Running head: THE CAUSATION AND EFFECTS OF BURNOUT 1

The Causation and Effects of Burnout Syndrome on Experienced and Newly Graduated Nurses

in the Intensive Care Unit

Valerie Torres, Morgan Garofola, Andrea Garverick, Anna Baldinger, Taylor Nirich,

Maureen MacLeod

James Madison University

THE CAUSATION AND EFFECTS OF BURNOUT 2

Abstract

Nursing burnout syndrome has become a prevalent issue among the nursing profession affecting

not only nurses and their psychological state, but also patients and the care they receive. The

objective of this paper is to study the cause and effects of burnout on newly graduated nurses

compared to that of experienced nurses in the ICU setting. Studies found that a variety of factors

contribute to nursing burnout in both newly graduated and experienced nurses, including poor

communication habits, low job satisfaction, depersonalization, and workload. In addition, both

experienced and newly graduated nurses experienced increased depressive symptoms, feelings of

lack of personal accomplishment, decreased job satisfaction, therefore leading to high turnover

rates. Further research is necessary to study the success of strategies aimed at reducing stressors,

including new nurse residency programs and mentoring groups.

THE CAUSATION AND EFFECTS OF BURNOUT 3

The Causation and Effects of Burnout Syndrome on Experienced and Newly Graduated Nurses

in the Intensive Care Unit

Nursing burnout syndrome has been viewed as a prolonged response to chronic emotional

and interpersonal stress on the job. This literature review aims to find the causation as well as

the effects of nursing burnout syndrome among newly graduated nurses compared to experienced

nurses. According to Chuang, Tseng, K. Lin, C. Lin, and Chen (2016), nurses working in critical

care settings often have little time to recover from their chronic stress, which could be a potential

threat to patient care. In a study where the prevalence of ICU burnout was examined, it was

found that up to forty-seven percent of professionals containing all levels of experience had signs

of burnout following employment in an intensive care unit (Chuang et al., 2016). Another study,

conducted by Tong and Epeneter (2018), in which both experienced and inexperienced nurses

were asked why they were leaving clinical nursing, three major reasons were identified:

unfriendly workplace, emotional distress related to patient care, and fatigue and exhaustion.

Additionally, younger nurses were more prone to intensive hours and feelings of dissatisfaction

compared to older nurses who had family obligations and feelings of a lack of personal

accomplishment (Tong & Epeneter, 2018). Burnout syndrome in ICU nurse can ultimately

impact patient care and potentially create a shortage of future critical care nurses due to demands

and emotional fatigue.

Hospitals are tasked with creating environments that are friendly and manageable to

retain a professional nursing staff who are eager to return. Opgenorth et al. (2018) identified

interventions such as new graduate nurse residency programs and a decrease in the nurse-to-

patient ratio with high acuity patients which can alleviate these challenges that ICU nurses face

daily. Residency programs assist nurses in transitioning from the classroom to clinical settings
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by providing them with access to resources and quality decision making skills which can be used

throughout their career. Collectively, these interventions can assist hospitals in attaining

professional nurses that return to work in the intensive care unit. (Opgenorth et al., 2018)

Synthesis of Literature

Research indicates that burnout-syndrome notably affects newly graduated nurses,

experienced nurses, and patient care, making it a critical situation for healthcare personnel. One

study conducted by Merlani et al. (2011) stated that among those listed at higher risk for

developing burnout were young women living alone. Assis Tavares, Oliveira Souza, da Silva,

and Fonseca Kestenberg (2013) accompanied this assertion, suggesting that marital status and

number of children act as protective factors for those at risk for burnout syndrome. In contrast to

the notion that younger, single nurses are more prone to burnout-syndrome, Jennings (2008)

concluded that experienced nurses with families felt that work interfered with family life and

combined, the two contributed to overall exhaustion.

Tong and Epeneter (2018) concluded that burnout-syndrome in newly graduated as well

as experienced ICU nurses is caused by poor communication habits between nurses and fellow

hospital colleagues, low job satisfaction, depersonalization, and workload. This article also

emphasized the point that organizational factors within the hospital, such as communication

barriers and long work hours, were the main contributors to burnout in an ICU setting (Tong &

Epeneter, 2018). Ntantana et al. (2017), however, argued that nurses faced with end of life

decisions were at high risk. Experienced nurses often handle end of life decisions more

efficiently due to their years of experience, whereas many newly graduated nurses feel

unprepared to deal with end of life scenarios. Although there was a sixty-five percent
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participation rate in this study, the thirty-five percent who declined to participate contribute a

limitation to this study. (Ntantana et al., 2017)

Research by Tong and Epeneter (2018) found that patient care was directly affected by

nurses who experienced burnout syndrome, resulting in dissatisfied patients, multi-morbidity,

high acuity, and treatment complexity. This differs from Vasconcelos, Martino, and Franca

(2018), whose research focused on the impact of nursing burnout syndrome on nurses. The

effects of nursing burnout on both experienced and newly-graduated nurses in the ICU included

increased depressive symptoms, feelings of lack of personal accomplishment, decreased job

satisfaction, and high turnover rates. The limitations to this research include the knowledge that

many respondents may have had other sources of distress, either personal or work related, which

were not explored in the study. (Vasconcelos et al., 2018)

Recommendations

The research indicates suggestions which aim to prevent new ICU nurses from

experiencing burnout. Assis Tavares et al. (2013) concluded that the younger, less experienced

nurses are at a greater risk of suffering from burnout syndrome. To rectify this lack of

knowledge, providing new graduate nurses with a residency program that allows them to grow

their skills within a safe network of other new nurses prior to their exposure to the ICU would

improve their skills and confidence and decrease their risk of burnout. This article also suggests

that ICU nurses at increased risk for burnout should be paired together to discuss their daily

struggles and emotions related to their work. (Assis Tavares et al., 2013) Research by Chiliza

and Masango (2015) stated that it would be beneficial for nursing programs to require ICU

clinical hours prior to graduation. To reduce the stress levels associated with the acuity of ICU

patients, Chiliza and Masango (2015) recommended that patients who have the highest acuity be
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assigned two nurses in order to alleviate the stress of the patient being placed on one single

nurse.

Each of these research studies have provided valuable recommendations for hospitals in

order to minimize their hospital levels of ICU nurse burnout. Although these studies have

offered great insight, there is still further research that needs to be conducted. There is a specific

demand for research within the U.S. since nurse residency programs are becoming more

prevalent within hospitals. Having research which reflects the benefits of residency programs for

new graduate ICU nurses is necessary to examine the greatest risk factors for these new nurses,

as well as solutions which would benefit them.

Conclusion

Nursing burnout syndrome is a response to multiple and chronic stressors, commonly

occurring in an ICU setting. Our research aimed to identify various stressors contributing to

burnout and the effects of these stressors on newly graduated and experienced nurses in the ICU

setting. It was found that a higher degree of burnout was prevalent in ICU nurses who were

young, single, women who lived alone, and did not have declared priorities outside of the

hospital. Alternatively, studies suggested that more experienced nurses often had families at

home that contributed to exhaustion and further burnout symptoms.

Burnout syndrome in both newly graduated and experienced ICU nurses was found to be

caused by factors including poor communication habits between nurses and fellow hospital

colleagues, low job satisfaction, depersonalization, and workload, such as long hours and high

patient acuity. Nurses who experienced burnout syndrome contributed to patient related factors

such as dissatisfied patients, multi-morbidity, high acuity, and treatment complexity. The effects

of nursing burnout on both experienced and newly-graduated nurses in the ICU included
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increased depressive symptoms, feelings of lack of personal accomplishment, decreased job

satisfaction and high turnover rates. This burnout can be prevented through effective

communication and nurse residency programs, which in turn will improve patient outcomes and

increase overall nurse retention rates.

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References

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