Classic Signs of Burnout

(as measured by the Maslach Burnout Inventory)1

Emotional Exhaustion Depersonalization Reduced Accomplishment
Ongoing exhaustion in one or more of the three levels: energy, emotion, spirit
Cynicism, detachment from job duties, low empathy, silence, passivity
Questioning self, doubting if work really makes a difference, loss of purpose

Classic Signs of Moral Distress2

Affective Symptoms Cognitive Symptoms Somatic Symptoms Behavioral Symptoms
Frustration, anger, depression, powerlessness, helplessness
Loss of self-worth, loss of sense of self
Fatigue, pain, sleeplessness, heart palpitations, nightmares
Gossip, tardiness, absenteeism, distancing, violence, work avoidance

Impacts of Burnout and Moral Distress

Healthcare Provider3,4 Patient5-10 Institution11
Job dissatisfaction, career changes, health and mental health issues, reduced sensitivity to moral issues, substance abuse, anxiety, depression
Basic care and supervision issues, missing vital tasks, medication and task errors, provider blindness, harm, hiding errors
Working around the system, unethical actions, retention issues, negative work climate, financial loss

If you’re interested in case-based education related to burnout and moral injury for your healthcare providers, please contact us at info@med-iq.com.

1 Maslach, C.; Jackson, S.E.; Leiter, M.P. (1996–2016). Maslach Burnout Inventory Manual (Fourth Edition). Menlo Park, CA: Mind Garden, Inc.
2 National Nurse (2012). Workplace violence: Assessing occupational hazards and identifying strategies for prevention: Part I. National Nurse108(1), 18-27.
3 Burston, A.S. & Tuckett, A.G. (2013). Moral distress in nursing: Contributing factors, outcomes and interventions. Nursing Ethics20(3), 312-324.
4 Lamiani, G.; & Borghi, L. & Argentero, P. (2015). When healthcare professionals cannot do the right thing: A systematic review of moral distress and its correlates. Journal of Health Psychology, 1-17.
5 Burston, A.S. & Tuckett, A.G. (2013). Moral distress in nursing: Contributing factors, outcomes and interventions. Nursing Ethics20(3), 312-324.
6 Corley, M. C. (2002). Nurse moral distress: A proposed theory and research agenda. Nursing Ethics, 9(6), 636-650. 
7 McCarthy, J. & Gastmans, C. (2015). Moral distress: A review of the argument-based nursing ethics literature. Nursing Ethics22(1), 131-152.
8 Peleki, T.; Resmpitha, Z.; Mavraki, A.; Linardakis, M. et. al., (2015). Assessment of patients and nurses’ opinions on the bidirectional communication during hospitalization: A descriptive study. Health Science Journal9(3), 1-7.
9 Pauly, B.M.; Varcoe, C. & Storch, J. (2012). Framing the issues: moral distress in health care. HEC Forum24(1), 1–11.
10 Wilson, M.A.; Goettemoeller, D.M.; Bevan, N.A. & McCord, J.M. (2013). Moral distress: levels, coping and preferred interventions in critical care and transitional care nurses. Journal of Clinical Nursing22, 1455–1466.
11 Burston, A.S. & Tuckett, A.G. (2013). Moral distress in nursing: Contributing factors, outcomes and interventions. Nursing Ethics20(3), 312-324.  

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