Often, life circumstances develop so that a person has to choose such a professional activity, which does not always positively affect their emotional and physical condition. These types of work include the professional training of medical personnel, which involves vibrant saturation and psychophysical stress. This can lead to the emergence of the emotional burnout syndrome. Even yesterday, such attitudes as indifference towards patients, disregard to their duties, ignoring colleagues’ opinions, dissatisfaction with work were manifestations of professional moral failure. Today, they are considered forms of expression of the professional burnout syndrome. Many medical professionals, especially nurses, are exposed to professional burnout without proper and practical guidance and leadership.
The Concept of Professional Burnout
The state of professional burnout is a complex syndrome accompanied by severe physical and moral exhaustion, alienation, and a decrease in the importance of achievements at work. It is caused by intense interpersonal interaction when working with people, accompanied by emotional saturation and cognitive complexity (Malloch, 2017). See (2018) claims that “professional burnout leads to the need for employees to seek professional help, which contributes to the emergence of a large number of psychological assistance centers” (para 3). The medical staff of medical institutions is the most numerous, taking on the most significant part of the workloads in providing medical and preventive care to the population (Malloch, 2017). Thus, in the study of ways to improve the effectiveness of medical, diagnostic, and preventative work of a medical institution, much attention should be paid to the features of the professional activity of medical personnel.
Currently, there is no single view on the structure of the professional burnout syndrome. Still, despite the differences in approaches to its study, it can be noted that it predetermines personal deformation (García‐Sierra, 2018). According to See (2018), “the symptoms of professional burnout indicate the characteristic features of prolonged stress and mental overload, which can lead to complete disintegration of various mental spheres” (para 4). Such a person often experiences anger, resentment, and bitterness; increased irritability manifested at work and home.
A person who is tired of work has significant changes in thinking and health, such as persistent thoughts about leaving a job and a decrease in concentrating attention. A medical worker experiencing professional burnout has disturbed sleep, increased susceptibility to infectious diseases, fatigue, and exhaustion during the day (García‐Sierra, 2018). However, this phenomenon may be closely related to how leadership is implemented in a particular medical institution. Adequate and correct guidance, and timely psychological support are vital, as they can prevent burnout of medical workers.
The Role of Transformational Leader in Nursing
One of the most effective leadership strategies in nursing is the transformational leadership model. In 1978, a book on leadership theories was published by James MacGregor Burns, in which he presented a theory of leadership, to which he gave the name transformational leadership (Giddens, 2018). Transformational leaders have the following qualities: honesty, fairness, and practical communication skills. Such leaders provide support and recognition, set clear goals, encourage and inspire others. This approach brings many positive changes, with the ultimate goal of turning followers into equally excellent and effective leaders. The support and understanding from the transformational leader can help nurses implement self-care and avoid possible professional burnout. The transformational leader takes care of the individual and also makes them a part of the team. The introduction of this theory in nursing will provide moral support, high motivation, and enthusiasm, despite the profession’s difficulties.
A big responsibility lies with the senior nurse, a responsible mentor, and an effective manager leader. The senior nurse should show that they care about the team and talk to subordinates if they notice any problems that may affect the work. As a transformational leader, a senior nurse should create a friendly atmosphere in their team. According to Seljemo (2020), “the transformational leader will also identify the organizational needs and work to transform the organizational culture, to the benefit of the organization itself” (para 1). Seljemo (2020) claims that “research suggests that a transformational leadership style positively influences nurses’ job satisfaction, work engagement and the psychosocial work environment, which also reduces the occurrence of adverse events in clinical practice” (para 2). Thus, connections between medical staff members will be established, the risks of professional burnout will be reduced, and the conditions of patient care will be improved.
In addition to various personal skills, transformational leaders should have impeccable personal and moral qualities to earn respect and trust of people. Moreover, such a leader should have the courage to tell the truth to the authorities and always act following their moral principles. Seljemo (2020) states that “adopting a transformational leadership style can also reduce factors related to burnout in nurses” (para 2) The concept of transformational leadership in global health is closely related to the idea of strategic leadership. Strategic management explains how public administration bodies and other social institutions interact, build relationships with citizens and make decisions (Borkowski & Meese, 2020). Transformational leaders should have a rich imagination, as well as good management skills, and always take into account scientific data.
In other words, unlike official powers or authority, leadership is primarily the ability to exert influence. Transformational leaders inspire others and strive to form and implement a shared vision. According to Seljemo (2020), “the American Institute of Medicine recommends leaders to adopt a transformational leadership style to create optimal working conditions for nurses, which is essential to prevent accidents and improve patient safety” (para 3). They are focused on the future and on what is possible. Influential transformational leaders demonstrate what needs to be done and motivate others to act, filling them with a sense of clarity, the direction of actions, and the integrity of the formulated perspective vision. At the individual level, leadership does not require a specific position or title. Transformational leadership is characterized by sincerity, so leaders serve as an example for others, keep their word, and communicate with people.
It becomes apparent that effective and responsible leadership can have a beneficial effect on the psychological state of nurses and prevent professional burnout. As mentioned above, in professional burnout, a medical employee loses a sense of the value of life. Seljemo (2020) claims that “transformational leadership was a strong predictor of patient safety culture and overall perception of patient safety” (para 5) The development and implementation of transformational leadership strategy are necessary for all medical institutions since a person who occupies the position of a leader can influence the situation at a critical moment (Al-Ali et al, 2017). According to Seljemo (2020), “transformational leaders are capable of seeing employees’ individual needs and keep them intellectually stimulated, which might impact employees’ willingness to acquire new knowledge and develop new skills” (para 5). A natural leader takes care of their subordinates, which means they will see the signs of professional burnout in time and take the necessary measures.
Since the beginning of the global economic crisis, significant political, economic, social, and technological changes have taken place in the ten years. An even more substantial amount of scientific knowledge and information about the health effects of numerous determinants has been accumulated (Al-Ali et. al, 2017). Particular attention was paid to improving overall health and well-being indicators and reducing health inequalities, focusing on vulnerable citizens (Al-Ali et. al, 2017). Approaches to enhancing health make it necessary to use new skills and new behaviors at the organizational level, facilitated by strengthened public health capacities and services.
The practical communication skills developed by the transformational leader will help them understand the current problem and develop a solution. A charismatic ethical leader creates a specific cultural environment, inspires their followers, helps cope with stress and burnout. A person who knows how to lead can find a solution to a problematic situation and options for actions that improve the team’s work and unite it. Seljemo (2020) states that “transformational leadership has a positive effect on healthcare personnel’s job satisfaction, which seemed to decrease the occurrence of adverse events and improve the quality of care” (para 6). In such an emotionally tricky profession as nursing, it is essential to trust a leader and know that this person is responsible, fair, and honest. Nurses should be confident that they will not be left in a difficult situation but will be helped and directed.
Transformational Leadership in Nursing
I am a registered nurse and have been working in the operating room for more than five years. Naturally, I never thought that the profession I chose would be simple, but I was sure that I would cope with any difficulties. Unfortunately, I was wrong because four years ago, I began experiencing depression, alternating with outbursts of irritation. I stopped getting any pleasure from work and life; everything around me lost its color and meaning. I realized that I had become a victim of a common but dangerous nervous disorder – a professional burnout. I struggled with this condition for two years.
I began experiencing intense emotional exhaustion and lost the desire to go somewhere other than work and home. My family told me that I had become detached from them and ceased being interested in their lives altogether. To my horror, I realized that I did not care about the feelings and experiences of patients, who had always been in the first place for me before. I developed cynicism and a frightening indifference, which started affecting my work. It seemed that attempts to achieve something at work and in life were in vain, and the goals set were too far away. I struggled with constant fatigue and the inability to control myself. Periods of absolute indifference were constantly replaced by the desire to cry and scream all day long.
Probably, the fact of what happened should be considered, given that I am an empathetic and emotional person. My responsiveness, the tendency to perceive someone else’s pain as my own, borders on pathology with self-destruction. Burnout manifested itself in me as an inadequate response to patients and my colleagues. I lost my emotional involvement and the ability to empathize with patients, which reduced professional responsibilities and the negative impact of work on my personal life. This job became a second home for me since I spent most of my time there. I took everything to heart; any failures and disappointments hurt me to the core. I reacted to problems at work more acutely than to issues in the family. At some point, this kind of “love” was transformed into hatred.
Before I realized what was happening to me, I went through three stages of professional burnout. At first, I was full of enthusiasm, and I was happy to take on any tasks and stayed late at work. This state did not last long until the first severe stresses and failures. After that, my activity and efficiency decreased, and even a promotion would not have brought proper satisfaction. Then the second stage began, characterized by constant fatigue, insomnia, lack of interest in work, and life in general. I began to shy away from fulfilling my duties, which caused relations with my superiors and colleagues. During the third stage, unpleasant symptoms appeared: irritability, depression, and emotional exhaustion increased. I became addicted to coffee and energy drinks, and I even started smoking cigarettes.
I needed to recognize the existence of a problem and the need to deal with it. My indifference has become a threat to my life and the lives of patients. I was helped out of this state by a senior nurse who was my mentor for a long time and taught me everything. She was a natural leader, fair and responsible, and always knew how to organize the team’s work. She knew how to achieve excellent interaction and mutual understanding from us to solve the tasks set quickly. Due to the practical application of the transformational leadership theory, the senior nurse helped me survive professional burnout and cope with its consequences. This leadership style implies a process in which the leader overcomes selfish aspirations to increase the level of consciousness of his subordinates. This theory includes an individual approach, intellectual stimulation, inspiring motivation, and idealized influence.
The senior nurse constantly assigned me a particular time in a separate room and talked to me one-on-one for a long time, not criticizing my actions but only listening attentively. She did not insist on the correctness of her words, but she took my problem calmly. The senior nurse listened to my thoughts and experiences because she realized that it was essential to understand my needs and feelings. In this way, she analyzed the difficulties I had encountered and took them seriously and professionally instead of accusing me of laziness and indiscipline. We met with her for several months, talking in a room, before realizing that my problem required a severe and immediate intervention. After that, my path of rethinking and restoring emotional balance began.
The senior nurse always approached all her subordinates individually, found her tactics for each person, which also characterized her as a natural leader. Thanks to her valuable advice, I began to rest more and devote more time to myself. I allocated 10-15 minutes during the working day and listened to soothing music or engaged in coloring books. Every day, I tried to highlight from three to five positive moments in work and communication with other people to tune in to a positive mood. When I came home, I left thoughts about work, tried to forget about all the unpleasant things that happened to me during the day. In addition, I took up yoga, and then the senior nurse began educating me in leadership skills to avoid a repeat of such a situation in the future.
She explained to me how important it is to cultivate charisma, confidence, and communication skills. Due to her, I learned that I need to overcome the fear of failures and disappointments since they are an integral part of our life. The senior nurse aroused in me the strongest motivation to be like her – the same purposeful and strong-willed person who knows how to inspire others. I adopted the transformational leadership style in patient care and interaction with colleagues from this amazing woman. All this led to the fact that I began communicating with patients, colleagues, and relatives differently. The transformational leadership model instilled high goals and motives in me, as well as the desire to develop myself and inspire other people to self-development.
As a leader, I have learned to make my subordinates understand the critical problems of a group or organization and interest them in achieving, growing, and developing. Now I strive to improve patient care and nursing conditions and attract others with me. After a year of mental anguish and complete indifference, I am finally utterly confident in the future. I have learned to perceive failures positively and inevitable tragedies calmly. Given the specifics of our work, it is necessary to calm down a person on the verge in time to protect him from jumping into the abyss. As a leader, I realized how important it is to quickly deal with the excitement and listen to the person with attention.
Becoming a transformational leader, I began treating my colleagues more carefully, realizing that they may be at risk of professional burnout. Patients have ceased to be the meaning of my life, but they have remained an essential element of my work, an indicator of my professional and human growth. My family now respects me and sees me not as a workaholic but as a person who controls his life and can make difficult decisions independently. My family members know they can turn to me for advice if something is gnawing at them because silence is the worst option, leading to terrible consequences.
Talking to patients, I try to inspire them to realize their dreams and aspirations. I tell them my story about how I almost reached the edge, but I could fix it. I like sharing my experience with people because I can also save someone’s career and life one day. This event almost became a tragedy for my family and me, but I survived this period and learned an essential lesson. I realized how important it is that to have the right mentor at the right moment, a leader who could guide you on the right path. Nurses face death every day, so they are under constant stress, seriously affecting their mental and physical health. Every day we witness terrible events that are forever imprinted in our memory, causing depression and burnout.
Nurses are a high-risk group that needs the practice of constant moral support and effective leadership. Every medical institution needs a leader who will carefully monitor the emotional state of the staff. If someone has signs of emotional burnout, a natural leader should talk to this person, and assess the seriousness of the situation. The belief in the correctness of their actions, the high goals of the organization, and confidence in the future will help facilitate professional burnout among nurses and prevent it in time.
Al-Ali, A. A., Singh, S. K., Al-Nahyan, M., & Sohal, A. S. (2017). Change management through leadership: the mediating role of organizational culture. International Journal of Organizational Analysis. 25 (4), 723-739. Web.
Borkowski, N., & Meese, K. A. (2020). Organizational behavior in health care. Jones & Bartlett Learning.
García‐Sierra, R., & Fernández‐Castro, J. (2018). Relationships between leadership, structural empowerment, and engagement in nurses. Journal of Advanced Nursing, 74(12), 2809-2819. Web.
Giddens, J. (2018). Transformational leadership: What every nursing dean should know. Journal of Professional Nursing, 34(2), 117-121. Web.
Malloch, K. (2017). Quantum leadership: Creating sustainable value in health care. Jones & Bartlett Learning.
See, K. C., Zhao, M. Y., Nakataki, E., Chittawatanarat, K., Fang, W. F., Faruq, M. O.,… & Phua, J. (2018). Professional burnout among physicians and nurses in Asian intensive care units: a multinational survey. Intensive care medicine, 44(12), 2079-2090. Web.
Seljemo, C., Viksveen, P. & Ree, E. (2020).The role of transformational leadership, job demands and job resources for patient safety culture in Norwegian nursing homes: a cross-sectional study. BMC Health Serv Res 20, (799). Web.