COVID 19 BURNOUT AMONG HEALTH CARE WORKERS 2
COVID 19 BURNOUT AMONG HEALTH CARE WORKERS 2
COVID 19 BURNOUT AMONG HEALTH CARE WORKERS 2
COVID 19 BURNOUT AMONG HEALTH CARE WORKERS 20
COVID 19 BURNOUT AMONG HEALTH CARE WORKERS
Research Paradigm: Positivism
COVID-19 Burnout among Health Care Workers
Table of Contents
Table of Contents 2
List of Figures 8
Section 1: Introduction to the Study 9
Background of the Problem 10
Problem Statement 11
Purpose Statement 12
Research Questions 13
How the Research Questions Relate to the Study Purpose 14
Nature of the Study 18
Discussion of Research Paradigms 18
Positivism 18
Post-Positivism 19
Constructivism 19
Pragmatism 19
Researcher’s Selected Paradigm 20
Discussion of Design 20
Fixed Design Using Quantitative Methods 20
Flexible Design Using Qualitative Methods 21
Mixed Methods Design using Quantitative and Qualitative Methods 21
The Appropriateness of the Flexible Design in the Project and the Rationale 22
Discussion of Method 24
Narrative 24
Phenomenology 25
Grounded Theory 25
Ethnography 26
Case Study 26
Discussion of the Appropriateness of the Best Method 27
Discussion of Triangulation 27
Summary of the nature of study 32
Research Framework 33
Figure 1. Research Framework Diagram 34
Concepts 34
Burnout Within Health Professionals 35
Shortages in Healthcare Professionals in Relations to COVID-19 36
Leadership Within the Organization 36
Effective Leadership 37
Theories 37
Job Demands–Resources Theory (JD-R) 38
Maslach’s Theory 40
Conservation of Resources Theory 41
Actors 42
Health Care Providers 42
Healthcare Managers/Administrators 43
Patient / Consumer 43
Constructs 44
The Role of Stakeholders in Dealing with Healthcare Professional Burnout 44
Creation of a Conducive Working Environment for the Employees 45
Relationship Between Concepts, Theories, Actors, and Constructs 46
Conclusion of Constructs 48
Summary of the Research Framework 49
Definition of Terms 49
Assumptions, Limitations, and Delimitations 50
Assumptions 51
Limitations 52
Delimitations 52
Significance of the Study 53
Reduction of Gaps in Literature 54
Implications for Biblical Integration 55
Benefit and Relationship to Leadership Practice 57
Summary of Significance of the Study 58
Overview 59
Leadership Practices and Employee Engagement 61
Figure 2. Employee Engagement Diagram 63
The Problem 67
The Role of Leadership 69
Burnout within Health Care Professionals 75
Shortages in Healthcare Professionals in Relations to COVID-19 77
Leadership within the Organization 78
Effective Leadership 78
Theories 79
Job Demands–Resources Theory (JD-R) 79
Maslach’s Theory 79
Conservation of Resources Theory 80
Health care professional 80
Healthcare managers/ Administrators 81
Patient / Consumer 81
Constructs 81
The Role of Stakeholders in Dealing with Healthcare Professional Burnout 83
Creating a Conducive Working Environment for the Employees 84
Related Studies 84
Anticipated and Discovered Themes 87
Literature Review Summary 92
Summary and Transition 93
Overview of Section 2 96
Introduction 97
Purpose Statement 97
Role of the Researcher 98
Research Methodology 102
Introduction 102
The rationale behind the Selected Research Design 102
Triangulation 104
Summary of the Research Methodology 106
Participants 106
Population and Sampling 107
Population 108
Sampling 109
Summary of Participants, Population, and Sampling 114
Data collection plan 116
Instruments 118
Interview guides 118
Surveys 120
Archive data 120
Data organization 121
Summary of data collection 122
Data analysis 122
Qualitative analysis 123
Analysis of triangulation 124
Summary of data analysis 125
Reliability and Validity 126
Reliability 126
Validity 127
Bracketing 130
Summary of reliability and validity 131
Overall Summary of Section 2 131
Conclusion 132
References 134
Liberale, A. P., & Kovach, J. V. (2017). Reducing the Time for IRB Reviews: A Case Study. Journal of Research Administration, 48(2), 37-50. 142
Appendices 152
Appendix A: Interview Guide 152
Appendix B: Survey Guide 154
COVID 19 BURNOUT AMONG HEALTH CARE WORKERS 6
List of Figures
Figure 1. Research Framework Diagram…………………………………………………… 31
Figure 2. Employee Engagement Diagram………………………………………………….60
Section 1: Introduction to the Study
The study is focused on understanding how the COVID-19 pandemic affected healthcare workers. It investigates the burnout experienced by health care providers since the inception of the COVID-19 pandemic. Also, the study examines the contributory role of leadership in shaping the exposure of healthcare workers to professional burnout. Leaders remain an effective support system in the healthcare domain due to the strategic quality interventional measures they integrate (Sultana et al., 2020). Therefore, the study evaluates how leaders exposed healthcare workers to professional burnout during the COVID-19 pandemic. The primary objective is to enable leaders to comprehend how to improve the working environment to ensure care providers deliver quality services in today’s setting and the future. Specifically, the inquiry determines if the Southeastern United States leaders failed to adopt proper COVID-19 response measures causing burnout among healthcare workers. It also investigates the appropriate response measures.
The study will adopt a variable case study design based on qualitative inquiry regarding methods (Kumar, 2018). The flexibility of the case study design allows the researcher to adjust the research methods based on the situation and target new participants if the selected are unavailable. The major participants of the study will include healthcare providers and leaders. Healthcare workers will respond to the burnout questions during the COVID-19 pandemic and whether their leaders took effective response measures. On the other hand, leaders will respond to difficulties experienced and measures to prevent and avoid burnout from healthcare workers (Kumar, 2018). The case study is appropriate to the current inquiry since, in addition to direct responses, the scholar will investigate situations in real-life situations (Kumar, 2018).
Consequently, the effective data gathering methods will comprise questionnaires, and interviews, which will help triangulate the facts collected (Park et al., 2020). Fundamentally, a positivist approach will help establish the objectivity of the current study (Park et al., 2020).
Generally, the methods facilitate the attainment of the research objectives.
The following section shows the relation of the existing research with the current study. Section one encompasses the background of the problem and the problem statement. The background of the study and problem statement will guide the researcher in framing viable research questions, objectives, and hypotheses. Following these will be the research design approaches that will focus on the paradigm, design, and selected data collection methods. These are essential elements that will determine the success of the study. For example, the selected data methods will determine the information collected and its likelihood of supporting the targeted outcomes. The research framework will develop a viable link between key concepts and theories used in the research (Part et al., 2020). After discussing the framework segment, the study defines the assumptions of the research, limitations, and delimitations. Some of the challenges and assumptions surrounding the research are highlighted. The study’s contribution is noted in the final segment of the paper, which shows the paper’s relevance in line with the research conducted. The evidence generated is supported by the list of references and appendices used for the research purpose.
Background of the Problem
Professional burnout among leaders based in the healthcare industry has become a prevalent problem since the COVID-19 pandemic (Jalili et al., 2021). As Jalili et al. (2021) believe, healthcare workers have become increasingly prone to burnout due to the care and attention they provide to their patients. With the rising number of patients in dire need of services, healthcare professionals have become increasingly exposed to exhaustion. The
absence of strategic frameworks has denied these professionals the opportunity to advance their health and well-being when caring for patients (Khasne et al., 2020). Research shows that healthcare professionals have continued to blame their leaders due to the lack of adequate preparedness in handling the COVID-19 menace (Khasne et al., 2020). The COVID-19 pandemic has exposed healthcare workers to different mental strains emerging from the continued care provision. Additional research shows that burnout among healthcare staff members continues to attract attention due to the leaders’ inability to address arising issues (Lasalvia et al., 2021). Due to the COVID-19 pandemic, there are significant gaps in leadership, responses, and strategies that continue to place healthcare providers at risk of physical and emotional problems.
Burnout is a primary occupational issue in the care sector, with leaders playing a vital role and responsibility in managing this problem (Sultana et al., 2020). Sultana et al. (2020) argued that leaders should use quality interventional measures to ensure healthcare providers achieve a stable emotional, physical, and mental status. Due to the rising concern over the health and welfare of healthcare providers, institutional leaders must adopt quality policies and strategies to prevent burnout. Lack of effective participation at the top leadership level has posed a threat to the healthcare system. Sultana et al. (2020) stressed that misunderstandings and work-related strains are common challenges likely to emerge with a lack of adequate leadership participation, leading to increased burnout among healthcare providers. The well-being of COVID-19 patients relies on the health status provided by the care providers. Therefore, leaders must remain committed to creating strategic frameworks that reduce professional burnout.
Problem Statement
The general problem is healthcare leaders’ failure to develop a strategic framework in
the wake of the COVID-19 pandemic resulting in increased burnout among healthcare professionals. According to Jalili et al. (2021), these burnouts occur because leaders fail to develop a strategic framework, there is an increased level of professional burnout among healthcare workers caring for COVID-19 patients. In a recent study, Khasne et al. (2020) found that many healthcare professionals blamed their leaders for lack of preparedness to deal with COVID19, resulting in mental strain for the caregivers.
A similar study by Lasalvia et al. (2021) reveals that burnout among healthcare staff members during the pandemic is an issue of concern. Still, leaders have not done enough to mitigate the adverse implications. Sultana et al. (2020) supports this issue by stating that burnout is a major occupational problem among healthcare providers, and leaders have a critical role in developing intervention measures. The specific problem addressed in this article is the potential failure of senior healthcare leaders within the South-Eastern United States to establish adequate response and preparedness to deal with COVID -19, resulting in a possible increased burnout among healthcare professionals.
Purpose Statement
The purpose of this flexible single case study aims to understand the inability of healthcare leaders in the South-Eastern United States area to create and implement potential response measures for addressing professional burnout emerging from the COVID-19 pandemic. The researcher will select healthcare workers and leaders to offer their ideas and perspectives about healthcare management and the administration’s impact on staff burnout during the pandemic. The targeted population will relay viable information that will answer the research questions. The research will focus on two major concepts: professional burnout and leadership. First, the study will investigate the increasing emotional and physical exhaustion among healthcare providers with COVID-19 infections (Cotel et al., 2021).
Second, in examining leadership contribution, the research will assess leaders creating the environment to address the burnout constructs. The results obtained from this research will supplement existing studies focusing on leadership strategies likely to develop a potential working environment for care providers during healthcare pandemics. This research will inform leaders on the courses of action they can take to advance the health and well-being of healthcare professionals amidst the harsh realities of the COVID-19 pandemic. In the future, these leaders can potentially improve the handling of burnout based on the successful implementation of the approaches obtained from this research.
Research Questions
Given the burnout rate of healthcare providers due to the COVID-19 pandemic, these research questions aim to provide leadership skills and interventions to reduce burnout in the healthcare profession (Sultana et al., 2020). Leadership will learn first-hand knowledge that can bring understanding to the problem and improve the rate of burnout (Zang et al., 2018). The study will combine open- and close-ended questions to achieve comprehensive research. Zhang, Liao, and Srivastava (2018) explain that combining available- and close ended questions is highly beneficial to research because it reduces the chances of participants being bored during the study and dropping out, which attributes to the use of feature elicitation that minimizes dialogue length. However, the most critical questions to the research are the open-ended questions because they are more comprehensive (Allen et al., 2017). As Allen (2017) explains, open-ended questions in research designs such as surveys and interviews allow participants to express themselves using views that may be unprecedented, extreme, or unknown to the researcher. The research questions will seek to draw information on the perspectives and opinions held by various health workers who have experienced or are familiar with burnout. The research questions will gather sufficient factual data on the
recommendations and solutions provided by the participants during the professional interaction with the interviewers (Khasne et al., 2020). The following are the main questions to be used in the research:
RQ1: How is professional burnout prevalent in healthcare among the nursing staff?
RQ1a: Why have nurses deemed the most affected medical staff by professional
burnout during the COVID-19 pandemic?
RQ1b: Why is professional burnout prevalent among the nurses during the COVID-19 pandemic?
RQ2: What are the leadership failures in addressing the professional burnout in healthcare organizations?
RQ2a: How do leadership failures affect the response toward professional burnout?
RQ2b: How have leaders failed to address professional burnout among healthcare workers?
RQ3: What proposals could address professional burnout among healthcare workers? RQ4:
How do healthcare management and administration affect staff burnout at hospitals in the
wake of COVID-19?
How the Research Questions Relate to the Study Purpose
RQ1: How does the professional burnout problem occur in the healthcare setting and more so during the COVID-19 era?
RQ1. Arguably, the COVID-19 pandemic had an unpreceded impact on the medical community (Essex et al., 2021). In this research question, the researcher investigates whether COVID-19 poses a risk of professional burnout to the medical team. The researcher focuses on the nursing workforce because it accounts for the most significant part of the medical community. This research question obtains evidence that will show why nurses are the most
affected people by professional burnout during COVID-19. Therefore, this will help develop evidence-based solutions.
RQ1a: Why have nurses deemed the most affected medical staff by professional burnout during the COVID-19 pandemic?
RQ1a. The researcher examines why COVID-19 leads to professional burnout among nurses. The question highlights why nurses are the most affected professionals in the
COVID-19 pandemic (Lasalvia et al., 2021). Nurses are the frontline medical workers who cater to the overwhelming number of patients due to the rapid spread of the disease and hospitalization (Lasalvia et al., 2021). Therefore, they are deemed the most affected medical staff by professional burnout.
RQ1b: Why is professional burnout prevalent among the nurses during the COVID-19 pandemic?
RQ1b.This question investigates how COVID-19 contributes to professional burnout within the nurse population. The research question addressed why professional burnout was prevalent among nurses during the COVID-19 era (Cotel et al., 2021).
RQ2: What impact do healthcare organizational policies have on the health and welfare of the healthcare providers and primarily during the pandemic?
RQ2. Lack of effective leadership is a possible issue hindering efforts to combat professional burnout facing the COVID-19 pandemic (Cotel et al., 2021). This research question examines leadership’s possible failures in dealing with professional burnout. Therefore, this helps determine how to combat leadership’s possible failures limiting healthcare professionals from burnout.
RQ2a: How do leadership failures affect the response toward professional burnout?
RQ2a will help identify effective leadership qualities and aspects that will help minimize professional burnout. Practical leadership qualities may include strategic planning and advocating for nurses’ rights (Zhang et al., 2018). Thus, this will help reduce professional burnout.
RQ2b: How have leaders failed to address professional burnout among healthcare workers?
RQ2b will help determine leadership actions and behaviors contributing to healthcare staff burnout. Choosing which activities are beneficial is a vital aspect for leaders. Selecting the best steps is imperative to chart the best course of action to decrease burnout within the healthcare field (Zhang et al., 2018). Determining leadership actions and behaviors can help change the strategies and reduce the burnout of healthcare providers (Jalili et al., 2021).
RQ3: What proposals could address professional burnout among healthcare workers?
RQ3. The researcher examines options that leaders could use to address healthcare professional burnout amid the COVID-19 pandemic. Thus, the study identifies the evidence-based interventions, such as working in shifts to avoid working extra time, that the medical community, policymakers, and health administrators could implement to overcome the challenge of professional burnout during the COVID-19 pandemic (Lasalvia et al., 2021). Evidence-based interventions are the most suitable solutions because experiments and scientific studies have proven them (Allen et al., 2017). In addition, investigating the leadership strategies to deal with the COVID-19 pandemic is fundamental to implementing reasonable measures to reduce burnout among healthcare workers (Allen et al., 2017).
RQ4: How do healthcare management and administration affect staff burnout at hospitals in the wake of COVID-19?
RQ4.The researcher seeks to analyze the role of the healthcare administration and their competencies to address professional burnout. Sufficient leadership qualities are necessary to address the COVID-19 pandemic (Cotel et al., 2021). Practical leadership qualities help leaders to make sound decisions concerning any change in health care (Cotel et al., 2021). Therefore, the administration initiates change and communicates the strategies for addressing the challenge and steps to address professional burnout (Cotel et al., 2021).
The questions examine different aspects concerning addressing professional burnout due to COVID-19 among health care workers. The answers to these questions will provide insights on strategies used in addressing professional burnout. The questions are highly relevant due to the increased healthcare sector issues arising from the high burnout among healthcare workers. The research questions will deliver the opinions and tribulations that healthcare workers have endured to encourage burnout during the pandemic.
The questions present the objectives of the research. They provide different ideas about the research concept. Stakeholders can use the ideas from the insights they potentially reveal in the health care sector to develop strategies for addressing professional burnout (Khasne et al., 2020). The questions address leadership attributes, qualities, plans, actions, and behaviors that promote professional burnout. The questions also cover these leadership aspects that can potentially assist in solving the problem. The research will potentially help the United States set standards and solutions to solve the patient safety and practitioner efficacy risks that the healthcare industry has experienced since the pandemic due to burnout. The research will offer solutions to help the leaders reflect on the most successful approaches to preventing healthcare burnout. The culmination of all four research questions and the four sub-questions can help provide options for possible ways to decrease healthcare burnout within Sentara Internal Medicine, Norfolk, Virginia.
Nature of the Study
The study focuses on understanding the status of COVID-19 burnout among healthcare workers and the leader’s role in handling the problem. The study calls for a single and flexible research design process. With a positivist perspective, the researcher can gain insights into participants’ emotions, opinions, and behavior. The triangulation process will allow the investigator to achieve credibility and validity.
Discussion of Research Paradigms
Positivism
The positive research paradigm targets a single objective reality that an investigator focuses on exploring (Park et al., 2020). The assessment is based on observation and reasoning (Park et al., 2020). This paradigm assumes that a tangible reality exists among variables (Park et al., 2020). The positivism model entails the act of being sure about something. In research, science is based on observable facts. Thus, the positivism research paradigm views the knowledge generation process as a quantifiable process. Understanding the relationship between research parameters focuses on observation and reasoning. This relationship can be understood, identified, and measured to reveal the causal framework. Therefore, this paradigm focuses on the accurate and objective interpretation of data to establish a particular set of knowledge. The positive research paradigm is very different from positivism because it uses principles and assumptions to guide any potential scientific discoveries. By understanding these assumptions, one can know more about the findings that could be used to identify research gaps and generate sound evidence. It also helps support scientific studies.
Post-Positivism
The post-positivism model is derived from the positivism paradigm and incorporates a better examination of the issues occurring in the real-world setting (Panhwar et al., 2017). It values methodological pluralism, which applies research methods that align with the research question (Panhwar et al., 2017). It integrates both positivism and empirical analysis methods to understand the social concept at hand better. This paradigm may offer a flexible model that allows researchers to incorporate multiple ways of answering a particular research question. Post- positivism was created from positivism to generate a more encompassing way of examining real-world problems (Kankan, 2019). This understanding does not negate or refute positivism but rather suggests that something subsequentially exists and is worth consideration (Kankan, 2019).
Constructivism
The constructivism research paradigm is based on experience and in-depth reflection of these experiences (Mogashoa, 2014). This method is primarily based on learning to construct the meaning of a particular element. Human beings generate knowledge through the interaction between their experiences and ideas (Mogashoa, 2014). This research paradigm portrays that each person constructs a meaning depending on their experiences and assessment. Overall, the constructivism model believes humans acquire knowledge through experiences and interpret the insights obtained.
Pragmatism
The pragmatism paradigm is based on the use of “what works” rather than what is deemed “true” or “real” (Frey, 2018). Researchers ensure that they view a problem in its broadest context after identification. Pragmatism portrays its experience-based and action oriented perspective. The paradigm addresses an issue based on how people experience it. For
instance, if people view the sea as beautiful, this means that the setting is gorgeous. The consideration of this statement is based on truth.
Researcher’s Selected Paradigm
The researcher has selected the positivism paradigm to assess the impact of the COVID-19 pandemic on burnout among healthcare workers. This paradigm will enable the researcher to integrate a suitable social, philosophical model that applies to the issue of burnout among health care workers. This paradigm will closely align with the observation and reasoning strategies to develop an interpretation based on objectivity (Park, Konge & Artino, 2020). Research shows that the positivist approach supports an objective method of viewing elements (Park, Konge & Artino, 2020). Understanding the burnout problem among these professionals will be based on objective analysis rather than a subjective one. Thus, the positivist model is appropriate for the study because it will depend on observation and reasoning instead of my understanding of this crucial issue. It will position the researcher in a better place to establish suitable and strategic recommendations capable of handling this menace across the healthcare setting.
Discussion of Design
Fixed Design Using Quantitative Methods
The fixed design model entails using permanent elements in the data collection process that are part of the research proposal (Kumaar, 2018). While relying on quantitative research tools, the investigator executes the research process. Some of the methods incorporated in the fixed design include experimental, quasi-experimental, and nonexperimental (Kumar, 2018). This design does not apply in the research because the data collected would be quantitative. However, the potential data derived in this research will be in qualitative form. The fact that it uses fixed data collection tools means that one cannot amend
the data in the collection phase, which is often used in quantitative research (Doyle et al., 2009). The fixed design method is often used in quantitative research, which helps ensure that the data collected is unbiased and cannot be tampered with (Doyle et al., 2009). This also means that it will help provide the most accurate conclusion for the research party.
Flexible Design Using Qualitative Methods
A flexible research design allows the researcher to adjust the process during the research (Kumar, 2018). One of the critical benefits of relying on this method is that it facilitates the investigator with a viable opportunity to enhance the research validity (Kumar, 2018). As Kumar (2018) notes, a flexible design is vital to improving research outcomes. The researcher can capture appropriate data and information depending on the situation. For instance, if the participants targeted for the study are unreachable due to work-related circumstances, the researcher can focus on a more flexible data collection method. Focusing on a more flexible study saves time and massive resources due to diminished limitations (Kumar, 2018). It also makes it possible for the researchers to investigate a myriad of other factors that could prove helpful to the research. With technology, the flexible study is more efficient since one can source participants from all parts of the world, making the data collected more conclusive. Overall, the flexible research design approach improves study validity and other relevant research-based outcomes. The flexible design methods that researchers can utilize include narrative, phenomenology, grounded theory, case study, and ethnography (Kumar, 2018).
Mixed Methods Design using Quantitative and Qualitative Methods
The mixed research design focuses on a combination of fixed and flexible methods. It ensures that these two approaches integrate. This design is especially relevant in answering research questions that cannot be addressed while relying on a singular tactic (Doyle et al.,
2009). The mixed-methods design paves the way to apply various methods that the investigator deems relevant to the study. The researcher can focus on convergent, explanatory, sequential, and exploratory transformative mixed design methods. A mixed research design is one of the most functional research designs. This is because it expands the scope of research such as no single method can (Doyle et al., 2009). It involves a process that provides both observations and statistical analysis, which helps make sure that the research is more comprehensive. A mixed design also offers more in terms of exploration rather than just focusing on analysis (Doyle et al., 2009). This makes sure that the data being used in the research is more than comprehensive, which offers subtle solutions to a problem that may seem too big to solve initially.
The Appropriateness of the Flexible Design in the Project and the Rationale
The study will be conducted using the single and flexible case study design that focuses on the qualitative method. The single study aspect aids in capturing data from a specific group of interest (Kumar, 2018). Capturing information from a single group is advantageous because it narrows down the scope of data that will need to be analyzed (Kumar, 2018). This, in turn, ensures that the data is thoroughly analyzed. Capturing information from a small group will also ensure that the participants are all diverse and represent the diverse groups as found on the ground (Kumar, 2018). This means that their information will be an authentic representation of what is happening in real life. The flexible design is a crucial way of applying and building an appropriate theory targeting a unique case (Kumar, 2018). In this case, the researcher will target a group of healthcare providers and leaders to share their ideas and thoughts on the issue of professional burnout amidst the COVID-19 pandemic. The investigator may better understand answering the research question and derive a quality conclusion by targeting a single interest group.
The flexible design suits the study because it will allow the investigator to gather a wide range of information obtained from the facts relayed by the participants through observing their behavior (Doyle et al., 2009). For example, the subjects will provide verbal details when asked about their leaders’ participation in creating a conducive working environment during the COVID-19 pandemic and the burnout experienced. Also, the researcher can rely on verbal cues to draw quality information (Doyle et al., 2009). The flexible design will also allow the researcher to capture information depending on the situation (Doyle et al., 2009). It suits both the researcher and the participants. For instance, if the investigator feels that the method used does not fit the context, one can change it to ensure that the results are more valid (Doyle et al., 2009). Also, it ensures that the subjects have the right to withhold information that they might find inappropriate. For example, if an interview does not allow the researcher to obtain the desired information, an observation can suit the process better as it captures facts. Overall, a flexible design aids in enhancing a study’s validity (Doyle et al., 2009). As Kumar (2018) highlights, adjusting a research design helps the researcher obtain relevant data and information for the study. A flexible design is essential to avoiding inappropriate conclusions based on inadequate information (Kumar, 2018). The fixed and mixed methods would not be ideal for the study to collect information focusing on attitudes and perceptions (Kumar, 2018). The flexible design is more about adapting to changing participant views, especially when the study is conducted relatively quickly (Kumar, 2018). The design will make it possible to navigate the changes and still be able to capture and integrate them into the study.
The study will focus on the qualitative method to gather and analyze the acquired information. The qualitative method will examine the experiences and perspectives that the subjects have toward an identified topic of study, known as ethnography (Al-Busaidi, 2008).
The study’s relevance will be determined in the healthcare domain to answer questions revolving around various issues. For example, examining the impact of the COVID-19 pandemic and the top leadership’s role in addressing burnout calls for qualitative research methods to enable the investigator to understand different attitudes and perceptions (Al-Busaidi, 2008). When quantitative research utilizes techniques, stakeholders might fail to understand better some of these issues (Al-Busaidi, 2008). This is primarily due to the lack of quantifiable data on participants’ attitudes and behaviors (Al-Busaidi, 2008). Thus, the qualitative design comes in handy as it supports information collection focusing on emotions, attitudes, and associated behavior (Al-Busaidi, 2008). The qualitative design is the right kind of research design because it does not need numerical statistics to conclude since the research is based on emotions and attitudes, which are not quantitative (Al-Busaidi, 2008). This research calls for the qualitative research method as it will accelerate accessing valuable information.
Discussion of Method
The study will incorporate the flexible design approach and focus on the narrative, phenomenology, grounded theory, case study, and ethnography methods (Naideo, 2012). The researcher can decide to use any of these methods depending on the context and desired results.
Narrative
The narrative methodology entails inquiries directed at human experience narratives or inquiries that yield data in the narrative form (Butina, 2015). The stories relayed from the subjects through their experiences develop into raw data. The researcher can rely on secondary data obtained from observations and interviews during the study. Notably, written or spoken information provided by the subjects during the actual research process becomes a
key source of quality information and data. The narrative methodology aligns with the researcher’s key, which focuses on acquiring raw data from participants’ experiences in the actual setting and through secondary narratives (Butina, 2015). The narrative method and the researcher’s key are cross-examined to reveal any outliers.
Phenomenology
Phenomenology is based on people’s experiences with a particular phenomenon depending on how it manifests in their lives (Williams, 2021). It uncovers “what experiences are like” (Williams 2021, p.366). Using an individual’s experience, an investigator can understand the concept at hand. For example, a researcher can study a group of people with first-hand knowledge of a particular area of interest or who have experienced an event. One’s individual experience may expose one to the manifestation of the problem in the actual world setting. This approach suits the study because the researcher can access viable participants to share their experiences and obtain necessary information (Williams, 2021). If the information collected from the participants is similar, then it can help the individual come up with a common theme, as will be proven by the data collected. If there are differing opinions, this can also be used to develop a theme since it shows a common discrepancy when it comes to the research topic.
Grounded Theory
Grounded Theory involves the collection and analysis of data (Konecki, 2018). Once the data is collected for research and analyzed, it is labeled grounded theory because the theories are supported by the data (Konecki, 2018). The grounded theory framework focuses on theory development (Pulla, 2016). Researchers can use it to explain how the participants of the study would handle the issue at hand or any similar potential problem in the future. It also makes it possible for the researcher to modify or alter a theory when comparing existing
data to the relevant data. Researchers systematically collect and analyze data to formulate appropriate theories (Pulla, 2016). The central aim of the grounded theory model is to establish social relationships and behaviors. The theory also provides the researcher with the benefit of being able to begin the study without a preconceived notion of what they will find. The grounded theory is based on the researcher’s ability to come up with a theory from the research results (Pulla, 2016). The theory obtained will be reliable since it is based on previous supportive research. The obtained findings become the theory that helps the researcher develop a viable conclusion. The grounded theory method can be integrated into the study to further future research on the conclusions of the impact of the pandemic and the leadership role in exposing healthcare providers to professional burnout.
Ethnography
Ethnography aims at learning about the culture of a particular setting (Naidoo, 2012). Researchers engage participant observational processes across the field to learn more about culture and learn about beliefs, social interactions, and behaviors (Naidoo, 2012). The outcomes inform investigators about interactions and relationships in a specific environment.
Ethnography methods aim to develop an analytical interpretation of cultures (Naidoo, 2012). The researcher gains new insights based on the in-depth understanding of a specific culture during the long span of the study.
Case Study
A case study method is a process that relies on real-life context. It is a comprehensive account of an individual case and its analysis (Starman, 2013). Researchers investigate a person, group of people, or events to examine the boundary between the phenomenon and the context (Starman, 2013). The case study method will assess the impact of the COVID-19 pandemic on professional burnout in the healthcare sector and the role that leaders have
played in addressing the challenge. By targeting a group of care providers and leaders to act as the case study, the investigator will access viable information highlighting a link between the issue and its context.
Discussion of the Appropriateness of the Best Method
The case study is the best method to understand how the COVID-19 pandemic has exposed healthcare providers to professional burnout and how leaders have handled the situation (Starman, 2013). The researcher can study the participants during a set time or location to unravel the challenges experienced and how leaders effectively dealt with the problem (Starman, 2013). For instance, through this approach, the investigator can study nurses handling patients on the ground and establish viable conclusions from the same.
Therefore, its ability to analyze the population in a real-life context makes it an ideal method. It also makes it easier to focus the study on a specific area, making the results even more viable due to the specificity.
It is also essential to make sure that the information presented in the study is valid. This can be done through a process called respondent validation (Starman, 2013). It involves retesting the initial results with the respondents to ensure they would give the same kind of response. This helps make sure that the researcher can overcome any personal bias.
Discussion of Triangulation
Triangulation entails combining different research methods and approaches to enhance credibility and validity (Campbell et al., 2020). Researchers use multiple methods to study a phenomenon of interest (Campbell et al., 2020). This process eliminates potential biases often witnessed when relying on a single research method. The focused study will entail questionnaires, focus group discussions and interviews to gather information. The information obtained from each of these methods will enhance credibility and validity. The
research methods that will be used in this study will include questionnaires, interviews, and focus group discussions. The first method that will be used is questionnaires to gather information from a group of healthcare providers. This questionnaire will allow participants to express their opinions about how the pandemic has affected their work environment. The researcher can create a questionnaire that allows participants to express their views on topics. The participants will answer questions like, have they been affected by the pandemic, and how has it affected their work environment? The researcher can also ask what kind of support system would make them feel better about handling the threat posed by pandemics.
Participants will be given time to respond to the questionnaire.
The second method that will be used is the use of focus groups. The main objective of this method is to obtain reliable information about participants’ perceptions of the pandemic in their organization (Campbell et al., 2020). It also allows participants to express their opinions regarding handling the problem if they were leaders or managers in their organizations (Campbell et al., 2020). The researcher could hold discussions with a group of healthcare providers and leaders and engage them in conversations on how they would handle the threat posed by pandemics if they were leaders or managers (Campbell et al., 2020). The participants in focus groups need to have a context to make sure that they give more realistic opinions.
The third method that will be used is the use of interviews. This method involves collecting information from participants one-on-one (Campbell et al., 2020). Interviews are considered helpful in qualitative studies because they can allow open discussion and reflection (Campbell et al., 2020). The researcher could hold individual interviews with a group of healthcare providers and leaders and engage them in discussions on how they would handle the threat posed by pandemics if they were leaders or managers.
The research will target different triangulation approaches. These include data, theory, and methodological modes of triangulation. First, the data triangulation approach will enable the researcher to examine the differential outcomes evidenced during the ‘normal’ operations and the pandemic era. Understanding the experiences that care providers have during the ‘normal’ times and the ones witnessed during the pandemic can shape a better view of the issue at hand. Evaluating data obtained from the two times will establish important generalizations and conclusions. Assessing ‘normal’ experiences from those evidenced during the pandemic can reveal realities and enable the researcher to develop quality judgments (Campbell et al., 2020). First, the researcher will collect information on healthcare provider’s experiences before the pandemic using questionnaires and interviews. This information can be availed from past research processes that delved into the issue of professional burnout in the healthcare domain. This will allow the investigator to assess to what extent healthcare providers encounter burnout in normal situations. Secondly, the researcher will undertake a primary process to examine how the pandemic has affected these professionals. A comparison of these two outcomes will pave the way for effective conclusions. Thus, the key aim is to ensure that the investigator determines if the COVID-19 pandemic and subsequent conditions position care providers at a burnout disadvantage. The central rationale is to evaluate the results obtained from the two approaches to assess commonly occurring themes and differences. The researcher can build arguments based on the results obtained from this process. These two steps lay the foundation towards achieving quality outcomes that open the room for quality conclusions. The triangulation approach becomes an excellent way of assessing how the pandemic has generated burnout among health care providers. The credibility and effectiveness of the results obtained heavily relies on the triangulation approach (Campbell et al., 2020). The triangulation approach portrays the need to utilize this
perspective and especially when focusing on strategic and appropriate theories. The central foundation is to obtain a wide range of data and information leading to an effective generalization and conclusion.
Theories support a better understanding of the various issues leading to professional burnout among healthcare workers. Each theory delves into a particular issue of interest. The major theories involved in this study are the Conservation of Resources, Maslach’s, and the Job Demands–Resources Theory. The conservation of resources theory analyzes how the lack of resources during the pandemic left care providers experiencing numerous challenges that led to professional burnout (Pulla, 2016). The job-demands resources and Maslach’s theories addressed the hectic and demanding working environment evidenced during the pandemic, as highlighted by Konlan et al. (2022). The issues mentioned in these theoretical frameworks are related to professional burnout in the healthcare industry. They boost a better understanding of the different factors capable of exposing care providers to professional burnout. Overall, these theories enhance a deeper understanding of the impact caused by the COVID-19 pandemic on healthcare providers (Pulla, 2016). The theories triangulate to allow the investigator to establish a quality generalization and conclusion.
The above-mentioned theories triangulate to develop a better view and understanding of the issue at hand. The theories focus on respective elements and conditions that leave healthcare professionals nursing burnout. The researcher’s main aim is to assess how care providers were exposed to professional burnout during the pandemic. For example, Maslach’s theory analyzes emotional exhaustion from limited energy and emotional exhaustion encountered by care providers (Dall’Ora et al., 2020). For instance, a high workload during the pandemic could have exposed healthcare workers to emotional exhaustion. Also, the job demands theory pays attention to a similar issue. This means that exposure to the two theories
can help the investigator to triangulate. It shapes a better outcome considering that the researcher has a better chance of generalizing the outcomes. This leads to a valuable conclusion leading to an informed standpoint. For instance, one theory might cover the issue of the lack of a safe working environment while the other targets are exposed to hectic working conditions.
Each theory establishes an analytical approach toward the emergence of professional burnout (Pulla, 2016). The researcher can develop a better conclusion using each of the insights obtained from these theoretical models. Some approaches that come into play include the job resource demand theory, Maslach’s model, and the conservation of resources theory. They allow the researcher to connect the burnout challenge with various circumstances and conditions in the workplace. For example, the job resource demand theory evaluates how the extensively demanding environment builds burnout (Pulla, 2016). When healthcare providers operate in a complex and challenging setting, they are bound to experience physical, emotional, and psychological problems (Shreffler et al., 2020). This leaves them exposed to professional burnouts that affect their ability and capacity to handle their duties. On the other hand, Maslach’s theory evaluates emotional exhaustion based on high workload (Dall’Ora et al., 2020). These theories develop vital thematic elements that the researcher can use to achieve a better outcome (Dall’Ora et al., 2020). For example, these theories reveal the presence of emotional exhaustion which is a key prerequisite factor for professional burnout. Overall, methodological triangulation will be used as it promises a wide range of data and information which supports effective analysis.
The researcher will target the use of interviews, questionnaires, and focus group discussions to collect vital information. Using these sets of different methodologies ensures broader access to important ideas that help in making informed and excellent decisions (
Noble & Heale, 2019). They may reveal that healthcare providers are exposed to emotional, psychological, and physical exhaustion based on the hectic working environment and other associated factors. Considering that each methodology and source provides unique insights, the investigator is better positioned to make a strategic generalization and conclusion. Overall, the selected methodology ensures that the researcher will have a vast range of data and information essential in determining the extent to which healthcare providers may be exposed to professional burnout during the COVID-19 pandemic era. Using triangulation guarantees access to quality data and information (Noble & Heale, 2019). This enhances credibility and validity of the research outcomes. The audience is more likely to trust and believe in the established research outcomes based on the use of the triangulation approach. Therefore, it becomes a vital perspective of concern when dealing with an issue such as professional burnout among healthcare professionals.
Summary of the nature of study
This single case study will address the issues of professional burnout among healthcare providers during the COVID-19 pandemic. The focus is on selected care providers and leaders in the healthcare setting. A positivist research paradigm will enable the researcher to base the process on an objective approach rather than a subjective one to interpret the situation. Also, a flexible design will be crucial to ensure that the researcher can adjust methods and techniques if needed. The case study approach is highly integrated with this case study as it will enable the investigator to study the subjects in a real-life context. Questionnaires and interviews will act as imperative data collection strategies supporting triangulation. The use of various qualitative methods as described will be beneficial to the researcher. They will be able to collect the most accurate data possible and come up with research that is conclusive and very informative.
Research Framework
The research will be guided by elements that will help the researchers focus and narrow their inquiry into burnout among healthcare workers. The study will apply concepts, theories, actors, and constructs to help structure and govern the research. Thus, the study will apply a combination of organizational, psychological, and social frameworks to research how leadership in medical institutions affects healthcare workers’ performance amidst the challenges of COVID-19. The metrics considered will be the healthcare personnel’s (HCP) working hours during the COVID-19 pandemic, the doctor-patient ratio, and the welfare provided. The psychological factors caused by COVID-19 may be responsible for healthcare workers’ burnout. The research questions seek to address professional burnout among nurses and understand if nurses are the most affected by burnout during the COVID-19 pandemic. Other research questions seek to understand how leadership burnout affected burnout and the proposals to arrest the burnout among health care workers. The following figure, Figure 1, is a visual representation of the relationship between these elements within the framework:
Figure 1. Research Framework Diagram
Concepts
Leadership plays an integral role in ensuring the smooth running of any given organization (Cotel et al., 2021). In a healthcare setup, leadership is crucial in facilitating quality services. In the past few years, the efficiency and effectiveness of leadership within the healthcare settings have been put under severe test by the outbreak of COVID-19. The
pandemic outbreak has exposed the gaps in the quality of leadership needed to run the healthcare facilities (Sharifi et al., 2021). As a result of inefficiency in leadership within the healthcare sector, cases of healthcare professionals experiencing burnout have drastically increased (Sharifi et al., 2021). Effective and efficient leadership is essential, ensuring various issues such as professional burnout do not affect the quality of health care services rendered to the patients (Anthony-McMann et al., 2017).
Burnout Within Health Professionals
The presence of effective and efficient leadership within the organization caters to the psychological welfare of its human resources (Sharifi et al., 2021). COVID-19 has caused chaos and confusion within the healthcare environment. For instance, the high number of deaths of patients within the hospital has led to healthcare providers experiencing shock and trauma. This massive loss of patients and healthcare professionals has led to fatigue and burnout of healthcare providers (Sharifi et al., 2021).
Comprehending the severity of healthcare professional burnout and the cause is vital in developing a supportive environment for healthcare professionals and their well-being, effectiveness, and efficacy within the healthcare workforce. Cotel et al. (2021) demonstrate that 50% of medical professionals have experienced exhaustion due to the COVID-19 pandemic in one instance. As shown in figure 1, the concept is linked to the psychological and organizational framework because it seeks to explain the psychology behind more than half of healthcare workers experiencing burnout. The impacts of COVID-19 on the healthcare employee’s psychological state are clear. Just like the pandemic led to psychological trauma due to loss of jobs, loved ones, school closures, and movement restrictions, it equally had a daunting experience for the nurses who were the frontline soldiers to combat its spread (Sharifi et al., 2021). Moreover, they had to care for their families, while others had to stay in
the hospitals due to movement restrictions (Sharifi et al., 2021). The long working hours, the high patient-nurse ratio, and the ever-increasing patient count caused burnout in the nurses (Sharifi et al., 2021).
Shortages in Healthcare Professionals in Relations to COVID-19
The outbreak of COVID-19 has exposed the acute shortage of healthcare providers within the healthcare systems (Dall’Ora et al., 2020). The exponential increase in the number of individuals seeking healthcare services due to the pandemic has stretched to limit the abilities of the available professionals. The influence of COVID-19 on healthcare safety cannot be underestimated. The burnout experienced by healthcare providers is of national concern (Dall’Ora et al., 2020). The emergence of COVID-19 did not stop other diseases from occurring while the doctor-patient ratio remained the same (Dall’Ora et al., 2020). As a result, the long working shift and lack of proper support leadership infrastructure have led to the health care professionals experiencing burnout while providing healthcare services.
Leadership Within the Organization
Healthcare organizations also lost income due to canceling non-emergency and specialty treatments after the pandemic (Dall’Ora et al., 2020). Therefore, the healthcare sector has strained beyond the limit, and the government’s relief has not been enough to address the impending more significant challenge. The loss of revenue and the overwhelming hospital capacities made the management of the healthcare facilities difficult. The healthcare administrators were thus overwhelmed with managing a balance between life and work (Dall’Ora et al., 2020). Therefore, the leadership attributes provided were short of the transactional qualities needed for success in the healthcare sector. Some of the vital aspects to be deliberated include the role of supervisors of healthcare institutions in causative to the cause of healthcare professionals’ burnout (Dall’Ora et al., 2020). Notably, crucial resource
allocation issues within the healthcare environment and shift patterns are essential in mediating burnout. Developing a clear insight of the influence the COVID-19 has on healthcare professional burnout can positively inspire positive human resource management (Cotel et al., 2021). Thus, the leadership within the healthcare facilities has the mandate of creating a conducive working environment.
However, to fully effect the necessary changes and help the doctors overcome the challenges of the pandemic, employee engagement is essential (Cotel et al., 2021). The healthcare administrators and senior managers must derive measures that reward the nurses and the clinical officers appropriately to motivate them and help overcome burnout (Cotel et al., 2021).
Effective Leadership
Employee engagement will be based on the participative institutional practices that embrace the current organizational design trends toward effective leadership (Anthony-Mcmann et al., 2017). The techniques needed to address the concept of employee relations and job satisfaction through incentive programs motivate employees to work and improve their welfare while in the workplace (Anthony-Mcmann et al., 2017). Leaders are responsible for creating a conducive working environment that encourages employee engagement. Leaders can adopt numerous strategies and programs to ensure employees are conversant with their roles hence reducing the cases of burnout (Cotel et al., 2021).
Theories
Theories are extensively beneficial in understanding how care providers are affected and impacted by professional burnout. They offer a set of principles that allow the audience to cultivate a better relationship between these aspects and the core issue at hand. They encompass an in-depth and valuable relationship of variables that lead to the issue at hand.
Primarily during the COVID-19 pandemic duration, where healthcare providers have experienced advanced professional burnout, the use of theories provides a greater understanding and view of the perspectives that led to the situation (Jalili et al., 2021). One of these theories is the job-demands resource which analyzes the hectic and demanding environment evidenced during the pandemic. Care providers developed burnout due to handling numerous roles and responsibilities (Konlan et al., 2022). Maslach’s theory covers emotional exhaustion emerging from a similar working environment. Lastly, Maslach’s theory covers the emotional drain from the high workload evidenced during the pandemic.
These significant theories target the prevailing work setting detailing the pandemic (Konecki, 2018). The issue of emotional, psychological, and physical exhaustion relates to leadership capacity (Konecki, 2018). The researcher will observe transactional and transformational leadership and the possible inefficiency of leaders in guiding healthcare organizations. The theory portion of the research framework is established on variables that may impact the possible responses of the sample population (Russell, 2014). As Russell (2014) further supports, a high perception of transformational leadership reduces burnout levels, especially among high-risk professionals such as the police and healthcare workers. The research seeks to utilize healthcare workers’ attitudes and perceptions to further understand burnout among healthcare workers, supported by theories and specific research questions.
Job Demands–Resources Theory (JD-R)
This theory posits that the working environment can expose care providers to professional burnout. Healthcare professionals who work in a hectic and demanding setting become extensively prone to burnout. These elements include workloads, emotional demands, and understaffing (Broetje et al., 2020). They become highly dissatisfied and demotivated in their work. The primary foundation behind burnout is the increased job demands in the
workplace. For example, during the COVID-19 pandemic, hospitals and other care centers experience a surge in demand for services. Care providers were handling numerous roles and responsibilities that left them overburdened. This created emotional, physical, and psychological challenges, especially in institutions that failed to capture the needs and well-being of these service providers (Broetje et al., 2020). This theory argues that the workload on an employee affects their stress levels (Cotel et al., 2021). Notably, when the work demands increase, stress levels increase simultaneously, leading to work burnout (Cotel et al., 2021). COVID-19 increased the tasks of healthcare people as the infections spread at a faster rate in all nations. The increase in demand for healthcare services strained the healthcare workers beyond the limit (Cotel et al., 2021). The healthcare workers had to handle more workload, work for long hours, lack enough sleep, suffer poor nutrition, and experience the mental trauma of experiencing patients suffering and dying due to the virus increase (Morgantini et al., 2020).
However, research shows that self-regulation is likely to ease burnout in the healthcare sector (Bakker & de Vries, 2021). This means that care providers should regulate themselves to avoid burnout. This research counters the argument that high job demand leaves healthcare providers exposed to job strain and emerging burnout. Overall, this theory is used in the evaluation of data to inform the research on the impacts that an environment based on high demand for care services can lead to professional burnout, primarily when leaders fail to integrate strategic actions. It allows institutional leaders to assess the status of the working environment to supplement the demand and supply of care services when dealing with a hectic setting.
Maslach’s Theory
Maslach’s theory focuses on the challenging environment that care providers work in, especially during pandemics (Dall’Ora et al., 2020). They operate in a complex and hectic setting that leaves them nursing emotional exhaustion. This theory applies where demanding working conditions expose care providers to emotional tribulations. They often face anxiety and stress, considering they are left to handle numerous critical roles and responsibilities (Teo et al., 2021). However, this does not mean that job demands, and resource availability are the only aspects that leave care providers prone to the menace. Personal characteristics also act as a critical factor that shapes the outcome, as identified by McCormack et al. (2018). This means that, contrary to the imagination that institutional leaders are to blame for burnout, healthcare providers can better manage their emotions and feelings to accelerate the fight against burnout.
The theory entails emotional exhaustion and a partial sense of personal accomplishment associated with their duties and responsibilities (Poghosyan, Aiken &
Sloane, 2009). Burnout undermines the care and attention services provided to patients.
Maslach’s theory has developed a framework capable of predicting the likelihood of burnout occurring within the organization’s human resources (Dall’Ora et al., 2020). The framework is the Maslach Burnout Inventory (MBI) (Dall’Ora et al., 2020). According to the framework, some of the key components contributing to burnout are extreme assignment, negative coexistence with the community, lack of motivation, and lack of resource control (Morgantini et al., 2020). The management of resources will help to employ more healthcare personnel, purchase PPEs, pay for the workers’ allowances and provide accommodation, childcare, and transport to ease the occupational stressors that lead to burnout in the workplace (Morgantini
et al., 2020). Maslach’s theory connects how using resources could help reduce burnout in the research framework (Dall’Ora et al., 2020).
This theory helps healthcare institutional leaders to realize that the foundation behind reduced burnout lies in the strategic allocation of resources. This can handle most of the gaps that leave care providers nursing burnout. For instance, a significant allocation of resources can facilitate employee mental welfare, providing quality personal protective equipment and workforce allowances. Advancing each of these areas can limit this menace. For example, during the COVID-19 pandemic, healthcare workers faced enormous and hectic tasks due to the surge in patients needing care and attention services. If their organizations could employ more staff, this may limit burnout.
Conservation of Resources Theory
The theory provides the necessary parameters to enhance the well-being of healthcare workers, including vitality, the working environment conditions, and the tools of the profession (Prapanjaroensin et al., 2017). According to the theory, the absence of the four above parameters leads to burnout among healthcare professionals. In line with the WHO (World Health Organization), the discussions of this theory define burnout as the lack of energy or fatigue, pessimism in the workplace, or leaving one’s profession (Morgantini et al., 2020). Therefore, the actor’s intervention to burnout must seek intervention mechanisms that guarantee energy, satisfaction at work, and healthy organizational culture. This revolves around collecting a significant resource base to pave the way for viable healthcare systems and structures. Research indicates that poorly resourced health systems lie as a critical challenge in reducing burnout (Alvaro et al., 2010). If healthcare establishments fail to assemble vital and substantial resources, they will likely expose their care professionals to
burnout. This portrays the need for leaders to invest in a crucial resource base to supplement emerging needs when operating in a hectic and demanding environment.
This theory will be used to analyze the stress factors, how those stress factors tie into healthcare workers burnout, and what the most efficient methods of addressing burnout are.
This theory will be used to guide interventions to decrease possible burnout and future research that examines the relationship between healthcare worker’s burnout and patient safety (Cocker & Joss., 2016). This theory captures the need for healthcare leaders to amass and allocate resources to establish a conducive working environment. A significant allocation of resources in various healthcare centers may pave the way for reduced burnout. This is because institutional leaders can address most of the issues that expose care providers to this problem. For example, they can employ more staff members to accelerate service delivery. This ensures there is greater flexibility and consequently enabling service providers to establish a work-life balance. Overall, this is a major theoretical approach capable of enabling healthcare leaders to address burnout occurring during the pandemic.
Actors
The activities in a healthcare system are influenced by various personnel who define the fluidity of operations in providing care (Morgantini et al., 2020). Fundamentally, the segmentation of these actors in terms of their role in a healthcare facility determines the suitability of care provision. Therefore, the care team is segmented into various units that facilitate a healthcare facility’s operations.
Health Care Providers
The healthcare professional is the core component under study. The study’s primary purpose is to determine how the pandemic has led to burnout in healthcare facilities. Burnout is a global health concern for nurses, physicians, and clinicians caused by stress in the
workplace and not appropriately managed (Sharifi et al., 2021). Burnout manifests itself in three forms: fatigue or energy loss, pessimism about the job or mental distraction from work, and reduced professional effectiveness (Sharifi et al., 2021). Generally, the symptoms of burnout are increased absenteeism, attempts to leave the profession, drug abuse, and low self-esteem. Since the emergence of COVID-19, the health care professionals, particularly those working in the emergency departments, have faced many occupational depressors, including the working hours, prolonged wearing of masks, lack of sleep, poor nutrition, dehydration, and heat generated by extra clothes, and increasing workload (Sharifi et al., 2021). These stressors had increased the burnout crisis in the healthcare sector due to the demanding work schedules even before the pandemic struck (Sharifi et al., 2021).
Healthcare Managers/Administrators
This actor plays an essential role within the healthcare environment. Some healthcare leaders’ responsibilities include employing and assigning duties and ensuring healthcare workers access resources and protective gear. Figure 1 links these actors to the organizational and psychological framework allowing the investigation of how each actor influences the psychological well-being of healthcare practitioners.
Patient / Consumer
The patient’s welfare is at the center of the healthcare service providers. However, this welfare is adversely affected when the service provider’s quality of health and safety is constrained by burnout (Sharifi et al., 2021). As a result of nurses experiencing burnout, careless mistakes are likely to occur, negatively impacting patients’ well-being. Moreover, the constant death, the suffering, and the need to sympathize with customers whose patients are admitted is also a cause of burnout for the nurses (Sharifi et al., 2021). The COVID-19 agony has undoubtedly caused mental health problems to the public, the patients, the nurses, and
other healthcare personnel (HCP). The research will play an integral role in demonstrating the roles patients can play in facilitating solving the problem of caregiver burnout.
Constructs
Constructs are essential in facilitating critical understanding regarding issues affecting the topic under research. The constructs refer to the connection between leadership and healthcare professionals, the effort of the healthcare administrators to contain burnout. Containing and controlling burnout among healthcare professionals is a challenging exercise that will require the pooling of resources and skills from all the profession’s stakeholders (Sharifi et al., 2021).
The Role of Stakeholders in Dealing with Healthcare Professional Burnout
The role of stakeholders exists as one of the imperative constructs in the professional burnout challenge. There are numerous parties affected and impacted by the different decisions established in the healthcare domain. This has been a major area of concern, as Wu et al. (2019) highlight that little attention is directed toward multiple stakeholders involved in healthcare matters. Organizational leaders should always integrate and observe the need and interests of all stakeholders (Ali et al., 2021). In this case, the project focusing on addressing professional burnout through effective leadership means that leaders should evaluate and meet the expectations of all stakeholders. These entail both the internal and external parties. For example, patients and care providers are internal stakeholders impacted by this initiative, while the community at large is a critical external party.
Patients and medical supervisors are crucial stakeholders within the healthcare sector. These groups of stakeholders have integral roles in addressing the issues of professional burnout. For instance, patients directly interact with the healthcare providers, and they can tell the level of burnout of the healthcare professionals. However, for the patients to be able to
report cases of professional burnout, several aspects are needed. One of the key aspects is how patients can realize and report incidences of burnout of healthcare professionals within the organization while still maintaining the professionalism of nurses (Morgantini et al., 2020). If patients realize that the care provider is offering inadequate services, they can always report this to the proper authorities. This paves the way for leaders to take immediate and quality actions. However, this does not mean that leaders should wait for such happenings to take action. They should evaluate the working environment and establish if it suits the needs and welfare of its team of professionals. This will ensure that leaders take the best steps to avoid exposing their healthcare workers to burnout. For example, during the pandemic, healthcare workers faced various mental issues like stress, depression, and anxiety (Ghassemi 2021). This was connected to the events and images that they observed in their line of duty. This called for leaders to invest in mental training and awareness programs. Understanding their mental health risks should have accelerated them into establishing this strategic action (Ghassemi, 2021). This means that organizational leaders remain a pivotal factor in making the work setting quality and conducive for everyone. Overall, this construct targets consideration of all stakeholders’ unique needs, interests, and expectations while observing them (Kelly et al., 2020).
Creation of a Conducive Working Environment for the Employees
Creating a conducive working environment for healthcare service providers is one of the most effective approaches to dealing with professional burnout (Morgantini et al., 2020). The healthcare environment changes rapidly, with strategic steps needed to build a quality working environment. For example, when the pandemic occurred, most hospitals and care centers experienced numerous patients needing admission and other critical services. Workers were left handling multiple roles that exposed them to burnout. This portrayed lack of
adjustments to allow these care providers to balance their work and personal life. They became heavily exposed to physical, emotional, and psychological challenges. Amidst the hectic environment was the lack of access to crucial equipment needed when handling patients. As Jalili et al. (2021) note, leaders failed in their mandate of making the working environment better for all healthcare workers. Immediately care leaders realized that the
COVID-19 pandemic could a take a toll on their organization, they would have liaised to create proactive measures. In case burnouts advanced, they would have implemented these guidelines to safeguard their team members from developing burnout.
The leadership role during the crisis was a critical factor in containing the spread of the disease and ensuring the healthcare workers’ welfare (Morgantini et al., 2020). The healthcare leadership during the pandemic played an essential part in the deployment of the healthcare personnel and the provision of home care for the nurses and physicians, arranging for transport services, accommodation, and social welfare (Morgantini et al., 2020). The healthcare administrators played an essential role in managing the workforce by recruiting non-specialized clinicians to assist in the hospitals’ wards while saving the most qualified doctors from the frontline and restricting them to emergency and intensive care units during the pandemic (Morgantini et al., 2020).
As indicated in Figure 1, the constructs are linked to the relationship between the organizational and social frameworks that will help identify the social impact of various strategies as part of a solution to burnout.
Relationship Between Concepts, Theories, Actors, and Constructs
The primary goal is to assess burnout challenges experienced by healthcare workers during the COVID-19 pandemic. Using relevant concepts, theories, actors, and constructs, the researcher can establish a viable explanation for the exposure to burnout among healthcare
professionals when the world is struggling with the COVID-19 pandemic. These four components interrelate to produce the desired outcome.
The major concepts include understanding the leadership role, the burnout situation among healthcare professionals, and the shortage of care providers. These are crucial concepts that enable the audience to understand the cause and status of the burnout problem among these professionals. For example, the acute shortage of healthcare providers has exposed the current workforce to job strains that have created burnout (Dall’Ora et al., 2020). This is because they are stretched beyond their limits.
The theories applicable in this situation include the Job Demands-resource (JD-R), Maslach’s, and the Conservation of Resources theories. The JD-R theory focuses on the increasing stress levels among healthcare professionals due to increased workloads (Morgantini et al., 2020). Maslach’s theory highlights that burnout occurs due to extreme workloads, lack of motivation, and the absence of resource control (Morgantini et al., 2020). Lastly, the Conservation of Resources Theory reveals that the inability to consider the wellbeing of healthcare workers and create a quality working environment exposes these professionals to burnout (Prapanjaroensin et al., 2017).
The primary actors, in this case, include the healthcare workers and the leaders. Burnout directly affects care providers who are limited in the care and attention services they provide to the consumers, the patients. The other vital actor is the healthcare managers or administrators responsible for addressing burnout among these professionals.
The addressed construct is the leadership approach that determines the effective handling of these vital issues. During the COVID-19 pandemic, the hospital needed talented leaders to manage the panic, provide medical workers with resources, and ensure enough employees to address the crisis (Brooms, 2020). Despite the prevailing crisis, leaders also
needed to ensure that healthcare professional gets adequate time to relax and reenergize. However, healthcare leaders may have responded inappropriately to the crisis, causing burnout among healthcare workers (Brooms, 2020). The leadership strategies developed and implemented by the hospital leaders will determine if the burnout challenge is adequately addressed (Al-Busaidi., 2008).
Conclusion of Constructs
This single case study aims to understand the different factors, particularly leadership strategies, that impact COVID-19 burnout among healthcare workers. It is understood that leadership style impacts production and organizational culture (Allen, 2019). The effectiveness of leadership must be assessed to determine plans for continuous improvement
(Brooms, 2020).
The emergence of COVID-19 added to the growing concern of burnout among health professionals. WHO defines burnout as a crisis that needs addressing for an effective healthcare system and the realization of quality care (Allen, 2019). However, the emergence of the pandemic prolonged the nurses’ working hours and exposed them directly to the virus. Health Care workers had to wear PPES for long hours, lacked sleep, suffer poor nutrition, and the sympathy of comforting patients in the wards and the death of patients caused mental health trauma and increased burnout (Allen, 2019). The role of the healthcare leadership and the healthcare administrators in reducing burnout during the pandemic encouraged the healthcare personnel to continue in the fight against the pandemic. Organizational leadership, mainly transactional leadership, and employee engagement were paramount. Providing childcare, accommodation, and transport reduced the healthcare workers’ pressures on work-life balance (Di Trani, 2021). The healthcare administrators were also critical in recruiting unspecialized clinicians and increasing bed capacity to reduce the work pressures on the most
qualified human resource in the hospitals (Allen, 2019). The owners provided the necessary allowances, purchased the essential PPEs, and paid healthcare allowances. The government intervention in terms of relief to healthcare institutions also helps to increase bed capacity, PPEs, and other facilities (Denning et al., 2021). All these constructs effectively addressed the burnout issue among healthcare personnel. Patients’ contribution was also significant because they are the end consumers of the services. The patients can notice when the efficiency and efficacy of services, which must reflect the standard quality care and excellence in not met. They thus help to notify the relevant authorities of burnout.
Summary of the Research Framework
The research framework develops a visualization of the role of leaders to the healthcare workers during everyday work environments and during irregular work schedules, which has been the case since the outbreak of COVID-19. This research framework seeks to effectively characterize each player and element of the healthcare sector by outlining how COVID-19 has evidenced the dependency of health workers on their leaders. This framework will allow the researchers to identify solutions to the high burnout levels that include all parties linked to the healthcare workers, including the practitioners. The role of the leaders, the psychological frameworks, and social and organizational frameworks have helped outline the response to burnout during the pandemic.
Definition of Terms
Burnout: Burnout is a state of emotional, mental, and often physical exhaustion brought on by prolonged or repeated stress. (De Hert, 2020).
Occupational Challenge: An event that undermines a person’s ability to perform their duties or one that occurs due to their engagement within a particular occupational role (Lasalvia et al., 2021).
Proactive Actions: Anticipating events before they occur and being prepared and ready for the incident if it were to happen (Covin & Miller, 2014). Critical strategic postures for companies to thrive in fast-changing and competitive market environments (Covin & Miller, 2014).
Strategic Framework: A well-established plan or any other course of action focused on addressing a challenge or making a crucial investment (Marciano et al., 2020).
Assumptions, Limitations, and Delimitations
Throughout the study, there are assumptions, limitations, and delimitations that need to be addressed. Maintaining reliability and validity in study is fundamentally to ensuring that data is solid and reproducible and that the findings are correct (Jalili et al., 2021). An instrument’s integrity and quality can be assured only if its validity and dependability can be shown. A study’s validity may factor in the selection of which questionnaire to employ and assist researchers guarantee that they are asking about areas of relevance that are genuinely being measured (Mohajan, 2018). The extent to which a study evaluates what it promises to measure is seen as an indicator of the validity of the data collected by it. The research identifies leadership, nursing activities, and anonymity (Jalili et al., 2021). Identifying the stated factors and accounting for them enables validating the research and improving its reliability. This research deals with time constraints and unwillingness to provide information. The investigator must identify strategies to overcome the limitations. Overcoming the study constraints improve outcomes validity and reliability. Last in this section is delimitation; the part accounts for how the research overcomes limitations (Mohajan, 2018). The study must mitigate the adverse effects of limitations to ensure a valid and reliable conclusion.
Assumptions
Assumptions are deemed accurate but not tested or verified by the researcher (Jalili et al., 2021). They are based on reasons or logic and assist the researcher in establishing a viable research process capable of answering the highlighted questions and verifying the hypothesis (Jalili et al., 2021). Assumptions validate the research process as they form the foundation behind the developed research problems. The study focuses on assessing the impact of professional burnout among healthcare providers during the COVID-19 pandemic.
One of the assumptions made is that the burnout experienced by care providers emerge from the leadership’s inability to initiate viable institutional changes to protect and safeguard them amidst the demanding and unsafe working environment (Jalili et al., 2021). The researcher will examine all potential antecedents, including leadership strategies and other possible causes linked to leadership capacity, to create a conducive working environment for healthcare providers during the pandemic through a strategic framework (Jalili et al., 2021).
Another assumption is that nurses are the most affected healthcare personnel during the pandemic (Jalili et al., 2021). They are always on the frontline to offer vital care and attention services to patients exposed to the virus. This means that they are increasingly exposed to professional burnout. This is a critical assumption that the researcher will focus on reducing the impact of burnout on healthcare professionals. Understanding their mental health and risk factors for burnout will help formulate strategic actions (Ghassemi, 2021). The investigator will target many nurses to participate in the research. The insights obtained from this assessment will allow the investigator to establish if nurses are exposed to professional burnout.
The final assumption is anonymity. Selected participants for the interview collection method will be anonymous, and the responses will be kept confidential to ensure they feel
comfortable sharing their experiences (Surmiak, 2018). Participants selected for the interview collection will have their responses remain anonymous. This portion will be smaller and generated based on the initial response from the survey and cross-referenced with the demographics to check for commonalities (Surmiak, 2018).
Limitations
Limitations exist as factors that influence the research process and the interpretation of the findings, and they are out of the researcher’s control (Theofanidis & Fountouki, 2018).
However, adequate risk management measures can limit these limitations. One of the limitations of this study is the reluctance to provide viable information due to fear associated with exposure of this information into the public domain. However, the researcher will promise to abide by anonymity and confidentiality (Dougherty, 2021). This will motivate the participants to provide crucial information, mainly focusing on the leadership’s inability to improve the working environment. The researcher will maintain communication with the healthcare representative to ensure they emphasize the confidentiality and anonymity of the research.
The other major limitation is time. The researcher is constrained by time to collect numerous information from many potential participants. Addressing this challenge calls for a flexible research design that allows the investigator to collect a significant amount of data and information within a short time (Mohajan, 2018). It leaves the researcher the ability to process and collect crucial information capable of supporting the desired outcomes. In this case, the investigator will focus on a single study approach.
Delimitations
This study will be conducted within one Hampton Roads organization using a minimum sample size of 20 participants. The hospital employs over 50,000 employees. The
researcher will focus on doctors, nurses, and medical assistants, who are viewed as the most common and active healthcare workers.
The research will focus on managing time and resources to assess the burnout levels among healthcare workers effectively. The research will apply a single case study as a strategy for gathering quality data to assess the topic. A single case study effectively focuses on the given topic by using the available data on a given population through sampling a smaller but more inclusive part of the population (Mohajan, 2018). The focus on conducting a single case study arises from the need to provide inclusive and applicable research on healthcare workers. The dominant difficulty with the topic is that it is impossible to sample each worker’s burnout levels or their opinions on the sources of burnout. A single study approach will manage data on a given population based on the interactions from a smaller group that portrays common chrematistics with the collective population. Also, focusing on healthcare workers forced the researcher to only focus on a selected part of the population as a time management strategy. The specific group of workers was chosen for exposure to different conditions and factors influencing healthcare workers, making their experiences more applicable to the research.
Significance of the Study
Healthcare professional burnout has emerged as a crucial problem in the industry, especially during the COVID-19 pandemic (Jalili et al., 2021). Health Care workers have been exposed to mental, psychological, and physical harm due to the enormous tasks they are expected to handle during the pandemic (Jalili et al., 2021). For example, nurses are increasingly burdened with the alarming number of individuals contracting the virus and taken into various healthcare institutions. Health care professionals are handling an increased number of patients than usual. Institutional leaders have failed in their mandate to protect and safeguard the health and well-being of care providers (Jalili et al., 2021). Jalili et al. (2021) believe that leaders have been unable to develop strategic frameworks, thus exposing healthcare workers to professional burnout. This problem lies with the leaders expected to establish robust and strategic interventional measures to address the issue. For example, leaders can create flexible working schedules, introduce wellness programs, and ensure that these professionals have the needed safety equipment when handling patients. Thus, the rationale behind the research is to enable healthcare administrators and other decision-makers to gain insights focusing on the actions they can implement to limit burnout (Jalili et al.,
2021). It may establish proactive measures that these leaders can incorporate when faced with similar pandemics in the future. Overall, the research exposes healthcare leaders to suitable interventional measures they can develop and implement to save healthcare providers from professional burnout currently and in the future (Jalili et al., 2021).
Reduction of Gaps in Literature
Even though leaders have a central role in reducing professional burnout among the healthcare personnel and have failed in this area, there is limited research focusing on their approaches, the effect of leadership, or actions that have or could be taken. The researcher will attempt to fill this gap in research by asking questions specific to COVID-19 burnout among healthcare workers, related to their perception of the role, actions, and leadership behaviors regarding the COVID-19 pandemic. More research will be established to assess leaders as frontline stakeholders handling and managing the burnout challenge through this study. With the experiences witnessed during the COVID-19 pandemic, there is a dire need for investigators to focus their attention on the leadership role and its impact on addressing professional burnout among health care workers (Lasalvia et al., 2021). As research indicates, healthcare administrators have failed in their mandate to address burnout (Lasalvia et al., 2021). Their limited attention toward the physical, psychological, and emotional health of
care providers has created a significant challenge in boosting overall health and well-being. Sharifi et al. (2020) argue that leaders are expected to use excellent interventional measures to provide these service providers with stable emotional, physical, and mental status. Leaders have a central role to play in addressing burnout. Therefore, more research should explore the phenomena.
Also, more research should focus on nurses’ exposure to professional burnout (Sharifi et al., 2020). They form a large part of the healthcare workforce. Nurses oversee patients’ health and overall well-being by spending a large amount of their working time managing their recovery and progress. Health care providers interact with patients. For example, a nurse visits patients to monitor their progress and overall status. This can expose them to burnout, especially if they fail to receive adequate support from top leadership. Thus, there is a need to advance research focusing on leadership strategies that may influence burnout, laying the foundation for quality leadership tactics that care administrators develop in protecting and safeguarding the health and welfare of the largest workforce in the industry.
Implications for Biblical Integration
Integrating the issue of professional burnout with biblical perspectives will likely target outcomes (Cook, 2020). Addressing this burnout among healthcare providers calls for alignment with biblical teachings and values, ensuring that the stakeholders targeted to handle and manage this problem live to their mandate and expectations. In this case, leaders ensure they advance their responsibility toward healthcare professionals where they observe the environment and introduce approaches that limit the emergence of burnout. As the Bible states in Proverbs 27:12, “A prudent person foresees danger and takes precautions while the simpleton goes blindly on and suffers the consequences” (New International Version). There is a call for healthcare leaders to identify gaps and dangers associated with professional
burnout and introduce viable ways of reducing their emergence. This will protect healthcare providers. For example, decreasing burnout will portray a healthcare establishment as a principal service provider that delivers quality outcomes. This biblical quote urges leaders to be attentive to issues that could expose care providers to burnout and take immediate and appropriate actions. There is an improved commitment to health care providers’ health and the overall well-being in a highly demanding working environment attributed to an increased surge in COVID-19 virus cases.
Research into the impact of leadership on burnout among healthcare practitioners can be effectively understood by analyzing the issue from a biblical perspective. The biblical perspective is significantly critical because it yields a fruitful analysis of various elements to understand that God has revealed everything to us in spirit (Badley et al., 2011, 1 Corinthians 2:10).
The research will be conducted from a biblical perspective through various research elements. Guided by the biblical perspective of research, the study will be initiated through effective planning. According to the Bible, God urges us to “Commit to the Lord whatever you do, and he will establish your plans” (Proverbs 16:9, New International Version). This evidences that the biblical perspective of research demands that researchers initiate every type of study through proper planning. The Biblical perspective of research affirms that appropriate planning will enhance the applicability and relevance of the research by ensuring that the investigation is guided by reason and yields benefits to those involved. Secondly, the research will be conducted to meet security standards. The Bible affirms that “The prudent see danger and take refuge, but the simple keep going and pay the penalty.” (Proverbs 22:3, NIV). Using a biblical perspective in research allows the understanding that security threats in research are more than physical concerns. This will enable the researchers to be careful not
to infringe the participant’s privacy and emotional balance with the understanding that the security of physical, mental, and emotional state is vital in promoting the accuracy and reliability of the research.
Benefit and Relationship to Leadership Practice
The research study focuses on addressing COVID-19 burnout among healthcare workers, potentially laying the foundation for effective leadership strategies to boost the health and welfare of all service providers (Dalla’Ora et al., 2020). The research may provide valuable insights that healthcare leaders can integrate and implement to create a conducive working environment for healthcare providers during the pandemic. Leaders will benefit from a wide range of potential ideas likely to reduce professional burnout among service providers. The research also helps in handling future pandemics that can generate similar outcomes. It positions healthcare leaders in a better place to develop proactive actions seeking to protect healthcare workers from mental, physical, and psychological exhaustion amidst the demanding working environment (Dalla’Ora et al., 2020). Excessive workload and lack of relevant resources are central issues that expose care providers to burnout (Dalla’Ora et al., 2020). Depending on the problems exposing care providers to burnout and the status of the working environment, leaders can introduce and initiate significant measures that diminish associated issues.
The principal focus of the research is to raise a call for the healthcare administrators and other leaders to focus on building strategic frameworks capable of addressing issues that generate professional burnout among care providers (Khasne et al., 2020). Research indicates that leaders have failed to adopt these frameworks, making care providers prone to increased burnout (Khasne et al., 2020). This leaves the healthcare personnel unable to offer vital services due to reduced motivation and job satisfaction (Khasne et al., 2020). For instance,
during the pandemic, most care providers terminated their services with various providers because they feared for their safety and lacked optimal job motivation. It is the responsibility of the leaders to create a potential working environment that allows care providers to carry out their job satisfactorily (Khasne et al., 2020). Thus, the research creates awareness of imperative leadership strategies likely to reduce professional burnout among the healthcare personnel during the COVID-19 pandemic and in the future. Overall, the central focus is to create leadership awareness of the strategic approaches they can invest in to limit burnout during the pandemic and future related conditions (Lasalvia et al., 2021). The solution to reduced burnout in the healthcare domain lies with the leaders (Lasalvia et al., 2021). As the key decision-makers, they have a crucial responsibility to initiate robust interventional measures that create a safe, secure, and flexible working environment for these team members during the pandemic (Lasalvia et al., 2021).
Summary of Significance of the Study
The central aim of the study is to assess strategies that leaders can utilize to reduce professional burnout among healthcare providers, especially during the pandemic (Lasalvia et al., 2021). Most issues leading to burnout within the healthcare workers connect to the leadership role (Lasalvia et al., 2021). For example, increased workloads, lack of viable support systems, and limited access to personal protective equipment are linked to the leadership role. They generate burnout that challenges care providers’ capacity and ability to offer essential services (Lasalvia et al., 2021). For example, when nurses are exhausted from handling many patients, they will likely produce bad outcomes. Burnout remains a primary occupational challenge that leaders have failed to address through strategic frameworks and associated plans (Lasalvia et al., 2021). This study will seek answers on the impact of leadership and specific practices that may offer relief from burnout. Integrating a biblical
perspective ensures that all healthcare stakeholders engage in behaviors and actions that fulfill everyone’s needs, interests, and expectations as recommended in the Bible.
Review of the Professional and Academic Literature
Overview
The review focuses on the role of leaders in handling professional burnout among care providers, especially during the COVID-19 pandemic and future occurrences. The primary aim is to evaluate how leaders can use their positions to introduce strategic actions that limit exposure to professional burnout. Research has shown that leaders have failed to initiate strategies and effective interventions to address and prevent burnout in the workplace (Jalili et al., 2021). This has continued to expose care providers to this problem. The analysis will delve into existing leadership gaps that have paved the way for massive burnout among healthcare providers during the pandemic. This will generate viable recommendations that healthcare institutional leaders should develop and implement to prevent their workforce from developing burnout.
Leadership is a critical aspect of the healthcare system (Jalili et al., 2021). Proper leadership ensures quality service delivery because of a motivated and enthusiastic workforce (Jalili et al., 2021). However, despite most healthcare institutions having great leaders, various issues may undermine the efforts of these leaders in achieving the best patient outcomes (Khasne et al., 2020). For instance, healthcare institutions should always be prepared to handle emergencies. Leaders are at the forefront, leading their followers to attain results even in challenging situations (Khasne et al., 2020). However, not many were prepared to handle pandemics as massive as the COVID-19 that ravaged the world (Khasne et al., 2020). The pandemic exposed the challenges facing healthcare institutions globally (Khasne et al., 2020). The COVID-19 pandemic has affected various institutions because
most medical facilities did not have a preparation model for their healthcare workers that would have ensured flawless transition into emergency care for COVID-19 victims (Khasne et al., 2020). The leaders should lead the team through change and make goals public. Burnout continues to be a significant challenge due to the leaders’ lack of effective strategies in addressing issues that expose healthcare workers to professional burnout (Lasalvia et al., 2021). The lack of strategic leadership in healthcare facilities has hindered effective interventions addressing professional burnout among health professionals (Jalili et al., 2021).
This research explores possible leadership failure in addressing professional burnout. Leadership gaps in healthcare organizations are to blame for the growing professional burnout among healthcare professionals (McPherson et al., 2022). Seemingly, many healthcare leaders may have lost touch with the realities facing medical professionals. Many health administrators did not respond to emerging COVID-19 risks. Many healthcare workers were forced to work under strenuous and unsafe conditions during the pandemic. However, burnout is not new among healthcare providers (Mcpherson et al., 2022). Before the pandemic, most healthcare professionals, especially nurses, worked 12-hour shifts contrary to 8-hours dictated by labor laws. Despite working for excessively long hours, medical professionals are unpaid and underappreciated (Mcpherson et al., 2022). As a result, this demoralizes medical professionals, attracting burnout. As COVID-19 infectious rose, some medical professionals worked for 14- 16 hours daily, accelerating professional burnout (Lasalvia et al., 2021). The enormous professional burnout within the medical community calls for leadership changes (Lasalvia et al., 2021). Leaders in the healthcare sector should be sensitive to their employees’ needs by adopting a supportive leadership strategy (Lasalvia et al., 2021).
Leadership Practices and Employee Engagement
Leadership is deemed a critical factor that generates exposure to professional burnout among healthcare providers (McPherson et al., 2022). McPherson et al. (2022) find that the lack of objectivity in decision-making leads to the overall feeling of powerlessness among care providers. This entails the absence of transparency and openness as far as decision-making is concerned. It portrays that leaders may have failed their task as decision-makers in the institutional setting. Further research indicates that nursing leaders have been unable to improve the working environment and thus exposed the workforce to professional burnout (Mudallal, Othman, & Al Hassan, 2017). This has caused an enormous gap in making the working environment safe and favorable for all the team workers. For instance, if care providers are working for longer hours, they tend to develop burnout. This hinders their ability and capacity to deliver the projected results.
Nurses have been primarily exposed to burnout due to the hectic nature of their work setting (Kelly & Hearld, 2020). Statistics reveal that 50% of healthcare providers report high stress levels due to high case workloads (Kelly & Hearld, 2020). This indicates that the leadership level has failed to introduce strategies to improve the working environment amidst demanding schedules. Thus, this calls for leaders to submit quality decisions to avoid exposing care providers to professional burnout. Daily job demands, longer working hours, and high workloads have exposed care providers to this menace (Bosak et al., 2021). This highlights the lack of effective leadership styles across various healthcare centers. For example, by introducing effective organizational policies, leaders can open the opportunity to address the existing cases of professional burnout among healthcare providers.
Policies have a significant relationship with the performance of healthcare workers because they allow leaders to create the desired work environment (Sultan et al., 2020). A
report indicates that 35% to 54% of healthcare workers experience burnout because none of the six goals provided by the National Academy of Medicine offer proper staffing ratios to the medical facilities to establish practitioner wellness (Vuong, 2020). According to research, a good approach for reducing employee burnout is providing stress management interventions, offering social support, and engaging the workers in decisions (Gabriel & Aguinis, 2021). As a result, this enables the employees to design and craft their work environment and introduce high-quality performance management strategies.
Employee engagement refers to the team’s ability and willingness to invest or use their effort to accomplish organizational objectives (Shahid, 2019). Without staff engagement, an organization is likely to demoralize the people. Hence, this shows why staff engagement is a critical motivation and success factor in the workplace. The engagement concept emphasizes flexibility and continuous improvement. Empowerment is also at the heart of employee engagement (Shahid, 2019). Thus, this shows why it is essential to invest in staff engagement.
Employee engagement introduces true inspiration to employees where a lack of it results in a disconnect among leaders and workers (Sultan et al., 2020). The staff engagement framework establishes a structured approach demonstrating how senior executives should engage with the staff and provides an outline of how to achieve objectives. As an employer, it is critical to engage with the staff members at different levels using various communication and consultation methods. The main reason for this aspect is to determine how to reward and recognize performance or achievement (Wicherts et al., 2016). Engaged people take ownership of their duties, are clear on their responsibilities, determine how they will fit into the broader organization, feel empowered, motivated, and enjoy being part of the organization (Democracy Towers Hamlets, n.d.). Staff engagement also ignites staff loyalty and helps an
organization maximize success. Thus, this shows why maximizing staff engagement should be a priority.
Organizations can implement a host of staff engagement practices. One way to maximize staff engagement is to ensure that the team members are actively involved in communication and decision-making matters within the workplace (Wicherts et al., 2016). Another effective way of staff engagement is to ensure appropriate communication (Shahid, 2019). Employees also need to be well-informed about relevant matters of the organization. The following figure illustrates the employee engagement model showing the relationship between different processes that affect staff engagement. Managers must utilize processes to promote staff engagement at different organizational levels.
Figure 2. Employee Engagement Diagram
Employee Engagement Diagram
Leadership dynamics is a fundamental factor in resolving burnout issues experienced by healthcare workers during and post COVID-19 season (Al-Malki et al., 2018). During the season of COVID-19, the factor that caused the progress the burnout was poor human resource management at the leadership level (Al-Malki et al., 2018). Poor structures that caused the healthcare workers to be subjected to long working hours caused the creation of the burnout factor that substantially reduced the overall scope of the burnout factor towards the operations of the personnel (Amanullah et al., 2020). The increment of the workload to the workers because of the surge for the patients who needed the critical attention for the progress of enhancing the operation’s sustainability became the overall dynamic that lacked objectivity in managing the situation for the specific needs for the issues raised through the platform (Amanullah et al., 2020). Therefore, it became the springboard for realizing the stress function of the healthcare workers in providing services to the patients. The leadership could ensure that outsourcing for the healthcare workers is incorporated into the strategies for managing the situation. Countries with high numbers of healthcare workers could supply the American health department with the requisite numbers of healthcare workers who would have mitigated the demand for healthcare services (Amanullah et al., 2020). This is a function of the leadership model that is incorporated at the executive level of determining the progressive solution to the specific answer to issues for creating sustainability.
Development of a sustainable schedule for managing the working hours for the workers and incorporating a model of instituting dynamics of relaxation may be a way to reduce stress for the healthcare workers (Lee et al., 2018). Despite being professionals, they have human nature in them, thus making them susceptible to stress function (Lee et al., 2018). From this scope, it becomes critical that creating a powerful solution to the scheduling model helps to cause the sustainability of managing the time for relaxation for the healthcare
workers. Integrating this management scope helps instill resilience in the employees’ workmanship and solve the sustainability of the focus (Lasalvia et al., 2021). The failure to integrate this model of creating focus causes the dynamic function for solving the progressive impact of the workers to be compromised on the account that they are obligated to work according to the requirements of the conditional provisions of the management. Therefore, it is integral in establishing a condition for improving the dynamics of solving the issues of the worker. Introducing the dynamics of providing nap time for the healthcare workers is a fundamental approach to managing their healthcare capacity and ensuring that they successfully help promote the operation’s sustainability. The failure to incorporate this operation model helps bolster effective dynamics in resolving the substantial solution to the workers’ tiredness issues (Amanullah et al., 2020). Introducing the approach of nap time would effectively cause the sustainability of resolving the substantial provisions for managing the sustainable dynamics in ensuring that progression of optimal health is attained.
Adopting different leadership styles that are progressive according to the situation’s issues helps solve the problem issues of burnout with healthcare providers (Eliyana et al., 2019). From this progress, it becomes instrumental in balancing the sustainability of the progress (Eliyana et al., 2019). Increasing these operation dynamics becomes the critical dimension that would help resolve the unique needs promoted through the scope of creating improvement into the unique issues that are advanced into incorporating sustainability. For instance, incorporating the transformational leadership model would help to progress the dimension of caring for the potential realization of the specific needs of the workers (Lasalvia et al., 2021). Accordingly, transformational leadership focuses on the special interests of the employees. In this scope, the leadership would help create the sustainability of the progress, essentially solving the specific focus in creating sustainability of the operation. Therefore, it
is beneficial to ensure that progress is made in realizing sustainability as a function for improving the quality of life that is advanced to the workers who do not have an alternative to the negative impact of the healthcare service demand.
Similarly, the democratic leadership approach is instrumental in the sustainability of the burnout effect that had engulfed healthcare workers during the pandemic (Eliyana et al., 2019). From this scope, sustainability is enhanced in developing progressive sustainability of progress (Eliyana et al., 2019). Creating these provisions is integral to resolving the essential dynamics of the problem (Eliyana et al., 2019). Therefore, it is critical to advance an approach that is developed through the advancement of sustainable improvement toward resolving the issues that the workers experience. This brings the aspect of key theories that can support healthcare leaders in reducing burnout in the workplace. These include transformation and servant leadership.
Healthcare institutional leaders should integrate transformative leadership to address the alarming cases of professional burnout among care providers (Liu et al., 2019). Research shows that transformational leadership can reduce the risk of burnout due to the promotion of workforce psychological empowerment (Liu et al., 2019). This entails leaders making crucial decisions that boost their employees’ physical and mental status. For example, when leaders stimulate their relationships with their followers, this leads to improved job satisfaction, motivation, and performance. This means that workers will develop in-depth satisfaction irrespective of the state of their working environment. Also, leaders can offer social support amidst the emotional strain healthcare providers experience in the workplace (Liu et al., 2019). This ensures that workers develop improved mental status while managing their duties and responsibilities. Further research indicates that transformational leaders can reduce burnout by making an organization’s mission attractive and salient (Bosak et al., 2021). This
focuses on a social-oriented mission. Leaders ensure that they develop an attractive and supportive mission to enable workers to deliver to the expectations while working in a safe and comfortable environment (Boamah, 2022). Boamah (2022) also reveals that transformational leadership strongly impacts workplace culture, job satisfaction, and an inverse direct outcome on burnout. This shows that leaders can introduce a quality working environment that boosts motivation and satisfaction irrespective of the challenges experienced. It lays the foundation for reduced exposure to burnout.
Servant leadership is another strategic model capable of supporting leaders in the fight against burnout in the healthcare domain (Ma et al., 2021). Ma et al. (2021) reveals that the COVID-19 pandemic has exposed care providers to burnout, with leaders being called to ensure that they integrate servant leadership strategies to alleviate this menace. This entails focusing on the health and well-being of the workforce. For instance, leaders ensure that they build quality working conditions to protect their employees from being prone to burnout.
Imran (2019) also argues that servant leaders can reduce workforce stress, leading to burnout. Their sole objective remains to be committed to serving workers. Thus, they use their positions to initiate decisions and actions that limit the emergence of burnout among care providers.
The Problem
The general problem is healthcare leaders’ failure to develop strategic frameworks in the wake of the COVID-19 pandemic resulting in increased burnout among healthcare professionals. According to Jalili et al. (2021), because the leaders failed to develop a strategic framework, there is an increased professional burnout among healthcare workers caring for COVID-19 patients. In a recent study, Khasne et al. (2020) found that many healthcare professionals blamed their leaders for a lack of preparedness to deal with
COVID-19, which resulted in mental strain for the caregivers. Therefore, this shows that leadership failure is a top driver driving professional burnout among healthcare providers.
A similar study by Lasalvia et al. (2021) revealed that burnout among healthcare staff members during the pandemic was an issue of concern. Still, leaders had not done enough to mitigate the adverse implications. Sultana et al. (2020) supports this issue by stating that burnout is a major occupational problem among healthcare providers, and leaders have a critical role in developing intervention measures. The specific problem to be addressed in evaluating the senior healthcare leaders within the south-eastern United States to effectively develop adequate responses to COVID-19, resulting in a potential increased burnout among healthcare professionals.
Research has revealed that professional burnout does not arise from the vacuum and that leaders play a vital role in creating a conducive environment that protects workers from exposure to burnout (Cotel et al., 2021). Lack of effective leadership abilities and capabilities leaves care providers prone to the menace. Professional burnout occurs from the healthcare domain’s hectic and demanding status, especially during the pandemic. Care providers exposed to burnout depict symptoms such as anger, irritation, loss of productivity, anxiety, and emotional distress (Sultana et al., 2021). These are crucial issues likely to undermine the productivity of healthcare providers when their services are primarily needed. The failure of leaders to develop strategic change approaches to diminish exposure to burnout continues to accelerate the situation. Cotel et al. (2021) reveal that healthcare institutional leaders should spot signs and create opportunities that pave the way for reduced burnout. If they are in a position to detect gaps that lead to increased cases of burnout, they can develop essential solutions that limit the emergence of this menace. According to available research, curing professional burnout is better and easier than preventing burnout (Cotel et al., 2021).
Purposeful and regular one-on-one meetings are critical anti-burnout strategies that leaders in the healthcare sector must embrace (Cotel et al., 2021). In addition, leaders are obligated to monitor the workload and support the professional interests of the team members. Leaders are forced to intervene if burnout arises. For example, leaders are forced to act if they identify behavior change or the rise of unbecoming behavior in the workplace.
Burnout of healthcare workers is a critical problem that derails the performance level that the employees provide (Liu et al., 2019). The scope of burnout is caused by the high demand for the services when the time and the high number of patients caused the creation of the stress function (Liu et al, 2019). Therefore, it became substantial that realizing the sustainable approach to developing situational dynamics is created by resolving the issues created to resolve the problem (Liu et al., 2019). The stakeholders in managing the burnout effect on the healthcare workers are responsible for enabling the solution to the progressive management of the problem (Liu et al., 2019). Progressively, resolving the issue of burnout is beneficial for allowing the solution to the provision of healthcare services.
Concepts
The Role of Leadership
The pandemic has led to increased emotional and physical exhaustion among healthcare professionals due to the increased COVID-19 infection rates globally (Cotel et al., 2021). However, professional burnout is not a new phenomenon. Professional burnout has remained a major issue across healthcare institutions for many years. However, it is the COVID-19 that reawakened the study interest in professional burnout across academic and research circles (Cotel et al., 2021). Current research has investigated the interrelationship between professional leadership and professional burnout. Researchers agree that leadership weaknesses or gaps were ineffective or poor responses to the COVID-19 pandemic (WHO,
2020, September 17). Therefore, this presented a classic and reliable finding on the leadership implication of professional leadership. Effective intervention toward professional burnout is likely to address issues that may undermine burnout concerns. There is a close link between professional leadership and burnout in healthcare. Papathanasiou et al. (2014) note that leadership is placed at the center of burnout which healthcare professionals experience. This means that leadership capacity determines the status of occupational burnout portrayed in the care setting. A call for leaders to invest in a tactical leadership approach such as the path-goal leadership strategy will pave the way for reduced burnout (Papathanasiou et al., 2014). Further research indicates that reducing burnout requires organizational leaders’ efforts to integrate crucial and advanced leadership strategies (McPherson et al., 2022). This means that leaders play a pivotal role in addressing the emergence of occupational burnout and should always live up to the expectation. They should adjust the working environment during the pandemic to accelerate the health and well-being of care providers. For example, alleviating burnout can focus on recruiting adequate staff and creating flexible schedules (Shah et al., 2021). This shows that reducing the risk of facing burnout lies in the leadership domain.
Afulani et al. (2021) believe that low perceived preparedness to respond to the COVID-19 pandemic exposed care providers to professional burnout. When the situation emerged, leaders failed to take prompt and quality actions to protect their workers from developing stress amidst the present demanding environment. This exposed them to burnout since they were working in a hectic work setting. Kniffin et al. (2021) also highlight that leaders have remained a major support system since the pandemic. With the organizational setting experiencing massive changes, leaders needed to adjust operations and strategies to ensure that their workers were protected from occupational burnout. Kloutsinotis et al. (2022) also
argue that the leadership approaches adopted by top-level leaders determined the milestones that healthcare providers experienced in the workplace.
Researchers across diverse studies have shown how the COVID-19 pandemic may have led to burnout concern (Kloutsinotis et al., 2022). First, the spike in the COVID-19 infectious strained the inadequate healthcare workers in many organizations (WHO, 2020). An abrupt rise in the infectious rate met many healthcare facilities and leaders ill-prepared for the surging demand for medical services. Apart from the shortage of healthcare workers, many health professionals, especially nurses and clinicians, worked for longer working hours. Second, working long hours and lack of resting time overwhelmed the healthcare workers, leading to physical and mental exhaustion (WHO, 2020). According to Afulani et al. (2021), exposure to longer working hours and staffing are some of the gaps that led to increased exposure to occupational burnout during the COVID-19 pandemic. This signifies the lack of adequate and strategic actions from the institutional leaders in making the environment better and conducive for these team members. Rising professional burnout was also evident from the symptoms exhibited by different healthcare workers. In addition, the harsh working environment led to professional burnout. Furthermore, the COVID-19 pandemic increased the safety and healthcare risks because of the high infection rate of the SARS-CoV2 virus (WHO, 2020). Therefore, this shows how the leadership failed to create a positive working environment to address staff psychological and physical safety.
Leadership plays an integral role in ensuring the smooth running of any given organization (Cotel et al., 2021). Great leadership pervades different organizational levels to ensure the smooth functioning of an organization. Great leaders support their staff’s welfare by addressing psychosocial and physical needs. According to research, there are various ways leaders support their team members. One way is to set realistic expectations and avoid
overwhelming the staff with duties. Overwhelmed employees are unlikely to perform quality work, leading to service deterioration and eroding patient satisfaction.
Another way is to provide career-life balance (Cotel et al., 2021). Many leaders in the healthcare field do not acknowledge how career-life balance is important for job satisfaction and quality work (WHO, 2020). Through work-life balance, employees can achieve their emotional and social needs, including interacting with their loved ones and having time to rest (Sharifi et al., 2021). An excellent way to promote work-life balance is to hire sufficient healthcare staff to prevent employees from being overwhelmed with duties (Cotel et al., 2021). The inability to provide adequate protective equipment discouraged many healthcare employees from joining the workplace (WHO, 2020). Therefore, this may indicate healthcare workers left were overwhelmed with medical duties, leading to pandemic concerns.
COVID-19 pandemic exposed the gaps in the leadership quality needed to run healthcare facilities (Sharifi et al., 2021). Ineffective response and ill-preparedness to deal with the COVID-19 aftermath and implications exhibited the leadership’s failure to respond effectually to the pandemic (Sharifi et al., 2021). Leadership comes under the test during the unprecedented crisis. Undoubtedly, the COVID-19 pandemic was a major event that exposed leadership gaps that must be addressed (WHO, 2020). Poor leadership demonstrated by the healthcare administrators and top government officials reflected the leadership weaknesses that the government must address to safeguard and promote the staff welfare, including responding to burnout before, during, and after a crisis (WHO, 2020). An effective response to the staff welfare, including addressing burnout, is critical for improving efficiency and reducing costs (Sharifi et al., 2021). During the COVID-19 pandemic, leadership inefficiency within the health sector was largely to blame for poor professional burnout (Sharifi et al., 2021). In the first place, leaders were ineffective in identifying professional burnout.
Effective leaders could have been quick to identify professional burnout if they cared about the professional burnout that comes with disruptive trends, such as emergency cases (WHO, 2020). In addition, effective leaders ensure that various issues such as professional burnout do not affect the quality of health care services rendered to the patients (Anthony-McMann et al., 2017). Therefore, the COVID-19 pandemic was a prime testimony to show leadership weaknesses among professional managers.
Various concepts are instrumental in resolving burnout factors faced by healthcare workers (Blake et al., 2020). Positive interaction is the primary model that effectively creates the solution for burnout (Blake et al., 2020). Improving the social relationships among the workers is instrumental in creating the right environment for managing the social needs that are provided for resolving the issue of burnout (Blake et al., 2020). Therefore, the environment must be developed to ensure the creation of interaction. Chatting among healthcare workers is an approach that could successfully help in resolving the negative impact of the burnout problem (Raudenská et al., 2020). Creating these problems helps to ensure that the sustainability of the problem is determined. From this scope, it becomes instrumental in ensuring that progress development is created. Establishing these dynamics is instrumental in developing the sustainability of the problem experienced by these workers
(Raudenská et al., 2020). Complimenting one another within the working space is a crucial approach for ensuring that healthcare workers can resolve the issue of burnout (Raudenská et al., 2020).
Incorporating yoga sessions by the workers is an instrumental concept for managing burnout (Raudenská et al., 2020). Yoga sessions are controlled through meditation (Raudenská et al., 2020). The workers engaged in the meditation time, becoming the progressive masters of the environment around them. This is the beneficial factor that helps
reduce the causative factors to the stress progress that the members of the workers feel in advancing their services (Raudenská et al., 2020). Creating these dynamic provisions helps to resolve the issue of the progressive improvement to the quality of the services promoted in creating sustainability of operations (Raudenská et al., 2020). The encouragement of the workers to engage in meditation during their relaxation time while in the workplace is an instrumental provision for ensuring that the stress factor that creates the burnout effect is controlled (Di Trani et al., 2021). This progressive factor helps make the sustainable dynamic of resolving the improvisation of critical progress. These dynamic factors help determine the progressive improvement to the quality of the work created for the employees.
Providing resting days for healthcare workers is a progressive approach to managing specific needs (Di Trani et al., 2021). In this dynamic, it becomes instrumental in creating a progressive improvement to the problem of the effective dynamic. Resolving to these factors are instrumental for creating a substantive solution to the issues created in establishing the operation’s sustainability (Di Trani et al., 2021). These are the critical dynamics that help resolve the sustainability of the management function. Affirmatively, incorporating days for resting, especially during a time of high demand for the workers’ services, is instrumental in managing the burnout problem that is instrumental to derailing the successful management of the problem (Di Trani et al., 2021). Failure to incorporate sustainable dynamics of resolving the progress of the problem becomes the dynamic factor in creating sustainability of the problem (Cleveland Clinic, 2022). These integral dynamics are instrumental in resolving the issues provided for through negative provision for determining the specific improvement of the problem (Cleveland Clinic, 2022). Therefore, the inclusion of resting days is an instrumental dimension for resolving the oppressive impact towards creating a substantial solution to the issue of realizing the improvement of the problem (Cleveland Clinic, 2022).
Burnout within Health Care Professionals
Effective leadership within the organization caters to the psychological welfare of its human resources (Sharifi et al., 2021). The massive loss of patients and healthcare professionals has led to fatigue and burnout of healthcare workers (Sharifi et al., 2021). Cotel et al., (2021) demonstrate that 50% of medical professionals have experienced exhaustion due to the COVID-19 pandemic (2021). It means that half of the medical professionals are burned out.
According to available health reports, medical workers are on the frontline fighting the COVID-19, increasing their vulnerability to infections (Denning et al., 2021). Data has also shown that health workers and their families are among the most vulnerable population groups to physical and mental health during this pandemic (Denning et al., 2021). In addition, data across different countries reveals that COVID-19 infection rates are significantly greater within the medical community than infection rates within the general population. Although health workers represent 2- 3% of the world population, they represent 14% of the COVID-
19 infection cases (WHO, 2020, September 17). In some nations, especially the underdeveloped ones, the infection rate is over 35% (WHO, 2020). Because of the high prevalence of COVID-19 within the medical community, thousands of healthcare workers have succumbed to this pandemic. Healthcare workers are far more vulnerable to COVID-19 infections than the general populace. However, there is limited data on whether infections among healthcare workers happen in community settings or within the workplace.
Besides the physical and biological risks, the COVID-19 pandemic has exposed healthcare workers to extraordinary stress levels (Essex & Weldon, 2021). Research has shown that many medical workers live in fear because of their exposure to extraordinary psychological stress levels and a highly demanding workplace. In addition, medical workers
constantly fear stigmatization because of the social stigmatization and isolation from their loved ones (Morgantini et al., 2020). Although COVID-19 accelerated psychological health risk, it is not the primary cause. A recent study has found that nearly 25% of healthcare workers experienced depression and anxiety before the pandemic (Essex & Weldon, 2021). In addition, the studies revealed that 33% of the medical professionals suffered from sleeping disorders during the pandemic (Morgantini et al., 2020). Reports by World Health Organization exposed an alarming rise in physical isolation, discrimination, and verbal harassment at the height of the COVID-19 (Morgantini et al., 2020).
In 2020, the World Health Organization called on governments and healthcare administrators to prioritize staff wellness by maintaining a safe working environment and addressing emerging safety threats to healthcare workers (WHO, 2020). This portrayed a central concern toward the health and well-being of the healthcare providers. As the infectious rate surged, the World Health Organization, through its director-general, Tedros Adhanon Ghebreyesus, continued emphasizing the unmatched role that healthcare workers play in maintaining public safety and health (WHO, 2020). For example, healthcare leaders were required to introduce mental resilience programs to help care providers to overcome the psychological and mental turmoil experienced in the line of duty (Ferreira & Gomes., 2021). This would enable healthcare professionals to handle critical services to the affected persons and at the same time escape the exposure to occupational burnout. Ma et al., (2021) also believes that mental resilience can reduce emergence of professional burnout in the workplace. This calls on leaders to ensure that they introduce and implement actions that diminish the likelihood of burnout occurring. Therefore, this implied that it is important to recognize and address the staff’s welfare and needs, including burnout issues.
In addition, this showed that the WHO understood the unique role healthcare professionals played in addressing the pandemic (WHO, 2020). Recent studies have also highlighted how managing healthcare workers’ wellness is critical to a properly functioning healthcare system and societal wellness (WHO, 2020). During the pandemic, the WHO released a circular with protocols exposing how to protect the welfare of healthcare workers.
Shortages in Healthcare Professionals in Relations to COVID-19
The outbreak of COVID-19 has exposed the acute shortage of healthcare providers within the healthcare system (Dall’Ora et al., 2020). The influence of COVID-19 on the safety of healthcare providers cannot be underestimated; hence, the burnout experienced by healthcare providers is of national concern, which has caused massive shortages within the healthcare system (Dall’Ora et al., 2020). Many healthcare facilities face a high attrition rate because of the low job satisfaction, leading to staff shortages. Attrition is the failure to hire new staff after the incumbent employees leave the workplace (Morgantini et al., 2020). As a result, this reduces the size of employees to meet organizational needs.
In addition, this forces employers to allocate more duties to employees to cover tasks previously performed by exiting employees (Ali et al., 2021). A decline in job satisfaction during the COVID-19 was also a major factor in job turnover and attrition. Many healthcare employees left the workforce after the COVID-19 because the working environment became increasingly riskier (Russell, 2014). Moreover, many healthcare providers lost interest in the job they have a passion for, encouraging them to leave their workplaces and look for alternative employment (Essex & Weldon, 2021). As major players in the fight against the pandemic, healthcare workers were at the highest risk of contracting the COVID-19 infection. Hence this encouraged many healthcare workers to resign.
Leadership within the Organization
The healthcare organization has lost income due to non-emergency and specialty treatment cancellations due to leadership decisions (Dall’Ora et al., 2020). During the height of the pandemic, many leaders shifted attention towards efforts to control SARs-CoV2 infections. However, these leaders overlooked the management of other health conditions, including mental health disorders, obesity, hypertension, cancers, and other illnesses. Effective leaders struck a balance between COVID-19 interventions and those for other medical conditions. Importantly, striking this balance is instrumental in ensuring that resources (human capital and materials) are not overstretched in one area. Some of the vital aspects to be deliberated include the role of supervisors of healthcare institutions in causative to the cause of healthcare professionals’ burnout (Dall’Ora et al., 2020). Developing a clear insight into the influence COVID-19 has on healthcare professionals’ burnout can positively inspire positive human resource management (Cotel et al., 2021). To fully effect the necessary changes and help the doctors overcome the challenges of the pandemic, employee engagement is essential.
Effective Leadership
The techniques needed to address the concept of employee relations and job satisfaction through incentive programs motivate employees to work and improve their welfare while in the workplace (Anthony-Mcmann et al., 2017). To successfully engage in employee engagement, leaders can adopt numerous strategies and programs to ensure employees are conversant with their roles, reducing burnout cases (Cotel et al., 2021). Under the WHO Charter, the governments should invest in health staff wellness, including adding risk allowances and protecting workers from physical and biological hazards. The WHO Charter also establishes safety and health protocols to advance safety measures and
procedures (Sultana et al., 2020). Leadership is instrumental in employee engagement as it facilitates a continuous chain of communication regarding the issues that lead to burnout in healthcare workers (Sultana et al., 2020). The absence of leaders’ attention to healthcare staff leads to misunderstanding and work-related strain, resulting in burnout (Cotel et al., 2021).
Theories
Job Demands–Resources Theory (JD-R)
Job Demands- Resource Theory argues that the workload on an employee affects their stress levels (Cotel et al., 2021). According to job demands-resource theory, stress levels are directly proportionate to job demands and burnout (Cotel et al., 2021). Conversely, the positive job burnout effects are inversely correlational. Therefore, it means that positive elements of a job address the job dissatisfaction issue. This finding indicates that leaders should invest heavily in promoting job satisfaction (Dall’Ora et al., 2020). Failure to invest in job satisfaction will bring severe issues to an organization, including eroding the satisfaction rate (Dall’Ora et al., 2020). When a leader increases job positives and lessens job demands, the staff will experience little stress. Hence, this will improve motivation and staff engagement levels. Therefore, this indicates why the research emphasizes maximum job experience and satisfaction in the workplace.
Maslach’s Theory
Maslach’s theory connects how using resources could help reduce burnout in the research framework (Morgantini et al., 2020). Maslach proposed a framework for predicting the occurrence of burnout. The framework is called Maslach Burnout Inventory (MBI) (Dall’Ora et al., 2020). According to the framework, some of the critical components that contribute to burnout are as follows: extreme assignment, negative co-existence with the community, lack of motivation, and lack of resource control (Morgantini et al., 2020). Hence,
leaders should address the factors contributing to professional burnout among healthcare providers.
Conservation of Resources Theory
The Conservation of Resource Theory provides the necessary parameters to enhance the healthcare workers’ well-being, including vitality, the working environment conditions, and the profession’s tools (Prapanjaroensin et al., 2017). The Conservation of Resource Theory proposes three significant resources for healthcare workers: energy, conditions of work objects that workers interact with, and one’s characteristics (Prapanjaroensin et al.,
2017). In line with the WHO (World Health Organization), the discussion of the
Conservation Resource Theory defines burnout as the lack of energy or fatigue, pessimism in the workplace, or leaving one’s profession (Morgantini et al., 2020). Undeniably, the conservation of resources theory has provided an effective framework to expose the elements of burnout.
Actors
Health care professional
The health care professional is the main subject of this study. They need to identify how their work affects their mental health to seek help to prevent burnout (Lasalvia et al., 2021).
Burnout is a global health concern for nurses, physicians, and clinicians caused by stress in the workplace and not appropriately managed (Sharifi et al., 2021). Burnout manifests itself in three forms: fatigue or energy loss, pessimism about the job or mental distraction from work, and reduced professional effectiveness (Sharifi et al., 2021). Hence, leaders should have the capacity to recognize these major symptoms or signs of professional burnout, and effective identification of these symptoms allows a leader to address burnout.
Healthcare managers/ Administrators
Healthcare administrators and managers hire and assign duties to the rest of the team members. They also make available resources required by healthcare workers, like protective gear (Sultana et al., 2020). Healthcare administrators and managers are top decision-makers responsible for formulating an organization’s strategic intent and direction in healthcare facilities. In addition, healthcare managers and administrators serve as the liaison and the spokespersons (Russell, 2014). As liaisons, these leaders build networks and enter into agreements with the strategic partners on the organization’s behalf. Thus, this shows why health managers and administrators are critical shareholders.
Patient / Consumer
Patient welfare is adversely affected when the service provider’s quality of health and safety is constrained by burnout (Sharifi et al., 2021). The patient is negatively affected when the health and safety of the healthcare worker are not guaranteed (Dall’Ora et al., 2020).
Nurse burnout may increase the risk of medical error, which negatively impacts patient health (Lasalvia et al., 2021). The constant death, the suffering, and the need to sympathize with customers who have admitted patients also cause burnout in the health care providers (Sharifi et al., 2021). At the COVID-19 peak, the surge in deaths traumatized many healthcare workers, increasing their burnout. Therefore, this shows that efforts to improve patient experience correlate with reducing professional burnout.
Constructs
The scope of managing the sustainability of operation is embedded in developing sustainability, thus impacting the lack of oppressive improvement to the quality of life for the healthcare workers (Blake et al., 2020). From this dimension, the quality of the healthcare workers’ work is a testament that burnout is developed (Blake et al., 2020). Sustainability is
thus instrumental in realizing effectiveness for managing the problem. Creating an effective dynamic that is promoted in creating an effective solution to the problem helps develop the critical solution to the specific progress created in promoting the sustainable solution to the specific issues that are advanced through the problem being created. The failure to incorporate the model helps increase a negative dynamic of the scope of work that is incorporated through a solution to the problem (Eliyana et al., 2019). These are the instrumental factors that help resolve the issues encouraged by the healthcare workers. The overall development of the safety provisions helps create a sustainable condition that is promoted to enhance progressive solutions.
Developing sustainable burnout management through establishing an effective reward system for the healthcare workers is an instrumental construct for resolving the burnout effect (Schunk et al., 2020). The development of sustainable operation helps create an effective environment that is a substantial resolution in creating a resounding impact in helping promote sustainable impact (Schunk et al., 2020). Therefore, it is ideal to realize effective progression of the solution to the burnout factor that the workers experience as they advance their mandate. The failure to incorporate a sustainable approach would thus create a negative impact as a factor for promoting improved operation as a dynamic progression of the problems. Paying employees fairly is an approach that would help create the right environment to ensure productivity sustainability. Thus, it is ideal to incorporate a system that focuses on the financial affairs of the workers since they dictate the serial burnout effect, mainly because of the lack of meaning as advanced through the poor payment provisions (Eliyana et al., 2019). These sustainable provisions would resoundingly help create progress that is enhanced in creating the right solution to the problem (Schunk et al., 2020). These are the essential provisions that help resolve the specific issues to promote critical impact
towards the resolution of the problem. Accordingly, it has been instrumental in realizing progress through enabling sustainability of reward dynamics that would provide the requisite motivation for curtailing the burnout effect.
Adopting physical development through exercising is a progressive model that is instrumental in realizing sustainability of the progress for managing the burnout effect (Shanukat et al., 2020). According to Shaukat et al. (2020), burnout is a factor promoted through the inclusion of negative health practices. Involvement in exercising regularly helps to enhance physical relaxation and reduce the chances of developing the burnout factor (Shaukat et al., 2020). Progressively, it becomes instrumental for enhancing improvement towards creating sustainable progress in creating the improvement towards the promotion of the progressive realization of the problem (Shaukat et al., 2020); (Verbeek et al., 2019). These are the instrumental provision that helps manage the burnout effect as realized by the high demand for the provision of services within an environment with high stress caused by the feeling that possible life-threatening infection may arise (Verbeek et al., 2019).
Integration of stress management is a fundamental factor in providing the resounding dynamics for resolving the negative impact of burnout (Verbeek et al., 2020). Accordingly, integration of the specific dynamics into solving the specific improvement to the quality of life becomes the instrumental factor that helps resolve the specific solutions attached through the provisions provided in the advancement of burnout control (Shreffler et al., 2020); (Verbeek et al., 2019). Thus, it is instrumental in ensuring that the progressive improvement to the quality of the working environment as a factor for promoting sustainability becomes the instrumental determinant for resolving burnout issues.
The Role of Stakeholders in Dealing with Healthcare Professional Burnout
The researcher will determine if the lack of a proper COVID-19 preventive
framework is the primary contributor to burnout healthcare providers experience during the pandemic (Jalili et al., 2021; Khasne et al., 2020). Determining if health care leaders understand the meaning of a practical structure necessary to mitigate COVID-19 without causing burnout among the staff members is necessary. The researcher will seek to establish whether a proper COVID -19 preventive framework is the primary contributor to healthcare providers’ burnout. The burnout in this case is that which they experienced during the pandemic (Jalili et al., 2021). The research will also determine if health care leaders understand the meaning of practical structure necessary to mitigate COVID-19 without causing burnout.
Creating a Conducive Working Environment for the Employees
Creating a conducive working environment for healthcare service providers is one of the most effective approaches to professional burnout (Morgantini et al., 2020). Health care leaders can implement a reliable framework to ensure staff members are sufficient to cater to the rising number of positive cases (Sultana et al., 2020). The healthcare leaders played an essential role in managing the workforce by recruiting non-specialized clinicians to assist in the hospitals while saving the most qualified healthcare workers from the frontline and restricting them to emergency and intensive care units during the pandemic.
Related Studies
The acute shortage of healthcare providers has exposed the current workforce to strains that have created burnout (Dall’Ora et al., 2020). Professional burnout remains a central challenge during the COVID-19 pandemic (Lasalvia et al., 2021). Healthcare workers are constantly emotionally and physically exhausted due to the alarming number of patients they handle during the pandemic (Anthony‐McMann et al., 2017). As the work demand increases across all hospital settings due to the high number of emerging infections, care
providers are likely to become worn out (Cotel et al., 2021). Identifying issues such as excessive workload, limited rewards and recognition, and the lack of control of healthcare resources might allow healthcare leaders to address burnout (Dall’Ora et al., 2020). Resource shortage has affected the provision of suitable rewards, appropriate resources for care delivery, and the employment of more care providers (Anthony‐McMann et al., 2017).
Professional stressors such as lack of PPEs (Personal Protective Equipment), inadequate compensation, and extreme assignments have led to increased burnout among these professionals (Morgantini et al., 2020). Facilitating healthcare providers with the right resources and systems is a prerequisite for reducing professional burnout (Prapanjaroensin et al., 2017). Healthcare providers face mental strains emerging from the lack of preparedness amidst the COVID-19 pandemic (Khasne et al., 2020). Leaders have failed to integrate and implement quality preparedness approaches to boost workforce well-being during the pandemic.
Leaders should examine factors that generate burnout and find effective handling to protect nurses against burnout (Anthony‐McMann et al., 2017). As Lasalvia et al. (2021) revealed, healthcare professionals act as the primary targets in this case, with leaders expected to safeguard their physical, emotional, and psychological well-being. Patients risk failing to achieve the projected outcomes when healthcare providers are exposed to burnout (Lasalvia et al., 2021). For example, care providers experiencing burnout are likely to cause medical errors that negatively impact patients’ health and welfare.
Overall, leaders’ inability to develop a robust and effective COVID-19 preventive framework is a primary barrier to the fight against professional burnout among healthcare providers (Jalili et al., 2021). Leaders have a paramount role in creating an excellent working environment that limits exhaustion among care providers. A strategy like adequate staffing
will ensure that care providers can sufficiently care for the patients amidst the rising number of positive cases.
Several studies related to burnout management have been realized from the literature review. Human resource management is the fundamental study advanced in promoting sustainable progress in developing progress. According to Tewari et al. (2019), it becomes instrumental in ensuring that progress is created in resolving the employees’ issues. The instrumental factor becomes the underlying factor in determining the problems that the employees experience. Incorporating sustainable employee management would thus help provide a progressive solution to the problems attached to realizing sustainable progress (Tewari et al., 2019). Accordingly, the integral function is promoted in helping the coping mechanism in times of need, as evidenced by the COVID-19 situation that caused even the retirees to resume their duties to help combat the pandemic.
Resource management is another related study that the platform has revealed. Accordingly, the utility of the factor is instrumental in creating the overall progress as the ideal provision for creating sustainable improvement in developing sustainability. Thus, it is instrumental in ensuring that progress is enhanced in resolving the specific focus for managing the progressive resolution to the specific focus of enabling resounding progress for the inclusion of the specific focus (Wen et al., 2019). Therefore, this is a crucial factor in improving the progress of the factor. Furthermore, understanding the sustainable ways of managing the supportive resources in advancing the quality of services is critical to developing realistic dynamics that are instrumental for enhancing the operation’s sustainability (Amanullah et al., 2020). Thus, the realization of the progressive improvement to the sustainability of creating improved provision helps resolve the issues of governance as
the main factor that helps provide the sustainable solution to the issue of enhancing the sustainability of the progress.
The public healthcare management study is another fundamental study. Accordingly, enhancing sustainability is a progressive factor that is instrumental in improving the quality of the healthcare services offered to the public (Wen, Ho et al., 2019). The provision of quality services depends on the quality of life provided by the scope of creating sustainability. Thus, it is critical to ensure that provision of the right progress is enhanced in resolving the overall progress for the creation of resounding pandemic management. It is thus a function of the public healthcare management that would help create sustainable service delivery as the optimal provision in developing progress (Eliyana et al., 2019). Thus, it is instrumental in ensuring that progress is provided for creating substantial solutions to the specific details for resolving the specific problems.
Anticipated and Discovered Themes
Most employees will recommend and emphasize the need for a better understanding of leaders’ role in protecting and safeguarding healthcare workers from professional burnout, especially during the COVID-19 pandemic and others likely to emerge (Khasne et al., 2020). Improved leadership participation will reduce misunderstanding and other work-related strains that leave crucial gaps or burnout (Sultana et al., 2020). Healthcare workers may present the unexpected increase in the number of individuals with COVID-19 infections as a source of burnout because of increased pressure (Cotel et al., 2021). The shift in work descriptions and cultures after the pandemic has introduced uncertainty and new practices that pressure the healthcare workers (Jalili et al., 2021). A flexible working schedule will reduce associated burdens that make providers prone to burnout (Cotel et al., 2021). Therefore, this
shows why healthcare providers should focus on developing a flexible schedule for their teams.
Employees might claim that increased appreciation through incentives such as rewards and bonuses might reduce their burnout levels (Anthony-Mcmann et al., 2017). Healthcare providers might report a failure by their administrators by claiming that the leaders should have evaluated the situation to develop proactive solutions when exposed to adverse conditions such as professional burnout (Khasne et al., 2020; Sultana et al., 2020). The employees might generally confirm that burnout is not a new concept by stating it has been prevalent before COVID-19 because of a lack of viable measures to mitigate this problem and its adverse outcomes (Lasalvia et al., 2021). Improved leadership participation will reduce misunderstanding and other work-related strains that leave crucial gaps or burnout.
Research has demonstrated various effective leadership practices to address burnout among healthcare workers (Sultana et al., 2020). Advisably, implementing safety precautions and infection control measures within the healthcare system is critical to improving employees’ physical and psychosocial health. Healthcare leaders can achieve safety within the workplace by offering adequate PPE supplies, and the PPEs should also be of great quality. In addition, adequate training of the medical workers on using PPEs and other safety precautions is essential. Adequate environmental services, including proper hygiene, sanitation, disinfection, and ventilation within the healthcare facility, are critical to maintaining population health. Moreover, vaccination of the medical staff to reduce their vulnerability to the COVID-19 infection is also critical in improving staff safety (Cook,
2020).
It is essential to establish policies that will prevent medical staff from overworking. In the policy, the leaders should ensure that the working schedules have realistic and fair working hours, allow for breaks, and reduce administrative healthcare burden (Ghassemi, 2021). The policy should also provide medical allowances and adequate insurance coverage for the growing risks in the healthcare-related environment (Ghassemi, 2021). Access to mental health in the medical community constitutes another major player in protecting population health. Sufficient access to social support and mental wellness for medical workers is crucial (Ali et al., 2021). Therefore, this will limit medical employees from experiencing professional burnout endemic in the COVID-19 environment.
Adequate protection of healthcare workers from violence can also address professional burnout. Anti-violence programs must be implemented according to relevant policies and laws (Ghassemi, 2021). In addition, leaders should cultivate zero tolerance for workplace violence. Reviewing labor legislation and introducing specific laws to limit workplace violence is also critical (Cook, 2020). Moreover, leaders should establish helplines to allow healthcare workers to report incidents of violence in the workplace and support a confidential reporting framework.
Healthcare workers also have a major obligation to establish safety protocols and policies. It is essential to establish linkages between occupational safety and health to address violence. Leaders must also work towards integrating and incorporating requirements to promote workers’ safety programs. Moreover, leaders should establish patient safety reporting and learning structures or systems.
Developing and executing national healthcare programs for occupational safety consistent with the national health and safety protocols is also vital. Healthcare leaders should review and upgrade national regulations or laws for occupational safety and health hazards. In
addition, leaders must develop guidelines or codes of practice to promote occupational safety and health among the leaders (Cook, 2020). Leaders must also promote intersectoral and interprofessional collaboration to ensure maximum safety accomplishment (Ali et al., 2021). Intersectoral and interprofessional safety management focuses on maximizing diversity and inclusion.
From the literature review, a critically anticipated theme revolved around employee management (Tewari et al., 2019). The dimension for creating impressive solutions to the problems faced by the employees in advancing their duties was an instrumental factor that required utmost improvement to ensure that the resou8bnding victory is realized. Creating a substantial solution to the problem of burnout became the critical determinant of employee management. Another integral theme anticipated revolved around crisis management (Tewari et al., 2019). In this scope, the focus is on the specific provisions. This provisional process would help resolve the critical need for creating overall progress. Thus, it is instrumental in focusing on developing the ideal progress in sustainable improvement of the ways for resolving problems once they occur.
The discovered themes may revolve around burnout management. The utility of meditation as a powerful tool for ensuring that sustainability is controlled became a critical factor in developing progress. Thus, the development of these factors became the ideal resolution that got the specification for improving progress (Tewari et al., 2019). These are the integral dynamics that help solve the respective dynamics for enhancing the necessary improvement in managing the stress as a causative function to the problem of the solution. Thus, it is instrumental in focusing on creating sustainable progress in developing effective solutions for the advancement of sustainable stress management.
The practical intervention to resolve the specific issues developed when managing stress among the target population was the application of different and suitable theories (Shaukat et al., 2020). Creating these models became the essential operation to help resolve the specific objectivity (Shaukat et al., 2020). Thus, sustainability improvement became the resounding factor that caused the creation of the critical improvement factor to be the ideal determinant in realizing adequate progress. For instance, the effort-recovery model has introduced the theme of managing the recovery process to promote progress in critically managing the solution. Accordingly, this operation model became the ideal process that helped create the progressive improvement toward managing the dynamics of operation (Shaukat et al., 2020); (Liu et al., 2019). These are the integral factors that help in maintaining the progressive improvement to the quality of resolving the specific issues that are connected to the burnout problem.
Acquisition of the requisite human resources in the healthcare department may be a fundamental theme introduced by the problem. Improvement of these dynamics is provided by creating a specific focus on recruiting foreign healthcare workers to mitigate the deficit created within the healthcare platform (Blake et al., 2020). This progressive model is instrumental in managing the specific objective of resolving the problem’s issues. Accordingly, realizing the beneficial progress was offered by the specific determination of the ideal progress became critical. These substantial provisions helped create the resounding improvement to the problems. These are the integral factors that are beneficial in creating a sustainable improvement to the quality of work as progress through promoting the resounding impact as a factor for enhancing improvement of service delivery (Blake et al., 2020); (Amanullah et al., 2020). These are the instrumental themes that have been realized in the study.
Literature Review Summary
This literature review provides a specific focus on the perceptions and experiences of health care providers that can possibly provide more insight by which leadership can improve burnout. Burnout remains a significant difficulty due to leaders’ lack of effective ways to deal with issues predisposing healthcare personnel to professional burnout (Lasalvia et al., 2021). Hence, this requires leadership to address burnout concerns among healthcare workers because it ensures that professionals are engaged (Sultan et al., 2020). Creating successful leadership strategies helps address factors that contribute to miscommunication and work pressures and is critical to addressing burnout issues (Sultan et al., 2020). Therefore, this suggests the significance of building effective leadership practices to address the challenges above facing health workers.
Burnouts are common among healthcare professionals. Influential leaders implement burnout intervention strategies (Sultan et al., 2020). Healthcare providers need to plan ahead of time to deal with and manage the COVID-19 outbreak (Khasne et al., 2020). To avoid burnout, leaders should implement initiatives that guarantee healthcare providers are wellversed and informed about COVID-19 mitigation strategies (Sultan et al., 2020). Healthcare executives should be aware of their responsibilities to improve their chances of avoiding workplace burnout. (Khasne et al., 2020). Leaders should establish adequate personnel levels to ensure that caregivers are not overburdened by their tasks (Sultana et al., 2020). Leaders should invest in quality leadership styles, including employee engagement and transactional leadership (Sultan et al., 2020). The primary aim is to ensure that administrators and other leaders commit their time and efforts to developing measures that limit exposure to professional burnout in the workplace (Sultan et al., 2020; Anthony-McMann et al., 2017). The absence of effective strategies to provide healthcare services
contributed to the high burnout rates among nurses during the COVID-19 pandemic (Lasalvia et al., 2021). Healthcare workers blamed hospital leadership for the inadequate preparedness measures that subsequently led to high burnout levels in healthcare workers (Khasne et al., 2020). Burnout among healthcare workers is a crucial issue; leaders have to ensure that such an issue does not affect the quality of services patients receive.
Among the most significant factors affecting employee performance is the work environment. Conducive work environments are the most effective solutions to burnout concerns in healthcare settings (Morgantini et al., 2020). Recruiting a sufficient workforce during the pandemic created a conducive healthcare working environment (Sultana et al., 2020; Morgantini et al., 2020). Workforce shortage contributes to burnout in healthcare professionals (Dall’Ora et al., 2020). Administrators shall enhance leadership participation to ensure that leaders understand issues such as employee burnout and work strains (Sultana et al., 2020). Physical and mental exhaustion arose from the influx of patients during the
COVID-19 pandemic.
Summary and Transition
The topic “COVID-19 burnout among healthcare workers” is an area that many investigators have delved into in the current times. The research outcomes will add to the current literature and support other investigators undertaking similar studies. The central focus is on how leaders have exposed healthcare providers to professional burnout, especially during the pandemic (Khasne et al., 2020). The results are intended to offer leaders valuable insights focused on the strategic actions they can develop to reduce burnout. For example, developing flexible schedules and offering mental and psychological support services are some of the potential recommendations that the research will investigate. Leaders can take the results of the research to protect the healthcare workers from burnout. Section one consists of the purpose statement, research questions, research paradigm, research design, research
framework, research assumptions, limitations, delimitations, summary, appendices, and academic references. The purpose statement section highlights the reasons behind the study. Also, it is the part that provides information regarding what the research intends to achieve (Bonache & Festing, 2020). In this case, the study aims to account for the healthcare provider burnout and mitigation measures during the COVID-19 pandemic. The research questions is a crucial part of the research because it identifies specific queries related to the study. The research must provide questions that guarantee focus from the beginning to the end (Gaya & Smith, 2016). Research questions enable researchers to remain grounded in the study topic. The Research Paradigm is the part of the study that provides information concerning beliefs and agreements from the scientific field. The section indicates the agreed strategies for exploring and understanding scientific topics (Gustafsson, 2017). The study should not utilize any research formulas and theories, but the ones ratified by the scientific community. The research design is part of the study that provides strategies used to incorporate all elements of the undertaking. It integrates all sections of the research into a comprehensible and logical unit. The research design includes an explanation of data collection (Gaya & Smith, 2016). Also, the section accounts for the measurement and data analysis. It ensures the researcher answers the research question or problem comprehensively. The research framework is a vital part of the research because it highlights and presents explanations of the relationships involving concepts, theories, and constructs (Gustafsson, 2017). Therefore, the study framework gives an overview of the right direction toward answering or solving the research problem. It guides scholars to focus on the objectives from the beginning to the end of the study. The research assumptions section accounts for the assumed factors within the research. Researchers must identify the assumptions because they can affect the outcomes adversely (Gustafsson, J. (2017).
Mitigating the unwanted outcomes of assumption is crucial. Limitations includes constraints related to the undertaking, and it could be time, resources, and lack of participants (Gaya & Smith, 2016). It is imperative to identify the limitations to plan how to overcome them. Delimitations entails the strategies to eliminate identified research limitations. Researchers must ensure the limitations do not interfere with outcome validity and reliability (Gaya, H. J., & Smith, E. E. (2016). In this way, the conclusion can be valid. The summary section summarizes explored concepts and offers an overview of the literature outline. The summary makes it easier for readers to understand the entire project (Butina, M. (2015). The summary should be comprehensive. Appendices and academic references are valuable in this research study. These are key perspectives that should be accommodated in the first section to prepare the readers for what they should expect to appear in section two.
The second part of this study will entail different segments such as research methodology, data collection, and measurement that establish an effective link with the first section to develop a solid picture of the overall research process and its projected goals and objectives. The researcher will establish the methodology for undertaking the research and provide supporting details surrounding the selected methods. An overview of the targeted population, sampling process, and sample size will be provided. This segment will pay indepth attention to the data collection methods whose aim will be to gather data and information. A rationale behind the target group selection will also be included. For example, if the researcher highlights questionnaires and interviews as the central data collection methods, one must portray the reasons behind selecting them over others. Following the data collection part will be a descriptive analysis stage that will concentrate on interpreting the obtained information. This will lead to generalization, recommendations, and conclusions. With the use of an effective data analysis process, the researcher will acquire valuable
information leading to an effective generalization and conclusion. Research reliability and validity will also be established to ensure the conclusion made from the research is valid and reliable. The recommendations and conclusions derived from the research will add to an existing pool of academic literature linked to the topic at hand. Overall, the second section remains one of the most critical phases in a research study. It cultivates a better understanding of the topic at hand as established by the research outcomes.
Overview of Section 2
Section two will focus on the research methodology, the targeted population, sampling methods, the data collection process, analysis, recommendations, and conclusions.
In the methodology part, the investigator will determine the integral research methods used. This might include surveys, interviews, observations, or experiments. The rationale behind each selection will be provided. This will consist of the targeted population, desired and selected sample size, sampling procedure, and rationale. One of the primary approaches that will define this segment is the data collection process. The researcher will collect valuable data and information useful in the research. A well-established plan of useful data tools, the collection strategy, and data organization will be highlighted in this part. The investigator will provide supporting information behind reliance on the selected data collection methods and their role in providing integrity and reliance. After collecting data, an analysis procedure will follow where the researcher will use vital tools and techniques to analyze the obtained data and information. A recommendation and conclusion part will follow to highlight to the audience the outcomes achieved and how they support the research questions. The researcher will also provide details focusing on the reliability and validity of the research project and supporting information. This research’s generalizations, recommendations, and conclusions will highlight if leaders are responsible for protecting healthcare workers against burnout.
This information will add to existing literature relevant to this domain.
Section 2: The Project
Introduction
The research’s central area of focus is assessing healthcare workers’ exposure to burnout during the pandemic. These professionals are crucial in advancing healthcare outcomes and establishing improved health and overall well-being. The research will exert possible efforts to examine how different stakeholders can help address these burnouts, especially when the industry is experiencing numerous issues from the pandemic. The key area of focus is how leaders can improve their skills and abilities to limit the development of burnout among healthcare providers. This flexible single case study aims to assess aspects that expose healthcare providers to professional burnout in the southeastern United States. The researcher will reach out to a segment of care providers and leaders to gather ideas and insights targeting the exposure to professional burnout during the pandemic. The researcher will use the outcome of the study to recommend best practices that leaders can adapt and implement to protect their workforce from burnout in the present and future. The results will build the foundation for reduced professional burnout among care providers, especially during pandemics.
Purpose Statement
The purpose of this flexible single case study aims to understand the inability of healthcare leaders in the Southeastern United States area to create and implement potential response measures for addressing professional burnout emerging from the COVID-19 pandemic. The researcher will select healthcare workers and leaders to offer their ideas and perspectives about healthcare management and the administration’s impact on staff burnout during the pandemic. The targeted population will relay viable information that will answer
the research questions. The research will focus on two major concepts: professional burnout and leadership. First, the study will investigate the increasing emotional and physical exhaustion among healthcare providers during the period of COVID-19 infections (Cotel et al., 2021). Second, in examining leadership contribution, the research will assess leaders creating the environment to address the burnout constructs. The results obtained from this research will supplement existing studies focusing on leadership strategies likely to develop a potential working environment for care providers during healthcare pandemics. This research will inform leaders on the courses of action they can take to advance the health and well-being of healthcare professionals amidst the harsh realities of the COVID-19 pandemic.
Role of the Researcher
The researcher remains a crucial part of the successful outcomes of this study. First, the researcher seeks to collect a wide range of information from the participants to better understand the actual situation on the ground. The role of the researcher is to ensure that the participants gathered for the study match the needs of the research. The researcher is also responsible for selecting the most appropriate research methods and approaches that match the study’s needs. One of the critical approaches that the investigator will need to pay attention to is collecting vital information on participants’ thoughts, feelings, and emotions because burnout is not a physical element readily seen (Salvaggioni et al., 2017). Salvagioni et al. (2017) emphasize this element of burnout by describing it as a syndrome that affects individuals’ well-being and health, making it a personal problem. The researcher will aim to understand how healthcare providers and leaders feel about the issue of burnout during the pandemic. This will expose the researcher to numerous themes, primarily those connected to the role of leaders in addressing burnout. The researcher will retrieve viable information that
answers the key research questions through interview sessions, questionnaires, and focus group discussions. In line with the ethical values and perspectives linked to research processes, the investigator will observe confidentiality, privacy, autonomy, and zero potential harm (Yip et al., 2016). This will boost the chances of obtaining valuable information that supports quality generalizations and conclusions. For instance, the assurance of privacy and confidentiality, which is also a major role of the researcher, will ensure that the targeted participants can offer helpful information in the research. They are more likely to agree to participate and relay quality information when they are guaranteed confidentiality, privacy, and zero exposure to harm. The investigator must abide by ethics and integrity to obtain the desired outcomes.
One of the main roles that the researcher will need to achieve is an excellent bond with all the participants. This will entail building positive relationships, which will allow greater openness. Building trust between researchers and participants translates to successful research outcomes (Guillemin et al., 2018). This portrays the need for researchers to create a valuable rapport with all the targeted respondents. Since leaders may be deemed the central factor behind the increased exposure to professional burnout, a connection is essential to ensure that leaders and care providers do not withhold information. There is a dire need for the researcher to focus on appropriate tools that enhance the data collection process (Fischer, 2009). This will accelerate the chances of obtaining valuable data and information that supports effective analysis of the study topic. The researcher will achieve the desired milestones through the selected data collection tools. Besides selecting viable tools, the investigator must address the bracketing perspective to reach the research outcomes.
The researcher understands that bracketing can affect the established outcomes and will remain committed to addressing it (Noble, 2019). Refraining from personal judgment is
one integrated approach the investigator will adopt to avoid personal bias (Gustafsson, 2017). The dominant approach which will be used to bracket is interviewing with an outsider, where biases and preconceptions will be discussed. The fundamental rationale behind bracketing is to ensure that a research outcome has zero presumption and bias that can influence the interpretation process (Fischer, 2009). The interviews with an outsider will raise awareness of the researcher’s perceptions by introducing a platform where alternative views can be discussed and openly identified. The overall goal of conducting bracketing interviews is to provide researchers with clarity, especially in emotionally charged studies that may apply or be compromised by personal experiences (Tufford & Newman, 2010). The outsider to be included as part of the bracketing interview will be identified from a selection of retired medical practitioners. The outsider will be different from the existing participants in that the retired medical practitioners will have retired from the medical field in the past five years, which will make them unique in assessing, affirming, and restructuring the researcher’s existing assumptions about burnout in practitioners. Bracketing is an opportunity for the researcher to lower their disruptive impact on research through assumptions, which is achieved by the researcher exploring and putting aside their pre-existing knowledge to develop a non-judgmental view of the research topic (Sorsa et al., 2015). The outsider will be sourced online through a survey targeting retired practitioners. A major focus will be identifying a female outsider who will provide diversity in understanding the practitioner’s culture and experiences. The outsider profile serves to provide the researcher with an understanding of the lives of the practitioner at work, which will help generate an understanding of the experiences of practitioners before the COVID-19 outbreak. The outsider will provide comparability and insight into the added vulnerability to burnout that COVID-19 introduced to practitioners. Writing a journal is a second approach that the
researcher will apply as part of bracketing. According to Weatherford and Maitra (2019), writing a journal provides a researcher the opportunity to reflect on the research process by observing how elements such as personal judgments, opinions, and narrative approaches influence their interaction with the participants and research in general. The journal will be initiated before the research questions are identified to include perceptions and questions that the researcher holds towards the topic of burnout. Overall, the researcher will incorporate and document the presence of any preconceived notions because they might sometimes be unavoidable. The central focus is to help the audience develop a baseline understanding of the final research outcomes associated with the project (Weller et al.,2018). Journaling is a crucial bracketing method that draws its efficiency from the fact that it is a process-guided approach that records changes as the research continues. Journaling will allow the researcher to record assumptions and identify how they are changed through interactions within the research.
Summary of the Role of the Researcher
The role of the researcher is to delve into how institutional leadership may have exposed care providers to professional burnout during the pandemic. Leaders play a vital role in creating and implementing strategic changes encompassing the needs and interests of their workforces (Weller et al., 2018). During the COVID-19 pandemic, leaders may have lagged in their mandate and thus exposed care providers to burnout. The researcher’s role is to investigate employees’ physical, psychosocial, and mental stability to identify their vulnerability to burnout (Rahman., 2016). The role of the researcher is to form non-biased bonds with the research participants to ensure that the population being investigated is comfortable enough to share information (Fischer, 2009). Additionally, the researcher reduces bias in the study, which is achieved through processes that ensure the researcher’s
perceptions do not interfere with the analysis. The researcher must also engage in bracketing to reduce the biases in the research, which will be achieved through bracketing interviews and journaling (Rahman, 2016). The researcher’s roles are vital to the research because they give the right momentum to the rest of the study and influence the research outcome.
Research Methodology
Introduction
A single and flexible research-based study will be used to evaluate the exposure of healthcare providers to burnout during the pandemic. The researcher will target crucial methods that offer more comprehensive access to relevant data and information. The key approaches the researcher will focus on are interviews, questionnaires, and focus group discussions. Also, secondary data sources will be used to enhance triangulation. Combining these methods will offer comprehensive access to quality data and information.
The rationale behind the Selected Research Design
The research will focus on a single case and flexible research design. The researcher will pay attention to a qualitative approach which will assist the researcher in collecting data focusing on perceptions and attitudes (Rahman, 2016). Rahman (2016) explains that qualitative research is advantageous because it allows the researcher to interact directly with the population being researched and gather personal perception and experience that encompasses experiences, perceptions, personal views, and emotions. These advantages guided the selection of qualitative research for the study because investigating burnout requires a more personal approach and factual data. A single case study will be essential in this research. The use of single case studies is presented as a viable research design because they offer researchers holistic and context-specific accounts of the research questions and theory-building and testing (Gustafsson, 2017). The issue of burnout and the COVID-19
pandemic can take a broader scope. However, the researcher’s primary target is to assess how institutional leadership exposes healthcare providers to professional burnout. Also, this will ensure that the researcher collects data from a limited scope, thus simplifying the interpretation and analytical processes. A flexible system will allow the researcher to adopt the best tactic which offers optimal benefits. Roser and Kazmer (2000) explain that flexible research design is highly advantageous because it provides an explorative window in research where the theory is not well-established while placing the researcher as the data gatherer to provide room for the researcher to intervene during data collection. The combination of flexible research design and single case study method is effective for the proposed research because these approaches deliver factual data while providing room for the researcher to build on the theory as the study progresses.
Single case studies can be designed to have strong internal validity for assessing causal relationships between interventions and results (Rahman, 2016). A single advantage of the case study exists at a more practical rather than a theoretical level (Rahman, 2016). The suitability of the single case study is evident in the topic selected for the research. The topic encompasses one of the crucial issues of concern in healthcare. It can be extensive due to the numerous burnout challenges experienced by various care providers. This calls for the researcher to narrow down the study and focus on a single approach that provides easy and smooth research operations. A single case study facilitates this because they involve the repetition of measures and the manipulation of independent variables to provide context-specific and rich research (Lobo et al., 2017). This may guarantee that the researcher can collect significant data on how care providers are exposed to burnout and how leaders may be able to accelerate the situation. The primary objective remains a commitment to deriving strategic research outcomes. The results may offer insights to assist future leaders. Overall,
the researcher will rely on a single, flexible case study to accelerate the likelihood of achieving the projected goals and objectives.
Triangulation
The researcher will rely on triangulation to boost the validity of the research on the issue of burnout among healthcare workers. Triangulation is the process through which numerous data-gathering sources, methods, and theories are used to investigate a given research question, which plays the role of helping a researcher improve the validity and credibility of the acquired findings (Noble et al., 2019). In this case, the researcher will apply two types of triangulations: methodological and theoretical. The dominant triangulation method in the proposed research is methodological triangulation. Heesen et al., (2016) describe methodological triangulation as a process where the researcher collects crucial information from multiple methods of gathering data. This entails collecting information using questionnaires, interviews, and focus group discussions. The researcher will use each of these approaches with the set of selected participants to ensure that different forms of factual data are collected, including the intensity of emotions and frequency of how a certain perception or opinion is shared. The healthcare workers and institutional leaders from the Southeastern United States area will offer vital details that will enable the researcher to establish crucial generalizations. The information provided through questionnaires, interviews, and focus group discussions will boost the analysis allowing comparison to arrive at critical conclusions.
As part of methodological triangulation, the investigator may frame strategic research questions, which will be the focal point behind the targeted analytical approach. The selected questions will be simple to prevent the study from delving into issues that do not support the research process and intended outcomes. The selected team of healthcare providers and
leaders participating in the research will be expected to offer important information helpful in answering the research questions. As highlighted, the researcher will use interviews, surveys, and focus group discussions. The answers from the interview sessions will be cross-examined against those collected from the other sources to evaluate occurring themes. One of the aspects that the research will need to pay attention to is using open-ended interview questions. Open-ended questions are important because they provide research participants with the flexibility of answering questions according to personal preferences, which may include lists, stories, and deep thoughts, resulting in more detailed data collection (Weller et al., 2018). This means that the researcher will have a crucial chance to collect essential details about the issue. Also, the researcher should consider well-established questions when using questionnaires and focus group discussions. Combining these data collection approaches helps to achieve the triangulation milestone.
Secondly, theoretical triangulation will be an additional method that the researcher will apply to cement the study’s credibility. Flick (2019) explains that theoretical triangulation encompasses using different theories to expand on the research questions by framing the research questions from different frameworks. The research may combine different theories to investigate the concept of burnout among healthcare workers, ensuring all elements contributing to the problem are effectively considered. Examples of theoretical frameworks applicable to the research include Maslach’s theory, Job demands-resources theory, and conservation of resources theory. Theory triangulation will achieve triangulation by approaching burnout from different lenses, including the role that the availability of resources plays in the development of burnout.
Summary of the Research Methodology
The researcher will invest in the qualitative approach, which integrates a flexible single case study. Also, questionnaires, interviews, and focus group discussions will be used to expand the data collection processes and deliver the triangulation perspective. Relying on triangulation will provide the researcher with a viable chance of establishing accurate generalizations and conclusions. More comprehensive access to numerous data sources and information supports the validity, reliability, and outcome of the case study. The primary data collection and theme development will continue from interviews. For example, by supplementing questionnaires with interviews, focus group discussions, and secondary sources, the investigator will obtain highly informative information, enhancing the generalization and conclusion processes. Through triangulation, the researcher will collect a broad range of information that can improve the analytical process and enable one to answer research questions and justify the established hypothesis.
Participants
The eligible persons of the case study will include healthcare workers and institutional leaders selected from various healthcare institutions in the Southeastern United States region. These are vital segments capable of generating quality information about professional burnout. Healthcare workers will reveal their exposure to professional burnout during the pandemic. The healthcare workers will be expected to provide honest and accurate feedback on present working conditions and the challenges experienced when handling patients. For example, if nurses and other care providers reveal that they have been experiencing physical and emotional exhaustion due to the high number of patients reporting to their care centers, the researcher will relate their status to hectic and demanding working conditions. Thus, the most important aspect is to ensure that nurses and other healthcare providers selected for the study can offer valuable and credible information without fear, as their anonymity and confidentiality will be highly observed.
Organizational leaders will provide information that allows the investigator to better understand the current situation being experienced by nursing professionals. Notably, leaders will be expected to offer quality information on the leadership tactics adopted during the pandemic and the outcomes experienced. Their leadership roles and interventions during this era may shape individual workforce outcomes. Research indicates that leaders develop strategic quality interventions in the healthcare sector (Sultana et al., 2020). This makes them a key area of focus since professional burnout during the pandemic is closely associated with the status of the present working environment. Leaders make decisions that determine the nature of the work setting. Thus, their participation is essential to allow the researcher to evaluate their contribution towards exposure of care providers to burnout. All the participants will be selected based on the informed consent approach.
Population and Sampling
The study population entails the larger group which the researcher targets for an assessment. It corresponds to the entire set of subjects whose characteristics are of vital interest to the investigating team (Martinez-Mesa et al., 2016). Depending on the research and context at hand, the investigator will use distinct characteristics to identify potential samples and obtain subjects from the larger group. The sample group will be narrowed down in line with the specific elements targeted in the study. The imperative goal is to ensure that the study outcomes are reliable. This remains a primary target for this qualitative-based study since the results cannot be generalized. This framework assists the investigator in developing key recommendations and conclusions.
The researcher will select a sample from the larger population to act as a representative. Since the study uses a qualitative approach, the researcher will aim to
achieve reliability instead of generalizing the outcomes to the larger population. This is based on the idea that qualitative studies are subjective, and the ideas and insights provided by the selected participants may not represent the views and opinions of other people. The fact that the study relies on human sense and subjectivity means that a limited sample size may not generalize the large population (Leung, 2015). Thus, the core goal behind the study is to achieve reliability where the obtained findings will be deemed consistent when similar methods are used under the same circumstances. This way, the researcher is assured that the study will generate similar outcomes when undertaken in a different setting. This enhances the study outcomes due to the higher reliability attributed to the study processes. The researcher will establish an appropriate sampling process to ensure that one obtains vital results.
Population
In this case, the population will be healthcare providers and institutional leaders who can relay valuable information focusing on professional burnout during the pandemic. Leaders will be vital to the research because they will provide comparability of opinions towards the concept of burnout. Previous research will guide the researcher in determining who is more exposed to professional burnout. Nurses will be a priority selection to include in the population for the research. (Kowalczuk et al., 2020) reveal that nurses are among the most vulnerable groups based on increased workloads. This makes them an important group the researcher can investigate with the mission to create insights and understanding. Exposure to their conditions and associated factors will open critical opportunities for institutional leaders to make strategic amendments. Therefore, the researcher can base the research on the nursing domain to determine how these professionals are affected by burnout, and crucial interventions leaders can adopt to change the situation. The researcher
will also consider practitioners in areas such as emergency and primary care settings. During the pandemic, these were vital segments expected to witness a surge in demand for care. Further specifications for the final sample population will be discussed in the sampling section.
Sampling
Considering that the study focuses on a qualitative approach, the investigator can utilize convenience, purposeful, and snowballing. However, the central methods that will be used are purposeful and snowballing as they accelerate the desired outcomes. Research shows that purposeful and snowballing are important sampling methods that researchers can integrate when dealing with qualitative studies (Naderifar et al., 2017). They allow the researcher to target participants that can provide ideal and reliable information. For example, professional burnout is quite a sensitive issue requiring the investigator to target and select persons capable of proving the targeted information. A mix of these two methods will facilitate a higher chance of obtaining an adequate sample size for the study.
Selecting the right participants is a major area of focus in every study (Etikan et al., 2016). Convenience sampling entails selecting a sample based on its ease of accessibility, availability, and willingness to participate (Etikan et al., 2016). However, samples selected using this strategy might not deliver viable outcomes. Research has shown that this method is not purposeful nor strategic, seeing that the method might result in a less diverse sample because the participants gained is either the easiest to reach or the closest (Etikan et al., 2016). This shows that convenience sampling is not ideal for most of the studies as it denies the investigator the chance to obtain quality feedback because it is a non-probability method of acquiring participants.
Next is the snowballing strategy, which entails recommendations of the best people who can participate in the research (Parker et al., 2020). According to Parker et al., (2020), snowballing is a non-probability sampling method where acquired participants are encouraged to recruit others based on their familiarity, network, and acquaintances. Snowballing is somewhat capable of acquiring a reliable sample because recruiters can knowingly recruit individuals that fit a given description (Naderifar et al., 2017). This approach is mainly beneficial as it enables the investigator to obtain a substantial sample group. The researcher might not have the information on a large segment of nurses exposed to professional burnout with mere observations. However, identifying a few and using them to reach out to more nursing professionals living and prone to burnout is of greater significance. The same case applies to those at the top-leadership level, where the investigator can target one of the leaders and use the subject to target and incorporate others who can deliver quality information. Overall, this mechanism allows the researcher to target care providers with burnout and ask the professional to recommend others. Snowballing would reduce the time and cost of accessing potential study participants for the research. However, it is prone to bias, and subjects feel as if their privacy and confidential status have been affected when others recommend them for the study. Purposeful sampling is an additional method used by researchers seeking reliable participants (Palinkas et al., 2015). It enhances the likelihood of obtaining samples with rich information about the topic under scrutiny. This is a key plus for the researcher as these samples can provide quality data and information useful in the study. The purposeful sampling method allows the researcher to obtain information linked to the phenomenon of interest (Palinkas et al., 2015). However, time inefficiency is the dominant concern when using the method because it requires a purposeful selection of characteristics.
The study will utilize the purposeful sampling method. It will pave the way for the researcher to gain access to rich and in-depth data and information. As Palinkas et al. (2015) explain, the purposeful sampling method ensures that the investigator obtains greater access to rich sets of information from the selected participants. After using the purposeful sampling method, the researcher will incorporate the snowballing tactic to meet an adequate sample size for the study, the latter bridging any gap in adequate sample size collection. Relying on these two methods will expand the sample size level to the desired level. This will make it easy for the researcher to saturate the data while relying on the set of information provided by the subjects. For example, by targeting healthcare workers and leaders who can provide rich-based information, the researcher will increase the likelihood of enhancing conclusions and generalizations. The study participants will be limited to healthcare providers and administrative leaders selected from identified healthcare organizations in the Southeastern United States area. The key focus when selecting professionals involved in the study will be based on the departmental area, the age of the practitioner, and the length of time the individuals have served in healthcare.
Departments such as emergency and primary care will be the main characteristics used to narrow down the sample population. This characteristic is important because certain departments in healthcare have been noted to be more vulnerable to burnout. (Toscano et al., 2022). For example, nurses working in the intensive care unit and the emergency departments are more prone to burnout compared to other professionals (Toscano et al., 2022). This is based on the numerous and hectic tasks that these nurses manage when handling patients in these segments. Their responsibilities include the care of people in critical condition who are in dire need of care and attention services. Age is also a vital characteristic of the sampling because age is identified as a crucial risk factor for burnout
among healthcare workers (Jiang et al., 2021). Research indicates that young nurses are more likely to develop occupational burnout compared to their counterparts (Jiang et al., 2021). The length of time practitioners have offered services will play a crucial role in the selection of a sample of participants. Based on this research, it is evident that nurses operating in highly demanding segments and those newly recruited risk experiencing occupational burnout. Therefore, the research will concentrate on those assigned to demanding areas and less tenured. The latter offers a key opportunity to evaluate how newly employed and less experienced care providers are exposed to professional burnout. Their behavioral tactics can imply their dissatisfaction with the working environment and thus pave the way for a valuable study.
In terms of statistical selection, the sampling process will attract healthcare professionals from all backgrounds. This will ensure that every care provider can be selected to participate irrespective of their racial, or ethnic background, and other major defining characteristics. The goal of the study is to obtain diversity and attract many participants capable of providing comparable data. To select a sample population, the researcher will have to meet specific requirements by the IRB process. The researcher will have to first obtain approval from IRB to ensure that one abides by ethical considerations. In the IRB process and approval, the researcher will be expected to observe the scope and timeline and be familiar with human participant research training knowledge (Liberale & Kovach, 2017). This will lay the foundation for well-undertaken research based on respect and value for human lives. After all the approvals are provided, the researcher will move ahead to undertake the research. The key rationale is to conclude whether leaders are responsible for exposing healthcare personnel to professional burnout during the pandemic. Selected care
providers and leaders from different hospitals located in the Southeastern United States locality will participate.
The sample size for the research will be a minimum of 30 and a maximum of 45 participants. This is a strategic number of subjects that can provide the required feedback. The researcher will use purposeful and snowballing strategies to generate the sample size. The selected sample size populations will provide the much-needed information that answers the research questions. The sample size in this qualitative study approach relies on the saturation level (Saunders et al., 2018). The researcher will utilize this strategy to ensure the realization of the desired outcome. For example, the selected minimum sample size will allow the researcher to collect vital information that paves the way for a quality generalization and conclusion. The researchers always align themselves to the smallest number in qualitative studies. As research has shown, qualitative studies encompass a small number of participants based on the depth of the case-oriented analysis (Vasileiou et al., 2018). The snowballing tactic used to obtain the sample size ensures that the researcher identifies subjects that can provide rich-textured information. Thus, using a minimum of 30 participants allows the investigator to obtain quality feedback. This ensures that the study outcomes are valid and highly reliable. Achieving validity and reliability translates to an excellent conclusion. This way, the researcher can develop a valuable recommendation for the issue being investigated. Thus, selecting an effective sampling approach helps the researcher find an adequate sample group to relay valid and reliable data and information. The saturation perspective comes in handy to explain the rationale behind the sample size selection.
The saturation concept explains why the researcher can use the minimum and maximum sample sizes. It is a key methodological approach that has gained relevance and acceptance among researchers (Saunders et al., 2018). It works on the idea that based on the data collected, further details and analysis are unnecessary (Saunders et al., 2018). This means the researcher can rely on already collected data to make viable conclusions, and any further emerging data and information have no impact on the outcomes. The researcher will focus on at least 30 sample populations and when the saturation level is reached, more data collected will not impact research outcomes and collection will cease.
Summary of Participants, Population, and Sampling
Overall, the participants in the study will entail a selected team of healthcare providers and organizational leaders based in the Southeastern United States area. Care providers can highlight key experiences that portray exposure to professional burnout. A study by Mudallal et al., (2017) shows that nurses experience emotional exhaustion, reduced motivation, and limited work efficiency due to higher levels of burnout. They become less motivated and satisfied with their duties primarily because their leaders fail to take quality actions to safeguard their health and well-being. Leaders must introduce and implement strategic guidelines and practices that reduce burnout (Sultana et al., 2020). However, their reluctance has developed a significant gap in accelerating care providers’ health and well-being in the industry. Thus, the key focus is understanding workforce experiences to examine their exposure and leadership role in handling the situation. For example, if the workers highlight energy depletion, exhaustion, and lack of free time to attend to personal affairs, the researcher will realize that nurses may be exposed to burnout. Also, organizational leaders will reveal their roles and help the researcher assess their role in the current situation. The key goal will be to examine how institutional leaders have facilitated exposure to professional burnout or how they have aided in easing the burden.
A purposeful sampling process will be used to select an appropriate sample because it facilitates access to subjects with rich information (Palinkas et al., 2015). Also, the
snowballing method will come in handy to substantiate the number of participants needed for the study (Naderifar et al., 2017). In each of these two methods, the process will start with the investigator identifying individuals who can provide quality information and expanding it progressively to obtain a strategic group of participants. In the initial steps, the researcher will form his evaluation based on aspects that one feels will likely affect the sampling process. Along the way, the investigator will accelerate the number and finally settle on a substantial number of participants. The primary focus is to ensure the final sample size can enhance reliability and a quality conclusion. This means the researcher should target a larger population and use it to narrow down the sample to the required level. It is easy for the investigator to look around and identify potential participants especially based on how care providers manage themselves when handling patients and other chores in the hospital and other care settings. Also, the researcher can identify leaders who can provide valuable information about professional burnout status. By identifying subjects with rich-based information, the researcher will enhance the process and achieve positive outcomes.
Also, the researcher will obtain all the necessary approvals from different institutions. Targeting more participants will allow the researcher to collect a wide range of data and information that supports reliability and effective conclusions (Andrade, 2020). The snowballing sampling method will fill the gap and allow the investigator to obtain an adequate sample size. For example, assuming the researcher only invested in purposeful sampling, then there is a higher chance of failing to target and recruit an adequate sample size. However, incorporating the snowballing approach expands the sample population. This method is valuable because it ensures that already selected subjects can recommend their
peers who they feel can partake in the exercise (Palinkas et al., 2015). The investigator can boost reliability and conclusion processes with a larger participant population.
Data Collection
The section will address the plan for data collection to provide details on how flexible design will be achieved. The section will justify the data collection methods to ensure all data collected will effectively advance the research. The section will predominantly use a qualitative research design, which will be articulated through interviews, questionnaires administered to a well-crafted sample population and archive data. Tenny et al., (2022) explain that a qualitative research method is preferred for its extensive data collection by providing acumen and a deeper understanding of real-life issues. The selected qualitative research methods will focus on providing factual data. The interviews have been selected for their interactive nature of gathering data, the focus groups to provide the chance to test narratives, and the questionnaires for insight into perceptions, experiences, and opinions on various concepts.
Data collection plan
The research is designed to analyze the effect of the COVID-19 outbreak on healthcare workers since its inception at the end of 2019. The researcher will take a distinct order for data collection to maximize the data gathering process. Data collection will be initiated by selecting and acquiring a sample population that will include healthcare practitioners from different fields and specialized areas. The compounded data from the sample population should also help leaders in healthcare advance their practices to minimize the exposure and vulnerability of professional workers to burnout (Dewale, 2018).
This flexible design case study will primarily gather qualitative data. The qualitative research method is endorsed for research into real-life phenomena because the method
generates the opportunity to gather actual emotions, opinions, experiences, perceptions, and attitudes toward problems (Aspers & Corte, 2019). The researcher will first administer online questionnaires to evaluate the research problem on burnout levels among healthcare workers during COVID-19. Online questionnaires focus on gathering factual data from diverse experiences, opinions, and attitudes relayed by numerous individuals accessible online, which makes data collection faster, more flexible, and more diverse (Dewaele, 2018). The final questionnaire questions will be used to request interview and focus group participants for additional data collection. Data from the surveys will be collected and transferred into a digital spreadsheet for easier analysis for the generation of patterns. The findings from the survey will be used to select participants for other steps of the research based on whether the participants confirm previously or currently suffering from burnout, their length of experience, and their area of specialization in healthcare.
The researcher will proceed to conduct physical interviews, which will be semi-structured interviews. A semi-structured interview is achieved by using a pre-determined set of questions alongside the flexibility of the interviewer asking questions as they arise when the interviews are being conducted (Ahlin, 2019). Thus, the researcher will develop a portfolio of questions to be used in the questionnaires. The sample population included in the interviewing will be smaller for a more focused assessment. All interviews will be conducted while being recorded for audio recordings and later transcribed to facilitate data storage on a digital spreadsheet. The research process will be finalized using focus groups, which will be further guided by the digital spreadsheets where a smaller participant group from the sample population will be asked to discuss and relay their perceptions and opinions towards the pandemic and the levels of burnout among healthcare workers during the period among themselves. The focus groups will have audio recordings that will be transcribed for
manual analysis. The focus group is included in the research because they present a more focused input into the topic of burnout because the focus group will only include practitioners who confirm suffering from burnout. The research methods will be founded on research questions 1 to 5 that have already been established in the early phases of the research.
Instruments
Interview guides
The interview guided purposes to cement the objectivity of the research process and data collection for each interview conducted. Roberts (2020) outlines that the interview guide provides guidelines that add structure to the interviewing while also providing transparency to the participants by providing details on the methods to be applied. The interview guide presents the research questions in a simplified format to ensure all parties involved in the research understand their roles. Appendix A indicates the interview guide to be applied in the research on the influence of COVID-19 on the prevalence of burnout among healthcare workers. The interview guide segments the interviewing process into six steps.
As indicated in Appendix A, the first part of the interview will act as the introductory section to set the environment. Lambley (2020) explains that the interviewing process for research into social problems becomes more effective through small talk, which can be achieved through simple questions unrelated to the research to help participants become more comfortable and willing to share genuine information during the research. The small talk for the research will be articulated through questions that will also gather background information on the participants. The consequent four sections will be based on the four research questions generated for the study. Part two of the interview will be founded on RQ1
(How is professional burnout prevalent in healthcare among the nursing staff?). This section will focus on gathering data on the perceptions and opinions on the rate of prevalence of burnout among healthcare workers. The section will ask participants to specify their perceived rate of prevalence of burnout among healthcare professionals. The section will also ask the participants to identify why they believe nurses are generally more affected by burnout. The section will also include questions on why the participants think nurses became more vulnerable after the onset of the pandemic.
The third part of the interviewing will focus on RQ2 (What are the possible leadership failures in addressing professional burnout in healthcare organizations?). The questions in this part will elicit genuine answers on the perceived role of leadership in managing healthcare workers and organizations. The section will include questions on the participants’ opinions regarding how leadership may have failed to address the issue of burnout in healthcare facilities. The section will also include questions on how leaders may have directly encouraged burnout among workers. The fourth section of the interviewing will be based on RQ3 (What proposals could address professional burnout among healthcare workers?). The section will include encouraging answers on the solutions that participants believe could help reduce the rate of burnout among healthcare professionals.
The fifth section will be based on RQ4 (How do healthcare management and administration affect staff burnout at hospitals in the wake of COVID-19?). The section will draw out distinct opinions on solutions to burnout based on experiences and attitudes toward burnout among nurses. The sixth and final section of the interview will help close the interactions between the researcher and the participant. The section will include questions that elicit off-script answers solely based on final statements and thoughts held by participants from their participation in the interview.
Surveys
The survey, in this case, will be administered online. The general structure of the survey will mimic the questions used on the interviewees, meaning the survey will be founded on the four research questions generated for the research. The survey will include a total of 17 questions, which will be founded on the four research questions to be utilized in the research. Questions 1-5 will act as warm-up questions to provide background information on the participant. Questions 6-9 will reflect RQ1 because they will elicit answers to questions on the prevalence of burnout among nurses before and during the COVID-19 pandemic. Questions 10-12 will focus on RQ2 and RQ4, which will explore the role of leadership, management, and administration in encouraging high levels of burnout among healthcare workers. Questions 13 and 14 will be based on RQ3, asking participants about solutions they think can help reduce burnout levels in healthcare. Questions 15, 16, and 17 will be the closing question that will ask the participants if they are willing to participate in a focus group and interview for other data collection methods being used in the study.
Archive data
The research will also incorporate existing archive data to provide assertions and comparability to the data collected. Archival data is essential to research because it introduces additional data to guarantee the comprehensiveness of the study, which facilitates the comparability of data to ensure a more conclusive understanding of a research problem (Turiano, 2014). The archive data to be used in the research will be generated from the Centers for Disease Control and Prevention, a federal organization responsible for evaluating the state of public records in the United States. The CDC conducts regular evaluations of healthcare workers to determine their stability in handling the public’s healthcare needs. Recently, the CDC conducted in-depth statistical research into the mental
state of healthcare workers, revealing that up to 79% of practitioners in healthcare have reported burnout, with 64% of the reports being from women (CDC, 2022). The archival data will focus on the RQ1 that analyzes and compares the prevalence of burnout among nurses compared to other professionals in healthcare.
Data organization
Data organization in the research will rely on the use of digital spreadsheets. The data collected will be entered into a digital spreadsheet for manual analysis and interpretation. Being qualitative research, the data must be manually evaluated and interpreted to generate patterns and categories that help in coding the data. The data coding will be facilitated by the researcher formulating coding schemes before the initiation of the interviewing process. Coding is essential to every research because the process establishes new and unchartered concepts by encouraging the researcher to explore and break down the data obtained. Data organization will also be facilitated by the recording of all the interactive research methods included in the study, namely the interviews and focus groups. The recordings will also be transcribed and coded according to the formulated coding schemes. An additional measure that the researcher will apply to maximize data organization is note-taking during the interviews, which will embody the observation element of physical interviews. According to De Villiers et al. (2021), interviews are a flexible data collection method that allows researchers to interact with participants who are required to provide information from their perceptions and experiences, which allows the researcher to identify cues in the tone of voice, body language, and facial expressions. These attributes make it essential for the researcher to develop notes during interviews, which will be interpreted and categorized according to the codes generated. The data organization process is vital to the research because it adds to the structure of the study. The organization makes it easier to
recognize and identify patterns within the participants, which provides insight into the intensity of the study.
Summary of data collection
Summatively, the data collection will be founded on a qualitative research design. The researcher will support the flexible design of the research by incorporating multiple collection methods. The primary rule when collecting data is to maintain the anonymity of the participants, including in the interviews where participant names and identities will not be noted in the data organization step. The four primary research questions will be the foundation for the survey and the interview questions. Archival data will also be a vital element of the research, where existing data from research conducted by the CDC on healthcare workers will be retrieved and compared to the data collected. Methods such as interviews and focus groups will be recorded for further transcription and entry into digital spreadsheets. All data gathered will be entered into a digital spreadsheet generated by the researcher, stored, and protected in a hard drive for ease of accessibility.
Data analysis
The section will include details on the analysis and organization of the data gathered from the qualitative research methods employed in the single case study. The prime role of data analysis in qualitative research is to ensure the data collected is coded to identify patterns and themes that can further be linked to the research problem (Lester et al., 2020). However, the researcher must stringently organize the analyzed data coherently and clearly for data analysis to be effective. Data analysis in research has evolved with the rise of technology that has introduced additional ways of evaluating data. Data analysis has long been done manually but the introduction of technologies such as artificial intelligence has facilitated a more structured approach for data evaluation. O’Kane et al., (2019) outline that
using technology-aided data analysis is advantageous to research because it reduces the time spent on analyzing data by using machine learning to develop coded patterns and categories and faster data exploration through text searches. However, the use of software-assisted analysis has been criticized for its efficiency. Based on the intricate nature of the social problem of burnout among healthcare workers paired with the small size of the sample population, the researcher will apply manual data analysis.
Qualitative analysis in the research will focus on categorizing the data into patterns and themes developed from the facts presented in the form of opinions and perceptions by the participants (Sutton & Austin, 2015). The deductive analysis may be applied to the research to confirm or annul codes and themes generated before the initiation of data collection. Also, the study will apply triangulation to compare data collected from qualitative research methods. A methodological approach to triangulation will be applied to allow the researcher to generate a deeper insight of the research problem of burnout among healthcare professionals.
Qualitative analysis
Qualitative analysis allows a researcher to understand the factual data collected from participants as it relates to research questions and problems. Coding through data analysis in qualitative research brings life to the research problem by fleshing out codes, themes, and patterns from the participants’ experiences to generate a story and image of the real-life experiences in real-life (Williams & Moser, 2019). There are two dominant methods of qualitative data analysis, namely deductive and inductive data analysis, that vary in terms of how they code the data. Mihas (2019) explains that deductive research is founded on testing an existing theory, while inductive analysis evaluates data to generate a new theory.
Deductive research will be more applicable to the case study because it will code the data to identify the comparability of the information to the theories on burnout.
A thematic analysis method will be further applied to support the deductive analysis approach. According to Kiger and Varpio (2020), a thematic analysis is more effective for qualitative research that will use codes to analyze collected data to generate themes based on the codes without the need for pre-existing perceptions from the data. Thematic analysis is highly flexible and interactive because it encourages the use of manual evaluations of data to identify common themes and meanings to data. The researcher will focus on generating themes based on the factual data collected, making manual analysis more effective. However, manual analysis is highly contested for its efficacy in delivering effective data analysis. Zwanenburg (2019) identifies that manual data analysis is vulnerable to bias because the data analyst may be encouraged to code the data based on preconceptions that make them only recognize concepts familiar to them. The thematic analytical model will examine the various concepts and ideas emerging from the participant’s feedback. The central goal is to ensure the researcher can derive essential themes relating to the topic. For example, suppose the patterns indicate that most nurses acting as subjects revealed that the lack of a flexible working schedule is a vital factor leading to increased professional burnout during the pandemic. Thus, the investigator will pay attention to the thematic analysis to establish core patterns and emerging themes with the help of assigned codes. The researcher being the primary coder will facilitate the generation of more themes based on their understanding of human behavior and communication.
Analysis of triangulation
Triangulation is a crucial step in research that encourages the evaluation of the validity of data collected by verifying data from multiple sources (Farquhar et al., 2020). The dominant
goal of triangulation in the research will be to evaluate the data to ensure biases are not present in the research. The case study’s research question will not only guide the data collection but will also direct the elimination of bias through the triangulation process. The research methods applied to the research will also make the triangulation process easier because they will generate diverse data. Triangulation can be achieved by the comparison of theory, data, and methodologies. For the case study, methodological triangulation will be applied to ensure the diversity of data. Methodological triangulation entails the use of multiple data collection methods to study a given research topic or phenomenon to reduce the deficiencies for increased validity (Thurmond, 2001). Triangulation through methodological triangulation will be achieved through a survey that will provide numerical data on the prevalence of burnout among healthcare professionals. A quantitative survey will provide statistical findings, which will be a different type of data from that obtained through the qualitative research methods applied in the research. This will encourage comparability of data for triangulation where facts and numerical findings from the target population, which may triangulate the data by confirming the validity of the qualitative data.
Summary of data analysis
The research will apply quality data analysis procedures to ensure the data is well-coded. By using coding, the researcher can present an impartial representation of the data gathered. This study will make use of deductive coding. The literature review will lead to the creation of an initial coding scheme, but when new themes surface, the coding strategy may change. As a mandatory step for every process in the case study, the researcher will employ the methodological approach to undertake triangulation to support this study’s qualitative aspect.
Reliability and Validity
The following section will outline the steps that the researcher will apply to establish the reliability and validity of the research. The section will also discuss how the researcher will achieve validity of the research by focusing on the trustworthiness and comparability of the data.
Reliability
Reliability in research refers to the ability of different research methods applied in research to consistently generate the same results upon multiple applications (McDonald et al., 2019). Utilizing multiple research methods will enact the parallel form of reliability. A parallel-form reliability assessment entails using the same sample that is passed through tests of similar methodology (Yadav, 2021). The three methods in the study are guided by the goal of providing comprehensive and descriptive data, namely, interviews, surveys, and focus groups. The interviews will entail accessing more personalized data due to the interactive platform interviews offer a researcher. The focus group will target providing participants the opportunity to explore and compare their opinions, perspectives, and views towards burnout among healthcare workers through discussions to be observed and recorded by the researcher. The surveys on the other hand will provide data that can be numerically tabulated to provide a comparison of the data gathered from other research methods. The surveys will provide a thematic summary of the patterns and prevalence of various answers toward the hypotheses on the role of leadership in burnout levels among healthcare workers. The interviews and focus groups will be recorded to produce both visual and audio records for transcription that will be stored on a spreadsheet. The surveys will be translated into spreadsheets for comparison of themes and commonalities. For security, the data will be stored electronically for easy access to the researcher.
Trustworthiness is a major concept associated with reliability. Unless the study process and the findings are trustworthy, they may fail to deliver the targeted reliability outcomes. The trustworthiness perspective entails credibility, transferability, dependability, and conformability. Credibility delves into how the results represent reality. A study by Stahl and King (2020) finds that credibility asks how congruent the research findings align with reality. It ensures that the outcomes can be applied to deal with the issues under scrutiny. One valuable way of achieving credibility is through triangulation, where the researcher targets numerous data sources and cross-examines correlating ideas and insights (Stahl & King, 2020). These sources reveal identifiable patterns that can be used to develop a valuable conclusion. The results should also be transferable in the sense that the results can be achieved when the study is done in other contexts. Notably, the study outcomes should be dependable, an aspect that is achieved through rigorous data collection approaches. Irrespective of the changes done in the study process, there should be an assurance that the findings are actual. Lastly, confirmability ensures that the study outcomes are credible and trustworthy. The researcher should develop the conclusion from the feedback obtained from the participants rather than one’s bias. Overall, the trustworthiness status attributed to the study and the acquired findings enhances reliability. The key rationale behind achieving reliability is to ensure that the results warrant the attention of various stakeholders targeted by the issue at hand.
Validity
Validity in qualitative research determines whether the results of the study represent actual findings that can be generated from similar participants outside the sample population (Rose & Johnson, 2020). Trustworthiness will be the guiding factor used to determine the validity in the study. The validity of the research on burnout levels among healthcare
practitioners will be initiated by the researcher being mandated not to exclude any data during the data collection, recording, transcription, and coding. This step will advance the concept of transferability of data used to determine validity. Also, the validity of the case study will be affirmed by applying extensive and interactive research methods. For the proposed study, the concept of credibility is asserted by focusing on interactive approaches such as interviews, focus groups, and surveys that encourage the generation of truthful data from facts, experiences, and opinions held by the participants. Bias in the coding and analysis will be eradicated through the use of multiple methods of data collection. Using multiple data collection methods will expose the researcher to underlying themes that could easily be sidelined or missed if one source was used. A second approach to reducing bias in the coding process is by employing a reliable coding method. Exploratory and interactive coding are the two commonly used coding methods, which have varying approaches to ensuring the data analysis is reliable, accurate, and valid.
Data saturation comes in handy when focusing on the validity element. The researcher will use the minimum and maximum range of participants to collect valuable data and information. The researcher will gather valuable feedback from the selected sample until one obtains the desired outcome. This will help reduce redundancy in the data collection process. The selected maximum sample size may provide similar deals, which portrays the need for the researcher to sample each individual and stop the process upon realizing that the feedback is similar to what one already has. A study by Saunders et al. (2018) reveals that when the investigator hears similar comments repeatedly, saturation has been attained. At this point, the researcher terminates the data collection and analyzes the already acquired data. In this case, the researcher will assess each subject to acquire important details about the study topic. Along the way, this professional will look for
similarities between the ideas gathered from the participants. If commonalities exist, the researcher will use the already acquired data and information and analyze it to examine emerging themes. This means that the information provided by the remaining subjects will not alter the outcomes in any way.
Also, triangulation enhances study validity since the researcher will have a set of information to derive quality outcomes. As Farquhar et al. (2020) state, data is examined from multiple sources to arrive at the best conclusion and decision possible. The investigator can assess similarities and differences that exist across these multiple sources. This paves the way for a valid outcome.
Member checking lays the foundation for a study’s trustworthiness and validity. The researcher will use the study participants to enhance the validity (Candela, 2019). The feedback forms and other documents acquired will be returned to the participants for accuracy purposes. Here, the subjects will provide information relating to the accuracy status of their feedback. For example, if a participant reveals that the information provided resonates with their experiences, the researcher will realize that the study outcomes will be valid and trustworthy. Lastly, follow-up interviews will help provide the desired outcome. The researcher will send all participants a memo about the follow-up interview. This is necessary to prepare the participants for a review that seeks to validate the information provided in the main data collection process. All participants will be involved in this session, considering the selected number was manageable. Thus, the researcher can spend the minimum time possible on this task since the study uses a minimum of 30 and a maximum of 50 participants. During this session, the researcher will seek further clarification of the ideas mentioned during the actual data collection process. This relates to the thematic concepts incorporated in the interviews and the questionnaire forms. Also, the
researcher will seek to obtain new insights. For instance, the subjects can expose the researcher to their experiences in line with the topic. This can help evaluate if the feedback provided is factual and correct, as mentioned during the primary interview sessions. Therefore, the researcher will engage all the study participants in the follow-up review and focus on validating already provided feedback while gathering new information. These interviews will allow new insights to emerge and shape a better result. For example, some participants may provide new and advanced ideas that the researcher can use to establish a more robust argument and conclusion.
Bracketing
Bracketing in research aims to eradicate the deleterious impact of personal opinions and preconceptions a researcher holds in research that introduces biases (Dörfler et al., 2020). A researcher’s preconceptions interfere with every activity within the study, including the collection of data, recording, analysis, and the study findings. Bracketing as a strategy to reduce bias will be achieved using bracketing interviews. Thomas (2020) defines bracketing interviews as a process requiring the researcher to list out their initial attitudes, opinions, experiences, attitudes, and assumptions toward research problems to inculcate humility and sensibility in the research. Bracketing will be conducted through an unstructured interview by the researcher, the researcher will be required to provide their opinions and perspectives towards the research topic. The unstructured bracketing interview will provide the researcher with the flexibility of exploring issues and personal subjectivities as they arise because the interviewer will not be guided by a set of predetermined questions. The questions to be included in the bracketing interview will revolve around COVID-19, burnout, and the role of leaders in healthcare professionals. The researcher will have the
freedom to reflect on and critically assess their assumptions and personal perceptions to identify how they affect the research process.
Summary of reliability and validity
The research will enact reliability using the parallel-form reliability evaluation that relies on the use of different methods of gathering data for triangulation to determine whether the same population will generate similar themes. The research will achieve reliability by using interviews, focus groups, and surveys. Validity in the research will be achieved through the focus on trustworthiness and credibility, which will prompt the researcher to use comprehensive research methods while also recording all details collected from the methods without the biased omission of data. The survey will provide thematic summaries that can be compared to the data gathered from other research methods.
Overall Summary of Section 2
The researcher’s job is to investigate if institutional leadership exposed healthcare workers to burnout during the pandemic. The researcher’s job is to look into an employee’s mental, emotional, and physical health in order to determine whether or not they experienced burnout and the role that leadership played in the development of burnout. Furthermore, the researcher lessens bias in the study using procedures that guarantee their perspectives will not influence the analysis. A qualitative research design will serve as the foundation for data gathering. By using a variety of data-gathering techniques, the researcher will support the adaptable design of the study. The fundamental guideline for data collection is to keep participants anonymous, including during interviews when names and identities will not be recorded throughout the data organization stage. Interviews and focus groups will be recorded so they may be later transcribed and entered into online spreadsheets. The researcher will create a computerized spreadsheet with all the collected
data, which will then be inputted and safely kept on a hard drive for easy access. To verify that the data is correctly coded, the research will use high-quality data analysis techniques. The researcher can give an unbiased representation of the data collected by applying coding. Deductive coding will be used in this investigation. An initial coding scheme will be made as a result of the literature review, however, when new topics emerge, the coding scheme may alter.
The researcher will use the methodological approach to carry out triangulation as a required step for each phase in the case study to support this study’s qualitative aspect. Bracketing will be achieved through a bracketing interview, which will be an unstructured interview where the researcher will be prompted to answer various questions. This will help the researcher identify preconceptions, attitudes, and assumptions that affect actual victims of burnout. The bracketing interview conducted with the researcher will provide a reflection on possible ways the researcher may influence the case study, which brings awareness to any possible biases. In order to test if the same population would provide comparable themes, the research will use parallel-form reliability evaluation, which depends on the utilization of several data collection techniques. The use of surveys, focus groups, and interviews will provide reliability in the study. The focus on reliability and credibility will encourage the researcher to employ thorough research methods and to document all the information obtained from those methods without intentionally omitting any information. This will help ensure the validity of the research.
Conclusion
Professional burnout is a key challenge that healthcare providers experience. Especially during the COVID-19 pandemic, these professionals were heavily exposed to burnout. They handled a surge of patients, among other increased duties that affected them
physically, emotionally, and psychologically. This led to the emergence of burnout, which often hampers service delivery since the care providers are less interested and motivated to handle their responsibilities due to the inadequate status of the working environment. This problem is often associated with inadequate leadership and the lack of resilient healthcare systems that can withstand the shocks of pandemics. The investigator relies on interviews, surveys, and archive data to acquire valuable information about the topic. The outcomes indicated the need for strategic leadership changes such as rapid information dissemination, team motivation, and massive resource pooling to pave the way for increased access to tools and equipment such as PPEs and oxygen facilities. These outcomes act as strategic recommendations that the healthcare industry should make to develop a strong and resilient healthcare domain that can withstand pressures brought about by pandemics. For example, if healthcare organizational leaders can provide motivational elements for workers during pandemics, this can lessen such a problem. Even though employees will experience increased responsibilities, they will still be motivated to handle increased patients, among other core duties. Also, pooling more resources would ensure an adequate supply of healthcare essentials and thus allow care providers to accomplish their duties efficiently. The central solution to the burnout problem lies with the healthcare leadership. The government, healthcare leaders, and other primary stakeholders should formulate and implement strategic policies and associated frameworks to help strengthen the industry. This helps cultivate a robust and resilient system that can withstand pressure.
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Appendices
Appendix A: Interview Guide
Interview Questions
Part One – Warm-Up Questions
How long have you worked in healthcare?
What is your role in healthcare?
Part Two – Prevalence of Burnout in Healthcare among Nurses
Can you attest to some of your nurse colleagues suffering from burnout?
If yes, what indicating factors did you notice?
Why do you think nurses were more susceptible to burnout before the pandemic?
Do you think nurses were more affected and vulnerable to burnout during the COVID-19 pandemic?
Part Three: Leadership Failures
How have the leadership policies and procedures in place impacted healthcare providers and especially during the COVID-19 outbreak?
How do you think leadership has contributed to the responses towards professional burnout among healthcare workers?
Do you believe that leaders should adjust their systems and structures to advance workforce health statuses amidst pandemics?
Part Five: Management and Administration
What do you believe are the policies and practices that seem to expose care providers to professional burnout?
Do you agree that the leadership level has a key role in shaping the working environment and ensure employees deliver optimal results?
What are the strategic changes that can be made to salvage the situation currently and prevent such outcomes in the future?
Part Five: Proposed Solutions
Do you think the problem of burnout among healthcare workers is solvable?
What solutions do you think should be applied to help reduce burnout among healthcare workers?
Part Six: Wrap-up Questions
If you were a leader in healthcare, what would you do differently?
If you were given another chance at life, would you still work in healthcare?
Do you think your hospital’s administration and leadership are doing enough to protect its workers from burnout?
Appendix B: Survey Guide
I believe that Working in a healthcare setting directly correlates with professional burnout.
Strongly Agree
Agree
Disagree
Strongly Disagree
I believe that one’s profession in the healthcare sector has a relationship to professional burnout.
Strongly Agree
Agree
Disagree
Strongly Disagree
I believe that healthcare workers are impacted by professional burnout due to their level of experience.
Strongly Agree
Agree
Disagree
Strongly Disagree
On a scale of 1to 10, how strongly would you agree or disagree with the following statement: I believe that burnout is a core concept in the healthcare domain.
Strongly Agree
Agree
Disagree
Strongly Disagree
I believe that the health and well-being of nursing professionals lies on how well they are treated and managed by the top-leadership level.
Strongly Agree
Agree
Disagree
Strongly Disagree
I believe that these elements fit your description of burnout.
Feeling unmotivated, exhausted, non-energetic, and unwilling to perform your duties as a healthcare worker.
Wanting a promotion so bad
Being unhappy at work
An overall feeling of demotivation when handling daily routines.
Strongly Agree
Agree
Disagree
Strongly Disagree
How vulnerable do you think you are to burnout?
Extremely
Very Much
Slightly
Not at all
I believe that nurses and other care providers are responsible for developing burnout, considering that most people would argue that these should develop shock absorbers that allow them to adjust accordingly.
Strongly Agree
Agree
Disagree
Strongly Disagree
I believe that care providers have been exposed to professional burnout during the pandemic, please note that you can look at this from your own perspective.
Strongly Agree
Agree
Disagree
Strongly Disagree
I believe that nurses are more liable to burnout as compared to other professions in the healthcare industry.
Strongly Agree
Agree
Disagree
Strongly Disagree
I believe that nurses were most affected by higher burnout levels during the COVID-19 pandemic.
Strongly Agree
Agree
Disagree
Strongly Disagree
On a scale of 1 to 10, how responsible do you believe leadership is for the high rates of burnout among healthcare workers?
Extremely
Very Much
Moderately
Slightly
Not at all
I believe that management and administration contributed to burnout among healthcare professionals after the outbreak COVID-19 pandemic.
Strongly Agree
Agree
Disagree
Strongly Disagree
I believe burnout among healthcare workers is solvable.
Strongly Agree
Agree
Disagree
Strongly Disagree
I believe that leaders can address the burnout menace across their institutions.
Strongly Agree
Agree
Disagree
Strongly Disagree
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