Discussion 6.1: Work Engagement Versus Burnout
Discussion 6.1: Work Engagement Versus Burnout
Discussion Guidelines
Initial Post
As a future DNP-prepared nurse, how could you use one of the frameworks of work engagement theory to combat nursing burnout and improve patient safety and quality of care? Be specific and share examples.
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Discussion 6.1: Work Engagement Versus Burnout
Nurse burnout is a major concern in the contemporary health care environment. Healthcare workers are commonly exposed to high levels of stress due to the demanding nature of their responsibilities. The individuals are required to exhibit heightened emotional and physical resilience resulting in burnout and compassion fatigue. Additionally, the mental and emotional state is under sustained exposure to stress, including working long hours due to the unpredictability of occurrences within the care facility.
Nurses commonly experience pressure to exhibit quick decision-making as the well-being of the patient is often determined by the swiftness of their response. Furthermore, they are prone to being devastated whenever their patients exhibit poor outcomes. The rate of Bernard has increased significantly in the United States over the past few decades. About 31.5% of all nurses leaving the profession have admitted to the decision being affected largely by burnout accounting for nearly 50,000 registered nurses (Shah et al., 2021). Therefore, it is imperative that a sustainable solution is developed to preserve the mental health of the professionals and minimize the high rate of turnover. The process not only improves the productivity of the practitioners but also significantly markedly raises the prospect of realizing positive patient outcomes. Kahn’s three dimensions of employee engagement suppose that there should be significant investment in the affairs of personnel to improve resource optimization and enable the successful completion of tasks. The concept aids the minimization of burnout amongst nurses by placing increased attention on the emotional affairs of the practitioner. The care facility should provide personal care services, including psychiatric sessions where individuals can interact with psychologists to address emerging mental health concerns. Kahn’s engagement theory also supposes that cognitive engagement is imperative to the realization of improved professional outcomes (Ababneh & Macky, 2017). Employers should improve the scheduling of assignments to avoid overworking nurses, thus, minimize burnout. The safety and security of the patients are consequentially guaranteed.
References
Ababneh, O. M. A., & Macky, K. (2017). The meaning and measurement of employee engagement: A review of the literature. New Zealand Journal of Human Resources Management, 15(1), 1-35.
Shah, M. K., Gandrakota, N., Cimiotti, J. P., Ghose, N., Moore, M., & Ali, M. K. (2021). Prevalence of and factors associated with nurse burnout in the US. JAMA network open, 4(2), e2036469-e2036469.
Work Engagement Versus Burnout
Nurse burnout is a very serious issue in modern nursing, especially since most, if not all, nurses have encountered matters such as rapidly increasing elderly populations, healthcare disparities, pandemics, etc. setting the basis for burnout to occur. Burnout transpires as a consequence of sustained incongruity between a person and one or more elements of work such as workload, control, reward, community, fairness, or values (Dall’Ora et al., 2020). According to Maslach and
Leiter’s Work Engagement Theory, there are three elements that makeup engagement: energy, involvement, and efficacy (Murphy, 2014). Energy amounts to vigor (Murphy, 2014). Involvement amounts to dedication (Murphy, 2014). Efficacy emphasizes the capacity to manage job demands successfully (Murphy, 2014). As a future Doctorate of Nursing Practice (DNP)-prepared nurse, I can use this framework to combat nursing burnout in whatever facilities in which I work in many ways. The identification of interventions targeted at confronting the crucial elements causing burnout is a means of promoting a better state of nurses’ well-being while enhancing patient care (The National Academy of Medicine, 2019). One very simple method is by maintaining positive energy myself, and it will rub off on the others around me, and show my involvement in all aspects of the business from basic patient care to higher level provider-based approaches (Murphy, 2014). I can also ensure that I am ordering things that can actually be completed. As a DNP-prepared nurse, I must use higher-level thinking to ensure that what I am ordering does not increase or create unnecessary stress on those carrying out the orders by ordering something that cannot be performed for reasons such as inadequate resources. Depending on my place of practice, I may or may not have any say when it comes to staffing. If I do, I can do my best to advocate for the staff, and promote safe staffing ratios which also leads to a reduction in turnover. I have personally witnessed this as the Medical Director of the facility in which I work made a huge argument about the decrease in patient satisfaction as a result of poor care due to high staffing ratios, and the Chief Executive Officer eventually implemented changes. I can also promote autonomy in the nurses I work with through clear communication, professionalism, approachability, and competence. This may not seem like it promotes autonomy, but from my experience, when nurses are comfortable with providers, they typically begin to learn the styles and mannerisms of the provider and will suggest interventions that they know the provider will approve with a simple yes. This gives nurses the liberty to treat their patients as they see fit under the guidance of a provider to say yes or no accordingly. In addition to that, I can also reward the nurses I work closely with (Dall’Ora et al., 2020). I can do this through verbal appreciation, occasional small appropriate gifts, or my personal favorite: really good food. I may not be in a position to provide extra time off or monetary compensation, but I can make my appreciation known. However, even if I perform all of these actions as an individual provider, burnout can and likely will nonetheless transpire if the organization itself as a whole does not create a healthy work design backed by job satisfaction, finding meaning in work, work-life balance, and professional fulfillment (The National Academy of Medicine, 2019).
References
Dall’Ora, C., Ball, J., Reinius, M., & Griffiths, P. (2020). Burnout in nursing: A theoretical review. Human Resources for Health, 18(41). https://doi.org/10.1186/s12960-020-00469-9
Murphy, M. O. (2014). Theory of work engagement. In J. J. Fitzpatrick & G. McCarthy (Eds.), Theories guiding nursing research and practice: Making nursing knowledge development explicit (pp. 183–200). Springer. https://doi.org/10.1891/9780826164056
The National Academy of Medicine. (2019). Taking action against clinician burnout: A systems approach to professional well-being. National Academies Press. https://doi.org/10.17226/25521
William Kahn created a theory of work engagement encompassing three psychological conditions including meaningfulness, safety, and availability (Murphy, 2014). These conditions are met through the completion of task-oriented behaviors (Murphy, 2014). Meaningfulness is achieved from a position promoting independence while continuing to keep the employee stimulated with new, ambitious tasks (Murphy, 2014). Once an employee is comfortable with their assigned role, they will search for more responsibilities to keep growing within the position. My first job out of nursing school was as an operating room nurse. I was hired directly to orthopedic surgery to learn all the specialties that make up the service. Once I felt comfortable being the circulating and scrub nurse for sports, joints, hand, and foot and ankle, I wanted to continue to expand my skills. I noticed spine surgeons beginning to operate in our pavilion, so I requested to go through a short orientation to learn another service line. I applied my current knowledge to understand the basics of spine surgery. After my orientation, I was proficient in spine surgery to be designated staff in those procedures. Spine surgery provided me new experiences such as proning patients, ordering blood, and placing IVs. There was a rare instance when a patient began to decompensate in my joint revision case. However, I felt comfortable ordering blood and helping anesthesia stabilize the patient from my previous experience in spine surgery. I was a more effective member of the team and provided better care because of the knowledge I had acquired. I also believe learning is one way to combat nursing burnout. There are many avenues of learning for nurses to explore. Nurses can become certified in their specialty, train to be charge nurse, switch to a new floor, or go back to school. The flexibility and opportunities within nursing keep the career appealing. The next tenet in Kahn’s theory is safety. He describes safety as a supportive work environment with respectful management and colleagues (Murphy, 2014). The management style of the unit leaders can influence the culture on the floor. A study analyzed the effect leadership behaviors of nurse managers had on nurse worker’s motivation and found most nurses prefer a democratic manager because they promote trust and confidence in employee decision-making (Selma Demirhan et. al, 2020). As a future Doctor of Nursing practice (DNP)-prepared nurse, I plan on using democratic influence when interacting with my team. The mutual like and respect between coworkers facilities a positive environment where nurses feel appreciated at work. The final concept is psychological availability defined by the employee’s physical and mental capacity to be present at work (Murphy, 2014). If an employee is not having their needs met outside of work, it most likely will impact their job performance as well. I want to be cognizant of my own needs and the needs of my coworkers. A real-life example of this was when my attending dismissed the resident we were working with early, so she was able to have time to pump before her lunch break. Personal lives influence job performance and it is important to contribute to a culture that encourages work-life balance.
References
Murphy, M. O. (2014). Theory of work engagement. In J. Fitzpatrick & G. McCarthy (Eds.) (PDF), Theories guiding nursing research and practice (pp. 183–200). New York: Springer.
Selma Demirhan, B., Gezginci, E., & Goktas, S. (2020). The effect of leadership behaviours of nurse managers on nurses’ work motivation. International Journal of Caring Sciences, 13(1), 381–391.
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