A Social Theory of Burnout For Intensive Care Unit Nurses
Joseph Peter Swindeman, Saint Louis University, Saint Louis, MO
It is in the interest of all parties to relieve burnout in nurses. And yet, while burnout has received significant consideration in the literature, there remains little social theorization of the condition of burnout as it appears in this population. Currently, the primary model of redressing this condition has been behavioral, attempting to equip nurses with the coping skills necessary for work within traumatic environments. Hospitals that provide and promote workshops on these coping skills attempt to move nurses from a place of psychological fatigue to a place of psychological resilience by developing in nurses the skills necessary to rest and replenish their ability to show compassion.
While these workshops may be helpful, and such coping skills are beneficial and even necessary for nurses to flourish within the field, there remains a problem if we come to consider burnout myopically with a behavioralist lens. This paper proposes a psychology of Burnout that is informed by Social Theory and seeks to develop a new multidimensional social approach to relieving the condition, especially within nurses who work in Intensive Care Units (ICUs). My study seeks to illustrate a social and psychological theory of how nurses come to experience Compassion Fatigue using social critical methods and a social theory of burnout provided by Byung-Chul Han. Although I base my study on Han’s theory of burnout, I depart from some aspects of Han’s theory of society—that presumes there is a strong difference between an achievement society, which is a society that exploits persons using the positive imperative to perform and a disciplinary society, which is a society that exploits persons through repressive punishments.
ICU nurses are at the nexus of both an achievement society and a disciplinary society, experiencing maladies that are proper to both. In short, although they are disciplined by their managers into performing a standard of care, this standard of care functions as an ideal that nurses are supposed to be. Confusing the superego—the embodiment of the expectation of their managers—and the ego-ideal—that is, the ideal form of themselves, nurses face exploitation both as members of the disciplinary society of medicine and as members of an achievement society. Psychologically, it is primarily their membership in achievement society that leads to burnout.
Burnout requires a fundamentally religious solution—that is, the development of a contemplative life. Four steps or conditions are necessary to relieve burnout. First, the subject must develop a Negative Freedom—the Freedom not to do something. Second, they must experience profound boredom to experience an extreme of mental relaxation. Third, they must, develop a contemplative life, in which they experience the freedom to experience being, beauty, and eternal truths. Finally, they must learn to master their attention to attend to reality apart from themselves.
While these workshops may be helpful, and such coping skills are beneficial and even necessary for nurses to flourish within the field, there remains a problem if we come to consider burnout myopically with a behavioralist lens. This paper proposes a psychology of Burnout that is informed by Social Theory and seeks to develop a new multidimensional social approach to relieving the condition, especially within nurses who work in Intensive Care Units (ICUs). My study seeks to illustrate a social and psychological theory of how nurses come to experience Compassion Fatigue using social critical methods and a social theory of burnout provided by Byung-Chul Han. Although I base my study on Han’s theory of burnout, I depart from some aspects of Han’s theory of society—that presumes there is a strong difference between an achievement society, which is a society that exploits persons using the positive imperative to perform and a disciplinary society, which is a society that exploits persons through repressive punishments.
ICU nurses are at the nexus of both an achievement society and a disciplinary society, experiencing maladies that are proper to both. In short, although they are disciplined by their managers into performing a standard of care, this standard of care functions as an ideal that nurses are supposed to be. Confusing the superego—the embodiment of the expectation of their managers—and the ego-ideal—that is, the ideal form of themselves, nurses face exploitation both as members of the disciplinary society of medicine and as members of an achievement society. Psychologically, it is primarily their membership in achievement society that leads to burnout.
Burnout requires a fundamentally religious solution—that is, the development of a contemplative life. Four steps or conditions are necessary to relieve burnout. First, the subject must develop a Negative Freedom—the Freedom not to do something. Second, they must experience profound boredom to experience an extreme of mental relaxation. Third, they must, develop a contemplative life, in which they experience the freedom to experience being, beauty, and eternal truths. Finally, they must learn to master their attention to attend to reality apart from themselves.