New management, rationalization and consequences in terms of stress and burnout by hospital caregivers: from the importance to develop resources

Introduction
In European countries, we are faced with an important paradox: that of working in a field whose goal is to promote the health of patients, even though the caregiver is increasingly jeopardized by working conditions (Clot, 2010).
The organization of the hospital sector is undergoing profound changes, subject to budgetary rationalization that induces many reforms in hospitals. For caregivers, these reforms sometimes provoke heavy consequences in terms of internal organization and workload (Delbrouck et al., 2008).

Methods
We are conducting an extensive study with 1700 caregivers of five major Swiss hospitals to highlight important malfunctions related to these new management methods. In the first part of this study, a quantitative phase organized in the form of a questionnaire gives dramatic results. The second phase, qualitative, consists of 30 focus groups, each including ten people. This phase aims to deepen the salient points which have emerged in the first phase, in order to provide a better understanding and foster synergy in research of resources.

Results
Caregivers suffer to see their professional ideal violated, their values undermined, a great increase in their responsibility, along with diminished autonomy, their work not recognized and increasingly meaningless, poorly valued and prospects vanished. These phenomena make caregivers more vulnerable to extreme stress and burnout (Martucelli, 2006). The results show clear signs of stress with physiological, psychological, social and professional consequences.

Discussion
Given the current context, it is important not to stuck in a defeatist attitude, but to reflect on elements which can be influenced. That's why our research is on helping caregivers to be aware of their resources and help them develop new ones. Whether personal, social or organizational resources, to be developed individually or in group, they want tools necessary for the welfare and health of caregivers as much as for the well-being and health of patients.