The title of the article “Burnout and Resilience Among Nurses Practicing in High-Intensity Settings” by Rushton, Batcheller, Schroeder, and Donohue (2015) reflects the area and the population of the study: nurses working in high-stress environments. In the beginning, author affiliations and contact information are provided, showing that the investigators are qualified to conduct this research.
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In the introduction, Rushton et al. (2015) discuss the background information about nurses’ exposure to stress and its possible detrimental effects. They also explain such concepts as burnout and resilience. The discussion helps to understand the importance of and the reason for the research in this area. The provided problem statement is as follows: “high-stress levels among nurses can lead to substance abuse, depression, and anxiety,” et cetera (Rushton et al., 2015, p. 413). Additionally, along with study objectives, the researchers list the purpose of the study in a separate paragraph.
The goals include the exploration of factors defining unhealthy/healthy work environments and the examination of the relationships between them and nurses’ perceived level of stress, resilience, and burnout (key variables in the study). As for the theoretical framework, it is not explained in the article, while the hypothesis (i.e., work in high-intensity units predicts burnout) is only implied. The article reports only the results of phase 1 of the total study aimed to “enhance nurses’ resilience while improving retention and reducing turnover through an innovative educational intervention” (Rushton et al., 2015, p. 413). Overall, the study has the potential to resolve the problem of burnout among nurses.
The article does not include a separate Literature Review section, but previous findings are evaluated in the introduction and discussion parts. The data is presented logically and integrated with the interpretation of current findings. Rushton et al. (2015) reveal that study results are consistent with previous findings. They also discuss the evidence about how emotional exhaustion may predict burnout, which indicates a knowledge gap referring to the need to search for strategies aimed to promote emotional stability in nurses.
The sample comprises 180 nurses working in six high-intensity units: “2 pediatric/neonatal, 2 oncology, and 2 adults critical care” (Rushton et al., 2015, p. 414). The sample size is sufficient for measuring the identified variables. The ethical issues of participant recruitment are not discussed in the article.
The study measured such aspects of burnout as moral distress, perceived stress, resilience, work meaning, and hope (dependent variables) and how they are affected by the work environment (independent variable). The study design is a cross-sectional survey, which is appropriate for measuring the outcome and exposures in the target population. The researchers sufficiently describe the used instruments such as the State Hope Scale and Maslach Burnout Inventory, including the information about their validity. The standardized tests ensure a high level of reliability and minimize possible interrater biases.
The collected data is analyzed by using descriptive tools: one-way ANOVA ̶ for comparison of group means, and multiple variable linear regression ̶ for identification of burnout predictors. The results related to demographic characteristics, as well as links between specialty areas, duration of work, and burnout, are provided in detail in the table format. For instance, Rushton et al. (2015) note that “nurses with 3 to 10 years of experience had the highest mean scores on emotional exhaustion and depersonalization,” which are defined as significant predictors of burnout (p. 415). The results are discussed and interpreted by using previous research evidence, and the interpretation supports the study hypothesis.
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The main limitation of the study is that “114 of 180 possible participants (63%) were enrolled from a single health system,” decreasing the possibility to generalize findings (Rushton et al., 2015, p. 418). As for the future research recommendations, Rushton et al. (2015) suggest exploring the links between “empathy, perspective-taking, and personal accomplishment and how the erosion of empathy contributes to depersonalization” (p. 418). Lastly, a potential implication of the findings is that they can be used in designing strategies aimed to increase nurses’ resilience to stress. At the same time, the study does not induce any risks, which makes it highly beneficial and valuable.
Rushton, C. H., Batcheller, J., Schroeder, K., & Donohue, P. (2015). Burnout and resilience among nurses practicing in high-intensity settings. American Journal of Critical Care, 24(5), 412-420.