Most nurses face different levels of stress levels associated with the burnout they experience in the places of work. The primary cause of burnout in nurses that predisposes them to stress is workload (Gulavani & Shinde, 2014). Once nurses are faced with such stressful events, they react through the adoption of coping strategies. Some of them may decide to use stress strategies while others may leave the profession. This leads to the PICO question on whether the use of stress strategies or quitting the profession in burnout nurses is the most effective way of reducing stress levels and giving nurses a balance in their work in six months. The studies conducted by Rushdy (2016) and Gulavani and Shinde (2014) provides the answer to this question. However, this paper will discuss the burnout problem, review the articles and establish their link to the problem and the PICO question, and finally propose evidence-based practice changes.

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Nurse Burnout

Nurses experience high levels of burnout in their practice settings mainly because of the nature of their involving work. Many researchers have investigated the major causes, effects, and ways of preventing or mitigating burnout in these professional care providers. According to Spooner-Lane and Patton (2007), most nurses experience burnout that is associated with nursing roles, role conflict with other professionals, role overload, and role ambiguity. In most cases, they work for many hours in work extended shifts of up to thirteen hours instead of the normal eight, which not only leads to the occurrence of physical but also emotional stress. Despite 80% of the nurses showing satisfaction with their working schedules, research studies have revealed that 13-hour work shifts have a significant adverse effect on patient care (Gulavani & Shinde, 2014). Burnout is directly associated with patient dissatisfaction with the care that nurses provide and job dissatisfaction among the nurses themselves.

The working environment is also a major role player in determining the occurrence and prevalence of burnout in nurses. Many studies that have explored stressors that result in burnout have majorly found the environment as a determinant of many nursing problems including high turnover rates and burnout. Some of the stressors include poor working relationships among healthcare professionals such as doctors and nurses (Konstantinos, 2008). Demanding communication, poor relationships with patients and their relatives, high levels of workloads, stressful emergency cases, and home and work imbalances predispose nurses to burnout. Moreover, the acute shortage of nurses due to understaffing and the lack of positive feedback or support from senior staff increase both emotional and physical burnout (Konstantinos, 2008). Therefore, nurses experience many problems in their areas of practice that increase the likelihood of developing burnout.

This problem affects not only the nurses and their healthcare institution but also the patients who receive care. Nurses who suffer from burnout are likely to express apathy and cynicism towards their patients in addition to showing reduced professional adequacy (Rushdy, 2016). Such a thing reduces healthcare quality and increases the likelihood of making errors when delivering care, something that endangers the lives of patients. Furthermore, the costs of healthcare increase because of poor quality care since patients may incur long hospital stays or even die in the course of treatment (Rushdy, 2016). The lack of motivation among nurses with burnout may further result in increased job stress and dissatisfaction, which still put patients at risk of suffering the consequences of this problem.

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Institutionally, burnout affects quality care delivery, retention of staff due to high employee turnover, and employee motivation among others. Suffering from many problems that cause burnout to compel nurses and other care providers to look for better places to work in an attempt to avoid the work-related challenges (Dalmolin, Lunardi, Barlem, & Silveira, 2012). As a result, high rates of staff turnover occur among nurses. Institutions face challenges in trying to hire new professionals to cover the shortage created by the leaving nurses. Consequentially, the quality of care is compromised leading to reduce patient satisfaction that, in turn, compromises institutional reputation (Dalmolin, Lunardi, Barlem, & Silveira, 2012)