Burnout among Nurses in Intensive Care Units and Emergency Departments: An empirical study of Pakistani Government Hospitals 1. Introduction Burnout is a pattern of emotional, physical, and mental exhaustion in response to chronic job stressors. It is a disorder characterized by emotional exhaustion, depersonalization and a low level of personal accomplishments, which primarily affects people who are dealing with other people in their work (Maslach, 1982). Burnout develops due to the persistent emotional strain, which is the result of dealing with other people who cope with serious problems.
Thus, burnout could be considered as a type of professional stress, which results from the social interaction between the person who provides help and the person who receives that help. Nurses are more susceptible to the development of burnout, mainly because of the nature and the emotional demands of their profession. Burnout is a serious problem. It directly affects the worker and it presents with various symptoms, both somatic and psychological. It is related to the weakening of relationships between the nurse and the patients, the coworkers, the family and the social environment.
Burnout is also closely related to the absenteeism of nurses from work, abandoning nursing profession and results in poor patient work overload. 1. 1. Problem Statement. There is high degree of burnout amongst nurses working in ICUs and Emergency Departments of government hospitals in Pakistan. No research has ever been conducted in Pakistan to find out the factors leading to high rate of burnout in nurses. A research study was conducted in Greece for investigating burnout of nurses working in Intensive Care Units, Internal Medicine Wards and Emergency Departments.
The researcher intends to conduct a similar study in Pakistani government hospitals. 1. 2. Significance of the Study 1. 2. 1 Theoretical Contribution: This research will add to the body of knowledge as no research on the subject has ever been conducted in Pakistan. 1. 2. 2 Applied Aspects Involved: This research will help to identify the reasons of burnout of ICUs / Emergency Departments nurses working in Pakistani government hospitals and will recommend remedial measures. The study can also be helpful to private hospitals/ clinics. 1. 3. Objectives of Study To study emotional exhaustion, depersonalization and personal accomplishment among nurses working in ICUs& Emergency Departments. • To study the degree of burnout experienced by the nurses working in ICUs and Emergency Departments of government hospitals in twin cities of Islamabad and Rawalpindi, Pakistan. • To identify job related factors and personal characteristics that contribute to the development of burnout. 2. Literature Review The main reasons which contribute to the development of burnout are the time that nurses spend for the patients care (Cronin-Stubbs.
D, 1985), the contact with patients having a poor diagnosis (Hare. J,1988), the contact with patients having increased emotional demands(Lewenson,1981),workload(Landsbergis. P. A,1988)ambiguity and role conflict(Pines A. M,1982), lack of support by the supervisors and colleagues(Firth H, McIntree J, 1982), lack of job satisfaction (Dolan N,1987) and fear of death (Mallett K,1991). Personality characteristics are also responsible for burnout those are the motivations for choosing humanistic profession (Vachon M. L. S, 1978), expectations from himself / herself and the others (Wessells D.
T, 1989), his / her values, self-esteem, ability to express feelings, the control over the events and personal style. All these factors influence the way of handling an emotional strain (Maslach C, 1982). It is said, that some people are more stress resistant, and thus less vulnerable to the development of burnout. The nurses working in different fields experience varying degree of burnout. This may be due to the staff conflicts, the decreased expertise of the workers and the work overload (Leiter M. P, & Maslach C, 1988).
Earlier researches indicate that nursing personnel working in emergency departments experienced significantly higher levels of emotional exhaustion and depersonalization in comparison to nurses of Intensive Care Units (ICUs) and other wards. 3. Theoretical Framework / Conceptual Model and Hypotheses 3. 1. Hypothesis. The hypothesis of this study are as follows:- H1. High level of Emotional Exhaustion leads to high degree of burnout. H2. High level of Depersonalization leads to high degree of burnout. H3. Low level of Personal Accomplishment leads to high degree of burnout.
H4. Job related factors and Personality Characteristics have moderating effect on the degree of burnout. 4. Research Design / Methodology 4. 1. Universe. Government hospitals located at Islamabad and Rawalpindi cities. 4. 2. Sample Size. 200 nurses having minimum one year nursing experience and presently working in ICUs and Emergency Departmwnts. 4. 3. Data Collection Method. Qustionnaire. 4. 4. Tools. For the collection of data the following tools will be used: 4. 4. 1. The Maslach Burnout Inventory. Developed by Maslach and Jackson.
It consists of 22 questions and records 3 dimensions of burnout: the emotional exhaustion, the depersonalization and the low personal accomplishments. 4. 4. 2 The Work Environment Scale. Developed by Moos and Insel, which consists of 90 questions of true-false type. This scale assesses the worker involvement, the coworker cohesion, the supervisor’s support, the autonomy, the task orientation, the work pressure, the clarity, the managerial control, the innovation, and finally the physical comfort. 4. 4. 3 General Information Questionnaire.
For recording the demographic and professional features of the sample of the study, formulated by the investigators according to similar questionnaires found in Pakistani and international literature. 4. 5 Data Analysis Plan. The possible relationship of burnout with the different independent variables (age, number of children, work experience and the work environment subscales etc. ), will be evaluated by using SPSS (Statistical Package for Social Sciences). 5. Report Writing Plan The proposed research will be developed in to a MBA thesis paper. Bibliography
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Motivation and stress experienced by staff working with terminally ill. Death Education 1978, 2:113-122. [pic] [pic] ———————– Moderating Variable Personality Characteristics Low Pesonal Accomplishment Depersonalization Emotional Exhaustion Dependent Variable Independent Variables Burnout Low Coworker Cohesion Contributing Factors Low Managerial Control Age Low Task Orientation Low Involvement Source: Variables is taken from study of Adali, Priami whereas conceptual model prepared by researcher. Low Managerial Control