The lived experience of transcending burnout as described by community mental health nurses working within a crisis assessment and treatment team (CATT) service

摘要

This research study was undertaken in order to explore the phenomenon of transcending burnout as described by mental health nurses working as part of Crisis Assessment and Treatment (CAT) Teams (operating in the community) including Enhanced CAT (ECAT) Teams. Community mental health nursing has repeatedly been reported to be a highly stressful and demanding working environment with community mental health nurses being considered to be at high risk of becoming burnt out. This has the potential to contribute to deterioration in the quality of care or service being provided, high rates of job turnover and workforce instability, absenteeism, and low individual and team morale. At a personal level burnout contributes to a variety of personal issues including physical and emotional exhaustion, insomnia, increased use of alcohol and drugs, and marital and family problems. Nurses working on CAT Teams are at high risk of burnout due to the high levels of acuity, risk and unpredictability in the consumers they provide care for. A descriptive phenomenological approach in the Husserlian tradition was chosen to guide the research process with Colaizzi’s (1978) method utilised to structure the data analysis process. Data was collected via in-depth, semi-structured interviews with 12 participants. Nine emergent themes were explicated: (1) Personal Strength: Grim Determination, Pragmatism and Optimism, (2) Reaching for Support, (3) Weathering the Storm, (4) Making Sense of the Personal Non-Sense and Re-Finding Clinical Meaning, (5) Regaining Balance and Lost Control, (6) Transcending Through Connection with the World Outside, (7) Rebuilding the Boundaries and Affirming Realistic Expectations, (8) Transcending Burnout as the Road Goes Ever On and (9) Increasing Confidence in Credibility. Ultimately, transcending burnout involved the participants undergoing an intense though achievable journey. In the earliest phase of the experience, the experience of transcending involved hanging on using whatever came to hand, be it person qualities or reached out reflexively to those around them. As the experience evolved there was a gradual change in the participant’s state of motion, shifted slowly from just holding their position to being able to exert some push back against the adversity that they were facing. In the final phase of the experience individuals experience of transcending broadened out as relationships and activities in the wider world were re-claimed as a source of positive emotion leading to the repairing and rebuilding their intrapersonal and interpersonal boundaries. Most importantly, the participants in the study showed that transcending burnout was possible, with their experiences having the potential to inform future professional developments in both clinical and educational practice.