Content area
Full text
Abstract
This article explores strategies that nurses can use to protect themselves from burnout. The literature emphasises the need for organisational reform to prevent burnout. In the absence of organisational change the use of problem-focused strategies and emotion-focused strategies, such as reflection, may offer some protection against burnout. There is evidence that improving nurses' wellbeing results in better patient care.
Keywords
Anxiety, burnout, clinical supervision, emotional intelligence, reflection, stress
BURNOUT WAS FIRST recognised as a psychological concept in the 1970s (Schaufeli and Enzmann 1998). The Maslach Burnout Inventory (Maslach and Jackson 1981) defines burnout according to three characteristics: emotional exhaustion, depersonalisation and a reduction in perceived personal accomplishment.
Emotional exhaustion results from feeling weighed down and emotionally overstretched (Maslach et al 2001, Maslach 2003). Depersonalisation occurs when you try to protect yourself psychologically from further strain by becoming overly detached (Maslach 2003). Reduced perceived personal accomplishment constitutes dissatisfaction in achievement and in productivity at work (Maslach et al 2001).
Burnout is thought to arise from a prolonged disparity between what the person gives and receives in the workplace (Maslach and Leiter 1997, Schaufeli and Enzmann 1998). Rousseau (1995) referred to this as the 'psychological contract': the reciprocal expectations between employee and employer. When an employee gives far beyond what he or she receives in terms of basic expectations - for example, sufficient resources to carry out the job - this psychological contract is breached (Maslach et al 2001).
A mismatch between the employee's expectations and the extent to which the workplace is meeting them is fundamental to the burnout process.
Maslach and Leiter (1997) identified six work-life areas that are particularly important: workload, control, reward, social support within the workplace, fairness and values.
Historical context
In 1980 the General Nursing Council, which was then the statutory body governing nursing in England and Wales, reported concerns regarding the amount of pressure the work environment was placing on nurses, and identified a disparity between resources and workload and the excessive expectations of some employers (Nursing Standard 1980).
A review by the Department of Health on the health and wellbeing of NHS staff found that more than one quarter of staff absence was due to stress, depression and anxiety (Boorman 2009). The review also linked increased nurse...