Introduction

Burnout is a multidimensional concept encompassing several variables, such as emotional exhaustion, negative perceptions of others, and self-deprecation [1, 2]. The first reports on burnout appeared in 1974 and were described by Freudenberger, who defined burnout as “a state of prolonged fatigue and frustration, accompanied by a loss of emotional empathy and a sense of futility” [3]. Subsequently, in 1981, Maslach and Jackson identified the construct of burnout as consisting of the following factors: emotional exhaustion, depersonalization, and reduced job satisfaction [4]. According to the American Psychological Association (APA), burnout is defined as physical, emotional, or mental exhaustion accompanied by decreased motivation, lowered performance, and negative attitudes toward oneself and others [5].

The problem of burnout among nursing staff in Poland and worldwide is becoming increasingly recognized. The sources of burnout can be traced to the often-difficult working conditions in the profession, which is inherently rooted in a sense of responsibility for values such as human health and life and the need to be constantly prepared. Furthermore, nursing staff face constant staff turnover, frequently changing schedules and work hours, which can result in an excessive workload and, consequently, physical and mental strain. A disparity in financial compensation is also noticeable among nursing staff, resulting from difficulties in advancing their qualifications and gaining recognition for these qualifications from superiors and society [6]. The international publication by Ge et al. from 2022 suggests that burnout syndrome among nurses is a global problem with a reported increase over time. The authors conducted a statistical meta-analysis based on a systematic review of 94 research papers published between 2012 and 2024 from over 30 countries. The results indicate that the prevalence of burnout among nursing staff worldwide is as high as 30.0%, which translates to a moderately high level of burnout. Increases were observed primarily in Europe (t = 4.23) and Africa (t = 3.75), while low levels were noted in Asia (t = 0.33) and South America (t = 0.10) [7]. The authors identify possible factors contributing to burnout, including unfavorable working conditions, work overload, low pay, lack of autonomy, as well as violence and workplace bullying. These factors can contribute to feelings of emotional exhaustion, low satisfaction with one’s own achievements, and depersonalization [7].

A 2021 publication by Filipiak et al. indicates that the level of burnout among nursing staff in Poland, considered in terms of emotional exhaustion and depersonalization, ranges from medium to high, i.e., 18% to 31%. The authors report a significant association between burnout and workplace characteristics. It has been reported that nursing staff employed in hospital departments such as anesthesiology and intensive care, oncology, and long-term care are at higher risk of burnout than nurses working in psychiatric or pediatric wards. The authors suggest that long-term workload may lead to symptoms of emotional, mental, and physical exhaustion, as well as problems with interpersonal communication between team members and in nurse-patient and nurse-family/patient relationships [8].

Nursing staff also reported discomfort resulting from unclear organizational conditions in the workplace, such as excessive responsibilities and a lack of established work boundaries, lack of support from superiors and colleagues, fatigue from frequent overtime, discouragement due to a lack of promotion opportunities, and discomfort due to unfair performance evaluations, as well as the devaluation of their work by other members of the therapeutic team.

Therefore, the main goal of this study was to conduct a quantitative and qualitative analysis of research on burnout among nursing staff in Poland, based on selected publications, and to identify the factors contributing to this phenomenon. To address the study objectives, the following research questions were posed: Is there a relationship between length of service and the feeling of burnout? Is there a significant relationship between salary and working conditions and the feeling of burnout? (Table 1) [1-21].

The aim of this narrative review was to quantitatively and qualitatively analyze selected publications from 2020 to 2024 regarding burnout among nursing staff in Poland. This review aimed to identify risk and protective factors, assess the prevalence of burnout, and determine its consequences for the professional and psychosocial functioning of nurses.

Material and methods

From among the Polish nursing journals included in the Ministry of Science and Higher Education’s list of journals with ratings from January 5, 2024, the following were selected for review: Pielęgniarstwo XXI wieku (Nursing in the 21^st Century) and Problemy Pielęgniarstwa (Nursing Problems). The choice of these journals was dictated by the main purpose and thematic scope of the study, as well as the possibility of conducting a detailed analysis of the selected content available in open access online. The review analyzed all issues of these journals published between 2020 and 2024, focusing on publications in which the issue of burnout in nurses was a primary or significant element of discussion. Inclusion criteria included the scientific nature of the publication, availability of the full text, and direct relevance to the topic of burnout in nursing staff. Articles that did not meet these criteria were excluded from the analysis.

Results

A total of 319 publications were retrieved from the archives of selected journals and their open access databases. In the next stage of the review, only articles containing the phrases “nursing burnout,” “depersonalization,” or “staff survey” in their titles, keywords, or abstracts were included. This screening process resulted in the exclusion of 313 publications, including duplicates and articles that did not meet the adopted criteria. Ultimately, six articles were selected for further analysis, four of which met the adopted criteria, presenting the results of surveys conducted among nursing staff in Poland in the context of burnout. The remaining two articles, despite being relevant to the topic, were excluded due to their descriptive nature (Table 2).

Burnout among nursing staff is a serious problem associated with numerous professional, psychological, and organizational factors. Respondents highlighted the following aspects:

1. Factors directly related to working conditions:

• high workload – large numbers of patients, overtime, insufficient staff,

• time pressure – the need for quick decision-making, working in stressful situations,

• night work and irregular working hours – disruption of circadian rhythm, fatigue, and lack of recovery,

• lack of adequate resources – shortages of equipment, medications, and protective equipment.

2. Emotional and psychological factors:

• constant exposure to suffering and death – negative impact on personal joy,

• high emotional demands – the need to maintain professionalism despite difficult situations,

• lack of psychological support – limited opportunities for consultation with a psychologist.

3. Organizational factors:

• difficulties in obtaining promotions and lack of development opportunities – limited career paths, lack of training,

• unsatisfactory remuneration – inadequate in relation to the workload and professional responsibilities,

• poor work organization – lack of clear division of responsibilities, role conflict.

4. Social and interpersonal factors:

• conflicts within the team – tensions between colleagues, lack of effective communication and willingness to cooperate,

• difficult patients and their families – verbal or physical aggression, rising expectations,

• lack of recognition and appreciation – being underestimated by superiors, patients, and society.

5. Personal factors:

• family problems and lack of work-life balance,

• a high sense of empathy and mission – leading to emotional exhaustion,

• health problems – resulting from stress and fatigue.

Qualitative analysis:

During the qualitative analysis of the selected studies, it was found that the publications exhibited many similarities in terms of:

• the specific study objective – an attempt to determine the average percentage of burnout among the surveyed nursing staff,

• the selection of the respondent group: nurses actively practicing in healthcare facilities in Poland,

• the use of standardized research tools, such as the Maslach questionnaire (MBI), BAT-12, SWING, Mini-COPE Stress Management Inventory, and HPCSS-12,

• the time period of the study: 2020-2024 (including during the COVID-19 pandemic),

• the acquisition of unique data specifying the age, gender, education level of respondents, and years of experience in the profession, etc.,

• the systematization and identification of factors causing burnout among nursing staff,

• the identification of the main symptoms emerging as a consequence of this dynamic phenomenon. A review of Lickiewicz’s research allowed us to determine the mean value of emotional exhaustion among nursing staff in the anesthesiology and intensive care unit. This value was –2.49, the mean depersonalization value was –1.13, and the sense of appreciation for personal achievement was –5.96 [9]. Lickiewicz used the MBI questionnaire and the Mini-Cope scale, thus identifying possible causes of burnout, primarily resulting from the specific nature of the workplace – working under stress and time pressure, a high sense of responsibility, and the need to make quick and crucial decisions regarding patients’ conditions. Nurses more often than other professional groups reported a work-life imbalance resulting from irregular working hours [9]. In Nowacka’s study, which also used the MBI and SWING questionnaires to examine the relationship between nurses’ burnout and their interactions with the home environment, the mean values for emotional exhaustion were –22.90, depersonalization –8.1, and self-esteem –27.63 [10]. Considering the above values, it can be concluded that the overall level of burnout experienced by the study group was high (45.6) [10]. Nurses reported a deterioration in their home relationships due to professional demands and responsibilities, which prevented them from relaxing and resting effectively at home, as well as from sleeping properly, and from eating regularly. The main factors contributing to nurses’ burnout were emotional exhaustion, depersonalization, and a lack of job satisfaction. Comparing the scale scores, the following differences can be observed:

• emotional exhaustion: significantly higher in Nowacka’s study (22.9 vs. 2.49), which also suggests a higher level of burnout in this group,

• depersonalization: the scale scores differ (8.1 vs. 1.13), which may indicate methodological differences (sample size, demographic factors, workplace),

• recognition of one’s own achievements: values differ (27.63 vs. 5.96), but the mean-to-SD ratio suggests greater variation in Nowacka’s group,

• overall MBI burnout index: significant difference (45.6 vs. 2.0), suggesting that the level of burnout among nursing staff in Nowacka’s study is very high. However, older age and longer tenure were associated with higher levels of burnout.

Pietraszek’s research, conducted among nurses working in hospital psychiatric wards during the COVID-19 pandemic, showed a high level of perceived stress – 47.19. A correlation was observed between the nurses’ older age and longer tenure in the profession, suggesting that experienced staff are more susceptible to burnout symptoms. Furthermore, the authors noted that individuals working on-call shifts, especially 24-hour shifts, are at increased risk of burnout and begin to experience symptoms of physical and mental exhaustion. Respondents reported experiencing generalized musculoskeletal pain, insomnia, frequent infections and colds, as well as feelings of depression and anxiety [11]. Furthermore, during the COVID-19 pandemic, respondents highlighted the accompanying feeling of anxiety when working with someone infected with the coronavirus, including a lack of freedom and disruptions in communication with a psychiatric patient (barriers due to personal protective equipment), as well as fear for the health and safety of themselves and their families. Mazur’s research, also conducted during the COVID-19 pandemic, determined an average burnout index of 27.44, indicating that the sense of burnout among respondents was also high. The individual index values for the scale used were: emotional exhaustion – 9.02, psychological distance – 6.68, and emotional deterioration – 6.12. The average age of the respondents, which was 50.4 years, is noteworthy. The obtained values indicate a close relationship between the mature age of nurses practicing their profession and the experience of complex symptoms of burnout. The author draws attention to the growing problem of workload and rationing of care, as well as the shortening time allocated for communication with patients [12].

Discussion

The nursing profession involves considerable responsibility for the lives and health of patients. The specific nature of the work heavily relies on interpersonal interactions, both in the professional context of the nurse-patient relationship and during the provision of care [5, 13].

Maslach and Jackson defined burnout as a long-term reaction to chronic interpersonal and emotional stressors. It can occur in individuals whose work involves providing social services that require close contact and direct interaction with others. A significant factor that may contribute to the feeling of burnout is financial reward, which, in line with growing market needs, remains insufficient and unsatisfactory considering the demands of the profession, the effort expended in performing professional tasks, and the development of qualifications.

Furthermore, a significant association has been demonstrated between length of service, salary, and working conditions, and burnout. The statistical analysis revealed a significant relationship between length of service and burnout. Recognizing the risk of burnout can help prevent the emergence of emotional problems in the workplace. There also seems to be a significant need to increase knowledge of factors that may prevent burnout and those that influence nurses’ job satisfaction [1-21].

Further research is necessary to better understand this phenomenon and develop effective prevention strategies.

Limitations

This narrative review has certain limitations that should be considered when interpreting the results. First, the analysis included only publications from 2020-2024, which may have resulted in the omission of previous studies relevant to a more comprehensive understanding of burnout among nursing staff. It should also be noted that a significant portion of the analyzed studies were conducted during the COVID-19 pandemic, which significantly impacted working conditions, occupational stress levels, and the severity of burnout symptoms [20]. Consequently, the findings may reflect the pandemic-related situation more closely than conditions in typical work environments [21].

The analysis was conducted by searching issues of two Polish scientific journals – Nursing in the 21^st Century and Nursing Problems – published between 2020 and 2024. This approach allowed for the acquisition of consistent research material, but it presents a significant limitation, as publications from other sources, both domestic and international, were omitted by design. Consequently, the obtained results reflect only a national perspective on the problem, while the phenomenon of burnout among nursing personnel is global in nature and may manifest differently in different cultural contexts and organizational healthcare systems.

Despite these limitations, this systematic review provides a reliable and up-to-date summary of the available knowledge on burnout among nurses. The obtained results can serve as a starting point for further comparative and meta-analytical studies, taking into account a broader temporal and geographical scope.

Conclusions

Based on a review of selected studies published between 2020 and 2024, it can be concluded that the phenomenon of burnout has been reported among nursing personnel in Poland. The authors of the analyzed studies reported associations between older age, length of service, and place of employment and the level of burnout [9, 10, 12]. This relationship primarily affects the physical and mental well-being of nursing personnel. The symptoms and effects of burnout may adversely affect individual professional and personal fulfillment and the quality of patient care.

The data obtained from the reviewed studies can provide a basis for identifying the causes, symptoms, and effects of burnout, as well as describing its prevalence in the populations studied. It is worth paying special attention to prevention and increasing awareness of burnout among this professional group, including during the early stages of professional education.

Disclosures

This research received no external funding.

Institutional review board statement: Not applicable.

The authors declare no conflict of interest.

References