Part I: Intro to the History of Nursing Burnout
I wrote an academic paper on nursing burnout from a mainly historical perspective. The pandemic and my mom was my motivation to research how the role of the nurse has changed and been impacted throughout the years.
As the paper is long, I will be releasing its contents in parts. Here is the introduction to my academic paper:
The Continuing Discourse on How to Discuss & Solve U.S. Nursing Burnout: A Historical Perspective on the Issue, From 1974 to 2023
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INTRODUCTION
Nurses in the United States have been through multiple breaking points in their careers that they sometimes believe that they have no choice but to leave their profession. In enterprise and public advocacy reporter Ivey DeJesus’s Penn Live article “A critical shortage: amid burnout, fatigue, exhaustion, nurses leave their jobs”, she discusses how over one-third of nurses were highly considering leaving the profession by the end of 2022 due to the stressful work environment. The growing sentiment of ditching the profession all together has especially hit nurses hard since the onset of the pandemic in the United States since February 2020, when nurses and their colleagues - certified nursing assistants (CNAs), physicians, case managers, social workers, pharmacists, medical students, residents, etc. - were expected to volunteer on the makeshift COVID units at least three times a week, float to different telemetry units from their home unit, reuse single-use N95 respirators for at least a week, be showered in skin-drying alcohol and soap before changing into disposable scrubs in the hospital, foregoing their lunch break, and returning home to their loved ones or roommates where they will be self-isolated from every other part of the home, except a singular, isolating room. These were the conditions that my mother, a CNA, had to work and live in for about two months before catching long-COVID from April to May 2020. At one point, she experienced a blood oxygen level of almost 66% for over one hour in the middle of the night without my father or I knowing, because she was isolated far away from us. For reference, the normal human levels for blood oxygen is 95-100%. When she did not have long-COVID, she and her fellow nursing colleagues were expected to do all of the tasks previously described above, all while still maintaining a smile on their face, resisting the urge to break out in a mental and emotional breakdown, and saving a patient’s life over their own. Unfortunately, my mother had to pause delivering care for her patients on the taxing cardiac failure telemetry unit, where she was expected to boost 300+ lb. patients in their beds all by herself as a 5’0”, 130 lb. woman due to the limited one healthcare worker per patient room restriction on the hospital floors.
The point of the lengthy tangent above about my mother’s experience as a 16-year veteran CNA working alongside nurses during the pandemic is this: nurses have definite probable cause to be burnt out and have the desire to just quit and be done with the medical field all together, despite their experience and passion for the job. Even after all of the obstacles that nurses have had to go through since February 2020, U.S. nurses are still burnt out as of 2023. In January 2023, over 7000 nurses in the Montefiore and Mount Sinai hospital systems in the greater New York City Metropolitan Area went on a three-day strike after deals to have safe staffing ratios on hospital unit floors failed. If the COVID pandemic did not change that much to lessen and eliminate nursing burnout, how have U.S. nurses coped with burnout throughout history?
This paper will be a chronological historical account and analysis regarding nurses and burnout in the United States since the 1970s. The research question that is attempting to be answered is this: when did “burnout” become associated with U.S. nurses and how have conversations about burnout amongst nurses changed since the 1970s? To answer this, the primary sources for this paper come mainly from articles published in the American Journal of Nursing, so that the information gathered is primarily associated with nurses. Because some of the sources found in American Journal of Nursing only mentioned “burnout” and its similar other phrases, such as burnt out and burning out, once or a few times without a full explanation of “burnout”, primary sources also stem from journal articles that were found using the PubMed database. Articles found on PubMed were determined to be useful if they filled in any gaps in information not found in the general time periods between the 1970s and present day 2023 in the American Journal of Nursing. This paper will expand on psychologist Herbert Freudenberger and social psychologist Christina Maslach’s general theories of burnout, in an attempt to see how nurses and general “human services providers” are similar and different in their burnout experiences. Furthermore, general scholarly discussions found using the University of Pennsylvania’s online library database and personal communications with Dr. Julie Sochalski, PhD, RN, FAAN, former Chief Nurse of the United States of America under the Obama Administration, regarding nursing education and legislative and hospital policies surrounding U.S. nurses are used to understand any action, if any, that has been taken to improve a U.S. nurse’s overall health and well-being at the workplace.
Based on the pioneering work of Freudenberger and Maslach, nurses have been a part of the discussion of “burnout” since the first time “burnout” was officially termed and given a stable definition in 1974. Despite the nearly 50 years since the coining of the term, there has not been actual change in the conversations about nurses and burnout. Rather, because of the increasing scholarship on nursing burnout in the United States since 1974, there has been continuing discourse on how to discuss and solve the problem of burnout in U.S. nurses.
In order to explore these findings, this paper is structured to highlight the general burnout themes that were determined for certain time periods. The first time period is 1974 to the 1980s, when burnout was just being conceived and the definition and its methods of solving it was most malleable. The second time period is the 1980s to late 2000s, when scholarship on how nurses defined burnout and how to combat burnout is most prominent in academic literature. Finally, the last time period is the late 2000s to present day 2023, when there has been increased discourse on how to discuss and solve burnout in U.S. nurses in the age of increasing U.S. political divide and sharing of information due to the rapid expansion of technology. This paper’s summary and analysis of scholarship in the field of nursing and its adjacent fields can be useful to determine how stakeholders - politicians, educators, medical professionals, storytellers, etc. - can use their professional backgrounds to work together and spearhead many projects and initiatives to hopefully save the profession of nursing in the United States as we know it.
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FOOTNOTES
Ivey DeJesus, “A critical shortage: amid burnout, fatigue, exhaustion, nurses leave their jobs,” Penn Live, January 11, 2023, https://www.pennlive.com/health/2023/01/a-critical-shortage-amid-burnout-fatigue-exhaustion-nurses-leave-their-jobs.html.
Anonymous-Named Individual (Author’s Mother), mutual conversation over a recorded Zoom call, May 6, 2023.
“Blood Oxygen Level,” Cleveland Clinic, https://my.clevelandclinic.org/health/diagnostics/22447-blood-oxygen-level#:~:text=For%20most%20people%2C%20a%20normal,know%20what%20levels%20are%20acceptable.
Sile Moloney & Miriam Quiñones, “Nurses Strike Against Montefiore and Mount Sinai Ends After Three Days as Deal Struck,” Norwood News, January 12, 2023, https://www.norwoodnews.org/nurses-strike-against-montefiore-and-mount-sinai-ends-after-three-days-as-deal-is-struck/.
