Healthcare is in a crisis. This is not about to be a political argument about the current state of our health system, rather it is an acknowledgement of our need of qualified healthcare professionals. With the aging of our society (directly related to our excellent health care system and medical advances- we are living longer) we have a large proportion of older adults needing healthcare. Additionally, a large portion of RNs currently in practice are at, or near, retirement age, meaning that they will soon no longer be in the workforce and need care themselves. An additional problem that adds to this burden on the healthcare system, is the alarming rates of emotional exhaustion and clinical depression among doctors and nurses (Paulus and Strand, 2017). This leads to burnout and, therefore, loss of effective workers (Bilal and Ahmed, 2017).
Burnout, more often leads doctors and nurses to leave their current jobs in search of new environments, or leaving their practice completely. I currently work as a nurse on a busy heart monitoring unit at a local hospital. I have only been on the unit 15 months, but have seen a lot of turnover in just under one year. At the last unit meeting, it was reported that 20 new RNs were added to the team since the spring. I asked my manager after the meeting, what happened to the 20 that were hired last spring? Where did they go? They went to fill other jobs, but where are the nurses now, who left the vacancies? Where have all the nurses gone? (It could be a good song).
I believe a key to understanding nurses leaving a unit (or the profession) is understanding key contributors to burnout. After some research, I believe a key contributor to burnout may be organizational communication (Bilal and Ahmed, 2017).
Critical Assessment of Burnout as a Product of Organizational Communication.
A search of “nursing burnout” and “organizational communication” through the ODU library database, provided me with plenty of articles and research studies to start this investigation. One research article by Bilal and Ahmed (2017) studied Pakistani pediatric nurses. They hypothesized five components of organizational communication that can affect, either positively or negatively, the “emotional exhaustion [at] the core of burnout” (p. 119). These components were not a surprise: having a voice in making decisions that affect their practice; having a set of clear policies and procedures, or “formalization”; “instrumental communication”: the organization sharing important information about the trajectory of the company, and its values, as well as key information that affects day-to-day practice; “integration”, or how well a group works together; and opportunities for advancement. Surprising, this study found that “formalization led to burnout,” (Bilal and Ahmed, 2017, p. 123): having clearly stated policies and procedures, likely with too much detail, leads to burnout. Also, the social factor (“integration”) had no correlation to burnout in this setting. In other words, they found that “support from coworkers may not be as important as support from supervisors” (p. 125). This reinforces the Organizational Communication component of this discussion.
A Google search of “nurse burnout and organizational communication” led me to an article by Paulus and Strand (2017) on Mission Health System’s strategy to combat burnout. They have concluded that, despite evidence that points to the economic value of investing in employees (happy employees equals increased production and happy customers), “health systems have underinvested in human capital.” Mission Health believes that focusing on the "joys" of work, addressing and remediating "hassles" of work, and instilling resiliency through training will all lead to improved morale and decreased burnout (Paulus and Strand, 2017).This is a positive example of organizational communication.
Reflection
I want to solve the problem of burnout for nurses, for my unit, but the issue is complex and can be very personal. From our course work thus far, I know that I need to see how Keyton’s (Comm 305, 2018) lens of “Narrative Reproduction” (storytelling) affects burnout. (For example, the manager extolling Jane who has picked up an extra 12 hour shift every week for the past 6 weeks. “What a great team player.”) Additionally, while I believe individual units have cultures that can lead to burnout; but this is not a localized problem, it is a nursing problem. I am wondering if seeing this phenomenon through Keyton’s “Symbolic Performance Lens” could shed some light on the issue as more of a problem with how society views nurses symbolically clashing with how the healthcare system views nurses, and the nurse’s own perception of who they are as person and as a nurse (Comm 305, 2018).
References
Bilal, A., & Ahmed, H. M. (2017). Organizational structure as a determinant of job
burnout. Workplace Health & Safety, 65(3), 118–128. https://doi-
Comm 305 Professional Communication PLE (Fall 2018) Keytons Lenses Module 3.
Paulus, R. and Strand, D. (2017, May 15). A roadmap to decreasing clinician burnout: 3
initiatives have helped Mission Health remove hassles, reduce stress. Hospitals and Health Networks. Retrieved from https://www.hhnmag.com/articles/8277-a-roadmap-to-decreasing- clinician-burnout
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