Senior Research Investigation Final
Senior Research Investigation Final
Senior Research Investigation Final
Kaela Mowrey
Ms. Barnhart
13 February 2019
Nursing Burnout 1
Introduction
Senior Exhibitions are approached from two viewpoints: Social Studies and English. The
Social Studies portion focuses on presentation skills, building a website, and the senior project
itself while the English approach uses a Senior Research Investigation. The Senior Research
Investigation uses rigorous research in order to enlighten students on different topics that
surround their senior projects. The senior projects allow students to explore something of their
choice and discover several things in the field of the project. The intentions are to broaden the
Choquette, throughout her daily work schedule in order to observe the life of a nurse. Alongside
her, I occasionally shadow other nurses and the nurse practitioner that work with her at
nursing home, so I chose to shadow her because she works in a place outside of my ideal future
career which will challenge me and further my learning stretch. This project will expose me to
the workload and stresses of my future career, as I wish to become a Nurse Practitioner,
influence me to either enjoy or dislike working in nursing homes, and hopefully increase my
For the Senior Research Investigation, I chose to research the causes of burnout within
nursing and how this can be prevented. I can expand upon this thesis question and research
topics like the stress differences between doctors and nurses, the psychological effects on nurses
from the workplace environment, and how hospitals today can accomodate employees in this
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situation. I want to research this to enlighten my audience and I of the importance of nurses’
physical and emotional help, and the faults throughout the workplaces that cause this issue. This
relates to my actual senior project because both my project and research investigation are
focusing around the field of nursing in some way. My actual research question is, “How can we
Entering into this investigation, some assumptions and beliefs lurk while forming an
argument. For example, the long and enduring shifts nurses work through physically exhaust
them and could cause mistakes and stress while working. Doctors and surgeons also require
more education than nurses, which could possibly set them up for greater success and less stress
as they enter their careers. Another hunch I have surrounding the causes of severe burnout in
nurses could be caused by a lack of recognition. Higher hospital positions, like doctors or
physicians, receive praise for their work and are glorified, leaving the nurses in the shadows. The
lack of recognition could leave nurses with feelings of uselessness or depression. With the help
of experimentation and administration, new techniques could be applied to the field of nursing to
decrease burnout.
An article on the website Thought Catalog states why people should stop glorifying
nurses and how due to the lesser education, nurses only do the dirty work while doctors do the
more complicated tasks. Instead of giving nurses more attention, this article argues nurses
complain too much about their jobs when there are other positions that work just as much
without the constant complaints. For example, nurses complain about their lengthy shifts while
doctors and surgeons work just as many hours if not more. Readers can infer that the stress
within nurses is self-inflicted. Other hospital positions as well could benefit from burnout
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experimentation rather than directing all the focus on nurses. An article on the website Nursing
Link reiterates the ideas mentioned in the previous source. This article lists things nurses should
stop complaining about such as salaries, workload, and supervisors. Points brought up in this
article suggest rather than complaining about the resources they are given, nurses should work
with what they have and consider stress amongst other people in the medical field. These sources
create strong arguments for the opposing viewpoints, showing the multiple opinions surrounding
Literature Review
Throughout the medical field of work, employees constantly have feelings of immense
stress and burnout. Burnout is categorized by emotional and interpersonal stressors that could be
measured through levels of emotional exhaustion, feelings of detachment from the job, inhibited
work habits, and lack of personal accomplishment. Medical workers, specifically nurses,
experience constant stress due to long hours, hefty workloads, and altercations dealing with
family or coworkers. Burnout is a growing phenomena occurring within nurses, but with the help
of varying strategies, may be hindered. This topic was researched using scholarly articles with
valid information that could enlighten any reader on the situation. A great deal of time went into
ensuring the articles being analyzed were valid and reliable before they were added to the list of
sources being used for the investigation. After researching this phenomena, the following sources
will be organized chronologically, starting in 2013, in order to see how research and solutions
have evolved over a short period of time in order to show how research and society has helped to
diminish this ongoing problem. In 2013, nurses nationwide started to leave their occupations due
Nursing Burnout 4
to high levels of stress and emotional exhaustion which would put them at risk for burnout. This
In the article “Stress, Social Support, and Burnout Among Long-Term Care Nursing
Staff” written by Erin L. Woodhead, Lynn Northrop, and Barry Edelstein, the authors review an
experiment they conducted. This source was published through Southern Gerontological Society,
which is a network of the South’s most respected gerontology professionals. This publisher is
highly credible due to its level of respect and knowledge. In the 2013 experiment conducted by
the three psychologists with PhDs, nurses working at a long-term care facility were tested on
their feelings of burnout based on their levels of stress and amount of social support. The
objectives of this experiment were to determine the amount of job demands and resources,
examine the correlations between demographic variables, job demands, and job resources, and to
examine the amount of variance accounted for by each of the job demands resources. Their
findings revealed that both personal and occupational stressors increase the likelihood of
burnout, however personal stressors had a greater impacts on the subjects’ stress levels. Evidence
shows that support from others at work, “[...] particularly support from supervisors, may be
particularly important in decreasing stress among long-term care nursing staff” (Woodhead et al.
87). Social support of some kind is important for nurses to obtain to help deal with both
intervention that teaches how to socially support others will help supervisors and coworkers
reassure other employees of their passions and decrease their feelings of burnout. Woodhead et
al., use a multitude of sources in order to validate their experiment and findings. Statistics and
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other data documented during the experiment are also present throughout the piece in order to
highlight the importance of social support. The data found in this experiment will reinforce the
need for social support in hospitals and promote a change. The psychologists are implicitly
stating that hospital workplaces now are not providing the employees the social needs and
comfort that is needed to exhibit proper patient care. The psychologists’ experiment initiates the
time period being observed and is the beginning of the timeline of evolution surrounding the
amount of help given to nurses in order to prevent burnout. This source directly relates to the
thesis question being investigated because it explains a cause of burnout and how it could be
inhibited. These are facts that are key to this investigation as they establish the cause, effect, and
An experiment conducted a year after the previous source being utilized for this
Intervention to Enhance the Effectiveness of Nurses’ Coping With Work-Related Stress.” Sarah
A. Smith, a nursing laboratory coordinator and the University of Hawaii Hilo with a PhD,
conducted a 2014 experiment in order to find a solution to reduce stress induced upon nurses
caused by patients and hospital budget cuts. The experiment mainly focused on
mindfulness-based stress reduction (MBSR) which is a specific type of meditation that could
help nurses cope with work-related stress and increase their patient care skills. This meditation
technique promotes both mental and physical health, as it combines the use of deliberate,
conscious breathing and some sort of exercise, specifically yoga. Results from Smith’s
decreased anxiety and stress, and lesser feelings of burnout within the test subjects. In short, the
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author’s central idea is how with further investigation and use, the MBSR technique could help
Key conclusions that can be drawn from this experiment include that the stress brought
upon nurses at work affect their work habits and emotional state, and the MBSR meditation
technique can help diminish this issue. Smith consults many other pieces to further her research
and includes an abundance of data from her experiment to ensure her conclusions are reliable.
This source implicitly states that nurses’ coping skills regarding stress are not at the strong levels
required for the field of Nursing. Their ineffective coping, defined as, “‘the inability to form a
valid appraisal of stressors, inadequate choices of adequate practical responses and/or inability to
use available resources’” (Smith 119), need to immensely improve. Smith conducted research on
the MBSR technique in order to give nurses a reliable way to improve their coping skills.
Evidence from this experiment could impact society by promoting change and taking additional
steps in order to make MBSR more widely known. This source builds off of the previous source
by suggesting additional ways for nurses to decrease their stress levels and, in the long run,
prevent their chances of burnout. A combination of social support and MBSR techniques could
The third source, written by Adam Waytz, is titled “The Limits of Empathy” from the
January-February 2016 issue of Harvard Business Review which discusses the multiple problems
with the feeling of empathy. The author’s central idea about the piece is how excessive empathy
released by anyone can lead to another form of burnout. Empathy has a list of faults including
the fact that it is exhausting, it is zero-sum, and it erodes ethics. The main issue with it being
exhausting is always present in medical workers. The constant requirement of empathy from
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medical workers can lead to compassion fatigue, which is defined as, “an acute inability to
empathize that’s driven by stress, and burnout” (Waytz). Ways to reduce excessive empathy
could be to split up the work, empathy is less bounded if it is managed across multiple
employees, or to give people breaks, it takes extreme effort to dive into another person’s mind
The author suggests that excessive use of empathy depletes one’s mental resources and
state of mind. From this piece, readers can conclude that nurses need to find a way to manage
their empathy. While empathy is important in the medical field, too much empathy can create a
strong relationship between the patient and caregiver which can cause the several problems
previously listed. The author hyperlinks several other sources such as alternative studies and data
to build his knowledge and solidify his argument against excessive. These additional sources
build credibility because they are experiments and research conducted by other scholars. The
idea that people in the medical field are under a great amount of pressure to show feelings of
empathy to patients is implicitly stated within this piece. This could impact nurses by
enlightening them on how to manage the amounts of empathy they give. Unlike what was stated
in the first source that suggested more social support from coworkers, this piece suggests nurses
could use time alone. In this time alone, workers could relax or maybe even meditate like the
Published only a few months after the previous source, the next source, written by David
A. Runge, is titled “Prevention of Burnout by Use of Balint Method of Group Therapy.” Runge,
Amherst, conducted a 2015 experiment which analyzed the effects of Balint group therapy on
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nurses. Runge published his experiment in 2016 with ScholarWorks from Umass Amherst, a
database showing a collection of research done by professionals at this school. The Balint
method is a type of group therapy that can reduce stress, prevent burnout, and have positive
effects overtime. Runge stated that the ultimate goal of the Balint method is for, “self-reflection
through group experience of difficult cases to better prepare the group of participants for difficult
patient encounters” (Runge 11). The objectives of the experiment included getting a group of
recent graduates to attend multiple group sessions each, for the people to actively participate in
multiple Balint sessions, having participants fill out a burnout questionnaire each session, and to
survey participants to document decreased feelings of burnout and desires to leave their
profession. The results of the experiment showed that through mentorship and the use of Balint
therapy, workers will see decreases in feelings of isolation, dissatisfaction, burnout, and desire to
Key conclusions that can be drawn from this research are that Balint group sessions have
a positive effect on burnout prevention in nurses. If the method was more widely known and
further researched, hospitals could integrate this group therapy technique into their work
routines. The group sessions will give employees more guidance and overall improve their
emotions in the workplace. The author referenced several other works to validate his research
and solidify his knowledge of the subject being studied. This built credibility because Runge set
aside a great deal of time and mastered the study of the technique before he implemented it in his
own experiment. This source implicitly states that if the Balint group sessions are used in a more
enduring method, the work habits will increase while stress levels decrease in nurses. Scholars
are left with the last steps of conducting more research and implementing these therapy sessions
Nursing Burnout 9
more often in order to see change. This source agrees heavily with the first source on social
resources and support. The Balint methods use group sessions to decrease stress, so these
sessions are allowing for an increase in social interaction between workers which will in turn
The fifth source analyzed jumps a period of time, published in 2018, lends a cause and
solution to burnout in nurses outside of the United States. This source written by Cortia
Bryan-Rose and Paul Andrew Bourne is another experiment titled, “Factors Determining
‘Burnout’ Among Nursing Staffers at a National Hospital in Jamaica.” This article was published
through Juniper Online Journal of Public Health, an international journal dedicated to articles
discussion research, research methods, and program evaluation in the field of public health. This
experiment analyzed nurses working at the Spanish Town Hospital in Jamaica, a hospital
this hospital left the occupation to work abroad, leaving the hospital short-staffed. Because of the
increase in shift hours and the number of patients cared for by individual nurses that was left by
the understaffing, nurses working in this hospital are under constant stress and at a great risk for
burnout. The experiment conducted by Cortia Bryan-Rose (College of Health Sciences School of
Allied Health and Nursing, University of Technology, Jamaica) and Paul Andrew Bourne
Jamaica), had three main objectives. These objective included determining the level of burnout
among nurses at the Spanish Town Hospital, establish the factors contributing to this burnout,
and to observe if the burnout affected the nurses’ attitudes towards working. The results
Nursing Burnout 10
concluded that the poor management of the hospital which resulted in longer hours and heftier
The important conclusion that must be drawn from this piece is that the poor management
occurring at the Spanish Town Hospital is the primary source of burnout in these nurses and is an
issue that must be addressed urgently. Managers of this establishment failed to make up for the
understaffing left behind by the nurses that fled Jamaica which created an intense burden on the
remaining employees. The researchers of this experiment referenced a great deal of works and
included several data and statistics retrieved from the subjects. These statistics showed the
nurses’ attitudes towards work were influenced by, “socioeconomic conditions such as social
class, income, occupational status and education” (Bryan-Rose et al. 4). These statistics could
impact the management at the hospital and promote adjustments in the system. Considering the
management should find alternatives to reduce this stress and create a positive workplace. The
authors implicitly state how if employees at this specific town were influenced so greatly by the
severe loss in staff, hospitals nationwide with understaffing could experience the same stress.
This implication will promote management alterations in many hospitals and burnout levels of
nurses will decrease. This source builds off of the second source about Mindfulness-Based Stress
Reduction regarding budget cuts. A decrease in manager involvement resulting in budget cuts
and understaffing negatively impacts employees and does not help diminish the burnout
situation.
The sixth and final source being analyzed, published in the spring of 2018 only a few
months after the previous, is a critical review of research on burnout. This source is titled “A
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Systematic Review: Factors for Burnout and Compassion Fatigue in U.S. Nurses” and is written
by three students from the University of Akron: Kaitlyn Marcum, Tabitha Rusnak, and Mckenzie
Koch. This article was published through IdeaExchange at the University of Akron, the public
research university in Northern Ohio. This article researches multiple sources in order to
determine major causes of compassion fatigue and burnout. Their research found that factors
such as the work environment, nurse’s specialty, education level, and coping skills influenced the
levels of burnout experienced by nurses. After extensive research, the authors concluded that
uninterrupted working breaks, decreases in changed to the specialty unit, and a progressive and
positive management style could help decrease the changes of compassion fatigue and reverse
negative feelings towards the occupation. The authors additionally concluded that, “ Meaningful
recognition of hard work or other positive attributes could also help to increase satisfaction”
(Marcum et al. 11). Relaxation periods, a steady routine, and appreciation all play a role in
Some key conclusions that could be drawn from this source include that a variety of
variables are synthesized in order to cause burnout, and by reversing these variables burnout can
be avoided. Several workplace and demographic variables play a role in nurses’ chances of
compassion fatigue. By creating a positive workplace environment, and increasing the amount of
recognition and appreciation from staff and managers can reverse these burnout effects. The
authors used a multitude of sources in order to increase and solidify their grasp on the concepts
that cause compassion fatigue and burnout. This piece implicitly states that changes in daily
routines heavily alter an employee’s attitude towards working. When workers are on a set
schedule of what needs to occur every shift, they become comfortable and confident with their
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work habits. However, when these rhythms are altered, it can become difficult for the employee
to adapt to their new surroundings. This could impact hospitals nationwide by enlightening them
on what not to do when discussing management changes. This source agrees heavily with the
fifth source that discussed management issues. Faulty and messy management immensely alters
nurses’ work habits and creates an intense amount of stress that could be avoided.
Conclusion
After investigating these sources, it is evident that burnout among nurses nationwide is a
growing issue that must be addressed. Because of intense stress, lack of workplace support, and
poor management in the workplace, nurses experience immense stress and desire to leave the
profession. Some advancements in the hospital workplace could be administered in order to help
resolve this issue. A multitude of changes must occur in order to diminish this ongoing situation.
If researchers refer to the methods that were investigated and replicate them on a larger scale,
more prominent effects and changes will be noticed by nurses. While the burnout phenomena has
no easy solution, the techniques already implemented are proficient entry points for further
Some of the sources investigated only focused through a small lens. It can be hard to
apply the results of these varying experiment to nurses as a whole if they concentrated on only a
sample of a population. For example, David A. Runge’s experimentation with the Balint method
of group therapy utilized newly graduated nurse practitioners and physician assistants. His goal
was to, “include these group sessions with both newly graduated physician assistants and nurse
practitioners as part of their upcoming residency program” (Runge 15-16). His experiment is
limited in scope which overlooks professional workers as well as careers with lesser degrees
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such as Certified Nursing Assistants and Registered Nurses. The stress levels within newly
graduated professionals will most likely be caused by the lack of experience. While some might
assume that workers with more experience have passed the burnout stage, increasing pressures
and schedules still impose a burden. If this experiment was conducted again with a greater
variation between experience levels among nurses, the results could establish an underlying
cause of immense stress for the entire nursing population as well as pinpointed issues in specific
areas of nursing. Slight changes and new iterations like this to the experiment would allow the
Similarly, Erin L. Woodhead’s and her colleagues’ experiment regarding stress and social
support within the workplace only zoomed in on nurses working in long-term care. The
psychologists stated, “The specific occupational demands required of long-term care staff [...]
may need to be addressed in a stress management program tailored to the nursing home setting”
(Woodhead et al. 89). While the experiment found a successful way to decrease burnout within
nurses, it only focused on the nursing home demographics. Stress levels and causes may vary
from specialty to specialty, so the resolution discussed in this experiment may not necessarily
assist a nurse working in an emergency room, for example. As a next step, researchers can use
techniques discussed in this experiment on nurses within other workplaces to see the effects. If
the results are not as beneficial as the one found with long-term nurses, other solutions can be
experimented.
Following the same trend, the piece written by Cortia Bryan-Rose and Paul Andrew
Bourne regarding nurses occupied at the Spanish Town Hospital in Jamaica experimented solely
surrounded by many communities, some that even involved in a lot of violence. The researches
state how, “[...] the workload of nurses excludes increased demands during periods of violence”
(Bryan-Rose and Bourne, 2). Because of the increased violence and the several surrounding
communities that rely on the Spanish Town Hospital, of course the employees would be under
severe stress and very prone to burnout. This source successfully established causes of burnouts
similar to the other sources, however it portrayed statistics related only to one specific area. A
nurse working in a rural area with no source of violence will have alternate causes of stress, so
Bryan-Rose and Bourne’s suggestions would not necessarily apply to them. If this experiment
had been tested on nurses in several different locations, the results could have been compared to
these experiments were conducted on a wider scale, the statistics and conclusions drawn could be
applied to the entire nursing community. The intentions of these sources were to establish a
cause of burnout and conclude how it can be prevented, however the research mechanisms were
flawed and did not consider other bodies of nursing. While focusing on a small group of people
is important statistically for the first steps of the research, it is important that the next steps of the
burnout investigation grows to a greater scale. The results of these experiments created a starting
point to the next investigations. Results from this research do, however, show importance to the
current field of nursing. This investigation revealed many beneficial techniques for decreasing
burnout within specific, varying areas of nursing that can be imposed as a temporary solution.
The issue of burnout is one that will take great experimentation and synthesis of techniques in
Works Consulted
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Marcum, Kaitlyn et al. “A Systematic Review: Factors For Burnout And Compassion Fatigue In
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nursinglink.monster.com/benefits/articles/9801-10-things-you-should-stop-complaining-a
bout-in-nursing.
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thoughtcatalog.com/hilary-thomas/2014/05/we-need-to-stop-glorifying-nurses/.
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Woodhead, Erin L. et al. “Stress, Social Support, And Burnout Among Long-Term Care Nursing
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