Towards a dynamic understanding of burnout

Dawson, Nicola (2015). Towards a dynamic understanding of burnout. (Unpublished Doctoral thesis, City University London)

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Abstract

Nurses in the UK currently face significant challenges: Austerity measures and efficiency drives have led to staff shortages (Nursing Times, 2013), and nurses suffering from higher rates of stress-related sickness when compared to other sectors (Foureur et al, 2013). The nature of the nursing role leaves nurses particularly vulnerable to burnout (Farrington, 1995). A pragmatic epistemological framework was adopted to conduct a mixed methods study, with qualitative focus, which set out to retrospectively explore how the nurse becomes vulnerable or resilient to burnout. Initially 100 nurses working in the high intensity fields of cancer care or ITU, in a leading UK, NHS Trust, were invited to take part in a quantitative study exploring burnout levels, using the MBI. 100 took part, 53% showed burnout on at least 1 dimension of burnout, ie. emotional exhaustion. 16 nurses were interviewed qualitatively: 10 showing various degrees/patterns of burnout and 6 showing high levels of resilience to burnout. A modified, analytical approach of classical grounded theory was adopted. Findings suggest burnout is a continuous, multi-faceted process involving a complex interplay of internal/interpersonal/external factors. The process is mediated by how reflective, insightful and adaptable a nurse is to work-based stressors, with marked differences being found between the vulnerable and resilient nurse positions. Of note the inherent preference for taskfocused or emotionally-driven nursing orientations variably influences how burnout develops. The pervasive culture of communication was also identified as significant with the optimum culture being one of understated stoicism, acceptance and collective management of vulnerability. Findings suggest far reaching implications for nursing training policy, selection, nursing practice and intervention development, which should function at the individual/interpersonal and organisational level, taking into account the impact of nursing orientations and the pervasive culture of communication on burnout.

Item Type: Thesis (Doctoral)
Subjects: B Philosophy. Psychology. Religion > BF Psychology
Divisions: School of Social Sciences > Department of Psychology
URI: http://openaccess.city.ac.uk/id/eprint/14702

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