Nurses dedicate their lives to improving patients’ emotional and physical wellness. They also fulfill different functions delegated to them by the physicians. Role strain in nursing occurs when nurses associate incompatible behaviors, obligations, or expectations with their social roles. On its part, burnout emanates from mental or physical collapse mainly caused by stress or overwork. According to Yılmaz (2017), nursing has been a demanding profession due to complex roles and responsibilities, lack of independence, staff shortages, regular night shifts, and insufficient patient cooperation, among other stressors. These factors have resulted in role stress or strain and burnout among the nurses, thus adversely affecting the provision of quality and timely patient care. Additionally, nurses operate under various legal and ethical guidelines, which further complicate their duties and independence level, interfering with their comprehensive healthcare delivery. Fundamentally, role strain or stress and burnout negatively influence nurses in achieving both personal and organizational goals, and thus, primary healthcare stakeholders should implement practical measures that create a favorable nursing working environment.
Role Strain, Patient Care Effect, and Ethical and Legal Issues
Excessive role stress or strain is harmful to the working ability of a nurse. A study by Vahedian-Azimi et al. (2019) established that role stress could be essential in improving a nurse’s performance level, but when it becomes overwhelming, it loses its beneficial effect. Specifically, extreme role stress and strain adversely affect a nurse’s capacity to accomplish a wide range of tasks and duties, leading to his or her inadequacy, inefficiency, and unproductivity. A strained or stressed nurse is often apathetic and dissatisfied with the job resulting in anxiety, increased absenteeism, irrational decisions, and unusual errors. Finally, an extremely stressed nurse may engage in drug misuse, which may change his or her behaviors, thus exacerbating adverse health conditions such as psychological disorders.
Stressing conditions in the nursing profession, especially those exceeding the tolerance threshold, have negative impacts on patient care. According to Yılmaz (2017), there is a positive relationship between job satisfaction and the nurses’ outcomes or productivity levels. In this regard, distressed or extremely strained nurses often become disoriented and lose the desire to work. Consequently, such nurses are disappointed and have bitter feelings, which they express to their colleagues or the patients. The outcomes are less teamwork, ineffective communication with patients, absenteeism, and a high turnover rate, leading to patient care deterioration. The unsatisfactory patient safety often results in legal and ethical issues because nurses work under a specified code of ethics. For example, nurses working in the United States must observe the American Nurses Association (ANA) code of ethics, guided by autonomy, non-maleficence, beneficence, and justice principles (Pozgar, 2019). Although the nursing leaders understand the existing staff shortage and the stressful circumstances experienced by nurses, the latter remain liable for behaviors or actions, which contradict their ethical code and patient care.
Nurses can reduce or manage role stress and strain using several practices, including organizing their work, embracing positivity, improved communication, meditation, and promoting emotional stability. Firstly, nurses should always be positive about their work to meet the nursing profession’s demanding conditions (Hetzel-Riggin et al., 2020). Positivity helps to ignore the negative aspects, which may lead to emotional instability and job dissatisfaction. Additionally, organizing work helps nurses keep track of their expected duties, thus dealing with any resulting anxiety and other psychological challenges. Effective communication is also essential in work planning and awareness creation on possible stressful situations because it improves performance levels. Lastly, meditation is an exceptional approach to help nurses gain mental peace leading to a strong emotional intelligence (EI), which helps evade exasperating circumstances causing stress and strain.
Two Causes of Burnout and Their Solutions
Two primary issues that cause burnout among nurses are lack of sleep and a high-stress working environment. For instance, there is a shortage of nurses in the United States, and thus, the available staff works for long hours (Vahedian-Azimi et al., 2019). Indeed, some nurses are compelled to work both day and night shifts, only resting a few hours. As a result, they experience a chronic lack of sleep, which leads to burnout and reduced productivity. The solution to this problem is the proper organization of work within a hospital. The nursing administrators should create a rational schedule based on the available nurses. In this way, every nurse can organize his or her work to accommodate enough sleeping time, at least seven hours a day, to ensure a better way of relieving daily stressors and strains.
A high-stress environment is also a significant source of nurses’ burnout. Unique challenges characterize every nursing specialty, and thus, some departments are typically more stressful than others (Hetzel-Riggin et al., 2020). For example, nurses working in the emergency department’s intensive care unit deal with traumatic injuries, combative patients, high mortality rates, and other ethical dilemmas, which increase their levels of stress and burnout. Such nurses need to analyze their behaviors to improve their EI, thus controlling how they react to different situations. They should also engage in meditation to gain mental peace as well as share their experiences with colleagues to achieve emotional relief.
Reflection on a Strain or Burnout Incident
A few months after the onset of the Covid-19 pandemic, I experienced burnout when working in a hospital in New York. During that period, I worked in the emergency department, and the number of Covid-19 patients was increasing daily. As the frontline health workers, we needed to keep watch on the admitted patients, and thus, we worked long hours. Indeed, I remember one day I slept at the workplace because the number of patients had increased substantially, and I had to attend and look after about 100 patients. This trend continued for about a week, and I was extremely exhausted emotionally and physically. However, based on the current situation in the United States and across the world, I had to remain emotionally stable. I started meditating for about one hour daily while embracing positivity. I encouraged myself that when I joined the nursing course, I knew its demanding aspects. Consequently, I could not let people die when I was their only hope. Meditation and optimism helped me to cope with burnout until the number of patients dropped.
Nursing is a demanding profession, and nurses experience role strain, stress, and burnout nearly every day. Different departments present unique circumstances, and a nurse has to be emotionally stable to efficiently deliver his or her services. Role stress and strain are essential for nurses because they inspire them to be vigilant and optimistic in their work. Notwithstanding, extreme levels of strain and burnout adversely affect the nurses’ productivity, thus lowering patient care standards. Despite the challenging working environments, nurses must fulfill their duties with diligence to avoid legal and ethical issues. They must abide by the nursing code of ethics and other contractual agreements. Therefore, nurses must embrace practical approaches, such as meditation, effective communication, work organization, and positivity, to lessen or manage stress and burnout with the prevailing shortage of staff and other work stressors.
Hetzel-Riggin, M. D., Swords, B. A., Tuang, H. L., Deck, J. M., & Spurgeon, N. S. (2020). Work engagement and resiliency impact the relationship between nursing stress and burnout. Psychological Reports, 123(5), 1835-1853. Web.
Pozgar, G. D. (2019). Legal and ethical issues for health professionals (5th ed.). Jones & Bartlett Learning.
Vahedian-Azimi, A., Hajiesmaeili, M., Kangasniemi, M., Fornés-Vives, J., Hunsucker, R. L., Rahimibashar, F., Pourhoseingholi, M. A., Farrokhvar, L., & Miller, A. C. (2019). Effects of stress on critical care nurses: A national cross-sectional study. Journal of Intensive Care Medicine, 34(4), 311-322. Web.
Yılmaz, E. B. (2017). Resilience as a strategy for struggling against challenges related to the nursing profession. Chinese Nursing Research, 4(1), 9-13. Web.