Scoping review with textual narrative synthesis of the literature reporting stress and burn-out in specialist nurses: making the case for inflammatory bowel disease nurse specialists

Abstract

ObjectiveInflammatory bowel disease clinical nurse specialists (IBD-CNSs) face increasing pressures due to rising clinical and patient demands, advanced complexity of work role, and minimal specialist management training and support. Stress and burn-out could undermine the stability of this workforce, disrupting clinical provision. We reviewed the literature on stress and burn-out to demonstrate the lack of evidence pertinent to IBD-CNSs and make the case for further research.DesignFollowing Levac et al’s scoping review framework, relevant databases were searched for publications reporting work-related stress and burn-out among specialist nurses. Following screening and consensus on selection of the final articles for review, all authors contributed to data charting. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Review extension guided reporting of the review.ResultsOf 194 retrieved articles, eight were eligible for review. None focused on IBD-CNSs, were qualitative, or UK-based. Three core themes were identified: Rates of Burn-out, Mitigating and Alleviating Factors, and Preventing and Resolving Burn-out. Risk of burn-out is greatest in novice and mid-career CNSs. Age and duration in role appear protective. Personal achievement is also protective and can mitigate earlier episodes of burn-out; opportunities for career progression are limited. Promoting personal well-being is beneficial. Senior managers have poor understanding of the role and provide inadequate support. Commitment to patients remains high.ConclusionBurn-out arises in CNSs across clinical specialisms in the international literature and has a significant negative effect on the workforce. Further research is needed to address the dearth of evidence on burn-out in IBD-CNSs in the UK.

Burnout among Junior Nurses: The Roles of Demographic and Workplace Relationship Factors, Psychological Flexibility, and Perceived Stress

“…Burnout is a complex multifactorial problem that is not easily addressed, even among nurses. Individual-specifc factors (such as demographic variables, stress, psychological fexibility, personality, and coping strategies) and existing workplace factors (like job demands, job control, and organizational support) have been found to have varying degrees of relationships with burnout levels in numerous studies [17][18][19][20][21].…”

“…Cognitive fusion can enhance an individual's believability of negative thoughts, leading to emotional discomfort [32]. Studies have shown that the lower the psychological fexibility was, the more the clinical nurses were tired of their job [20]. Meanwhile, the literature indicated a direct and predictive relationship between psychological infexibility and burnout among nurses in the acute phase of the epidemic [33].…”