Nurses and burnout syndrome

© 2013 Obradovic et al.; licensee University of Sarajevo Faculty of Health Studies. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. UNIVERSITY OF SARAJEVO FACULTY OF HEALTH STUDIES ABSTRACT


INTRODUCTION
Th e work of nurses is very human because they help people in saving their health and protection against diseases.Th e role of nurses in the social community is important because they have an infl uence on creating positive habits related to health.Th eir role in the health system is also great because they make up the largest percentage of health workers and are a part of each team (1).In order to fulfi ll their obligations correctly, nurses should be emotionally mature and stable persons which can understand human suff ering and deal with them.Th ey need to know how to adequately function in emergencies and respond fairly to solve

RESEARCH ARTICLE
Open Access many ethical dilemmas.Performing all of these jobs and tasks leads to physical as well as intellectual exhaustion that deepens from day to day.In the last years the term "burnout syndrome" is used for these conditions and represents a set of physical and mental exhaustion symptoms which mostly occur as a delayed response to chronic emotional and interpersonal stressful events in the workplace.Burnout syndrome (BOS) is a psychological state resulting from prolonged exposure to job stressors.
Nurses are considered to be particularly susceptible to burnout.Measuring burnout among nurses is important because their well-being has implications for stability in the healthcare workforce and the quality of care provided (2).Th e fi rst talks on the phenomenon of burnout began in highly industrialized countries, and now this is an unavoidable issue worldwide (3,4)

METHODS
Out study was the fi rst study of burnout syndrome in Regional Medical Center "Dr Safet Mujic" Mostar and we decided to take as a sample 30% of employed nurses (from the total number of 312 our sample were 104 nurses).
In the random sample we included 30% of nurses from every department.
For the research we used own questionnaire with 20 questions.It was done anonymously.Our research is a cross sectional descriptive study, conducted in January and February 2012.We researched age structure and work experience of nurses in Regional Medical Center "Dr Safet Mujic" Mostar, Bosnia and Herzegovina and the attitude of nurses towards overload at work, interpersonal relationships and their motivation to work.

DISCUSSION
Burnout syndrome has become a great problem in all countries of the world, in almost all professions.Among health care workers nurses are considered to be particularly susceptible to burnout.Although nurses on all departments are exposed to the risks, nurses on some departments are especially exposed.Among the most vulnerable groups of nurses are those working in hospitals.Our results are similar with results authors form Croatia, Hungary and China (1-4).
In our study the most nurses (77.9%) work in hospitals and we can consider the results adequate for nurses working in hospitals.Despite that, not all departments inside the hospital have the same exposure to factors which lead to burnout and thus intensive care, oncology and neonatology units are considered the most critical (5-8).
Younger nurses reported higher levels of burnout in our study and the study in China (9).Although there is an objective need for nurses on many departments, there are not enough employments for them.For that reason, some nurses wait for years before they get their fi rst job.As a result there is a discrepancy between age and work experience (10-12).
In the meantime, the risk of forgetting things, introduced new techniques and technologies create fear of failure at work.A study conducted in China shows that a more frequent burnout in younger and less educated nurses is statistically signifi cant (13).One of the major risks which leads to burnout is overwork.Even 83.7% of our examinees consider that the number of nurses working on their departments is not suffi cient for the amount of work.Similar data are found in Croatia in a study by authors   Kopačević and Protkrić (1).A study made in China shows that a big infl uence on burnout at work have also long working hours, which means that more than 10 working hours per day leads to overload (9).Th e most of our examinees work in shifts which last for 12 hours, thus this type of risk is present.
Other factors that might lead to burnout are related to the working environment.In our study only 34.6% of nurses are satisfi ed with interpersonal relations at their department.Th e possibility to make progress is one of the important motivation factors which contribute to the decreasing of burnout.On the question if they think they can make progress at work, almost 2/3 (71.2 %) of nurses answered negative and consider that they will not have a chance for progress during their work .Th is certainly causes a dose of discontent.Th ese devastating facts lead to the condition that 51% nurses don't feel motivated to do their job.Studies of diff erent authors pointed out the necessity of creating positive working atmosphere as a basic precaution for good quality work of nurses (13)(14)(15).Working stress and burnout at work eff ect the life quality which can be seen from our results and which authors from Pakistan (16).
Only 38,5% of our examinees sleep well and even 56.7%get up tired.It is interesting that half of our examinees feel bad because of their work.
One interesting fact in our study is that, according to their answers, even 85.6% of examinees manage to separate work from private life and they don't think at home about the problems at work.Even 75% of the nurses look diff erently on their job now and 41.3% would like to change their workplace.Similar results are presented in the papers by authors from India and Australia (17,18).

CONCLUSION
Nurses employed in Regional Medical Center "Dr Safet Mujić" in Mostar assess their working environment as very conductive for the appearance of stress and burnout.As our study is the fi rst of this kind, conducted on a small sample, it is necessary to conduct additional, more detailed studies for reliable conclusions and planning of prevention measures and decrease of burnout syndrome at work All results, including the ones from cited authors and ours, indicate the need to improve working conditions of nurses.Among the most important measures which are proven to lead to improvement are: decreasing of overtime, decreasing of unpaid overtime hours and creating of better working environment.Implementation of these measures would significantly contribute to the improvement of life quality of nurses.
to working place in our sample are 77.9%nurses from the hospital and 22.1% which work in primary health care.Th e nurses belong to diff erent age groups.Th e mean age is 41,4 ± 16 years.In the structure the most common is the age group from 31-40 years old (36.5%), and the rarest is the age group 20-30 years, with only 15.4%.
(Figure1) Th e most nurses have a long work experience, longer than 16 years (52%).In the structure 26% of all nurses are with work experience from 16 -20 and longer than 20 years.Th e lowest percentage,11.5% are the nurses with work experience 6-10 years (Figure2).In Table1we will present answers on the questions about the attitude of nurses.FIGURE 1. Sample structure by age groupsFIGURE 2. Work experienceTh e big percentage of nurses, 83.7% think the number of nurses according to job preferences in not adequate, and 71.2% think they cannot make progress at working place.In Table2are the main burnout symptoms present in this group.Only 38.5% of our examinees sleep well, 56.7% get up tired, 50% feel bad because of their work.

TABLE 1 .
Questions about the attitude of nurses

TABLE 2 .
Questions about the burnout symptoms