorders. Stress due to continued burnout impairs the function of the HPA (hypothalamic-pituitary-adrenocortical) axes, which in turn affects the cardiovascular system, in the process making one susceptible to cardiovascular heart diseases (He et al., 2014). The muscular system is also affected by burnout due to continuous straining which leads to body muscles tightly contracting, thus becoming shorter. In such an event a person experiences muscle soreness, spams, pain and even immobility.
In an experiment conducted by Alexandra (2016), it was stated that work burnt leads to changes in various cellular functions, especially in the brain. Research aimed at discovering how individuals suffer from burnout assessed how people react to negative emotions, while at the same time observing the brain structure. From the results collected, it was observed that individuals suffering from burnout had a relatively enlarged amygdala – the brain region associated with aggression and fear. In addition, they demonstrated a relatively weaker connection between the brain amygdala and other brain regions associated with emotional distress, for instance, the ACC (anterior cingulate cortex) (Alexandra, 2016). Therefore, the more stressed an individual is due to work burnout, the less the connection between the brain regions, leading to a signature mark in their brain structure.
Nurse burnout leads to development of certain biological and chemical problems. For instance, elevated stress levels due to burnout negatively influences the HPA (hypothalamic-pituitary-adrenal) axis - the body’s endocrine system that is responsible for regulation of an individual’s stress response by monitoring level of the “stress hormone” cortisol. Normally, cortisol is released into the blood stream when a person perceives an eminent threat, that is, appearance of a snake. The elevated levels of cortisol lead to a number of changes in the human body, that is, memory formation and changes in the cardiovascular activities such as an increased heartbeat (Mazurenko et al., 2015). When the threat goes away, production of cortisol stops and the body returns to normal levels. However, when stress becomes chronic (prolonged), mainly due to work burnout, the body never returns to normalcy (Alexandra, 2016). In the event of such a situation, the body shifts to a state of hypocortisolism, where cortisol is produced at abnormally low levels. Individuals that suffer from hypocortisolism are normally associated with severe stress and trauma due to ‘burnout’ of their body stress response system.
Level 1 Research Question/Writing Prompt
Mathematical/analytical Perspective of Inquiry
Research indicates that nurse burnout in ICU and ER leads to a number of economic implications that result from medical errors, days of work missed and nursing turnover. Due to work burnout associated with high demand medical environments (ICU and ER), a registered nurse (RN) or nursing aide, might decide to change from one organization to another in same field (organizational turnover), entirely leave the nursing profession for another field (professional turnover), or altogether become unemployed/retired (involuntary turnover) (Adriaenssens, De Gucht & Maes, 2015). Huge financial loses in the healthcare sectors can also be attributed to absenteeism/missed days of work/absenteeism, which is also caused by work burnout and stress.
Nurse burnout contributes to numerous economic challenges and pressures that are well explained through a number of economic approaches. The economic approaches are related to economic issues associated with burnout among nurses working in high demand medical settings such as the ICU and the ER. For instance, work burnout is cited as one of the major causes of nurse turnover and is particularly high in medical departments that deal with traumatic situation such as the ER and ICU. Such nurses tend to experience elevated levels of physical and emotional fatigue and even suffer from compassion fatigue, a condition associated with higher levels of anxiety, apathy, hopelessness and despair (Hatch & Tomé, 2017) . The high level of Physical and emotional fatigue suffered by nurses attending to patients in ICU and ER facilities can make them avoid reporting to work, leave work earlier than required or develop feelings of being unappreciated (Hatch & Tomé, 2017). Research demonstrates that burnout among healthcare professionals’ leads to chronic organizational stress, thus amounting to reduced patient safety a recipe for numerous medical errors.
Numerous financial costs and expenditures are incurred by the healthcare sector due to nurse burnout. The statistical costs are demonstrated using figures contained in this section. Currently, the nurse turnover rate it estimated to be 16.5% and is predicted to continue increasing (Mazurenko et al., 2015). In report published by the National Healthcare Retention & RN Staffing Report, average cost of turnover of a nurse was estimated to be between $37,000 to $58,500. Further, it was also reported that the healthcare sector loses between $5.2 to $8.1 million annually, due to nurse turnover (Mazurenko, Gupte & Shan, 2015). Absenteeism of nurses due to burnout leads to high financial loses in the healthcare sector, amounting to millions of dollars due to high administrative costs incurred when managing absenteeism, replacing employees and paying absent nurses (Hatch & Tomé 2017). Medical errors resulting from work burnout among nurses also contribute to huge economic costs in the health care sector. Presently, it is estimated that 1 out 20 medical prescriptions contain medical errors. Factoring in all medical errors, the healthcare sectors incurs over $2.3 million in additional bed charges and $1.5 million in litigation costs annually. Alarmingly, proposed costs are likely to be underestimated considering that many cases of medical errors remain unreported. Amongst all variables, the one responsible for the largest financial loss comprise of medical errors committed by nurses struggling with burnout. Hypothesis testing was the statistical processes used to study the issue of n urse burn out in intensive care and emergency room. The process entails studying if a particular premise is true for a certain population. All sources used in the study tested for a particular issue affecting nurse burnout (Adriaenssens, De Gucht & Maes, 2015). Thus, majority of data presented in the paper was derived from secondary sources testing for certain hypothesis.
Conclusion
Nursing as a profession involves tedious work that can possibly lead to work burnout, especially for individuals working in intensive care unit and emergency room. Burnout has negative effects on health status on a nurse since it leads to anatomical, physiological and pathological problems. For instance, it leads to musculoskeletal disorders, anxiety and stress. Further, it also has a negative impact on body systems such as cardiovascular and muscular systems. Incidences of burnout among nurses leads to changes in the cellular structure of the brain amygdala and influences a number biological processes, that is, over secretion of the “stress hormone” cortisol. The numerous negative factors associated with nurse burnout have a high economic implication. Numerous finances go to waste due to effects of nurse burnout, that is, occurrence of medical errors, days of work missed and nursing turnover.
References
Adriaenssens, J., De Gucht, V., & Maes, S. (2015). Determinants and prevalence of burnout in emergency nurses: A systematic review of 25 years of research. International journal of nursing studies , 52 (2), 649-661.
Alexandra, M. (2016). Burnout and the Brain. Association for Psychological Science . Retrieved from https://www.psychologicalscience.org/observer/burnout-and-the-brain
Hatch, A. P., & Tomé, E. (2017). MSDs: Overlooked Opportunity for Health Care Cost Savings and Productivity Loss Prevention. Theory and Applications in the Knowledge Economy , 351.
He, S., Chen, Y., Zhan, J., Wu, J., & Opler, M. (2014). Job burnout, mood state, and cardiovascular variable changes of doctors and nurses in a children’s hospital in China. ISRN nursing , 2014 .
Lee, S., & Rhee, D. K. (2017). Effects of ginseng on stress-related depression, anxiety, and the hypothalamic–pituitary–adrenal axis. Journal of ginseng research , 41 (4), 589-594.
Mazurenko, O., Gupte, G., & Shan, G. (2015). Analyzing US nurse turnover: Are nurses leaving their jobs or the profession itself? Journal of Hospital Administration , 4 (4), 48.
