Advertisement

Intensive Care Burnout

  • Cory Franklin
Chapter

Abstract

Perhaps more than any other healthcare workers, intensive care unit (ICU) personnel are prone to job burnout. Over time, the long hours, life or death situations, and moral dilemmas inherent in ICU care can overtax practitioners, leading to physical and emotional symptoms and often to serious personal problems.

Besides being a threat to the well-being of ICU staff, burnout poses a serious risk to patients in the form of substandard care, resulting in more complications, and greater morbidity and mortality. It is also a societal issue; the job turnover created by burnout disrupts continuity of care and costs millions of dollars in replacement personnel.

Even though the symptoms, consequences, and many of the problems may be the same for both professions, some root causes for burnout are different in ICU nurses and ICU physicians. Nursing stress is frequently a result of lack of control within an organization, while physicians are subject to long hours and the life or death consequences of ICU decision-making. The Maslach Burnout Index, the most widely used survey intended to identify those with burnout, looks for three main characteristics: exhaustion, depersonalization, and reduced personal accomplishment.

Because job stress affects people in different ways, there is no single way to combat burnout in every practitioner. Some suggestions for avoiding burnout are introduced in this chapter, with the understanding that it is an ever-present threat to those who work in the ICU.

Keywords

Burnout Maslach Burnout Inventory Intensive care Exhaustion Depersonalization Reduced personal accomplishment Moral dilemmas End-of-life policies ICU staffing Sir William Osler Aequanimitas 

References

  1. 1.
    Ladou J. The European influence on workers’ compensation reform in the United States. Environ Health. 2011;10:103. Published 2011 Dec 7.  https://doi.org/10.1186/1476-069X-10-103.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Loughran T. Shell shock, trauma, and the first world war: the making of a diagnosis and its histories. J Hist Med Allied Sci. 2012;67(1):94–119.  https://doi.org/10.1093/jhmas/jrq052.CrossRefPubMedGoogle Scholar
  3. 3.
    Embriaco N, Azoulay E, Barrau K, Kentish N, Pochard F, Loundou A, Papazian L. High level of burnout in intensivists: prevalence and associated factors. Am J Respir Crit Care Med. 2007;175:686–92, https://www.ncbi.nlm.nih.gov/pubmed/27367887CrossRefGoogle Scholar
  4. 4.
    Freudenberger HJ. Staff burn-out. J Soc Issues. 1974;30:159–65.CrossRefGoogle Scholar
  5. 5.
    Ginsburg SG. The problem of the burned-out executive. Pers J. 1974;48:598–600.Google Scholar
  6. 6.
    Heinemann LV, Heinemann T. Burnout research: emergence and scientific investigation of a contested diagnosis. SAGE Open. 2017;  https://doi.org/10.1177/2158244017697154.CrossRefGoogle Scholar
  7. 7.
    Maslach C, Jackson SE. The measurement of experienced burnout. J Organ Behav. 1981;2:99–113.CrossRefGoogle Scholar
  8. 8.
    Maslach C, Schaufeli WB, Leiter MP. Job burnout. Annu Rev Psychol. 2001;52:397–422.  https://doi.org/10.1146/annurev.psych.52.1.397.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Kristensen TS, Borritz M, Villadsen E, Christensen KB. The Copenhagen burnout inventory: a new tool for the assessment of burnout. Work Stress. 2005;19(3):192–207.  https://doi.org/10.1080/02678370500297720.CrossRefGoogle Scholar
  10. 10.
    Salmela-Aro K, Rantanen J, Hyvönen K, et al. Int Arch Occup Environ Health. 2011;84:635.  https://doi.org/10.1007/s00420-010-0594-3.CrossRefPubMedGoogle Scholar
  11. 11.
    Moss M, Good VS, Gozal D, Kleinpell R, Sessler CN. An official critical care societies collaborative statement: burnout syndrome in critical care health care professionals: a call for action. Am J Crit Care. 2016;25:368–76.  https://doi.org/10.4037/ajcc2016133. (Also Chest 2016; 150: 17–26; Am J Respir Crit Care Med 2016; 194:106–13; Crit Care Med 2016; 44: 1414–21)CrossRefGoogle Scholar
  12. 12.
    Poncet MC, Toullic P, Papazion L, et al. Burnout syndrome in critical care nursing staff. Am J Respir Crit Care Med. 2007;175:698–704.CrossRefGoogle Scholar
  13. 13.
    Franklin C. Caring for the notorious patient. Chicago Tribune. 2013;13Google Scholar
  14. 14.
    Burnout syndrome in the ICU – a sign of the times? Lancet Respir Med. 2016;4:593.  https://doi.org/10.1016/S2213-2600(16)30192-8.CrossRefGoogle Scholar
  15. 15.
    Shanafelt TD, Balch CM, Bechamps G, et al. Burnout and medical errors among American surgeons. Am Surg. 2010;251:995–1000.Google Scholar
  16. 16.
    Franklin, C. Newtown tragedy is a reminder that police, first responders also suffer PTSD. The Guardian, 20 March 2013. https://www.theguardian.com/commentisfree/2013/mar/20/newtown-police-post-traumatic-stress-disorder
  17. 17.
    Cimiotti JP, Aiken LH, Sloane DM, et al. Nurse staffing, burnout and health care-associated infection. Am J Infect Control. 2012;40:486–90.CrossRefGoogle Scholar
  18. 18.
    Poghosyan L, Clarke SP, Finlayson M, et al. Nurse burnout and quality of care: cross-national investigation in six countries. Res Nurs Health. 2010;33:288–98.CrossRefGoogle Scholar
  19. 19.
    Kosel K, Olivio T. The business case for work force stability. Irvington: VHA; 2002.Google Scholar
  20. 20.
    Linzer M, Levine R, Meltzer D, et al. 10 bold steps to prevent burnout in general internal medicine. J Gen Intern Med. 2014;29:18–20.CrossRefGoogle Scholar
  21. 21.
    Sokol D. Aequanimitas. BMJ. 2007;335(7628):1049.CrossRefGoogle Scholar
  22. 22.
    Franklin CM. Deconstructing the black box known as the intensive care unit. Crit Care Med. 1998;26:1300–1.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Cory Franklin
    • 1
  1. 1.MICU Cook County HospitalWilmetteUSA

Personalised recommendations