Small changes can help health service staff avoid burnout

A survey of nurses working with older adults across three National Health Service trusts in England explored how perceptions of the workplace affect nurse wellbeing. Standardised validated measures were used to assess burnout, perceived organisational support and organisational culture. Significant associations were found between innovative organisational culture and nurses' sense of personal accomplishment, which reduce the likelihood of burnout.

An evaluation of staff 'burnout' in older people's care has concluded that nurses who perceive their employing organisation to be more dynamic and entrepreneurial are more satisfied at work.

Authors of the report suggest that at a time when much attention is being paid to the reorganisation of the National Health Service (NHS) in England and Wales change need not be considered disruptive in the long term.

Writing in the journal Nursing Management, the authors say their evaluation showed nurses perceived their organisations to be more bureaucratic than innovative, which they add is not unusual given that hospital environments are described as hierarchical and conservative workplaces.

The study explored the relationship between nurses' experiences of burnout and their perceptions of organisational culture and support across three NHS trusts delivering acute and community care in the Midlands of England.

 'To reduce staff burnout, organisational culture may need to change, but changes do not need to be large; small changes that foster mutual support at ward level and facilitate collaboration may be effective.

'Burnout scores in this study were higher than reported occupational norms suggesting that supportive action is warranted. Implementing occupational health interventions to reduce burnout can be problematic, because staff may want to avoid being labelled as unable to cope and concerned that expressions of distress could be detrimental to their promotion prospects. It is therefore important that staff feel comfortable about seeking support and this should be considered to be normal and routine.'

The authors recommend that senior NHS managers emphasise the benefits of the health service being continually evolving 'and challenge notions that it is static and unresponsive'.

'Length of nursing experience in this study was not a predictor of burnout, although perceived organisational support and organisational culture may explain it,' they say.

'Further research could consider whether these factors are truly the cause of staff burnout and, furthermore explore how staff burnout affects staff-to-patient ratios and the number of direct patient contact hours.'