What is causing nurses stress? The American Holistic Nursing Association (2015) lists staffing (or the lack thereof ), schedules (rotating), long shifts (often back to back), fatigue (both mental and physical), excessive noise in the workplace, workload (too much to
do), time pressures (not enough time to get the work done), difficult colleagues (teamwork or the lack of ), supervisors (not qualified for the role and/or not supportive of staff needs), challenging patients and families (sicker patients and families with unrealistic expectations), a lack of control in the work environment (mandates driven by others), role conflict, ambiguity, inadequate resources of all types, floating to new work areas with little or no orientation, underuse of talent, exposure to toxic substances, and the potential to experience hostility or violence (by patients, visitors, or co-workers), to name a few. Although this is not an exhaustive list of the challenges nurses face, it a fairly comprehensive list of what might qualify as daily stressors in the work environment.

Why are nurses burning out? Three out of four nurses cited the effects of stress and overwork as a top health concern in a 2011 survey by the American Nurses Association (ANA); the ANA attributed problems of fatigue and burnout to what seems to be a chronic nursing shortage (ANA, 2011). Recent research has found nurses working shifts longer than 8 to 9 hours were two-and-a-half times more likely to experience burnout (Gupta, 2015). A 2012 study by Stimpfel, Sloan, and Aiken revealed that nurses underestimate their own recovery time from long, in- tense clinical engagements and that consolidating challenging work into shorter time frames may not be a sustainable strategy to attain work-life balance.

In addition, researchers at the University of Akron (Dill and Erickson) found in 2014 that nurses who are primarily motivated by the desire to help others, rather than enjoyment of work, were more likely to burn out (American Sociological Association, 2014). Could we be our own worst enemies? Should education and awareness about the potential for burnout begin in formal nursing training? Should selection criteria to become a nurse include an assessment for motivation and the potential to burn out?

Nurses are qualitative experts; we are constantly gathering information on a daily basis. What we have not been quite as good at is collecting formal data, analyzing it, and sharing evidence in our practice environments. If nurses were able to use the information they collect more effectively, or on a real-time basis, could it decrease the potential for burnout? If nurses were allowed more autonomy in role design, assessing job fit, and analyzing systems affecting their work, and given training for optimal interpersonal relationships, it is plausible that burnout could be lessened and maybe entirely avoided.

In addition, what are the responsibilities of nurses and nurse leaders collaboratively in relation to stress, fatigue, and burnout in nursing?