Journal of Nursing Education

Burnout in Doctorally Prepared Nurse Faculty

Margaret Jorgensen Dick, PhD, RN

Abstract

ABSTRACT

This correlational study examined burnout in doctorally prepared nurse faculty and its relationships to management style, collegial support, and workload. The Matthews Burnout Scale and the Maslach Burnout Inventory were used to measure burnout of 400 doctorally prepared American Nurses Association (ANA) members employed as faculty in schools of nursing. Analysis of 236 (59%) returns revealed that 39% of the faculty experienced moderate to high levels of burnout. Significant negative relationships (p<.05) were found between burnout and participative management, presence of collégial support, and time spent in research and in clinical practice. Multiple regression indicated that management style was the strongest predictor of burnout, with collégial support the second predictor.

Abstract

ABSTRACT

This correlational study examined burnout in doctorally prepared nurse faculty and its relationships to management style, collegial support, and workload. The Matthews Burnout Scale and the Maslach Burnout Inventory were used to measure burnout of 400 doctorally prepared American Nurses Association (ANA) members employed as faculty in schools of nursing. Analysis of 236 (59%) returns revealed that 39% of the faculty experienced moderate to high levels of burnout. Significant negative relationships (p<.05) were found between burnout and participative management, presence of collégial support, and time spent in research and in clinical practice. Multiple regression indicated that management style was the strongest predictor of burnout, with collégial support the second predictor.

Introduction

Burnout is characterized by exhaustion, by feelings of being used up, and by fatigue that is not relieved by rest or vacations. It includes a decreased sense of personal accomplishment and a feeling that the individual's actions do not matter. Burnout also is characterized by negative reactions to others and active withdrawal from interactions (Freudenberger & Richelson, 1980; Maslach, 1982; Maslach & Jackson, 1986). Burnout is debilitating for the individual, and because it reduces productivity when it occurs in nursing faculty, it is debilitating for the school and the profession as well (Armour, Caffarella, Fuhrmann, & Wergin, 1987). The purpose of this correlational study was to identify the extent of burnout in doctorally prepared nurse faculty and its relationships to management style, collegia! support, and workload.

Burnout and the Organization

Burnout is an example of depletion of the individual's adaptation energy, or the stage of exhaustion described by Selye (1976). Each individual has a finite level of adaptation energy available to deal with Stressors. When individuals are able to meet their needs within the work setting, adaptation energy is preserved. When this energy is exhausted by prolonged or excessive exposure to Stressors, the individual is no longer able to adapt and altered physiopsychological states such as burnout occur. Although stressors arise from multiple sources, in burnout the source lies within the job setting (Cherniss, 1980; Maslach, 1982; Rountree, Golembiewski, & Deckard, 1989).

According to Alderfer (1972), when basic needs for existence are met, higher order needs - for relationships, for a sense of esteem in one's own and others' eyes, and for growth - are paramount. A work environment that fosters a sense of control, participation, and support facilitates meeting these higher order needs. When the environment does not provide support for, or interferes with, meeting these needs, increased and prolonged stress may occur. Burnout is then likely.

Several investigators have found relationships between authoritarian management style and burnout (Dick, 1986; Duxbury, Armstrong, Drew, & Henly, 1984). Authoritarian management is characterized by vertical communication, with information flowing primarily downward, and tight control by management over all decisions. At the other end of the continuum is participative management. Here communications flow up and down and laterally, and individuals at various levels have a voice in decisions and evaluation (Likert & Likert, 1976). In participative management, there is confidence in clarity of communication, trust in abilities, and awareness of goals, problems, and needs at all levels. In a study of faculty in collegiate schools of nursing, Dick found negative associations between perceptions of participatory management style in the school and burnout. Similarly, Fong (1990) found that a chairperson's support and encouragement of faculty colleagues were among the factors related to lower burnout.

Collegial support also has been found to be related to burnout. Among nurses, teachers, and social service workers, co-workers' positive feedback, help with client problems, and sharing of stresses and joys were related to a greater sense of accomplishment and more positive feelings toward clients (Cherniss, 1980, 1989; CroninStubbs & Rooks, 1985; Huberty & Huebner, 1988). For college faculty, collegial support includes open communication, trust, understanding, and encouragement, as well as a reference group against which to measure achievement and growth (Beyer, 1979). Collegial support provides the most direct opportunity to meet needs for belonging and esteem among one's peers. Among nurse faculty in collegiate programs, collegia! support has been shown to be negatively related to burnout, accounting for the largest amount of variance in burnout (Dick, 1986).

Workload also has been related to burnout, though not consistently. Cherniss (1980), in a study of social service workers, and Huberty and Huebner (1988), in a study of school psychologists, found that when individuals were in constant contact with clients or students and dealing with difficult situations, burnout tended to increase as workload increased. However, when the workload was varied and included activities in less intense situations or allowed the individual to control hours and situations, the number of hours worked - even long hours - was not related to burnout. Dick (1986) found that while overall workload was not related to burnout, among nurse faculty there was a small, positive relationship between burnout and amount of time spent in clinical teaching. The variety in the faculty workload may make faculty less susceptible to burnout than other human service professionals in continuous, intense contact with clients.

Methods

The purpose of this study was to examine burnout in doctorally prepared nurse faculty and to explore the associations between burnout and management style, collegial support, and workload. A descriptive correlational design with a mailed survey was used to answer the research questions.

Research questions

1. To what extent does burnout occur in doctorally prepared nurse faculty?

2. Is burnout positively related to authoritarian management style?

3. Is burnout negatively related to collegial support?

4. Is burnout related to components of the workload?

5. Which of the following best predict burnout: management style, collegial support, and/or workload?

Sample

Subjects were doctorally prepared members of the American Nurses Association (ANA) who were employed as faculty in schools of nursing. The ANA provides researchers with lists of members in 22 states that geographically represent the United States. Power analysis for a correlational study (power - .80; alpha - .05; effect size= .20) indicated that 200 subjects would be necessary (Shelley, 1984). To allow for a 50% response rate, 400 names were randomly selected from the ANA lists and questionnaires were mailed.

Instruments

Burnout was measured with two instruments, the Educator Form of the Maslach Burnout Inventory (MBI) and the Matthews Burnout Scale. The MBI (Maslach & Jackson, 1986) has three subscales: emotional exhaustion, consisting of nine items measuring the perception of being used up, frustrated, tired, or stressed; depersonalization, consisting of five items pertaining to perceptions of treating others impersonally, becoming callous, and becoming hardened emotionally; and personal accomplishment, consisting of eight items measuring perception of having an influence on others, working well with others, and dealing well with clients and with problems. High emotional exhaustion and depersonalization and low personal accomplishment are considered to be indicative of burnout. While Maslach and Jackson (1986) present normative ranges for low, average, and high scores on each of the subscales, they recommend that mean scores be used and that each subscale be considered separately. Reliability and validity data reported by Maslach and Jackson (1986) are consistent with Cronbach alphas in the current study (MBI = .77, emotional exhaustion =.89, depersonalization =.68, personal accomplishment =.74).

A second measure of burnout, the Matthews Burnout Scale, yields a single measure of burnout and is easier to interpret (Matthews, 1986). The 50-item Matthews Burnout Scale includes positively and negatively stated perceptions about health, work setting, relationships with co-workers, and personal performance. Initial psychometric development of the tool indicates that it is a useful composite measure of burnout; normative groups for development included nurses and college faculty (Matthews). Reliability reported by Matthews is consistent with the Cronbach alpha (.93) found in the current study.

Collegial support was measured with a shortened version of Beyer's Survey of Collegial Communication Beyer 1979). The original 40-item instrument consisted of five items in each of eight categories such as freedom to exchange ideas, trust, ability to resolve differences, and willingness to share knowledge. The shortened version consists of the two items from each subscale that were ranked as most important by nurse faculty in Beyer's study. The Survey of Collegial Communication produces a composite score - the higher the score, the more supportive are collegial relationships. The Cronbach alpha for this scale was .96 in the current study.

Management style was measured with a 12-item adaptation of Likert's Profile of Organizational Characteristics, developed by Lasher (1975) for use with college faculty. It perceptions of upward and downward communidecision-making patterns, and interaction between dean and faculty and provides a composite score indicating perception of management style. Scores represent, from low to high, exploitative-authoritative, benevolent-authoritative, consultive, and participative management. The Cronbach alpha for this scale in the current study was .91.

Workload was measured by asking faculty how many hours per week they usually spent in clinical supervision of students, classroom teaching, course preparation, committee work, research or writing, administrative duties, counseling students, service to profession, and clinical practice. Faculty also were asked to indicate the levels of students with whom they worked (associate degree [ADN] to doctoral). Content validity was measured by submitting the list to four doctorally prepared faculty at two schools who were asked to categorize their activities according to the measure. No activities were identified that could not be placed in the identified categories.

Results

Sixty-five percent (261) of the subjects returned questionnaires. Of these, 236 (59% of the total) were usable for data analysis. Ninety-five percent of the subjects were female. They ranged in age from 31 to 70 (mean 47.3) and had from one to 40 years of teaching experience (mean 15.4). They had held doctoral degrees from one to 27 years (mean 6.9). Three percent were instructors, 30% were assistant professors, 44% were associate professors, and 23% were full professors; 57% were tenured. Four percent taught ADN students, 29% taught baccalaureate students, 36% taught graduate students, 30% taught both baccalaureate and graduate students, and 1% reported teaching other types of students.

Using scores from the MBI, these subjects were compared with a normative group of postsecondary educators. Ranges for low, moderate, and high burnout were identified by Maslach and Jackson (1986) with a group of 635 educators in colleges and professional schools. Scores on the MBI (Table 1) ranged from low to high on each of the subscales; however, the mean scores for all subscales reflected moderate burnout. The mean score for emotional exhaustion was 22.3 (SD = 1 1.0), falling within the normative range for moderate burnout of 14 to 23. The mean score for depersonalization was 4.1 (SZ> = 3.8), falling within the normative range for moderate burnout of 3 to 8. The mean score for personal accomplishment was 38.5 (SD -5. 9), falling within the normative range for moderate burnout of 36 to 42.

Table

TABLE 1Possible and Actual Ranges of Scores, Means, and Standard Deviations for Burnout, Management Style, and Collegial Support Scales

TABLE 1

Possible and Actual Ranges of Scores, Means, and Standard Deviations for Burnout, Management Style, and Collegial Support Scales

The Matthews Burnout Scale was used to provide a composite measure of burnout among doctorally prepared nurse faculty. Using ranges identified by Matthews (1986), 7% scored in the high burnout range (51-100), 32% in the moderate range (26-50), and 61% in the low burnout range (0-25). Thus, with the Matthews Burnout Scale, 39% of the faculty scores fell within the moderate-to-high burnout range. The ranges of responses, means, and standard deviations for burnout, management style, and collegial support instruments are given in Table 1.

A major aim of the study was to identify organizational factors related to burnout among doctorally prepared faculty. Pearson's product-moment correlations were used to measure relationships between burnout and management style, collegia! support, and workload (Table 2). Burnout was expected to be negatively related to participative management style. Fourteen percent of the respondents rated the management style in their school as exploitative-authoritative; 40% rated it as benevolentauthoritative; 44% perceived the style as consultative; only 2% rated the management style at their school as participative.

Pearson's correlations indicated that scores on both the Matthews Burnout Scale and the three subscales of the MBI were negatively related to participative management style (Table 2). As individuals perceived higher levels of participative management, burnout was reduced. Emotional exhaustion and depersonalization scores went down and personal accomplishment scores increased with perceptions of participative management. This relationship was more clearly evident using the composite Matthews Burnout Scale scores. These findings are consistent with earlier studies of nurse faculty and other social service professionals (Dick, 1986; Duxbury et al., 1984).

Table

TABLE 2Relationships of Management Style and Collegial Support: Subscales of MBI and Matthews Burnout Scale

TABLE 2

Relationships of Management Style and Collegial Support: Subscales of MBI and Matthews Burnout Scale

Similarly, as perceptions of collegial support increased, burnout was reduced - emotional exhaustion and depersonalization scores went down and personal accomplishment scores increased, although the latter correlation was not statistically significant (Table 2). This negative relationship between burnout and collegial support was much stronger for the Matthews Burnout Scale scores. When faculty groups were perceived as having high standards while being open, supportive, and trustworthy, burnout was decreased. These findings are consistent with earlier studies of nurse faculty (Dick, 1986; Fong, 1990) and with studies of nurses in clinical practice and teachers (Cherniss, 1980; Cronin-Stubbs & Rooks, 1985).

To identify relationships between burnout and workload, the Matthews Burnout Scale was compared to each of the workload components. Burnout was positively related to clinical supervision hours (.17) and negatively related to hours in research ( - .14), hours in clinical practice ( - .11), and hours in professional service ( - .12). None of the other correlations between workload and burnout were statistically significant at the .05 level. While burnout increased as clinical supervision hours increased, burnout decreased when faculty reported more hours spent in those activities where they may exert more choice and control - research, clinical practice, and professional service. Taken together, these findings support the hypothesis that providing variety and a sense of individual control over activities results in lower levels of burnout (Cherniss, 1980; Huberty & Huebner, 1988; Maslach, 1982).

These correlations were used to guide variable selection for further data analysis. A stepwise multiple regression equation was used to assess the relative importance of management style, collegial support, and time spent in clinical supervision, research, clinical practice, and professional service in predicting burnout. Only management style, collegial support, and research time entered the equation at the .05 level.

Table

TABLE 3Multiple Regression* of Organizational and Workload Variables on the Matthews Burnout Scale

TABLE 3

Multiple Regression* of Organizational and Workload Variables on the Matthews Burnout Scale

All were negatively related to burnout (Table 3). Management style was the strongest predictor, with collegial support also being important. Of all workload variables, only research time significantly added to the predictive value of the equation. Taken together, these three variables accounted for 47% of the variance in scores on the Matthews Burnout Scale. These data suggest that interpersonal factors are more important than time commitments in predicting burnout.

Discussion

Results of this study indicate that burnout exists among doctorally prepared nurse faculty. Mean scores on the three subscales of the MBI were in the moderate burnout range, when compared to a normative group of postsecondary school educators. While only 7% of the sample scored in the high burnout range on the Matthews composite scale, an additional 32% scored in the moderate range. Because burnout is a debilitating syndrome, the finding that 39% of these faculty experienced moderate to high burnout has serious implications for further development of the profession. While cause and effect cannot be drawn from a correlational study, the proportion of variance in burnout accounted for by management style and by collegial support identifies potential areas for addressing the problem.

Management style was found to be the strongest predictor of burnout. When faculty perceived management style to be open, allowing for involvement in decisionmaking, burnout was lower. The strength of the relationship found in this study between management style and burnout, and the consistency with which management style has been found to be related to burnout across studies in various settings (Dick, 1986; Duxbury et al., 1984) support the proposition that enhancing the individual's sense of control reduces burnout. This view is further supported by the finding that the components of workload that are relatively self-controlled - research or writing, clinical practice, and professional service - were negatively related to burnout. These activities may provide both internal rewards and external recognition from peers and the organization. In particular, being able to devote time to research and other scholarly activity is likely to be related to greater success in achieving tenure, and perhaps to meeting self-expectations.

Collegial support was a second major predictor of burnout among this group of doctorally prepared faculty. In an earlier study that included both master's and doctorally prepared faculty in collegiate schools of nursing, collegial support was the strongest predictor of burnout, with management style being the second strongest (Dick, 1986). This difference in relative importance may be due to different expectations and needs for collégial support between doctorally and master's-prepared faculty. While collégial support is important to both, doctorally prepared faculty may have less need for collégial support and greater need for emotional and professional investment in the control over their professional lives that is provided by a participative management style.

Recommendations for practice must be tentative given the correlational nature of the study. However, the importance of management style and collégial support in both this study and the earlier study of nurse faculty by Dick (1986) supports attempts by faculty and administrators to increase opportunities for faculty control within the organization as well as supportive relationships among faculty.

Ways for increasing opportunities for faculty control within the organization and for developing supportive relationships among faculty need to be addressed. Deans, other administrators, and faculty members in schools of nursing should evaluate their interactions to identify the type of management style being used. These evaluations should compare administrators' perceptions to faculty members' perceptions. Evaluations of the decision process also should be considered - who makes what decisions, and why; and are the decision patterns efficient, effective, and acceptable to those concerned? It may be necessary to obtain help from someone not directly involved in the relationship to make an accurate assessment and to help faculty and administrators determine what changes may be needed or possible.

Similarly, the level and type of collégial support present and desired may need to be evaluated on an individual and small-group basis. Questions asked should include whether an environment of trust exists, with free exchange of ideas and recognition for accomplishments. As with administrators, a neutral professional person may be helpful to clearly identify and discuss faculty members' expectations of each other. It is important to identify when these expectations are realistic, achievable, and desirable.

The negative relationship between burnout and time spent in research provides a third area for assessment by faculty and administration. Open discussion of the needs and appropriate utilization of the diversity among faculty members could be helpful. Doctorally prepared faculty are likely to have different interests and abilities than they had prior to doctoral education. Increasing support, opportunities, and time to use their educational preparation in research may be useful.

Although research was the only workload variable to enter the regression equation, time in professional practice and service were also negatively related to burnout. These three aspects of the workload are relatively selfcontrolled. These findings are consistent with the earlier study of nurse faculty (Dick, 1986) and indicate that a greater sense of involvement in decisions about time and resource allocation may be helpful in reducing burnout.

The results of this study indicate that as many as one third of the doctorally prepared faculty may experience moderate-to-high burnout. As burnout is debilitating to the individual, and, when large numbers of faculty are affected, debilitating to the profession, these findings should be of concern to the profession, to schools of nursing, and to faculty. In this study, management style, collegial support, and time devoted to research, clinical practice, and professional service are identified as three components of the organization where initial efforts may be focused to reduce burnout.

References

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TABLE 1

Possible and Actual Ranges of Scores, Means, and Standard Deviations for Burnout, Management Style, and Collegial Support Scales

TABLE 2

Relationships of Management Style and Collegial Support: Subscales of MBI and Matthews Burnout Scale

TABLE 3

Multiple Regression* of Organizational and Workload Variables on the Matthews Burnout Scale

10.3928/0148-4834-19921001-04

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