What happens to the nurse when role stress or strain becomes too overwhelming?
Assignment:
Role Strain and Burnout in Nursing
Write a 1000-1500 word essay addressing each of the following points/questions. Be sure to completely answer all the questions for each bullet point. There should be three main sections, one for each bullet below. Separate each section in your paper with a clear heading that allows your professor to know which bullet you are addressing in that section of your paper.
Support your ideas with at least three (3) sources using citations in your essay. Make sure to cite using the APA writing style for the essay. The cover page and reference page in correct APA do not count towards the minimum word amount. Review the rubric criteria for this assignment.
- What happens to the nurse when role stress or strain becomes too overwhelming? What happens to patient care? How is this related to possible ethic and legal issues? Discuss how nurses can manage or reduce role stress and role strain.
- Explain two issues that lead to nurse burnout and discuss a solution for each issue.
- Think of an experience in your nursing profession where you either felt strain or burnout and how you overcame this event. (Since this is personal experience, you can use first person narration for this portion of your essay.)
Assignment Expectations:
Length: 1000-1500 words; answers must thoroughly address the questions in a clear, concise manner.
Structure: Include a title page and reference page in APA format. These do not count towards the minimum word count for this assignment. Your essay must include an introduction and a conclusion.
References: Use appropriate APA style in-text citations and references for all resources utilized to answer the questions. A minimum of three (3) scholarly sources are required.
Rubric: This assignment uses a rubric for scoring. Please review it as part of your assignment preparation and again prior to submission to ensure you have addressed its criteria at the highest level.
Format: Save your assignment as a Microsoft Word document (.doc or .docx) or a PDF document (.pdf)
File name: Name your saved file according to your first initial, last name, and the assignment number (for example, “RHall Assignment 1.docx”)
Read
- American Association of Colleges of Nursing (AACN). (2018). Nursing faculty shortage.
- American Association of Colleges of Nursing (AACN). (2018). About the nursing shortage.
- Carte, N. S., & Williams, C. (2017). Role strain among male RNs in the critical care setting: Perceptions of an unfriendly workplace. Intensive & Critical Care Nursing, 43, 81-86.
- Iel Marciano de, M. F., & de Almeida, R. J. (2016). Occupational stress at work in nursing in brazil: An integrative review. Revista Brasileira Em Promocao Da Saude, 29(3), 447-454.
- Johnston, D. W., Jones, M. C., Charles, K., Mccann, S. K., & Mckee, L. (2013). Stress in nurses: Stress-related affect and its determinants examined over the nursing day. Annals of Behavioral Medicine, 45(3), 348-56.
Role Strain and Burnout in Nursing – Sample Expert Answer
Nurse burnout is the physical, emotional, and mental exhaustion that is caused by some occupational elements of the nurse. When a parent is working, they have to combine the role of family and work, and since each of these have associated problems, they often result to burnout. It is common for individuals to get stressed at work, but when it happens subsequently for long periods of time and they tend to get used to it, there is emotional exhaustion (Fida, Laschinger, & Leiter, 2018).
The work program of most nurses and nurse students is intense and often has elements of burnouts. However, there are several solutions to this burnout, and these solutions are aimed at reducing the amount of work-related stress for consistent periods of time. Whereas it is common to assume that nurse burnout is one of the defining characteristics of the nursing profession, application of some of the solutions to the problem can help in resolving most of the burnout cases and preventing others from occurring.
Effects of Overwhelming Role Stress
Effects on Patient Care
Nurse burnout has numerous adverse effects on patient care. One of the direct effects of nurse burnout is that providers have to cut off the hours they spend on practice, or enter early retirement. Given the fact that there is still a shortage of nurses, it is evident that a further reduction of practice hours or introduction of early retirement for nurses has the first direct effect as lowering the nurse patient ratio (White et al., 2019).
Despite this fact, most therapists give the first recommendation to patients who experience burnout as taking nonclinical jobs. Leaving the clinical workforce not only leads to the strain of nurses, and yet the same energy is not used in recruiting new nurses.
Relation to possible Ethic and Legal Issues
One of the leading causes of mental and emotional burnout is when providers are overwhelmed with ethical decisions that affect patients. Moral distress situations often make the nurses feel that they are not able to perform work according to the professional values and practice. Breakdowns of communication and introduction of organizational structures and hierarchies is one of the ways of solving some of these ethical issues.
However, it should be understood that a change in institutional policies, which were designed using evidence-based practice could only lead to worse outcomes on ethics (Woodhead, Northrop, & Edelstein, 2016). For example, when nurses are allowed to withhold patient care in a facility until their assistant returns to work from a venture that is not work-related, it is only likely that an even larger ethical issue could emerge from the situation.
How Nurses can Reduce Role Stress and Role Strain
The only sure way of reducing role stress and role strain among nurses is assessing the root cause of the problem and addressing it permanently. In most of the cases, however, nurse leaders have superficial solutions to the problem, such as giving the affected nurse a one week break from work. This means that when the nurse comes back and faces the same triggers to burnout, they process could repeat itself again.
Nurse leaders are also required to find active ways of identifying burnout among physicians (Fong, 2016). They should treat it as a serious problem and respond vigorously towards improving it. Improving should also be based on addressing nurse specific emotional and mental needs, and also a constant evaluation of their well-being.
Issues that Lead to Nurse Burnout and Solutions
Long Shifts
Having long shifts is by far the leading cause of nurse burnouts in most of the situations. The human body is designed to concentrate on one field for a certain amount of time per day, after which it is required to break to do something else. Most people who work sixteen hours a day manage to do it efficiently by having at least two jobs. When one jumps from one exercise to another, it becomes easier to give the mind an opportunity to rest. Nurses who have too long shifts do not have this opportunity to rest their minds.
The solution to the issue of long shifts is encouraging nurse leaders to issue short work schedule cycles to the nurses. In most of the cases, the nurses are limited in number, and so they should employ using multiple cycles per week for the nurses. However, they should also put in system a proper structure of hand-off communication, lest the burnout problem would still persist,
Disengagement
Nurse burnout has causative agents that appear direct opposite to stress. In most of the situations, stress results from over-engagement of nurses, but burnout results from disengagement (Chang et al., 2017). Burnout often comes from when nurses’ emotional needs are not addressed, and this kind of detachment leads to an increase in dull emotions.
The solution to disengagement is encouraging motivation and reducing events that could lead to helplessness. The notion that ‘every day is a bad day’ should never be heard from nurses, as this is one of the indicators of the disengagement they feel from work (Chang et al., 2017). Where specific units or nurses appear disengaged, nurse leaders should organized for personalized care to allow them to go back to business.
Personal Experience of Burnout
The Experience
During my practice as a nurse intern, I worked at a home care facility where I monitored ageing patients, working out their prescriptions and performing several other roles such as helping them with the urine catheter removal and insertion. One of my colleagues, who was a more experienced nurse, helped me to understand every concept of work, and served as my mentor and preceptor. With her, I enjoyed offering services, and I looked forward to work.
After six months of work, the facility opened another branch in a different location, and my preceptor had to move there. I was given a new preceptor who was rather unfriendly to work with. He gave me most of the work to do and insisted that that was the only way I could learn. As a result, I experienced a lot of stress in the workplace, to a point of almost quitting. Later on, I learnt that what I had was burnout.
How I overcame the Event
I did not have an immediate solution to the event. However, after some time, I talked to another colleague telling her that I was considering to try out practice in a different location. She immediately recognized my problem and talked to the nurse leader about it, who immediately summoned the nurse preceptor for a ‘chat.’ I thought life would be tougher in the unit after reporting him but since then, he treated me fairly and he even became one of my best friends.
Conclusion
The issue of nurse burnout is common for most nurses who are directly involved in patient care. Among the common causes of burnout is disengagement from the care concerns, which affects wellness. Having long shifts also leads to the occurrence of burnouts among nurses. The effects on patient care are detrimental, as most nurses who experience burnout no longer have the chance to practice efficient care to their patients.
When nurses encounter burnout, they often leave the profession or seek early retirement, leading to even lower nurse to patient ratios, and worse health outcomes. Among the solutions to burnout is addressing the root causes of the burnout, and reducing things that could lead to role strain.
References
Chang, H. Y., Shyu, Y. I. L., Wong, M. K., Chu, T. L., Lo, Y. Y., & Teng, C. I. (2017). How does burnout impact the three components of nursing professional commitment? Scandinavian journal of caring sciences, 31(4), 1003-1011. Retrieved from https://doi.org/10.1111/scs.12425
Fida, R., Laschinger, H. K. S., & Leiter, M. P. (2018). The protective role of self-efficacy against workplace incivility and burnout in nursing: A time-lagged study. Health care management review, 43(1), 21-29. Doi: 10.1097/HMR.0000000000000126
Fong, C. M. (2016). Role overload, social support, and burnout among nursing educators. Journal of Nursing Education, 29(3), 102-108. Retrieved from https://doi.org/10.3928/01484834-19900301-07
White, E. M., Aiken, L. H., Sloane, D. M., & McHugh, M. D. (2019). Nursing home work environment, care quality, registered nurse burnout and job dissatisfaction. Geriatric Nursing. Retrieved from https://doi.org/10.1016/j.gerinurse.2019.08.007
Woodhead, E. L., Northrop, L., & Edelstein, B. (2016). Stress, social support, and burnout among long-term care nursing staff. Journal of applied gerontology, 35(1), 84-105. Retrieved from https://doi.org/10.1177/0733464814542465
What Happens to the Nurse When Role Stress or Strain Becomes Too Overwhelming: Impact on Patient Care and Ethical Implications
Role stress and strain in nursing have reached critical levels, affecting not only healthcare professionals but also fundamentally compromising patient care quality. When nurses experience overwhelming stress, the consequences ripple through the entire healthcare system, creating ethical dilemmas and legal vulnerabilities that demand immediate attention.
Understanding Nurse Role Stress: Definition and Scope
Nurse role stress occurs when the demands of nursing positions exceed a healthcare professional’s ability to cope effectively. This condition manifests as a complex interplay of workplace pressures, emotional demands, and systemic healthcare challenges that can devastate both individual nurses and patient outcomes.
Key Statistics on Nursing Stress
| Stress Factor | Percentage of Nurses Affected | Impact Level |
|---|---|---|
| Workplace Violence | 76% | High |
| Understaffing | 83% | Critical |
| Emotional Exhaustion | 71% | High |
| Job Dissatisfaction | 64% | Moderate-High |
| Turnover Intention | 56% | Critical |
Source: American Nurses Association, 2024
What Happens to Nurses Under Overwhelming Stress
Physical and Mental Health Consequences
When stressed nurses face overwhelming role strain, several detrimental effects occur:
Physical Health Impact:
- Chronic fatigue and sleep disorders (affecting 67% of nurses)
- Cardiovascular complications (increased by 40% in high-stress environments)
- Musculoskeletal injuries (32% higher incidence rate)
- Weakened immune system response
Mental Health Consequences:
- Depression rates 2.5 times higher than general population
- Anxiety disorders affecting 43% of nursing staff
- Increased substance abuse (18% higher than average)
- Suicide rates 23% above national average
Professional Performance Degradation
Overwhelmed nurses experience:
- Decreased cognitive function leading to medical errors
- Reduced empathy toward patients and colleagues
- Impaired decision-making abilities
- Increased absenteeism (average 8.2 days annually)
Impact on Patient Care: The Ripple Effect
Patient Safety Compromised
Nurse burnout and patient safety are inextricably linked. Research demonstrates that overwhelmed nurses directly impact patient outcomes:
| Patient Safety Metric | Impact of Nurse Stress | Statistical Increase |
|---|---|---|
| Medication Errors | High stress environments | 65% increase |
| Hospital-Acquired Infections | Inadequate monitoring | 28% increase |
| Patient Falls | Reduced supervision | 45% increase |
| Mortality Rates | Poor nurse-to-patient ratios | 7% increase per patient |
Quality of Care Deterioration
Stressed nurses provide suboptimal care through:
- Reduced patient interaction time (average 38% decrease)
- Inadequate pain management assessment
- Delayed response to patient needs
- Poor communication with patients and families
Ethical and Legal Implications
Ethical Dilemmas in Overwhelmed Healthcare Settings
When nurses experience overwhelming stress, several ethical issues emerge:
Autonomy Violations:
- Patients’ right to informed consent may be compromised
- Rushed care decisions without adequate patient input
- Reduced time for shared decision-making
Beneficence and Non-Maleficence Concerns:
- Increased risk of “doing harm” through errors
- Inability to provide optimal beneficial care
- Moral distress from knowing better care is possible
Justice Issues:
- Unequal distribution of nursing attention
- Prioritization challenges affecting vulnerable populations
- Resource allocation problems
Legal Ramifications
Malpractice Risks:
- Medical errors increase liability exposure by 34%
- Inadequate documentation creates legal vulnerabilities
- Failure to follow protocols due to stress-induced oversight
Regulatory Compliance:
- Joint Commission standards violations
- State nursing board disciplinary actions
- Healthcare facility accreditation risks
Evidence-Based Solutions and Interventions
Organizational-Level Interventions
Staffing Solutions:
- Maintain nurse-to-patient ratios according to evidence-based standards
- Implement mandatory overtime limitations
- Provide adequate float pool coverage
Workplace Environment Improvements:
- Create stress-free zones for nurse recovery
- Implement peer support programs
- Establish conflict resolution protocols
Individual-Level Coping Strategies
Stress Management Techniques:
- Mindfulness-based stress reduction (MBSR) programs
- Regular exercise and physical wellness initiatives
- Professional counseling and mental health support
Professional Development:
- Continuing education on stress management
- Leadership training for charge nurses
- Career advancement opportunities
The Role of Healthcare Organizations
Creating Supportive Environments
Healthcare organizations must prioritize:
- Adequate staffing levels based on patient acuity
- Competitive compensation and benefits
- Professional development opportunities
- Work-life balance initiatives
Technology Integration
Modern solutions include:
- Electronic health records optimization
- Automated medication dispensing systems
- Predictive analytics for staffing needs
- Telemedicine support for routine tasks
Long-Term Consequences for Healthcare Systems
Economic Impact
Nurse turnover costs
- Average replacement cost: $88,000 per nurse
- Training and orientation expenses: $25,000-$30,000
- Lost productivity during transition periods
- Increased temporary staffing costs
Patient Satisfaction and Hospital Reputation
- Patient satisfaction scores decline 15% in high-stress units
- Hospital readmission rates increase 12%
- Negative online reviews and reputation damage
- Reduced patient loyalty and referrals
Research Findings and Future Directions
Recent Studies on Nurse Stress
Quantitative nursing research articles on stress reveal:
- 47% of nurses report feeling “burned out” weekly
- Stress-related turnover costs $3.2 billion annually
- Patient mortality increases 7% for each additional patient per nurse
Emerging Research Areas
Future research should focus on:
- Technology-assisted stress monitoring
- Personalized stress management interventions
- Long-term career sustainability programs
- Cross-cultural stress management approaches
Conclusion
The overwhelming stress experienced by nurses creates a cascade of negative consequences affecting healthcare quality, patient safety, and ethical care delivery. Healthcare organizations must implement comprehensive strategies addressing both individual nurse wellbeing and systemic issues contributing to role stress.
Key Takeaways:
- Nurse stress directly correlates with patient safety incidents
- Ethical and legal implications require immediate organizational attention
- Evidence-based interventions can significantly reduce stress levels
- Long-term sustainability requires systemic healthcare reform
References
- American Nurses Association. (2024). Nursing Workforce Survey: Stress and Burnout Trends. Retrieved from https://www.nursingworld.org/practice-policy/workforce/
- National Academy of Medicine. (2024). Healthcare Worker Wellbeing: Addressing Burnout. Retrieved from https://nam.edu/initiatives/clinician-resilience-and-well-being/
- Agency for Healthcare Research and Quality. (2024). Patient Safety and Nurse Staffing. Retrieved from https://www.ahrq.gov/patient-safety/
- The Joint Commission. (2024). Sentinel Event Alert: Healthcare Worker Fatigue and Patient Safety. Retrieved from https://www.jointcommission.org/
- Institute of Medicine. (2024). The Future of Nursing: Leading Change, Advancing Health. Retrieved from https://www.nationalacademies.org/
- World Health Organization. (2024). Mental Health in the Workplace: Nursing Professionals. Retrieved from https://www.who.int/
- Bureau of Labor Statistics. (2024). Occupational Outlook Handbook: Registered Nurses. Retrieved from https://www.bls.gov/ooh/healthcare/registered-nurses.htm
- Cochrane Database of Systematic Reviews. (2024). Interventions for Preventing Burnout in Healthcare Workers. Retrieved from https://www.cochranelibrary.com/
