Jenny Watts - The Consequences of Providing Older Adult Care: Burnout and/or Satisfaction?

In this article, Jenny Watts of the School of Psychology describes her research exploring how perceptions of the workplace impact on employee wellbeing. Jenny's research has investigated the role of organisational culture in nurse burnout.

About My Research

Occupational health research aims to apply knowledge about workplace stressors to improve staff health and performance. I am interested in how emotionally engaging work impacts on professional helpers, such as nurses.

Many researchers have studied burnout in nurses, yet nurses providing older adult care have received limited attention. To ensure quality of care and staff wellbeing it is vital that we understand how caring for this patient cohort effects staff. To explore this topic I had three main questions:

  1. Is there evidence of specific distress and reward associated with patient contact?
  2. How prevalent and problematic is this distress?
  3. Do any staff characteristics, such as experience and patient-contact hours predict distress?

Research Approach

My project was based upon three sources of evidence:

  • A systematic review of published literature
  • Interviews with senior nurses
  • A survey which gathered data across three NHS Trusts

The systematic search of the literature was used to determine how distress had been understood and measured and if any variables were able to predict distress in nurses.

I then conducted explorative interviews with nurses. I wanted to understand how older adult care impacts on staff, so I asked participants to describe the most enjoyable and challenging aspects of their role. Themes from the interviews were used to guide the choice of questions for a survey collecting responses from staff working in Primary Care, Mental Health and Acute Care.

Research Findings

The interviews also revealed that staff experienced satisfaction and a sense of reward. Therefore when designing the survey I chose scales capable of measuring both positive and negative responses. I also investigated the impact of social support and perceptions of the organisation.

The interviews provided preliminary evidence that nurses can experience aspects of ‘burnout’ due to interacting with older adults within their care. Burnout is a specific form of distress resulting from engaging with or assisting others. It has three components:

  • Emotional Exhaustion- depletion of emotional reserves
  • Depersonalisation- a detached cynical attitude
  • Personal Accomplishment- satisfaction and achievement from the helping-role

Burnout has been documented in other helping-professionals, such as police officers and teachers (see Watts, J & Robertson, N. 2011. Burnout in university teaching staff: a systematic literature review, Educational Research 53, 33-50).

Over 160 staff responded to the survey, with data collected from both registered nurses and other nursing staff, such as Health Care Assistants.

Diagram - Experiences of Providing Older Adult Care

Burnout scores were higher than expected, with the majority of staff positive for depersonalisation and reduced personal accomplishment. This suggests that staff were at risk of detached attitudes and feeling lower satisfaction in their role. To place the burnout scores in context 67% of the nurses met clinical thresholds for anxiety and 29% for depression.

Perceptions of the organisation as more innovative and supportive predicted lower burnout. Staff who found their environment to be more dynamic, entrepreneurial or collaborative were less likely to experience depersonalisation or low personal achievement. This suggests that supportive and innovative culture may be beneficial for staff wellbeing and potentially patient care. Previous research has demonstrated links between burnout, nurse voluntary turnover and quality of care. Therefore burnout has implications for the wider organisation too as it can contribute to staffing problems.

This study determined that nurse’s empathy did not predict burnout. Also, no differences in empathy were detected according to nurse registration status. This means that when nurses with advanced training were compared with Health Care Assistants, empathy scores were not significantly different. Therefore this study does not support media suggestions that academic training erodes nurses’ capacity for empathy.

Overall my research revealed that perceptions of the working environment had a greater impact of nurse wellbeing than any other variables, including years of experience. To reduce nurse burnout wards need to foster a more supportive and innovative culture. This need not be a big change. Nurses have already been involved in re-shaping their workplaces to improve care and reduce costs. The Royal College of Nurses (RCN) is promoting nurse-led innovations and encouraging staff to apply their frontline knowledge to deliver care efficiently. Advice for nurses is available on how to design their innovations and demonstrate value for money. For more information visit the RCN Innovations website.

About Jenny Watts

Jenny WattsJenny Watts is a research student working towards completion of her doctoral degree in the School of Psychology.

Jenny is supervised by Dr Noelle Robertson and Professor Richard Baker.

School of Psychology
University of Leicester
Henry Wellcome Building
Lancaster Road

Jenny will present her work at the Festival of Postgraduate Research 27 June 2013 - see Jenny's Festival poster.

The Festival is open to all members of the University community and the public - book your place here.


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