Operational burnout: “a result of the psychological and emotional demand of the relationships between caregivers and their patients” (Garrosa, Rainho, Moreno-Jimenez& Monteiro, 2010) “Burnout is a state of emotional, mental, and physical exhaustion caused by excessive and prolonged stress. It occurs when you feel overwhelmed and unable to meet constant demands” (Smith, Jaffe-Gill, Segal & Segal)

Psychological problems Psychological problems Somatic and physiological arousal Somatic and physiological arousal Reduced immunity Reduced immunity Lower mortality and productivity Lower mortality and productivity Increased Absenteeism, job turnover Increased Absenteeism, job turnover and drug use and drug use (Garrosa, Rainho, Morino- Jimenez& Monteiro, 2010)

High Self-Esteem Hardy Personalities Self Efficacy Sense of Coherence Optimism (Garrosa, Rainho, Morino- Jimenez & Monteiro, 2010)

Low levels of hardiness External Locus of Control Passive Defensive Coping Styles Low Self-Esteem Anxiety, Hostility, Depression, Self-Consciousness, Impulsivity, and Vulnerability Sensitivity Introversion (Gustafsson,Persson,Erikson,Norburg & Strandberg,2009)

Exposure to pain and death Role stress and overload Lack of supervisors support Misguided expectations Inadequate physical conditions Interpersonal conflicts Lack of communication Lack of knowledge and decision making latitude Increased complexity and demand of most job descriptions Unpredictability in job routine Unrealistic expectations of patients and families (Garrosa, Rainho, Morino- Jimenez& Monteiro, 2010) (Mealer,Burnham,Goode,Rothbaum&Moss,2009)

Burnout is a gradual process, it happens over time, not suddenly. If you pay attention to signs and symptoms of burnout, you can avoid a breakdown: Physical Emotional Behavioral

Depression Insomnia High blood pressure Headache (Smith, Jaffe-Gill, Segal & Segal) Increased irritability Feeling sick a lot, lowered immunity Feeling tired, drained most of the time

Sense of failure Feeling hopeless Loss of motivation (Smith, Jaffe-Gill, Segal & Segal) Cynical, negative outlook No longer enjoying going to work

Isolating yourself from others Taking longer to get things done Using food, alcohol or drugs to cope (Smith, Jaffe-Gill, Segal & Segal) Skipping work or coming in late Having difficulty focusing

Those in high risk areas: Neo-natal nurses Oncology nurses Critical care nurses Emergency department nurses Hostile management Poor organization High nurse to patient ratios (Wollf, 2010)

Those with stressful personal lives: Nurses with young children Nurses with the recent death of a loved one Nurses with stressful personal/family relationships (Wollf, 2010)

Be well informed about the job position a. scope of responsibilities b. workload c. supervision Seek out helpful supervision (Smith, Jaffe-Gill, Segal & Segal) Feel comfortable with yourself, set limits Encourage and practice good communication Learn how to manage stress

Healthy eating, exercising and sleeping habits Take a break from technology Relaxation techniques such as meditation (Smith, Jaffe-Gill, Segal & Segal) Develop an active outside life Build a positive support system

SLOW DOWN!! Take a break! Rest Reflect Heal Cut back! On commitments On activities (Smith, Jaffe-Gill, Segal & Segal)

To relax try: Favorite activities Running Yoga Exercising Swimming Guided imagery Reading Put together a puzzle Anything that makes you relax! (Smith, Jaffe-Gill, Segal & Segal)

Guided imagery example…. ???? Discuss with girls (Smith, Jaffe-Gill, Segal & Segal)

Get support ! Talk to someone Share feelings Let out frustrations DO NOT ISSOLATE YOURSELF! !!! (Smith, Jaffe-Gill, Segal & Segal)

Reevaluate goals and priorities Think about: Hopes Goals Dreams Are you neglecting something? (Smith, Jaffe-Gill, Segal & Segal)

Acknowledge losses Recognize losses Make a list Reflect on losses Grieve over losses Dreams over why you entered career Loss of job identity Loss of physical/emotional energy Loss of friends/family Loss of esteem, self-worth Loss of joy that makes work/life worthwhile (Smith, Jaffe-Gill, Segal & Segal)

Change! Stop doing what you’re doing Change jobs (if possible) Different floor Different employer Change careers (if possible) (Smith, Jaffe-Gill, Segal & Segal)

“A mentally or emotionally disruptive or upsetting condition occurring in response to adverse external influences and capable of affecting physical health, usually characterized by increased heart rate, a rise in blood pressure, muscular tension, irritability, and depression.” “Physical or emotional exhaustion, especially as a result of long-term stress or dissipation.” “One who is worn out physically or emotionally, as from long-term stress.”

Too much pressure/demand Over engagement Over reactive emotions Urgency and hyperactivity Loss of energy Leads to anxiety disorders Primary damage is physical (Smith, Jaffe-Gill, Segal & Segal) Feel empty Disengagement Emotions are blunted Helplessness and hopelessness Loss of motivation, ideals Leads to detachment and depression Primary damage is emotional

References Garrosa, E., Rainho, C., Moreno-Jimenez, B., & Monteiro, M. (2010). The relationship between job stressors, hardy personality, coping resources and burnout in a sample of nurses: A correlation study at two time points. International Journal of Nursing, 1(47), Gustafsson, G., Persson, B., Eriksson, S., Norberg, A., & Strandberg, G. (2009). Personality traits among burnt out and non-burnt out health care personnel at the same workplace: A pilot study. International Journal of Mental Health, 2(19), Mealer, M., Burnham, E., Goode, C., Rothbaum, B., & Moss, M. (2009). The prevalence and impact of post traumatic stress disorder and burnout syndrome in nurses. Depression and Anxiety, 2(26), Nurses Neighborhood, nursing profession resource for nurses and nursing students. (n.d.). Nurses Neighborhood, nursing profession resource for nurses and nursing students. Retrieved February 11, 2010, from Preventing Burnout | LIVESTRONG.COM. (n.d.). LIVESTRONG.COM - Health, Fitness, Lifestyle | LIVESTRONG.COM. Retrieved February 11, 2010, from preventing-burnout/#JUMP4http:// Smith, M., Jaffe-Gill, E., Segal, J., & Segal, R. (n.d.). Preventing Burnout: Signs, Symptoms, Causes, and Coping Strategies. Helpguide.org: Understand, Prevent and Resolve Life's Challenges. Retrieved February 11, 2010, from Wollf, J. (2010). About nursing burnout occur. Retrieved from