Recent findings suggesting a link between long shifts, overtime and burnout should prompt healthcare providers to address the
risks of work-related ill health to staff and patients alike. By fostering effective collaboration, leadership and training, burnout can be mitigated if not eliminated entirely.
According to an international study published in the British Medical Journal, working long shifts increases the likelihood of nurses experiencing burnout: a medical condition caused by prolonged exposure to job stress, and a widely recognised hazard to occupational safety in healthcare. Symptoms may include a lack energy and frequent feelings of tiredness, insomnia, forgetfulness/impaired concentration and attention, loss of appetite, anxiety and depression.
The study, led by University of Southampton’s Chiara Dall’Ora, suggests that, far from being a useful strategy to address nursing shortage, overtime adds to one of the key challenges facing healthcare providers worldwide: looking after their employees’ wellbeing. And that includes preventing any negative health outcome, such as burnout, that may result from inadequate working conditions.
Burnout typically manifests with mental and physical exhaustion, feelings of helplessness or self-blame, negative thinking and cynicism. It has long been associated with significant increases in sick-leave absences, reduced job satisfaction and high turnover rates, particularly among nurses. Most importantly, if not recognised and treated, burnout can cause serious medical complications, including depression and cardiovascular disease.
Patient safety at risk
Since burnout, like all stress-related illnesses, can impair judgment and concentration, there is also an increased risk for medical errors, which can have a devastating impact on patient safety.
What’s more, new research conducted in Italy has linked nurse burnout to the spread of healthcare-associated infections (HAIs) in hospitals. The lead author, Maura Galletta, of the University of Cagliari, reports in Intensive and Critical Care Nursing that “burnout can indirectly affect healthcare-related infections as a result of the quality of teamwork. Thus, reducing burnout can be a good strategy to decrease infections, [while]increasing workers’ well-being [and]improving patient care.”
Number one priority
So, there is undoubtedly great scope for healthcare providers to create the right conditions for a burnout-free workplace, and make this a number one priority. They must be familiar with the risk factors of the condition, and be able to deliver continuously improving systems for the identification and effective management of these factors, to ensure that no employee or patient is made ill as a result of it.
Addressing modifiable risk factors
In nursing, common risk factors for work-related stress and burnout include excessive workload, difficulty coping with the emotional and physical demands of caregiving, and lack of work-life balance. Additionally, as the BMJ study mentioned earlier has demonstrated, overtime also has a negative impact; nurses who work shifts of 12 hours or more are at high risk of experiencing the three key dimensions of burnout: emotional exhaustion, reduced sense of personal accomplishment, and depersonalisation.
These are not the only risk factors for burnout – age, gender and personality, among others, also affect the likelihood of developing the condition – but they have the advantage of being modifiable.
Richard Evens, Commercial Director of the British Safety Council, says: “This means they can be addressed, with the right training and interventions, effectively preventing burnout and its consequences. For this to be possible, however, managers need to be adequately trained in assessing and managing risk factors within their organisation.”
Making it a team effort
Evens elaborates, “Creating the conditions for a healthy workplace is not just a manager’s job. The involvement of frontline healthcare workers, enabled through education to take an active role in identifying and managing risks, is also crucial.”
Such training can make the difference between a thriving burnout-free facility, where patients receive safe and effective care from highly-performing staff, and one plagued by turnover and lawsuits due to medical errors.
Leadership style and burnout
Leadership is often cited as one of the most influential factors, when it comes to preserving the mental and physical wellbeing of workers in all sectors. And there is evidence that certain leadership styles can have significant protective effects against work-related stressors in healthcare settings, specifically.
This was found, for example, in a joint study by researchers from the University of Western Ontario, Canada, and the University of
Rome, Italy. The team’s analyses show that nurse burnout is less likely in healthcare organisations that adopt the Authentic Leadership model – a leadership style that aims to promote positive work relationships, and emphasises the value of honesty, transparency and integrity.
Lastly, it is worth noting that not all healthcare providers and their staff are familiar with recommended strategies for the effective prevention and management of burnout. Examples of these strategies, according to the results of a review of relevant research, include creating a positive work environment, giving employees control over their job, and promoting the use of stress-relieving techniques. Such lack of knowledge can hinder efforts to reduce work-related ill health, and clearly points to the need for more awareness.
The recent findings – linking long shifts and overtime to burnout in nurses – should be a wake-up call for healthcare providers. It clearly underlines the need to foster collaboration, leadership and training as enablers for staff at all levels to effectively manage risks to health and performance.
Such an approach would have far-reaching benefits in terms of achieving high standards of workplace safety, to the advantage of staff, patients and organisations alike.
Commissioning Editor, Further.co.uk