Conclussion and Recommendation Nursing Dissertation


6.1 Introduction

This chapter entails the conclusion and recommendation of the study on the impacts of burnout on A&E nurses and how this affects the standards of patient care.

6.2 Conclusions

Burnout is prevalence among nurses in England and the adverse effect on the quality of care. To achieve this, primary data was sourced from leading databases such as; PubMed, CINAHL, SciELO (Scientific Electronic Library Online), Scopus, LILACS, Science Direct (Elsevier), and the Proquest Platform (Proquest Health & Medical Complete). The study addressed the diagnosis of burnout, where the nurse tends to lose interest and the motivation that led them to choose the career. Exhaustion saps an individual’s energy leaving them feeling helpless, skeptical, desperate, and bitter. Hence leads the person experiencing burnout to feel like they are no longer useful in their places of work.

The study addressed burn out, the causes, impacts, effects, and management of burnout, in the main objectives which were as follows; To explore the epidemiology on burnout in hospital settings. To identify the factors which lead to burnout. To examine how the hospital workforce is planned to ensure the retainment of staff while ensuring efficiency. To investigate how the Working Time Regulation 1998 is applied by the Royal College of Nursing (RCN) and hinders managers from identifying burnout amongst staff. To examine how absenteeism inflicted by burnout impact on quality of care. To identify changes hospitals can implement to minimize burnout amongst staff while maintaining quality care.

Long working hours with minimal rest in between, leads to burnout, reducing the quality of patient care. Flexibility in work schedule, adequate supervisory, open communication and team building, reduces the chances of burnout among the staff. The nurses who already experience burnout cases require clinical psychologists o help through the trauma, improving their condition and reducing absenteeism, sick leaves, and nurses turnover. There is a need for adequate staffing in all departments, fair pay for nurses, implementation of corrective actions, and identifying potential sources of burnout.

Based on systematic review, this study concludes that, A&E nurses should not have long work hours, flexible work schedule to reduce monotony, have adequate break in between the shifts, have the support of clinical psychologists, open communication with the managers and supervisors, team building to raise the levels of morale, motivation, and confidence. These measures will improve the physical, psychological and mental state of the nurses raises the standards of quality of patient care.

6.3 Recommendations

Nurses who work in accidents and emergency, ICUs and other intense departments have high cases of burnout. This is because these departments are characterized by overcrowding, confrontations, unpredictability, a wide range of infectious diseases, traumatic events and injuries. The job demand is very high, with a high level of stress and emotional exhaustion, job depersonalization, minimal job controls, and social support. Managers and supervisors need to pay more attention to these departments to prevent turnover, illnesses, and burnout.

At an individual level, nurses should identify the primary source of stress at the workplace, use teamwork as a support network, practice self-care, find a hobby or interest to distract them during work breaks, and have open communication with the managers and supervisors. To reduce the chances of burnout for the A&E nurses at the hospital, managers and supervisors should reduce the chances of conflict at work. This will ensure job satisfaction, raise global empowerment, organization support, increased psychological empowerment, the cohesion of work groups, and personal achievements. 

Adequate staffing in all departments, fair pay of nurses both for work done during their shifts and those who prefer to add some extra shifts. This ensures that they have adequate workload ensuring efficiency, implementation of corrective actions, and identifying potential sources of turnover. Hospitals should create a nurses burnout advisory council led by the hospital management. Frequent surveys should also be done in departments that need critical attention from the nurses; for example; A &E, ICU, and surgical nurses. The hospital should have respect for all the nurses and other health representatives, empower workers in various departments, solve the problem immediately when they arise and have clear goals and alignment of the hospital`s goals, and objectives. This will ensure the provision of quality patient care.

New structures for professionalism and organization at the workplace, including clear work schedules and workloads, ought to be put in place to ensure quality provision of patient care. The managers and supervisors should also identify stress, depression, and burnout in nurses on time. To identify the signs of burnout on time, managers should provide frequent clinical psychology for the nurses, create an open platform for communication between the management and nurses, providing team building and retreats, work compensations for extra work shifts. This ensures that the nurses identified with cases of burnout are assisted, thus, improving work outputs.

Promoting job satisfaction, confidence and morale will help to retain the current workforce, by ensuring that the cases of sick leaves, absenteeism, and reduce nurses turnover. Ensuring that the nurses have enough rest between work schedules, flexible work schedules, reducing workload intensity and volume, out-of-hour commitments, frequent work motivation, and incentive payments. This will reduce stress, depression, burnout and job dissatisfaction, ensuring that the nurses comfortable at work, providing high-quality provision of patient care.

1.4  Summary

Adequate workload and clear work schedules ensure that nurses have proper attention in service provision. Nurses need to have some down time, in between work shifts, to avoid burnout. This ensures that they provide quality and standard patient care.

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