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A major concern in the nursing profession is the high occurrence of burnout resulting in mental health issues. Stress is another concern which has enormous effects on psychosocial and family aspects, (Cleary, Jackson, & Hungerford (2014). Common pressures are work overload, performance rivalry, lack of time, staffing issues, shift work, lack of personal care, job-related relationships, family concerns, struggling with competing demands, conflict with colleagues, supervisors and insufficient emotional planning, (Cleary et al (2014).
Nursing as a profession is an incredibly physical and frequently psychologically and emotionally taxing profession, thus presents situations of fatigue, irritability, lack of concentration, emotional exhaustion and unhappiness, which has the capacity to lead to depressive symptoms, (Cleary et al (2014).
As work and family being the two major realms of people’s lives, one domain has the effect to influence the other, in relation to attitudes, emotions and behaviours. Furthermore, irregular work schedules can be a significant potential of work-to-family conflict and this can have a diverse effect on individuals mental and physical health, (Hamaideh, S.
H., (2011). One risk factor commonly identified by nurses is burnout, (Mallak & Yildiz, (2016). Burnout is not a single event but a process in which everyday stresses and anxieties gradually undermine mental and physical health, (Cleary et al (2014). Whilst burnout is a manifestation of mental health, it is not considered to be a mental illness, but rather a form of chronic workplace stress, (Mallak et al (2016). Burnout has a broad spectrum of predeterminants, some people completely shut down, whilst others show signs of anxiety, low mood and feeling detached from day-to-day life.
As there is not one facet that causes burnout, some of the main perpetrators are feeling overwhelmed, unappreciated, fear, insecurity and trying to meet high demands and working expectations. Burnout is defined as a physical or mental collapse caused by overwork or stress, (Mallak et al (2016). Burnout has been identified as a syndrome depicted by emotional exhaustion, disassociation, and reduced personal accomplishment, (Mallak, et al (2016).
One protective factor is resilience this referred to as the ability of individuals to bounce back or cope successfully despite adverse circumstances, (Mallak et al (2016). The improvement of resilience among nurses is often connected to the quality of life, better health and the effective use of adaptable coping strategies, (Mallak et al (2016). Resilience facilitates nurses to cope with their work environment and enables them to maintain a healthy and stable emotional function. Risk and protective factors for nurses include personal lifestyle, behavioural, social, medical, psychological, self-confidence, emotional exhaustion, physical and family commitments. Prolonged and excessive exposure to stress can increase the risk of human errors and injuries and affect the quality of patient care. Furthermore, fatigue reduces performance and job satisfaction, increasing sick days and often encourages the use of medications for relaxation and sleep, (Van Bogaert, Peremans, Van Heusden, Verspuy, Kureckova, Van de Cruys & Franck, (2017).
Sleep deprivation due to shift work can lead to minimum cognitive performance which they can then have a flow-on effect impacting on family and social life. Furthermore, having the insecurity of casual employment, unpredictable hours and unstable income resources leads to significant financial difficulties, which ultimately impacts negatively on financial well-being, (Parul, Anuradha, Sanjeev, Arvind, Shrivastava & Rahul, (2014). Effective protective factors for improving resilience and to relieve burnout and stress can be manageable with regular physical exercise, as physical fitness increases tolerance by lessening fatigue, increases relaxation, calms anxiety by releasing endorphins and improves self-confidence. (Mallak et al (2016). Self-esteem plays an important role in coping with stress, recovering from difficult events, being confident in one’s personal abilities and recognizing strengths and accomplishments, (Mallak et al (2016).
Another protective factor is having a supportive social and community network which maintains a sense of connection to other’s and can be an integral part in the reduction of stress, as this heightens feelings of belonging, safety, security and empowers the individual’s confidence levels, (Hamaideh et al (2011). A supportive relationship with partners, family and friends helps contribute to handling stress or difficulty in a positive way, discussing feelings openly, being more adaptable to situations and change, staying optimistic and maintaining positive thinking can boost overall health and resilience to stressful situations, (Sharma, Lochan & Tyagi, (2016). Moreover, employers and supervisors must take on the responsibility of becoming proactive in promoting workplace wellbeing, implementing strategies and promoting stress-management techniques. Employers have the responsibility to ensure that employees have the necessary resources to meet expectations, provide ongoing training to maintain staff proficiency and setting reasonable and realistic expectations, (Higgins, Doyle, Downes, Morrissey, Costello, Brennan & Nash, (2016).
With more workplaces accepting responsibility and developing organisational policies and procedures with the recognition of workplace culture, education on resilience skills, coping mechanisms, counselling, rehabilitation, health interventions and decreased workloads which all negatively impact on employee’s psychological health and wellbeing, thus reducing claims for injury, disease or disability caused or contributed to by workplace stressors, (Guthrie, Ciccarelli & Babic, (2010). Communicating with staff on a level that develops and promotes a workplace that is conducive, to staff feeling comfortable in approaching their supervisors or colleagues about any stressful situations or health concerns they may be experiencing, (Higgins et al (2016). Workplaces can help promote resilience and self-care strategies, such as debriefing in the workplace which is an important component of stress reduction. Benefits of debriefing can provide nurses with healthy coping skills which can be shared with colleagues who are coping in less effective ways, (Higgins et al (2016). Having a positive and supportive network, both in and out of the workplace, is very important in building resilience, this aids in developing a sense of belonging, confidence and self-worth which enables nurses to cope better with adversity, (Higgins et al (2016).
The more support achieved from relatives, friends, work colleagues or supervisors, the less the burnout heightens. Social support helps to create a balance associated with the negative effects of stress, personal burnout and emotional exhaustion, (Fu, Yang, Leung, Liu, Huang & Wang, (2018). Resilience and self-care strategies do not necessarily require lifestyle changes, but by becoming self-aware and being mindful of personal stressors can have beneficial effects on stress prevention and reduction, (Higgins et al (2016). By embracing a healthier lifestyle, establishing adequate sleep patterns, maintaining healthy self-care strategies lays the foundation for the development of enthusiasm, self-confidence and equanimity thus improving the ability to be resourceful and reliable during complex situations, (Higgins et al (2016). Having accountability for the care of your own mental and physical health is just as imperative as taking care of patient’s health, by employing a combination of problem and emotionally focused coping strategies can help normalise reactions to complex situations, (Higgins et al (2016). Furthermore, having a good team environment acts as a good support structure, which in turn establishes opportunities for ongoing learning and professional development and acknowledgement of good work performance, (Higgins et al (2016).
Mental health affects everyone on an individual basis globally regardless of health, wealth, race, age or religion. Enhancing resilience and social support as well as decreasing burnout and stress contributes to the positive, physical and mental health of nurses. To alleviate nurse burnout and stress effectively, organisations need to recognise the importance of resilience thus implement effective strategies and interventions to increase nurse resilience. The more improvements that can be implemented, the fewer nurses will experience burnout and stress. As burnout and stress disencumber the nursing profession of its fervour and ability to maintain effective mental health quality, the effects of burnout and stress are not health issues that can be ignored, left unevaluated it has disastrous ramifications on individuals, social, psychosocial, physical, family dynamics, employment and emotional health. Thus, it is essential that nurses maintain good physical and mental health to maintain positive outcomes.
Furthermore, as burnout and stress are recognised globally, it is vital that employers and training organisations move to prevent and address these issues through policies and procedures aimed at constructing better work environments. Moreover, adopting the Ottawa charter by creating caring environments, durable community actions, building healthy public policies, developing personal skills and re-orientating health care services enabling employees to have the sense of security and access to current resources enabling successful execution of their jobs, thereupon improving their personal and mental health outcomes.
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