chapter 13 | Work-Related Stress and Burnout 207main causes of the shortage are individuals not
entering the profession and nurses leaving. As dis-
cussed, one reason for leaving is burnout. A recent
study of 106 nurses demonstrated that the three
dimensions of burnout (emotional exhaustion,
depersonalization, and personal accomplishment)
were correlated with work excitement. Work
excitement is defined as “personal enthusiasm
and commitment for work evidenced by creativi-
ty, receptivity to learning, and ability to see
opportunity in everyday situations (Sadovich,
2005, p. 91). Work excitement factors include:
work arrangements, variable work experiences,
the work environment, and growth and develop-
ment opportunities. As you pursue your nursing
career, consider looking for positions that support
a favorable work environment.
A Buffer Against Burnout
The idea that personal hardiness provides a buffer
against burnout has been explored in recent years.
Hardiness includes the following:
■A sense of personal control rather than power-
lessness
■Commitment to work and life’s activities rather
than alienation
■Seeing life’s demands and changes as challenges
rather than as threats
The hardiness that comes from having this perspec-
tive leads to the use of adaptive coping responses,
such as optimism, effective use of support systems,
and healthy lifestyle habits (Duquette, Sandhu, &
Beaudet, 1994; Nowak & Pentkowski, 1994). In
addition, letting go of guilt, fear of change, and
the self-blaming, “wallowing-in-the-problem” syn-
drome will help you buffer yourself against burnout
(Lenson, 2001).
Ask yourself, “What can I possibly do as a new
graduate? I don’t even have a job yet, let alone
understand the politics of health-care organiza-
tions.” It is never too early to understand yourself—
what triggers stressful situations for you, how you
respond to stress, and how you manage it.
Stress Management
Although you cannot always control the demands
placed on you, you can learn to manage your reac-
tions to them and to make healthy lifestyle choices
that better prepare you to meet those demands.
ABCs of Stress Management
Frances Johnston (1994) suggested using the
ABCs of stress management (awareness, belief, and
commitment) in order to have as constructive a
response to stress as possible (Box 13-2).Awareness
How do you know that you are under stress and
may be beginning to burn out? The key is being
honest with yourself. Asking yourself the questions
in Box 13-3 and answering them honestly is one
way to assess your personal risk. To analyze your
responses to stress further, you may also want to
answer the questions in Box 13-4. The answers to
these questions require some thought. You do not
have to share your answers with others unless you
want to, but you do need to be completely honest
with yourself when you answer them or the exercise
will not be worth the time spent on it. Try to deter-
mine the sources of your stress (Goliszek, 1992):
■Is it the time of dayyou do the activity?
■Is it the reasonyou do the activity?
■Is it the wayyou do the activity?
■Is it the amount of timeyou need to do the activity?
Another suggestion is to keep a stress diary. People
often have “flash points” that send stress levels sky-
rocketing. Keeping a stress diary often helps in
identifying these triggers. Identify the date, time,
situation, scale (on a scale from 1 to 10), symptoms,
reaction, and efficiency (on a scale from 1 to 10,
how well did you cope with this stressor?). What
was your reaction? Did you solve the problem, qui-
etly seethe, or become reactionary? After 2 weeks,
analyze the diary, and reflect on where and when
your highest stress levels occured. Keep your stress
diary for as long as you think necessary in order to
identify personal stress triggers and patterns of
behavior (Bruce, 2007).box 13-2
ABCs of Stress Management
Become Awareof your own responses to stress and the
consequences of too much stress.
Believethat you can change your perspective and your
behavior.
Commityourself to take action to prevent conflicts that
cause stress, to learn techniques that help you cope in
situations over which you have no control, and to understand
that you can choose how to react in stressful situations.