nursing burnout essay

Understanding and prioritizing nurses’ mental health and well-being

Healthcare organizations continue to feel the effects of the COVID-19 pandemic, including prolonged workforce shortages, rising labor costs, and increased staff burnout. 1 The World Health Organization defines burnout as “a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed,” with symptoms including “feelings of energy depletion or exhaustion; increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job; and reduced professional efficacy.” For more, see “Burn-out an ‘occupational phenomenon’: International Classification of Diseases,” World Health Organization, May 28, 2019; and “Doctors not the only ones feeling burned out,” Harvard Gazette , March 31, 2023. Although nurses routinely experience job-related stress and symptoms of burnout, the COVID-19 pandemic exacerbated the challenges of this high-intensity role.

About the research collaboration between the American Nurses Foundation and McKinsey

The American Nurses Foundation is a national research, educational, and philanthropic affiliate of the American Nurses Association committed to advancing the nursing profession by serving as a thought leader, catalyst for action, convener, and funding conduit. The American Nurses Foundation and McKinsey are partnering to assess and report on trends related to the nursing profession. A foundational part of this effort is jointly publishing novel insights related to supporting nurses throughout their careers.

In April and May 2023, the American Nurses Foundation and McKinsey surveyed 7,419 nurses in the United States to better understand their experiences, needs, preferences, and career intentions. All survey questions were based on the experiences of the individual professional. All questions were also optional for survey respondents; therefore, the number of responses may vary by question. Additionally, publicly shared examples, tools, and healthcare systems referenced in this article are representative of actions that stakeholders are taking to address workforce challenges.

As part of an ongoing, collaborative research effort, the American Nurses Foundation (the Foundation) and McKinsey surveyed more than 7,000 nurses in April and May 2023 to better understand mental health and well-being in the nursing workforce (see sidebar “About the research collaboration between the American Nurses Foundation and McKinsey”). The survey results revealed that symptoms of burnout and mental-health challenges among nurses remain high; the potential long-term workforce and health implications of these persistent pressures are not yet fully understood.

In this report, we share the highlights of our most recent survey and trends over the past few years. As healthcare organizations and other stakeholders continue to evolve their approaches to these important issues, this research provides additional insight into the challenges nurses face today and highlights opportunities to ensure adequate support to sustain the profession and ensure access to care for patients.

Current state of the nursing workforce

Although many organizations have taken steps to address the challenges facing the nursing workforce, findings from the joint American Nurses Foundation and McKinsey survey from May 2023 indicate that continued action is required. Nursing turnover is beginning to decline from its 2021 high but remains above prepandemic levels. 2 2023 NSI national health care retention & RN staffing report , NSI Nursing Solutions, 2023. Intent to leave also remains high: about 20 percent of surveyed nurses indicated they had changed positions in the past six months, and about 39 percent indicated they were likely to leave their current position in the next six months. 3 Based on data from Pulse on the Nation’s Nurses Survey Series: Mental Health and Wellness Survey 4. Intent to leave was roughly 41 percent among nurses who provide direct care to patients, compared with 30 percent for nurses not in direct-patient-care roles. 4 Based on data from Pulse on the Nation’s Nurses Survey Series: Mental Health and Wellness Survey 4.

Surveyed nurses who indicated they were likely to leave cited not feeling valued by their organizations, insufficient staffing, and inadequate compensation as the top three factors influencing their decisions. 5 Based on data from Pulse on the Nation’s Nurses Survey Series: Mental Health and Wellness Survey 4. Insufficient staffing was especially important to respondents with less than ten years of experience 6 Based on data from Pulse on the Nation’s Nurses Survey Series: Mental Health and Wellness Survey 4. —a population that will be critical to retain to ensure future workforce stability.

Key survey insights on mental health and well-being

Our joint research highlighted the magnitude of the health and well-being challenges, both physical and mental, facing the nursing workforce. More than 57 percent of surveyed nurses indicated they had been diagnosed with COVID-19, and 11 percent of those indicated they had been diagnosed with post-COVID-19 conditions (PCC or “long COVID”). Additional research may be needed to fully understand the impact of PCC on nurses, but in the meantime, employers could consider augmenting their PCC services for clinicians.

Research conducted by both the Foundation and McKinsey over the past three years has identified sustained feelings of burnout among surveyed nurses—a trend that continued this year. 7 For more, see the following articles: “Mental health and wellness survey 1,” American Nurses Foundation, August 2020; “Mental health and wellness survey 2,” American Nurses Foundation, December 2020; “Mental health and wellness survey 3,” American Nurses Foundation, September 2021; Gretchen Berlin, Meredith Lapointe, Mhoire Murphy, and Molly Viscardi, “ Nursing in 2021: Retaining the healthcare workforce when we need it most ,” McKinsey, May 11, 2021; Gretchen Berlin, Meredith Lapointe, Mhoire Murphy, and Joanna Wexler, “ Assessing the lingering impact of COVID-19 on the nursing workforce ,” McKinsey, May 11, 2022; “ Nursing in 2023: How hospitals are confronting shortages ,” McKinsey, May 5, 2023. Reported contributors to burnout include insufficient staffing, high patient loads, poor and difficult leadership, and too much time spent on administrative tasks. In our joint survey, 56 percent of nurses reported experiencing symptoms of burnout, such as emotional exhaustion (Exhibit 1). Well more than half (64 percent) indicated they feel “a great deal of stress” because of their jobs. Additionally, although there have been slight improvements year over year in respondents’ reports of stress, anxiety, and feeling overwhelmed, reports of positive emotions such as feeling empowered, grateful, and confident have declined. 8 “Pulse on the Nation’s Nurses Survey Series results,” American Nurses Foundation, accessed October 20, 2023.

Our results indicate that mental health and well-being vary by nurse experience levels (Exhibit 2). Less-tenured nurse respondents were more likely to report less satisfaction with their role, had a higher likelihood of leaving their role, and were more likely to be experiencing burnout.

Despite these sustained and high levels of burnout, approximately two-thirds of surveyed nurses indicated they were not currently receiving mental-health support (a figure that remained relatively consistent in Foundation surveys over the past two years), and 56 percent of surveyed nurses believe there is stigma attached to mental-health challenges. 9 Based on data from Pulse on the Nation’s Nurses Survey Series: Mental Health and Wellness Survey 4; “Pulse on the Nation’s Nurses,” accessed October 20, 2023.

Reasons cited by nurse respondents for not seeking professional mental-health support have remained consistent over the past two years, 10 “Mental health and wellness survey 3,” September 2021. with 29 percent indicating a lack of time, 23 percent indicating they feel they should be able to handle their own mental health, and 10 percent citing cost or a lack of financial resources (Exhibit 3). For nurses with ten or fewer years of experience, lack of time ranked as the top reason for not seeking professional mental help.

Despite slight improvements to the most severe symptoms over the past six to 12 months, reported levels of sustained burnout and well-being challenges have remained consistently high since we began assessing this population in 2021. Moreover, research indicates that burnout has several adverse, long-term health effects; for example, it is a predictor of a wide range of illnesses. 11 Denise Albieri Jodas Salvagioni et al., “Physical, psychological and occupational consequences of job burnout: A systematic review of prospective studies,” PLoS One , October 2017, Volume 12, Number 10; D. Smith Bailey, “Burnout harms workers’ physical health through many pathways,” Monitor on Psychology , June 2006, Volume 37, Number 7. These health conditions incur not only personal costs but also societal and organizational costs because they influence productivity, employee retention, presence at work, and career longevity. 12 Prioritise people: Unlock the value of a thriving workforce , Business in the Community and the McKinsey Health Institute, April 2023.

Actions stakeholders can take to address mental health and well-being

To address these sustained levels of burnout, stakeholders will need to take steps to support nurses’ mental health and well-being. They will also need to address the underlying structural issues—for example, workload and administrative burden—that affect the nursing profession and that have been consistently acknowledged as root causes of burnout. Simultaneously reducing workload demands and increasing resources available to meet those demands will be critical.

A variety of interventions could address the drivers and effects of adverse nursing mental health and well-being, bolstering support for individuals, organizations, and the healthcare system at large. Various stakeholders are deploying a number of initiatives.

Applying process and operating-model interventions

Addressing the underlying drivers of burnout could help to prevent it in the first place. Research from the McKinsey Health Institute shows that the day-to-day work environment has a substantial impact on the mental health and well-being of employees. 13 “ Addressing employee burnout: Are you solving the right problem? ,” McKinsey Health Institute, May 27, 2022. Process and operating-model shifts—in the context of ongoing broader shifts in care models—could enable organizations and care teams to evolve working practices to better support job satisfaction and sustainability.

In our most recent collaborative research, almost a quarter of surveyed nurses believed their teams were not working efficiently; more than 40 percent reported that they had poor control over their workloads and that their day-to-day work was hectic and intense. 14 Based on data from Pulse on the Nation’s Nurses Survey Series: Mental Health and Wellness Survey 4. Evaluating and addressing structural aspects of the job that contribute to workload—for example, by identifying opportunities to delegate activities and enable nurses to use technology—could help support these themes. 15 Gretchen Berlin, Ani Bilazarian, Joyce Chang, and Stephanie Hammer, “ Reimagining the nursing workload: Finding time to close the workforce gap ,” McKinsey, May 26, 2023. However, providing these resources without also addressing the underlying structural drivers contributing to mental-health and well-being challenges is insufficient and can unintentionally appear to place the burden for solving problems on employees themselves. Both individual-level supports and collaborative efforts to drive structural change are required.

In addition to addressing workload challenges, employers could provide flexible work options—for example, in shift length, start time, shift commitments, and virtual activities 16 Erica Carbajal, “‘Resilience isn’t a pillar by itself’: CommonSpirit’s plan to support 44,000 nurses in 2023,” Becker’s Clinical Leadership, December 9, 2022. —to better enable employees to recharge from high levels of demands and to reduce conflicts with demands outside of work.

Finally, employers could take steps to reduce the administrative burden on nurses. More than a third of nursing respondents in our joint survey felt they spent excessive time working on electronic health records on breaks or after shifts, and 45 percent reported this activity adds frustration to their day. 17 Based on data from Pulse on the Nation’s Nurses Survey Series: Mental Health and Wellness Survey 4. Employers can look for opportunities to delegate some documentation to nursing scribes, reduce documentation requirements, or use AI to aid with documentation to help reduce this burden.

Increasing availability, awareness, and accessibility of evidence-based resources

When nurses experience symptoms of burnout or other mental-health and well-being challenges, evidence-based resources need to be available. In addition, employees need to know these resources are available, and they need to feel comfortable accessing them within the organization’s cultural context.

Investments in resources for mental health and well-being span the continuum—from mental healthcare for those experiencing clinical symptoms to well-being support tools and programs to promote healthy behaviors and mitigate sources of stress. On the higher-acuity end of the continuum, providing employees with free or subsidized access to professionally provided therapy or counseling services could help reduce the barriers employees face in getting the care they need. On the lower-acuity end, providing access to resources and training on mental-health literacy, self-monitoring, and adaptability skills could help nurses identify and mitigate sources of stress.

Investments in awareness and accessibility are important to ensure available resources are used. Roughly 19 percent of surveyed nurses who indicated they had not sought mental-health support in the past 12 months cited lack of knowledge, lack of resources, fear of losing their job, or concern about colleagues finding out as reasons for not seeking support. 18 Based on data from Pulse on the Nation’s Nurses Survey Series: Mental Health and Wellness Survey 4. To reinforce their support, employers can take steps such as establishing support networks for communities and allies, providing forums to share stories of mental health, and introducing avenues for peer-to-peer support. Additionally, resources such as a behavioral-health concierge can help all employees (including nurses) navigate, find, and access care and support.

Resources available through the Foundation

The American Nurses Foundation (the Foundation) and the American Nurses Association (ANA) provide numerous free support resources, including the following:

Well-Being Initiative. The Foundation launched the Well-Being Initiative to offer resources that focus on caring for nurses as they tirelessly care for others. 1 “Well-Being Initiative,” American Nurses Foundation, accessed October 20, 2023. These free, multimodal resources are accessible to all US nurses at any time and are completely anonymous.

Stress and Burnout Prevention Pilot Program. The Foundation launched the Stress and Burnout Prevention Pilot Program with support from the United Health Foundation to address nurse burnout and manage stress, among other goals. 2 “Stress & Burnout Prevention Program,” American Nurses Foundation, accessed October 20, 2023. The program uses the “Stress First Aid” model to facilitate discussions about stress and burnout and reduce stigma for nurses in need of support. The program goes beyond identification of burnout to intervention by helping nurses speak about stress and burnout using a common language, normalizing talking about and understanding support resources for them and their peers.

Healthy Nurse, Healthy Nation (HNHN). This ANA Enterprise program is designed to improve the nation’s health, “one nurse at a time.” 3 “Healthy Nurse, Healthy Nation,” American Nurses Foundation, accessed October 20, 2023. HNHN supports nurses in six areas: physical activity, rest, nutrition, quality of life, safety, and mental health. An online platform offers nurses inspiration, friendly competition, content and resources, and connections with other nurses, employers, and organizations.

Nurse suicide prevention. Nurses are at higher risk of suicide than the general population. 4 Christopher R. Friese and Kathryn A. Lee, “Deaths by suicide among nurses: A rapid response call,” Journal of Psychosocial Nursing and Mental Health Services , August 2021, Volume 59, Number 8. The multiple stressors they face in their profession may lead to emotional turmoil, moral distress or injury, and cognitive overload. ANA offers resources to educate nurses about suicide prevention and strategies to help them support themselves and one another. 5 “Nurse suicide prevention/resilience,” American Nurses Association, accessed October 20, 2023; “Suicide among nurses: What we don’t know might hurt us,” American Nurses Association, accessed October 20, 2023.

Accessibility of resources within the organization’s cultural context is also important, given that stigmatization of beliefs, behaviors, and policies can prevent people from feeling able to seek help when they need it. Because mental-illness stigma includes self-stigma, public stigma, and structural stigma, companies can take a holistic approach to root it out, 19 Erica Coe, Jenny Cordina, Kana Enomoto, and Nikhil Seshan, “ Overcoming stigma: Three strategies toward better mental health in the workplace ,” McKinsey Quarterly , July 23, 2021. including with education, leadership role modeling, and policies addressing discriminatory behaviors. 20 Allison Nordberg and Marla J. Weston, “Stigma: A barrier in supporting nurse well-being during the pandemic,” Nurse Leader , April 2022, Volume 20, Number 2. They can also provide information about free support resources, such as those provided by the American Nurses Foundation and the American Nurses Association (see sidebar “Resources available through the Foundation”).

Bolstering skills and capabilities

Efforts to address structural issues can be advanced by investing in training opportunities to help individuals and teams proactively support their own mental health and that of their colleagues. Training areas could include workplace mental-health intervention; critical skills for leaders and managers, such as conflict resolution and bystander intervention; and resilience and adaptability training to inculcate mindsets and behaviors across the organization that ultimately support employee mental health and well-being.

Toward a healthier future for nurses

Tackling these sustained challenges for mental health and well-being will be critical for addressing near-term workforce shortages and ensuring the health and well-being of the nursing profession in the long term. In our joint survey, many surveyed nurses indicated they chose the profession because they wanted to make a difference—by helping improve patients’ lives and care for patients in their most vulnerable moments. They value their colleagues and the care and trust of their teams. However, with less than half of surveyed nurses feeling satisfied with their jobs, they clearly need more in return to sustain them in the profession. There isn’t a one-size-fits-all approach to tackling some of the sustained well-being challenges that face nurses, but now is the time to bring additional energy and commitment to tackle the multifaceted drivers of symptoms of burnout and to support the profession in improving sustainability and fulfillment for years to come.

Gretchen Berlin, RN , is a senior partner in McKinsey’s Washington, DC, office, where Faith Burns is an associate partner; Brad Herbig is an associate partner in the Philadelphia office; and Mhoire Murphy is a partner in the Boston office. Amy Hanley is a program manager at the American Nurses Foundation, and Kate Judge is the executive director of the American Nurses Foundation.

The authors wish to thank the nurses, physicians, and staff on the front lines who are caring for patients and communities. They also wish to thank Nitzy Bustamante, Stephanie Hammer, and Brooke Tobin for their contributions to this article.

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• Open access
• Published: 05 June 2020

Burnout in nursing: a theoretical review

• Chiara Dall’Ora 1 ,
• Jane Ball 2 ,
• Maria Reinius 2 &
• Peter Griffiths 1 , 2  

Human Resources for Health volume  18 , Article number:  41 ( 2020 ) Cite this article

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Workforce studies often identify burnout as a nursing ‘outcome’. Yet, burnout itself—what constitutes it, what factors contribute to its development, and what the wider consequences are for individuals, organisations, or their patients—is rarely made explicit. We aimed to provide a comprehensive summary of research that examines theorised relationships between burnout and other variables, in order to determine what is known (and not known) about the causes and consequences of burnout in nursing, and how this relates to theories of burnout.

We searched MEDLINE, CINAHL, and PsycINFO. We included quantitative primary empirical studies (published in English) which examined associations between burnout and work-related factors in the nursing workforce.

Ninety-one papers were identified. The majority ( n = 87) were cross-sectional studies; 39 studies used all three subscales of the Maslach Burnout Inventory (MBI) Scale to measure burnout. As hypothesised by Maslach, we identified high workload, value incongruence, low control over the job, low decision latitude, poor social climate/social support, and low rewards as predictors of burnout. Maslach suggested that turnover, sickness absence, and general health were effects of burnout; however, we identified relationships only with general health and sickness absence. Other factors that were classified as predictors of burnout in the nursing literature were low/inadequate nurse staffing levels, ≥ 12-h shifts, low schedule flexibility, time pressure, high job and psychological demands, low task variety, role conflict, low autonomy, negative nurse-physician relationship, poor supervisor/leader support, poor leadership, negative team relationship, and job insecurity. Among the outcomes of burnout, we found reduced job performance, poor quality of care, poor patient safety, adverse events, patient negative experience, medication errors, infections, patient falls, and intention to leave.

Conclusions

The patterns identified by these studies consistently show that adverse job characteristics—high workload, low staffing levels, long shifts, and low control—are associated with burnout in nursing. The potential consequences for staff and patients are severe. The literature on burnout in nursing partly supports Maslach’s theory, but some areas are insufficiently tested, in particular, the association between burnout and turnover, and relationships were found for some MBI dimensions only.

Peer Review reports

Introduction

The past decades have seen a growing research and policy interest around how work organisation characteristics impact upon different outcomes in nursing. Several studies and reviews have considered relationships between work organisation variables and outcomes such as quality of care, patient safety, sickness absence, turnover, and job dissatisfaction [ 1 , 2 , 3 , 4 ]. Burnout is often identified as a nursing ‘outcome’ in workforce studies that seek to understand the effect of context and ‘inputs’ on outcomes in health care environments. Yet, burnout itself—what constitutes it, what factors contribute to its development, and what the wider consequences are for individuals, organisations, or their patients—is not always elucidated in these studies.

The term burnout was introduced by Freudenberger in 1974 when he observed a loss of motivation and reduced commitment among volunteers at a mental health clinic [ 5 ]. It was Maslach who developed a scale, the Maslach Burnout Inventory (MBI), which internationally is the most widely used instrument to measure burnout [ 6 ]. According to Maslach’s conceptualisation, burnout is a response to excessive stress at work, which is characterised by feelings of being emotionally drained and lacking emotional resources—Emotional Exhaustion; by a negative and detached response to other people and loss of idealism—Depersonalisation; and by a decline in feelings of competence and performance at work—reduced Personal Accomplishment [ 7 ].

Maslach theorised that burnout is a state, which occurs as a result of a prolonged mismatch between a person and at least one of the following six dimensions of work [ 7 , 8 , 9 ]:

Workload: excessive workload and demands, so that recovery cannot be achieved.

Control: employees do not have sufficient control over the resources needed to complete or accomplish their job.

Reward: lack of adequate reward for the job done. Rewards can be financial, social, and intrinsic (i.e. the pride one may experience when doing a job).

Community: employees do not perceive a sense of positive connections with their colleagues and managers, leading to frustration and reducing the likelihood of social support.

Fairness: a person perceiving unfairness at the workplace, including inequity of workload and pay.

Values: employees feeling constrained by their job to act against their own values and their aspiration or when they experience conflicts between the organisation’s values.

Maslach theorised these six work characteristics as factors causing burnout and placed deterioration in employees’ health and job performance as outcomes arising from burnout [ 7 ].

Subsequent models of burnout differ from Maslach’s in one of two ways: they do not conceptualise burnout as an exclusively work-related syndrome; they view burnout as a process rather than a state [ 10 ].

The job resources-demands model [ 11 ] builds on the view of burnout as a work-based mismatch but differs from Maslach’s model in that it posits that burnout develops via two separate pathways: excessive job demands leading to exhaustion, and insufficient job resources leading to disengagement. Along with Maslach and Schaufeli, this model sees burnout as the negative pole of a continuum of employee’s well-being, with ‘work engagement’ as the positive pole [ 12 ].

Among those who regard burnout as a process, Cherniss used a longitudinal approach to investigate the development of burnout in early career human services workers. Burnout is presented as a process characterised by negative changes in attitudes and behaviours towards clients that occur over time, often associated with workers’ disillusionment about the ideals that had led them to the job [ 13 ]. Gustavsson and colleagues used this model in examining longitudinal data on early career nurses and found that exhaustion was a first phase in the burnout process, proceeding further only if nurses present dysfunctional coping (i.e. cynicism and disengagement) [ 14 ].

Shirom and colleagues suggested that burnout occurs when individuals exhaust their resources due to long-term exposures to emotionally demanding circumstances in both work and life settings, suggesting that burnout is not exclusively an occupational syndrome [ 15 , 16 ].

This review aims to identify research that has examined theorised relationships with burnout, in order to determine what is known (and not known) about the factors associated with burnout in nursing and to determine the extent to which studies have been underpinned by, and/or have supported or refuted, theories of burnout.

This was a theoretical review conducted according to the methodology outlined by Campbell et al. and Pare et al. [ 17 , 18 ]. Theoretical reviews draw on empirical studies to understand a concept from a theoretical perspective and highlight knowledge gaps. Theoretical reviews are systematic in terms of searching and inclusion/exclusion criteria and do not include a formal appraisal of quality. They have been previously used in nursing, but not focussing on burnout [ 19 ]. While no reporting guideline for theoretical reviews currently exists, the PRISMA-ScR was deemed to be suitable, with some modifications, to enhance the transparency of reporting for the purposes of this review. The checklist, which can be found as Additional file 2 , has been modified as follows:

Checklist title has been modified to indicate that the checklist has been adapted for theoretical reviews.

Introduction (item 3) has been modified to reflect that the review questions lend themselves to a theoretical review approach.

Selection of sources of evidence (item 9) has been modified to state the process for selecting sources of evidence in the theoretical review.

Limitations (item 20) has been amended to discuss the limitations of the theoretical review process.

Funding (item 22) has been amended to describe sources of funding and the role of funders in the theoretical review.

All changes from the original version have been highlighted.

Literature search

A systematic search of empirical studies examining burnout in nursing published in journal articles since 1975 was performed in May 2019, using MEDLINE, CINAHL, and PsycINFO. The main search terms were ‘burnout’ and ‘nursing’, using both free-search terms and indexed terms, synonyms, and abbreviations. The full search and the total number of papers identified are in Additional file 1 .

We included papers written in English that measured the association between burnout and work-related factors or outcomes in all types of nurses or nursing assistants working in a healthcare setting, including hospitals, care homes, primary care, the community, and ambulance services. Because there are different theories of burnout, we did not restrict the definition of burnout according to any specific theory. Burnout is a work-related phenomenon [ 8 ], so we excluded studies focussing exclusively on personal factors (e.g. gender, age). Our aim was to identify theorised relationships; therefore, we excluded studies which were only comparing the levels of burnout among different settings (e.g. in cancer services vs emergency departments). We excluded literature reviews, commentaries, and editorials.

Data extraction and quality appraisal

The following data were extracted from included studies: country, setting, sample size, staff group, measure of burnout, variables the relationship with burnout was tested against, and findings against the hypothesised relationships. One reviewer (MEB) extracted data from all the studies, with CDO and JEB extracting 10 studies each to check for agreement in data extraction. In line with the theoretical review methodology, we did not formally assess the quality of studies [ 19 ]. However, in Additional file 3 , we have summarised the key aspects of quality for each study, covering generalisability (e.g. a multisite study with more than 500 participants); risk of bias from common methods variance (e.g. burnout and correlates assessed with the same survey. This bias arises when there is a shared (common) variance because of the common method rather than a true (causal) association between variables); evidence of clustering (e.g. nurses nested in wards, wards nested in hospitals); and evidence of statistical adjustment (e.g. the association between burnout and correlates has been adjusted to control for potentially influencing variables). It should be noted that cells are shaded in green when the above-mentioned quality standards have been met, and in red when they have not. In the ‘Discussion’ section, we offer a reflection on the common limitations of research in the field and present a graphic summary of the ‘strength of evidence’ in Fig. 1 .

Graphical representation of strength of relationships with burnout

Data synthesis

Due to the breadth of the evidence, we summarised extracted data by identifying common categories through a coding frame. The starting point of the coding frame was the burnout multidimensional theory outlined by Maslach [ 7 ]. We then considered whether the studies’ variables fit into Maslach’s categorisation, and where they did not, we created new categories. We identified nine broad categories: (1) Areas of Worklife; (2) Workload and Staffing Levels; (3) Job Control, Reward, Values, Fairness, and Community; (4) Shift Work and Working Patterns; (5) Psychological Demands and Job Complexity; (6) Support Factors: Working Relationships and Leadership; (7) Work Environment and Hospital Characteristics; (8) Staff Outcomes and Job Performance; and (9) Patient Care and Outcomes. In the literature, categories 1–7 were treated as predictors of burnout and categories 8 and 9 as outcomes, with the exception of missed care and job satisfaction which were treated both as predictors and outcomes.

When the coding frame was finalised, CDO and MLR applied it to all studies. Where there was disagreement, a third reviewer (JEB) made the final decision.

The database search yielded 12 248 studies, of which 11 870 were rapidly excluded as either duplicates or titles and/or abstract not meeting the inclusion criteria. Of the 368 studies accessed in full text, 277 were excluded, and 91 studies were included in the review. Figure 2 presents a flow chart of the study selection.

Study selection flow chart

The 91 studies identified covered 28 countries; four studies included multiple countries, and in one, the country was not reported. Most were from North America ( n = 35), Europe ( n = 28), and Asia ( n = 18).

The majority had cross-sectional designs ( n = 87, 97%); of these, 84 were entirely survey-based. Three studies were longitudinal. Most studies were undertaken in hospitals ( n = 82). Eight studies surveyed nurses at a national level, regardless of their work setting.

Sample sizes ranged from hundreds of hospitals (max = 927) with hundreds of thousands of nurses (max = 326 750) [ 20 ] to small single-site studies with the smallest sample being 73 nurses [ 21 ] (see Additional file 3 ).

The relationships examined are summarised in Table 1 .

Measures of burnout

Most studies used the Maslach Burnout Inventory Scale ( n = 81), which comprises three subscales reflecting the theoretical model: Emotional Exhaustion, Depersonalisation, and reduced Personal Accomplishment. However, less than half (47%, n = 39) of the papers measured and reported results with all three subscales. Twenty-three papers used the Emotional Exhaustion subscale only, and 11 papers used the Emotional Exhaustion and Depersonalisation subscales. In nine studies, the three MBI subscales were summed up to provide a composite score of burnout, despite Maslach and colleagues advising against such an approach [ 22 ].

Five studies used the Copenhagen Burnout Inventory (CBI) [ 23 ]. This scale consists of three dimensions of burnout: personal, work-related, and client-related. Two studies used the Malach-Pines Scale [ 24 ], and one used the burnout subscale of the Professional Quality of Life Measure (ProQoL5) scale, which posits burnout as an element of compassion fatigue [ 25 ]. Two studies used idiosyncratic measures of burnout based on items from other instruments [ 20 , 26 ].

Factors examined in relation to burnout: an overview

The studies which tested the relationships between burnout and Maslach’s six areas of worklife—workload, control, reward, community, fairness, and values—typically supported Maslach’s theory that these areas are predictors of burnout. However, some evidence is based only on certain MBI dimensions. High scores on the Areas of Worklife Scale [ 27 ] (indicating a higher degree of congruence between the job and the respondent) were associated with less likelihood of burnout, either directly [ 28 , 29 ] or through high occupational coping self-efficacy [ 30 ] and presence of civility norms and co-worker incivility [ 31 ].

The majority of studies looking at job characteristics hypothesised by the Maslach model considered workload ( n = 31) and job control and reward ( n = 10). While only a few studies ( n = 9) explicitly examined the hypothesised relationships between burnout and community, fairness, or values, we identified 39 studies that covered ‘supportive factors’ including relationships with colleagues and leadership.

A large number of studies included factors that fall outside of the Maslach model. Six main areas were identified:

Working patterns and shifts working ( n = 15)

Features inherent in the job such as psychological demand and complexity ( n = 24)

Job support from working relationships and leadership ( n = 39)

Hospital or environmental characteristics ( n = 28)

Staff outcomes and job performance ( n = 33)

Patient outcomes ( n = 17)

Individual attributes (personal or professional) ( n = 16)

Workload and staffing levels

Workload and characteristics of jobs that contribute to workload, such as staffing levels, were the most frequently examined factor in relation to burnout. Thirty studies found an association between high workload and burnout.

Of these, 13 studies looked specifically at measures of workload as a predictor of burnout. Workload was associated with Emotional Exhaustion in five studies [ 32 , 33 , 34 , 35 , 36 ], with some studies also reporting a relationship with Depersonalisation, and others Cynicism. Janssen reported that ‘mental work overload’ predicted Emotional Exhaustion [ 37 ]. Three studies concluded that workload is associated with both Emotional Exhaustion and Depersonalisation [ 38 , 39 , 40 ]. Kitaoka-Higashiguchi tested a model of burnout and found that heavy workload predicted Emotional Exhaustion, which in turn predicted Cynicism [ 41 ]. This was also observed in a larger study by Greengrass et al. who found that high workload was associated with Emotional Exhaustion, which consequently predicted Cynicism [ 42 ]. One study reported no association between workload and burnout components [ 43 ], and one study found an association between manageable workload and a composite burnout score [ 44 ].

Further 15 studies looked specifically at nurse staffing levels, and most reported that when nurses were caring for a higher number of patients or were reporting staffing inadequacy, they were more likely to experience burnout. No studies found an association between better staffing levels and burnout.

While three studies did not find a significant association with staffing levels [ 32 , 45 , 46 ], three studies found that higher patient-to-nurse ratios were associated with Emotional Exhaustion [ 47 , 48 , 49 ], and in one study, higher patient-to-nurse-ratios were associated with Emotional Exhaustion, Depersonalisation, and Personal Accomplishment [ 50 ]. One study concluded that Emotional Exhaustion mediated the relationship between patient-to-nurse ratios and patient safety [ 51 ]. Akman and colleagues found that the lower the number of patients nurses were responsible for, the lower the burnout composite score [ 52 ]. Similar results were highlighted by Faller and colleagues [ 53 ]. Lower RN hours per patient day were associated with burnout in a study by Thompson [ 20 ].

When newly qualified RNs reported being short-staffed, they were more likely to report Emotional Exhaustion and Cynicism 1 year later [ 54 ]. In a further study, low staffing adequacy was associated with Emotional Exhaustion [ 55 ]. Similarly, Leineweber and colleagues found that poor staff adequacy was associated with Emotional Exhaustion, Depersonalisation, and Personal Accomplishment [ 56 ]. Leiter and Spence Laschinger explored the relationship between staffing adequacy and all MBI subscales and found that Emotional Exhaustion mediated the relationship between staffing adequacy and Depersonalisation [ 57 ]. Time pressure was investigated in three studies, which all concluded that reported time pressure was associated with Emotional Exhaustion [ 58 , 59 , 60 ].

In summary, there is evidence that high workload is associated with Emotional Exhaustion, nurse staffing levels are associated with burnout, and time pressure is associated with Emotional Exhaustion.

Job control, reward, values, fairness, and community

Having control over the job was examined in seven studies. Galletta et al. found that low job control was associated with all MBI subscales [ 40 ], as did Gandi et al. [ 61 ]. Leiter and Maslach found that control predicted fairness, reward, and community, and in turn, fairness predicted values, and values predicted all MBI subscales [ 35 ]. Low control predicted Emotional Exhaustion only for nurses working the day shift [ 62 ], and Emotional Exhaustion was significantly related to control over practice setting [ 63 ]; two studies reported no effect of job control on burnout [ 44 , 64 ].

Reward predicted Cynicism [ 35 ] and burnout on a composite score [ 44 ]. Shamian and colleagues found that a higher score in the effort and reward imbalance scale was associated with Emotional Exhaustion, and higher scores in the effort and reward imbalance scale were associated with burnout measured by the CBI [ 65 ].

Value congruence refers to a match between the requirements of the job and people’s personal principles [ 7 ]. Value conflicts were related with a composite score of burnout [ 44 ], and one study concluded that nurses with a high value congruence reported lower Emotional Exhaustion than those with a low value congruence, and nurses with a low value congruence experienced more severe Depersonalisation than nurses with a high value congruence [ 66 ]. Low value congruence was a predictor of all three MBI dimensions [ 35 ] and of burnout measured with the Malach-Pines Burnout Scale [ 67 ]. Two studies considered social capital, defined as a social structure that benefits its members including trust, reciprocity, and a set of shared values, and they both concluded that lower social capital in the hospital-predicted Emotional Exhaustion [ 33 , 36 ]. A single study showed fairness predicted values, which in turn predicted all MBI Scales [ 35 ]. Two studies looked at community, and one found that community predicts a composite score of burnout [ 44 ], while the other found no relationships [ 35 ].

While not directly expressed in the terms described by Maslach, other studies demonstrate associations with possible causal factors, many of which are reflected in Maslach’s theory.

In summary, there is evidence that control over the job is associated with reduced burnout, and value congruence is associated with reduced Emotional Exhaustion and Depersonalisation.

Working patterns and shift work

Shift work and working patterns variables were considered by 15 studies. Overall, there was mixed evidence on the relationship between night work, number of hours worked per week, and burnout, with more conclusive results regarding the association between long shifts and burnout, and the potential protective effect of schedule flexibility.

Working night shifts was associated with burnout (composite score) [ 68 ] and Emotional Exhaustion [ 62 ], but the relationship was not significant in two studies [ 69 , 70 ]. Working on permanent as opposed to rotating shift patterns did not impact burnout [ 71 ], but working irregular shifts did impact a composite burnout score [ 72 ]. When nurses reported working a higher number of shifts, they were more likely to report higher burnout composite scores [ 68 ], but results did not generalise in a further study [ 69 ]. One study found working that overtime was associated with composite MBI score [ 73 ]. On-call requirement was not significantly associated with any MBI dimensions [ 71 ].

The number of hours worked per week was not a significant predictor of burnout according to two studies [ 25 , 53 ], but having a higher number of weekly hours was associated with Emotional Exhaustion and Depersonalisation in one study [ 70 ]. Long shifts of 12 h or more were associated with all MBI subscales [ 74 ] and with Emotional Exhaustion [ 49 , 75 ]. A study using the ProQoL5 burnout scale found that shorter shifts were protective of burnout [ 25 ].

Having higher schedule flexibility was protective of Emotional Exhaustion [ 46 ], and so was the ability to schedule days off for a burnout composite score [ 76 ]. Having more than 8 days off per month was associated with lower burnout [ 69 ]. Stone et al. found that a positive scheduling climate was protective of Emotional Exhaustion only [ 77 ].

In summary, we found an association between ≥ 12-h shifts and Emotional Exhaustion and between schedule flexibility and reduced Emotional Exhaustion.

Psychological demands and job complexity

There is evidence from 24 studies that job demands and aspects intrinsic to the job, including role conflict, autonomy, and task variety, are associated with some burnout dimensions.

Eight studies considered psychological demands. The higher the psychological demands, the higher the likelihood of experiencing all burnout dimensions [ 72 ], and high psychological demands were associated with higher odds of Emotional Exhaustion [ 62 , 78 ]. Emotional demands, in terms of hindrances, had an effect on burnout [ 67 ]. One study reported that job demands, measured with the Effort-Reward Imbalance Questionnaire, were correlated with all burnout dimensions [ 79 ], and similarly, Garcia-Sierra et al. found that demands predict burnout, measured with a composite scale of Emotional Exhaustion and Cynicism [ 80 ]. According to one study, job demands were not associated with burnout [ 73 ], and Rouxel et al. concluded that the higher the job demands, the higher the impact on both Emotional Exhaustion and Depersonalisation [ 64 ].

Four studies looked at task nature and variety, quality of job content, in terms of skill variety, skill discretion, task identity, task significance, influenced Emotional Exhaustion through intrinsic work motivation [ 37 ]. Skill variety and task significance were related to Emotional Exhaustion; task significance was also related to Personal Accomplishment [ 60 ]. Having no administrative tasks in the job was associated with a reduced likelihood to experience Depersonalisation [ 71 ]. Higher task clarity was associated with reduced levels of Emotional Exhaustion and increased Personal Accomplishment [ 58 ].

Patient characteristics/requirements were investigated in four papers. When nurses were caring for suffering patients and patients who had multiple requirements, they were more likely to experience Emotional Exhaustion and Cynicism. Similarly, caring for a dying patient and having a high number of decisions to forego life-sustaining treatments were associated with a higher likelihood of burnout (measured with a composite score) [ 76 ]. Stress resulting from patient care was associated with a composite burnout score [ 73 ]. Patient violence also had an impact on burnout, measured with CBI [ 81 ], as did conflict with patients [ 76 ].

Role conflict is a situation in which contradictory, competing, or incompatible expectations are placed on an individual by two or more roles held at the same time. Role conflict predicted Emotional Exhaustion [ 41 ], and so it did in a study by Konstantinou et al., who found that role conflict was associated with Emotional Exhaustion and Depersonalisation [ 34 ]; Levert and colleagues reported that role conflict correlated with Emotional Exhaustion, Depersonalisation, and Personal Accomplishment. They also considered role ambiguity, which correlated with Emotional Exhaustion and Depersonalisation, but not Personal Accomplishment [ 39 ]. Andela et al. investigated the impact of emotional dissonance, defined as the mismatch between the emotions that are felt and the emotions required to be displayed by organisations. They reported that emotional dissonance is a mediator between job aspects (i.e. workload, patient characteristics, and team issues) and Emotional Exhaustion and Cynicism. Rouxel et al. found that perceived negative display rules were associated with Emotional Exhaustion [ 64 ].

Autonomy related to Emotional Exhaustion and Depersonalisation [ 60 ], and in another study, it only related to Depersonalisation [ 43 ]. Low autonomy impacted Emotional Exhaustion via organisational trust [ 82 ]. Autonomy correlated with burnout [ 67 ]. There was no effect of autonomy on burnout according to two studies [ 58 , 63 ]. Low decision-making at the ward level was associated with all MBI subscales [ 77 ]. Decision latitude impacted Personal Accomplishment only [ 36 ], and in one study, it was found to be related to Emotional Exhaustion [ 78 ]. High decision latitude was associated with Personal Accomplishment [ 41 ] and low Emotional Exhaustion [ 33 ].

Overall, high job and psychological demands were associated with Emotional Exhaustion, as was role conflict. Patient complexity was associated with burnout, while task variety, autonomy, and decision latitude were protective of burnout.

Working relationships and leadership

Overall, evidence from 39 studies supports that having positive support factors and working relationships in place, including positive relationships with physicians, support from the leader, positive leadership style, and teamwork, might play a protective role towards burnout.

The quality of the relationship with physicians was investigated by 12 studies. In two studies, having negative relationships with physicians was associated with all MBI dimensions [ 77 , 83 ]; quality of nurse-physician relationship was associated with Emotional Exhaustion and Depersonalisation, but not PA [ 50 ]. Two studies found an association with Emotional Exhaustion only [ 55 , 84 ], and one concluded that quality of relationship with physicians indirectly supported PA [ 36 ]. This was also found by Leiter and Laschinger, who found that positive nurse-physician collaborations predicted Personal Accomplishment [ 57 , 85 ]. When burnout was measured with composite scores of MBI and a not validated scale, two studies reported an association with nurse-physician relationship [ 20 , 76 ], and two studies found no associations [ 56 , 63 ].

Having support from the supervisor or leader was considered in 12 studies, which found relationships with different MBI dimensions. A relationship between low support from nurse managers and all MBI subscales was observed in one study [ 77 ], while two studies reported it is a protective factor from Emotional Exhaustion only [ 58 , 83 ], and one that it was also associated with Depersonalisation [ 86 ]. Kitaoka-Higashiguchi reported an association only with Cynicism [ 41 ], and Jansen et al. found it was only associated with Depersonalisation and Personal Accomplishment [ 60 ]. Van Bogaert and colleagues found that support from managers predicted low Emotional Exhaustion and high Personal Accomplishment [ 84 ], but in a later study, it only predicted high Personal Accomplishment [ 36 ]. Regarding the relationship with the manager, it had a direct effect on Depersonalisation, and it moderated the effect of time pressure on Emotional Exhaustion and Depersonalisation [ 59 ]; a protective effect of a quality relationship with the head nurse on a composite burnout score was also reported [ 76 ]. Two studies using different burnout scales found an association between manager support and reduced burnout [ 25 , 67 ]. Low trust in the leader showed a negative impact on burnout, measured with a composite score [ 87 ]. Two further studies focused on the perceived nurse manager’s ability: authors found that it was related to Emotional Exhaustion [ 46 ], and Emotional Exhaustion and Personal Accomplishment [ 50 ].

Fourteen studies looked at the leadership style and found that it affects burnout through different pathways and mechanisms. Boamah et al. found that authentic leadership—described as leaders who have high self-awareness, balanced processing, an internalised moral perspective, and transparency—predicted higher empowerment, which in turn predicted lower levels of Emotional Exhaustion and Cynicism a year later [ 54 ]. Authentic leadership had a negative direct effect on workplace bullying, which in turn had a direct positive effect on Emotional Exhaustion [ 88 ]. Effective leadership predicted staffing adequacy, which in turn predicted Emotional Exhaustion [ 57 , 85 ]. Authentic leadership predicted all areas of worklife, which in turn predicted all MBI dimensions of burnout [ 30 ], and a similar pathway was identified by Laschiner and Read, although authentic leadership impacted Emotional Exhaustion only and it was also through civility norms and co-worker incivility [ 31 ]. Emotional Exhaustion mediated the relationship between authentic leadership and intention to leave the job [ 89 ]. ‘Leader empowering behaviour’ had an indirect effect on Emotional Exhaustion through structural empowerment [ 29 ], and empowering leadership predicted trust in the leader, which in turn was associated with burnout composite score [ 87 ]. Active management-by-exception was beneficial for Depersonalisation and Personal Accomplishment, passive laissez-faire leadership negatively affected Emotional Exhaustion and Personal Accomplishment, and rewarding transformational leadership protected from Depersonalisation [ 90 ]. Contrary to this, Madathil et al. found that transformational leadership protected against Emotional Exhaustion, but not Depersonalisation, and promoted Personal Accomplishment [ 43 ]. Transformational leadership predicted positive work environments, which in turn predicted lower burnout (composite score) [ 44 ]. Positive leadership affected Emotional Exhaustion and Depersonalisation [ 56 ] and burnout measured with a non-validated scale [ 20 ].

Teamwork and social support were also explored. Co-worker cohesion was only related to Depersonalisation [ 58 ]; team collaboration problems predicted negative scores on all MBI subscales [ 38 ], and workplace support protected from Emotional Exhaustion [ 72 ]. Similarly, support received from peers had a protective effect on Emotional Exhaustion [ 60 ]. Collegial support was related to Emotional Exhaustion and Personal Accomplishment [ 39 ], and colleague support protected from burnout [ 67 ]. Interpersonal conflict affected Emotional Exhaustion through role conflict, but co-worker support had no effect on any burnout dimensions [ 41 ], and similarly, co-worker incivility predicted Emotional Exhaustion [ 31 ], and so did bullying [ 88 ]. Poor team communication was associated with all MBI dimensions [ 40 ], staff issues predicted burnout measured with a composite score [ 73 ], and so did verbal violence from colleagues [ 68 ]. One study found that seeking social support was not associated with any of the burnout dimensions, while another study found that low social support predicted Emotional Exhaustion [ 37 ], and social support was associated with lower Emotional Exhaustion and higher Personal Accomplishment [ 21 ]. Vidotti et al. found an association between low social support and all MBI dimensions [ 62 ].

Work environment and hospital characteristics

Eleven studies were considering the work environment measured with the PES-NWI scale [ 91 ], where higher scores indicate positive work environments. Five studies comprising diverse samples and settings concluded that the better rated the work environment, the lower the likelihood of experiencing Emotional Exhaustion [ 32 , 47 , 49 , 51 , 92 ], and four studies found the same relationship, but on both Emotional Exhaustion and Depersonalisation [ 50 , 66 , 93 , 94 ]; only one study concluded there is an association between work environment and all MBI dimensions [ 95 ]. Negative work environments affected burnout (measured with a composite score) via job dissatisfaction [ 96 ]. One study looked at organisational characteristics on a single scale and found that a higher rating of organisational characteristics predicted lower Emotional Exhaustion [ 82 ]. Environmental uncertainty was related to all MBI dimensions [ 86 ].

Structural empowerment was also considered in relation to burnout: high structural empowerment led to lower Emotional Exhaustion and Cynicism via staffing levels and worklife interference [ 54 ]; in a study using a similar methodology, structural empowerment affected Emotional Exhaustion via Areas of Worklife [ 29 ]. The relationship between Emotional Exhaustion and Cynicism was moderated by organisational empowerment [ 40 ], and organisational support had a protective effect on burnout [ 67 ]. Hospital management and organisational support had a direct effect on Emotional Exhaustion and Personal Accomplishment [ 84 ]. Trust in the organisation predicted lower levels of Emotional Exhaustion [ 82 ] and of burnout measured with a composite MBI score [ 87 ].

Three studies considered whether policy involvement had an effect on burnout. Two studies on the same sample found that having the opportunity to participate in policy decisions was associated with reduced burnout (all subscales) [ 57 , 85 ], and one study did not report results for the association [ 20 ]. Emotional Exhaustion mediated the relationship between nurses’ participation in hospital affairs and their intention to leave the job [ 97 ]; a further study did not found an association between participation in hospital affairs and Emotional Exhaustion, but only with Personal Accomplishment [ 50 ]. Lastly, one study investigated participation in research groups and concluded it was associated with reduced burnout measured with a composite score [ 76 ].

There was an association between opportunity for career advancement and all MBI dimensions [ 77 ]; however, another study found that having promotion opportunities was not related to burnout [ 79 ]. Moloney et al. found that professional development was not related to burnout [ 67 ]. Two studies considered pay. In one study, no effect was found on any MBI dimension [ 73 ], and a very small study ( n = 78 nurses) reported an effect of satisfaction with pay on Emotional Exhaustion and Depersonalisation [ 34 ]. Job insecurity predicted Depersonalisation and PA [ 79 ].

When the hospital adopted nursing models of care rather than medical models of care, nurses were more likely to report high levels of Personal Accomplishment [ 57 , 85 ]. However, another study found no significant relationship [ 20 ]. Regarding ward and hospital type, Aiken and Sloane found that RNs working in specialised AIDS units reported lower levels of Emotional Exhaustion [ 98 ]; however, ward type was not found to be significantly associated with burnout in a study on temporary nurses [ 53 ]. Working in different ward settings was not associated with burnout, but working in hospitals as opposed to in primary care was associated with lower Emotional Exhaustion [ 71 ]. Working in a small hospital was associated with a lower likelihood of Emotional Exhaustion, when compared to working in a community hospital [ 63 ]. Faller’s study also concluded that working in California was a significant predictor of reduced burnout.

When the hospitals’ investment in the quality of care was considered, one study found that having foundations for quality of care was associated with reduced Emotional Exhaustion only [ 50 ], but in another study, foundations for quality of care were associated with all MBI dimensions [ 83 ]. Working in a Magnet hospital was not associated with burnout [ 53 ].

In summary, having a positive work environment (generally work environments scoring higher on the PES-NWI scale) was associated with reduced Emotional Exhaustion, and so was higher structural empowerment. However, none of the organisational characteristics at the hospital level was consistently associated with burnout.

Staff outcomes and job performance

Nineteen studies considered the impact of burnout on intention to leave. Two studies found that Emotional Exhaustion and Cynicism had a direct effect on turnover intentions [ 28 , 99 ], and four studies reported that only Emotional Exhaustion affected intentions to leave the job [ 21 , 32 , 37 , 100 ], with one of these indicating that Emotional Exhaustion affected also intention to leave the organisation [ 32 ], but one study did not replicate such findings [ 101 ] and concluded that only Cynicism was associated with intention to leave the job and nursing. Similarly, one study found that Cynicism was directly related to intention to leave [ 35 ]. A further study found that Emotional Exhaustion affected turnover intentions via job satisfaction [ 88 ], and one article reported that Emotional Exhaustion mediated the effect of authentic leadership on intention to leave [ 89 ]. Emotional Exhaustion was a mediator between nurses’ involvement with decisions and intention to leave the organisation [ 97 ]. Burnout measured on a composite score was associated with a higher intention to leave [ 96 ]. Laeeque et al. reported that burnout, captured with CBI, related to intention to leave [ 81 ]; Estryn-Behar et al. used the same scale to measure burnout and found that high burnout was associated with higher intention to leave in all countries, except for Slovakia [ 102 ]. Burnout, measured with the Malach-Pines Scale, was associated with intention to quit, and stronger associations were found for nurses who had higher perceptions of organisational politics [ 103 ]. Burnout (Malach-Pines Scale) predicted both the intention to leave the job and nursing [ 67 ]. Three studies investigated the relationship between burnout and intention to leave; one of these aggregated all job outcomes in a single variable (i.e. job satisfaction, intention to leave the hospital, applied for another job, and intention to leave nursing) and reported that Depersonalisation and Personal Accomplishment predict job outcomes [ 84 ]; they replicated a similar approach and found the same associations [ 36 ]. They later found that all MBI dimensions were associated with leaving the nursing profession [ 104 ]. Only one study in a sample of 106 nurses from one hospital found an association between Depersonalisation and turnover within 2 years [ 105 ].

Two studies looked at the effect of burnout on job performance: one found a negative association between burnout (measured with CBI) and both task performance and contextual performance [ 106 ]. Only Emotional Exhaustion was associated with self-rated and supervisor-rated job performance of 73 RNs [ 21 ]. Missed care was investigated in three studies, and it was found to be both predictor of Emotional Exhaustion [ 32 ], an outcome of burnout [ 20 , 103 ].

Four studies considered sickness absence. When RNs had high levels of Emotional Exhaustion, they were more likely to experience short-term sickness absence (i.e. 1–10 days of absence), which was obtained from hospital administrative records. Similarly, Emotional Exhaustion was associated with seven or more days of absence in a longitudinal study [ 105 ]. Emotional Exhaustion was significantly associated with reported mental health absenteeism, but not reported physical health absenteeism, and sickness absence from administrative records [ 21 ]. One study did not find any meaningful relationships between burnout and absenteeism [ 107 ].

Emotional Exhaustion was a significant predictor of general health [ 73 ], and in a further study, both Emotional Exhaustion and Personal Accomplishment were associated with perceived health [ 70 ]. Final-year nursing students who experienced health issues were more likely to develop high burnout when entering the profession [ 26 ]. When quality of sleep was treated both as a predictor and outcome of burnout, relationships were found in both instances [ 106 ].

Focussing on mental health, one study found that burnout predicted mental health problems for newly qualified nurses [ 30 ], and Emotional Exhaustion and Cynicism predicted somatisation [ 42 ]. Depressive symptoms were predictive of Emotional Exhaustion and Depersonalisation, considering therefore depression as a predictor of burnout [ 108 ]. Rudman and Gustavsson also found that having depressive mood and depressive episodes were common features of newly qualified nurses who developed or got worse levels of burnout throughout their first years in the profession [ 26 ]. Tourigny et al. considered depression as a predictor and found it was significantly related to Emotional Exhaustion [ 107 ].

Eleven studies considered job satisfaction: of these, three treated job satisfaction as a predictor of burnout and concluded that higher levels of job satisfaction were associated with a lower level of composite burnout scores [ 52 , 96 ] and all MBI dimensions [ 94 ]. According to two studies, Emotional Exhaustion and Cynicism predicted job dissatisfaction [ 54 , 101 ], while four studies reported that Emotional Exhaustion only was associated with increased odds to report job dissatisfaction [ 73 , 82 , 88 , 100 ]; one study reported that Cynicism only was associated with job dissatisfaction [ 99 ]. Rouxel et al. did not find support in their hypothesised model that Emotional Exhaustion and Depersonalisation predicted job satisfaction [ 64 ].

In summary, considering 39 studies, there is conflicting evidence on the direction of the relationship between burnout and missed care, mental health, and job satisfaction. An association between burnout and intention to leave was found, although only one small study reported an association between burnout and turnover. A moderate relationship was found for the effect of burnout on sickness absence, job performance, and general health.

Patient care and outcomes

Among the patient outcomes of burnout, quality of care was investigated by eight studies. Two studies in diverse samples and settings reported that high Emotional Exhaustion, high Depersonalisation, and low Personal Accomplishment were associated with poor quality of care [ 109 , 110 ], but one study found that only Personal Accomplishment was related to better quality of care at the last shift [ 104 ]; Emotional Exhaustion and Cynicism predict low quality of care [ 54 ]; two articles reported that Emotional Exhaustion predicts poor nurse ratings of quality of care [ 82 , 84 ]. A high burnout composite score predicted poor nurse-assessed quality of care [ 96 ]. In one instance, no associations were found between any of the burnout dimensions and quality of care [ 36 ].

Five studies considered aspects of patient safety: burnout was correlated with negative patient safety climate [ 111 ]. Emotional Exhaustion and Depersonalisation were both associated with negative patient safety grades and safety perceptions [ 112 ], and burnout fully mediated the relationship between depression and individual-level safety perceptions and work area/unit level safety perceptions [ 108 ]. Emotional Exhaustion mediated the relationship between workload and patient safety [ 51 ], and a higher composite burnout score was associated with lower patient safety ratings [ 113 ].

Regarding adverse events, high DEP and low Personal Accomplishment predicted a higher rate of adverse events [ 85 ], but in another study, only Emotional Exhaustion predicted adverse events [ 51 ]. When nurses were experiencing high levels of Emotional Exhaustion, they were less likely to report near misses and adverse events, and when they were experiencing high levels of Depersonalisation, they were less likely to report near misses [ 112 ].

All three MBI dimensions predicted medication errors in one study [ 109 ], but Van Bogaert et al. found that only high levels of Depersonalisation were associated with medication errors [ 104 ]. High scores in Emotional Exhaustion and Depersonalisation predicted infections [ 109 ]. Cimiotti et al. found that Emotional Exhaustion was associated with catheter-associated urinary tract infections and surgical site infections [ 114 ], while in another study, Depersonalisation was associated with nosocomial infections [ 104 ]. Lastly, patient falls were also explored, and Depersonalisation and low Personal Accomplishment were significant predictors in one study [ 109 ], while in a further study, only Depersonalisation was associated with patient falls [ 104 ]. There was no association between burnout and hospital-acquired pressure ulcers [ 20 ].

Considering patient experience, Vahey et al. concluded that higher Emotional Exhaustion and low Personal Accomplishment levels were associated with patient dissatisfaction [ 93 ], and Van Bogaert et al. found that Emotional Exhaustion was related to patient and family verbal abuse, and Depersonalisation was related to both patient and family verbal abuse and patient and family complaints [ 104 ].

In summary, evidence deriving from 17 studies points to a negative effect of burnout on quality of care, patient safety, adverse events, error reporting, medication error, infections, patient falls, patient dissatisfaction, and family complaints, but not on pressure ulcers.

Individual characteristics

In total, 16 studies, which had examined work characteristics related to burnout, also considered the relationship between characteristics of the individual and burnout. Relationships were tested on demographic variables, including gender, age, and family status; on personality aspects; on work-life interference; and on professional attributes including length of experience and educational level. Because our focus on burnout is as a job-related phenomenon, we have not reported results of these studies into detail, but overall evidence on demographic and personality factors was inconclusive, and having family issues and high work-life interference was associated with different burnout dimensions. Being younger and not having a bachelor’s degree were found to be associated with a higher incidence of burnout.

This review aimed to identify research that had examined theorised relationships with burnout, in order to determine what is known (and not known) about the factors associated with burnout in nursing and to determine the extent to which studies have been underpinned by, and/or have supported or refuted, theories of burnout. We found that the associations hypothesised by Maslach’s theory between mismatches in areas of worklife and burnout were generally supported.

Research consistently found that adverse job characteristics—high workload, low staffing levels, long shifts, low control, low schedule flexibility, time pressure, high job and psychological demands, low task variety, role conflict, low autonomy, negative nurse-physician relationship, poor supervisor/leader support, poor leadership, negative team relationship, and job insecurity—were associated with burnout in nursing.

However few studies used all three MBI subscales in the way intended, and nine used different approaches to measuring burnout.

The field has been dominated by cross-sectional studies that seek to identify associations with one or two factors, rarely going beyond establishing correlation. Most studies were limited by their cross-sectional nature, the use of different or incorrectly applied burnout measures, the use of common methods (i.e. survey to capture both burnout and correlates), and omitted variables in the models. The 91 studies reviewed, while highlighting the importance of burnout as a feature affecting nurses and patient care, have generally lacked a theoretical approach, or identified mechanisms to test and develop a theory on the causes and consequences of burnout, but were limited in their testing of likely mechanisms due to cross-sectional and observational designs.

For example, 19 studies showed relationships between burnout and job satisfaction, missed care, and mental health. But while some studies treated these as predictors of burnout, others handled as outcomes of burnout. This highlights a further issue that characterises the burnout literature in nursing: the simultaneity bias, due to the cross-sectional nature of the evidence. The inability to establish a temporal link means limits the inference of causality [ 115 ]. Thus, a factor such as ‘missed care’ could lead to a growing sense of compromise and ‘crushed ideals’ in nurses [ 116 ], which causes burnout. Equally, it could be that job performance of nurses experiencing burnout is reduced, leading to increased levels of ‘missed care’. Both are plausible in relation to Maslach’s original theory of burnout, but research is insufficient to determine which is most likely, and thereby develop the theory.

To help address this, three areas of development within research are proposed. Future research adopting longitudinal designs that follow individuals over time would improve the potential to understand the direction of the relationships observed. Research using Maslach’s theory should use and report all three MBI dimensions; where only the Emotional Exhaustion subscale is used, this should be explicit and it should not be treated as being synonymous to burnout. Finally, to move our theoretical understanding of burnout forward, research needs to prioritise the use of empirical data on employee behaviours (such as absenteeism, turnover) rather than self-report intentions or predictions.

Addressing these gaps would provide better evidence of the nature of burnout in nursing, what causes it and its potential consequences, helping to develop evidence-based solutions and motivate work-place change. With better insight, health care organisations can set about reducing the negative consequences of having patient care provided by staff whose work has led them to become emotionally exhausted, detached, and less able to do the job, that is, burnout.

Limitations

Our theoretical review of the literature aimed to summarise information from a large quantity of studies; this meant that we had to report studies without describing their context in the text and also without providing estimates (i.e. ORs and 95% CIs). In appraising studies, we did not apply a formal quality appraisal instrument, although we noted key omissions of important details. However, the results of the review serve to illustrate the variety of factors that may influence/result from burnout and demonstrate where information is missing. We did not consider personality and other individual variables when extracting data from studies. However, Maslach and Leiter recently reiterated that although some connections have been made between burnout and personality characteristics, the evidence firmly points towards work characteristics as the primary drivers of burnout [ 8 ].

While we used a reproducible search strategy searching MEDLINE, CINAHL, and PsycINFO, it is possible that there are studies indexed elsewhere and we did not identify them, and we did not include grey literature. It seems unlikely that these exist in sufficient quantity to substantively change our conclusions.

Patterns identified across 91 studies consistently show that adverse job characteristics are associated with burnout in nursing. The potential consequences for staff and patients are severe. Maslach’s theory offers a plausible mechanism to explain the associations observed. However incomplete measurement of burnout and limited research on some relationships means that the causes and consequences of burnout cannot be reliably identified and distinguished, which makes it difficult to use the evidence to design interventions to reduce burnout.

Availability of data and materials

Not applicable

Abbreviations

• Maslach Burnout Inventory

Copenhagen Burnout Inventory

Professional Quality of Life Measure

Dall’Ora C, Ball J, Recio-Saucedo A, Griffiths P. Characteristics of shift work and their impact on employee performance and wellbeing: a literature review. Int J Nurs Stud. 2016;57:12–27.

Article   PubMed   Google Scholar  

Griffiths P, Ball J, Drennan J, Dall’Ora C, Jones J, Maruotti A, et al. Nurse staffing and patient outcomes: Strengths and limitations of the evidence to inform policy and practice. A review and discussion paper based on evidence reviewed for the National Institute for Health and Care Excellence Safe Staffing guideline development. Int J Nurs Stud. 2016;63:213–25.

Cummings GG, MacGregor T, Davey M, Lee H, Wong CA, Lo E, et al. Leadership styles and outcome patterns for the nursing workforce and work environment: a systematic review. Int J Nurs Stud. 2010;47(3):363–85.

Rafferty AM, Ball J, Aiken LH. Are teamwork and professional autonomy compatible, and do they result in improved hospital care? Qual Health Care. 2001;10(suppl 2):ii32-iii7.

Freudenberger HJ. Staff burn-out. J Soc Issues. 1974;30(1):159–65.

Article   Google Scholar  

Maslach C, Jackson SE. The measurement of experienced burnout. J Occup Behav. 1981;2(2):99–113.

Maslach C. A Multidimensional theory of burnout. In: Cooper CL, editor. Theories of Organizational Stress Oxford University Press Inc.; 1999.

Maslach C, Leiter M. Burnout. Fink G, editor. London, UK: Academic Press; 2016. 351-7 p.

Maslach C, Schaufeli WB, Leiter MP. Job burnout. Annu Rev Psychol. 2001;52(1):397–422.

Article   CAS   PubMed   Google Scholar  

Ekstedt M. Burnout and sleep: Institutionen för folkhälsovetenskap/Department of Public Health Sciences; 2005.

Google Scholar  

Demerouti E, Bakker AB, Nachreiner F, Schaufeli WB. The job demands-resources model of burnout. J Appl Psychol. 2001;86(3):499.

Schaufeli WB, Leiter MP, Maslach C. Burnout: 35 years of research and practice. Career Dev Int. 2009;14(2-3):204–20.

Cherniss C. Burnout in new professionals: a long-term follow-up study. J Health Hum Resour Adm. 1989;12(1):11–24.

Gustavsson JP, Hallsten L, Rudman A. Early career burnout among nurses: modelling a hypothesized process using an item response approach. Int J Nurs Stud. 2010;47(7):864–75.

Shirom A. Job-related burnout: a review. Handbook of occupational health psychology. Washington, DC, US: American Psychological Association; 2003. p. 245-264.

Melamed S, Kushnir T, Shirom A. Burnout and risk factors for cardiovascular diseases. Behav Med. 1992;18(2):53–60.

Campbell M, Egan M, Lorenc T, Bond L, Popham F, Fenton C, et al. Considering methodological options for reviews of theory: illustrated by a review of theories linking income and health. Syst Rev. 2014;3(1):114.

Article   PubMed   PubMed Central   Google Scholar  

Pare G, Trudel MC, Jaana M, Kitsiou S. Synthesizing information systems knowledge: a typology of literature reviews. Inf Manag. 2015;52(2):183–99.

Lavoie P, Michaud C, Bélisle M, Boyer L, Gosselin É, Grondin M, et al. Learning theories and tools for the assessment of core nursing competencies in simulation: a theoretical review. J Adv Nurs. 2018;74(2):239–50.

Thompson D. The examination of practice environment, burnout, and missed care on pressure ulcer prevalence rates using a complexity science framework: University of Kansas; 2014.

Parker PA, Kulik JA. Burnout, self- and supervisor-rated job performance, and absenteeism among nurses. J Behav Med. 1995;18(6):581–99.

Maslach C, Jackson SE, Leiter M. Maslach burnout inventory manual. 3rd ed. ed: Mind Garden, Inc.; 2010.

Kristensen TS, Borritz M, Villadsen E, Christensen KB. The Copenhagen Burnout Inventory: a new tool for the assessment of burnout. Work Stress. 2005;19(3):192–207.

Malach-Pines A. The burnout measure, short version. Int J Stress Manag. 2005;12(1):78–88.

Hunsaker S, Chen HC, Maughan D, Heaston S. Factors that influence the development of compassion fatigue, burnout, and compassion satisfaction in emergency department nurses. J Nurs Scholarsh. 2015;47(2):186–94.

Rudman A, Gustavsson JP. Early-career burnout among new graduate nurses: a prospective observational study of intra-individual change trajectories. Int J Nurs Stud. 2011;48(3):292–306.

Leiter MP, Maslach C. Areas of worklife survey manual. Centre for Organizational Research and Development, Acadia University, Wolfville. 2006.

Boamah SA, Laschinger H. The influence of areas of worklife fit and work-life interference on burnout and turnover intentions among new graduate nurses. J Nurs Manag. 2016;24(2):E164–74.

Greco P, Laschinger HK, Wong C. Leader empowering behaviours, staff nurse empowerment and work engagement/burnout. Nurs Leadersh (Tor Ont). 2006;19(4):41–56.

Laschinger HK, Borgogni L, Consiglio C, Read E. The effects of authentic leadership, six areas of worklife, and occupational coping self-efficacy on new graduate nurses’ burnout and mental health: a cross-sectional study. Int J Nurs Stud. 2015;52(6):1080–9.

Laschinger HK, Read EA. The effect of authentic leadership, person-job fit, and civility norms on new graduate nurses’ experiences of coworker incivility and burnout. J Nurs Adm. 2016;46(11):574–80.

Flynn L, Thomas-Hawkins C, Clarke SP. Organizational traits, care processes, and burnout among chronic hemodialysis nurses. West J Nurs Res. 2009;31(5):569–82.

Kowalski C, Ommen O, Driller E, Ernstmann N, Wirtz MA, Kohler T, et al. Burnout in nurses - the relationship between social capital in hospitals and emotional exhaustion. J Clin Nurs. 2010;19(11-12):1654–63.

Konstantinou AK, Bonotis K, Sokratous M, Siokas V, Dardiotis E. Burnout evaluation and potential predictors in a Greek cohort of mental health nurses. Arch Psychiatr Nurs. 2018;32(3):449–56.

Leiter MP, Maslach C. Nurse turnover: the mediating role of burnout. J Nurs Manag. 2009;17(3):331–9.

Van Bogaert P, Kowalski C, Weeks SM, Van Heusden D, Clarke SP. The relationship between nurse practice environment, nurse work characteristics, burnout and job outcome and quality of nursing care: a cross-sectional survey. Int J Nurs Stud. 2013;50(12):1667–77.

Janssen PP, Jonge JD, Bakker AB. Specific determinants of intrinsic work motivation, burnout and turnover intentions: a study among nurses. J Adv Nurs. 1999;29(6):1360–9.

Andela M, Truchot D, Van der Doef M. Job stressors and burnout in hospitals: the mediating role of emotional dissonance. Int J Stress Manag. 2016;23(3):298–317.

Levert T, Lucas M, Ortlepp K. Burnout in psychiatric nurses: contributions of the work environment and a Sense of Coherence. S Afr J Psychol. 2000;30(2):36–43.

Galletta M, Portoghese I, Ciuffi M, Sancassiani F, Aloja E, Campagna M. Working and environmental factors on job burnout: a cross-sectional study among nurses. Clin Pract Epidemiol Ment Health. 2016;12:132–41.

Kitaoka-Higashiguchi K. Burnout as a developmental process among Japanese nurses: investigation of Leiter’s model. Jpn J Nurs Sci. 2005;2(1):9–16.

Greenglass ER, Burke RJ, Fiksenbaum L. Workload and burnout in nurses. J Community Appl Soc Psychol. 2001;11(3):211–5.

Madathil R, Heck NC, Schuldberg D. Burnout in psychiatric nursing: examining the interplay of autonomy, leadership style, and depressive symptoms. Arch Psychiatr Nurs. 2014;28(3):160–6.

Lewis HS, Cunningham CJ. Linking nurse leadership and work characteristics to nurse burnout and engagement. Nurs Res. 2016;65(1):13–23.

Lu M, Ruan H, Xing W, Hu Y. Nurse burnout in China: a questionnaire survey on staffing, job satisfaction, and quality of care. J Nurs Manag. 2015;23(4):440–7.

Dhaini SR, Denhaerynck K, Bachnick S, Schwendimann R, Schubert M, De Geest S, et al. Work schedule flexibility is associated with emotional exhaustion among registered nurses in Swiss hospitals: a cross-sectional study. Int J Nurs Stud. 2018;82:99–105.

Aiken LH, Clarke SP, Sloane DM, Lake ET, Cheney T. Effects of hospital care environment on patient mortality and nurse outcomes. J Nurs Adm. 2008;38(5):223–9.

Aiken LH, Clarke SP, Sloane DM, Sochalski J, Silber JH. Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. JAMA. 2002;288(16):1987–93.

Zhou W, He G, Wang H, He Y, Yuan Q, Liu D. Job dissatisfaction and burnout of nurses in Hunan, China: A cross-sectional survey. Nurs Health Sci. 2015;17(4):444–50.

Hanrahan NP, Aiken LH, McClaine L, Hanlon AL. Relationship between psychiatric nurse work environments and nurse burnout in acute care general hospitals. Issues Ment Health Nurs. 2010;31(3):198–207.

Liu X, Zheng J, Liu K, Baggs JG, Liu J, Wu Y, et al. Hospital nursing organizational factors, nursing care left undone, and nurse burnout as predictors of patient safety: a structural equation modeling analysis. Int J Nurs Stud. 2018;86:82–9.

Akman O, Ozturk C, Bektas M, Ayar D, Armstrong MA. Job satisfaction and burnout among paediatric nurses. J Nurs Manag. 2016;24(7):923–33.

Faller MS, Gates MG, Georges JM, Connelly CD. Work-related burnout, job satisfaction, intent to leave, and nurse-assessed quality of care among travel nurses. J Nurs Adm. 2011;41(2):71–7.

Boamah SA, Read EA, Spence Laschinger HK. Factors influencing new graduate nurse burnout development, job satisfaction and patient care quality: a time-lagged study. J Adv Nurs. 2017;73(5):1182–95.

Kanai-Pak M, Aiken LH, Sloane DM, Poghosyan L. Poor work environments and nurse inexperience are associated with burnout, job dissatisfaction and quality deficits in Japanese hospitals. J Clin Nurs. 2008;17(24):3324–9.

Leineweber C, Westerlund H, Chungkham HS, Lindqvist R, Runesdotter S, Tishelman C. Nurses’ practice environment and work-family conflict in relation to burn out: a multilevel modelling approach. PLoS One. 2014;9(5):e96991.

Article   PubMed   PubMed Central   CAS   Google Scholar  

Leiter MP, Spence Laschinger HK. Relationships of work and practice environment to professional burnout: testing a causal model. Nurs Res. 2006;55(2):137–46.

Adali E, Priami M, Evagelou H, Mougia V, Ifanti M, Alevizopoulos G. Burnout in psychiatric nursing personnel in Greek hospitals. European Journal of Psychiatry. 2003;17(3):173–81.

Cao X, Naruse T. Effect of time pressure on the burnout of home-visiting nurses: the moderating role of relational coordination with nursing managers. Jpn J Nurs Sci. 2019;16(2):221–31.

Jansen PG, Kerkstra A, Abu-Saad HH, van der Zee J. The effects of job characteristics and individual characteristics on job satisfaction and burnout in community nursing. Int J Nurs Stud. 1996;33(4):407–21.

Gandi JC, Wai PS, Karick H, Dagona ZK. The role of stress and level of burnout in job performance among nurses. Ment Health Fam Med. 2011;8(3):181–94.

PubMed   PubMed Central   Google Scholar  

Vidotti V, Ribeiro RP, Galdino MJQ, Martins JT. Burnout syndrome and shift work among the nursing staff. Rev Lat Am Enfermagem. 2018;26:e3022.

Shamian J, Kerr MS, Laschinger HK, Thomson D. A hospital-level analysis of the work environment and workforce health indicators for registered nurses in Ontario’s acute-care hospitals. Can J Nurs Res. 2002;33(4):35–50.

CAS   PubMed   Google Scholar  

Rouxel G, Michinov E, Dodeler V. The influence of work characteristics, emotional display rules and affectivity on burnout and job satisfaction: a survey among geriatric care workers. Int J Nurs Stud. 2016;62:81–9.

Colindres CV, Bryce E, Coral-Rosero P, Ramos-Soto RM, Bonilla F, Yassi A. Effect of effort-reward imbalance and burnout on infection control among Ecuadorian nurses. Int Nurs Rev. 2018;65(2):190–9.

Shao J, Tang L, Wang X, Qiu R, Zhang Y, Jia Y, et al. Nursing work environment, value congruence and their relationships with nurses’ work outcomes. J Nurs Manag. 2018;26(8):1091–9.

Moloney W, Boxall P, Parsons M, Cheung G. Factors predicting registered nurses’ intentions to leave their organization and profession: a job demands-resources framework. J Adv Nurs. 2018;74(4):864–75.

Anwar MM, Elareed HR. Burnout among Egyptian nurses. Journal of Public Health-Heidelberg. 2017;25(6):693–7.

Wisetborisut A, Angkurawaranon C, Jiraporncharoen W, Uaphanthasath R, Wiwatanadate P. Shift work and burnout among health care workers. Occup Med (Lond). 2014;64(4):279–86.

Article   CAS   Google Scholar  

Ilhan MN, Durukan E, Taner E, Maral I, Bumin MA. Burnout and its correlates among nursing staff: questionnaire survey. J Adv Nurs. 2008;61(1):100–6.

Canadas-De la Fuente GA, Vargas C, San Luis C, Garcia I, Canadas GR, De la Fuente EI. Risk factors and prevalence of burnout syndrome in the nursing profession. Int J Nurs Stud. 2015;52(1):240–9.

Bagheri Hosseinabadi M, Ebrahimi MH, Khanjani N, Biganeh J, Mohammadi S, Abdolahfard M. The effects of amplitude and stability of circadian rhythm and occupational stress on burnout syndrome and job dissatisfaction among irregular shift working nurses. J Clin Nurs. 2019;28(9-10):1868–78.

Khamisa N, Peltzer K, Ilic D, Oldenburg B. Work related stress, burnout, job satisfaction and general health of nurses: a follow-up study. Int J Nurs Pract. 2016;22(6):538–45.

Dall’Ora C, Griffiths P, Ball J, Simon M, Aiken LH. Association of 12 h shifts and nurses’ job satisfaction, burnout and intention to leave: findings from a cross-sectional study of 12 European countries. BMJ Open. 2015;5(9):e008331.

Stimpfel AW, Sloane DM, Aiken LH. The longer the shifts for hospital nurses, the higher the levels of burnout and patient dissatisfaction. Health Aff (Millwood). 2012;31(11):2501–9.

Poncet MC, Toullic P, Papazian L, Kentish-Barnes N, Timsit JF, Pochard F, et al. Burnout syndrome in critical care nursing staff. Am J Respir Crit Care Med. 2007;175(7):698–704.

Stone PW, Du Y, Gershon RR. Organizational climate and occupational health outcomes in hospital nurses. J Occup Environ Med. 2007;49(1):50–8.

Bourbonnais R, Comeau M, Vezina M, Dion G. Job strain, psychological distress, and burnout in nurses. Am J Ind Med. 1998;34(1):20–8.

Basinska BA, Wilczek-Ruzyczka E. The role of rewards and demands in burnout among surgical nurses. Int J Occup Med Environ Health. 2013;26(4):593–604.

Garcia-Sierra R, Fernandez-Castro J, Martinez-Zaragoza F. Relationship between job demand and burnout in nurses: does it depend on work engagement? J Nurs Manag. 2016;24(6):780–8.

Laeeque SH, Bilal A, Babar S, Khan Z, Rahman SU. How patient-perpetrated workplace violence leads to turnover intention among nurses: the mediating mechanism of occupational stress and burnout. J Aggress Maltreat Trauma. 2018;27(1):96–118.

Laschinger HKS, Shamian J, Thomson D. Impact of magnet hospital characteristics on nurses’ perceptions of trust, burnout, quality of care, and work satisfaction. Nurs Econ. 2001;19(5):209–19.

Li B, Bruyneel L, Sermeus W, Van den Heede K, Matawie K, Aiken L, et al. Group-level impact of work environment dimensions on burnout experiences among nurses: a multivariate multilevel probit model. Int J Nurs Stud. 2013;50(2):281–91.

Van Bogaert P, Meulemans H, Clarke S, Vermeyen K, Van de Heyning P. Hospital nurse practice environment, burnout, job outcomes and quality of care: test of a structural equation model. J Adv Nurs. 2009;65(10):2175–85.

Laschinger HKS, Leiter MP. The impact of nursing work environments on patient safety outcomes - the mediating role of burnout/engagement. J Nurs Adm. 2006;36(5):259–67.

Garrett DK, McDaniel AM. A new look at nurse burnout: the effects of environmental uncertainty and social climate. J Nurs Adm. 2001;31(2):91–6.

Bobbio A, Bellan M, Manganelli AM. Empowering leadership, perceived organizational support, trust, and job burnout for nurses: a study in an Italian general hospital. Health Care Manag Rev. 2012;37(1):77–87.

Spence Laschinger HK, Wong CA, Grau AL. The influence of authentic leadership on newly graduated nurses’ experiences of workplace bullying, burnout and retention outcomes: a cross-sectional study. Int J Nurs Stud. 2012;49(10):1266–76.

Lee HF, Chiang HY, Kuo HT. Relationship between authentic leadership and nurses’ intent to leave: the mediating role of work environment and burnout. J Nurs Manag. 2019;27(1):52–65.

Kanste O, Kyngas H, Nikkila J. The relationship between multidimensional leadership and burnout among nursing staff. J Nurs Manag. 2007;15(7):731–9.

Lake ET. Development of the practice environment scale of the Nursing Work Index. Res Nurs Health. 2002;25(3):176–88.

Nantsupawat A, Kunaviktikul W, Nantsupawat R, Wichaikhum OA, Thienthong H, Poghosyan L. Effects of nurse work environment on job dissatisfaction, burnout, intention to leave. Int Nurs Rev. 2017;64(1):91–8.

Vahey DC, Aiken LH, Sloane DM, Clarke SP, Vargas D. Nurse burnout and patient satisfaction. Med Care. 2004;42(2 Suppl):II57–66.

Klopper HC, Coetzee SK, Pretorius R, Bester P. Practice environment, job satisfaction and burnout of critical care nurses in South Africa. J Nurs Manag. 2012;20(5):685–95.

Zhang LF, You LM, Liu K, Zheng J, Fang JB, Lu MM, et al. The association of Chinese hospital work environment with nurse burnout, job satisfaction, and intention to leave. Nurs Outlook. 2014;62(2):128–37.

Liu Y, Aungsuroch Y. Factors influencing nurse-assessed quality nursing care: a cross-sectional study in hospitals. J Adv Nurs. 2018;74(4):935–45.

Marques-Pinto A, Jesus EH, Mendes A, Fronteira I, Roberto MS. Nurses’ intention to leave the organization: a mediation study of professional burnout and engagement. Span J Psychol. 2018;21:E32.

Aiken LH, Sloane DM. Effects of organizational innovations in AIDS care on burnout among urban hospital nurses. Work Occup. 1997;24(4):453–77.

Spence Laschinger HK, Leiter M, Day A, Gilin D. Workplace empowerment, incivility, and burnout: impact on staff nurse recruitment and retention outcomes. J Nurs Manag. 2009;17(3):302–11.

Dutra HS, Cimiotti JP, Guirardello EB. Nurse work environment and job-related outcomes in Brazilian hospitals. Appl Nurs Res. 2018;41:68–72.

Laschinger HK. Job and career satisfaction and turnover intentions of newly graduated nurses. J Nurs Manag. 2012;20(4):472–84.

Estryn-Behar M, Van der Heijden BI, Oginska H, Camerino D, Le Nezet O, Conway PM, et al. The impact of social work environment, teamwork characteristics, burnout, and personal factors upon intent to leave among European nurses. Med Care. 2007;45(10):939–50.

Basar U, Basim N. A cross-sectional survey on consequences of nurses’ burnout: moderating role of organizational politics. J Adv Nurs. 2016;72(8):1838–50.

Van Bogaert P, Timmermans O, Weeks SM, van Heusden D, Wouters K, Franck E. Nursing unit teams matter: impact of unit-level nurse practice environment, nurse work characteristics, and burnout on nurse reported job outcomes, and quality of care, and patient adverse events--a cross-sectional survey. Int J Nurs Stud. 2014;51(8):1123–34.

Firth H, Britton P. Burnout, absence and turnover amongst British nursing staff. J Occup Psychol. 1989;62(1):55–9.

Giorgi F, Mattei A, Notarnicola I, Petrucci C, Lancia L. Can sleep quality and burnout affect the job performance of shift-work nurses? A hospital cross-sectional study. J Adv Nurs. 2018;74(3):698–708.

Tourigny L, Baba VV, Wang XY. Burnout and depression among nurses in Japan and China: the moderating effects of job satisfaction and absence. Int J Hum Resour Manag. 2010;21(15):2741–61.

Johnson J, Louch G, Dunning A, Johnson O, Grange A, Reynolds C, et al. Burnout mediates the association between depression and patient safety perceptions: a cross-sectional study in hospital nurses. J Adv Nurs. 2017;73(7):1667–80.

Nantsupawat A, Nantsupawat R, Kunaviktikul W, Turale S, Poghosyan L. Nurse burnout, nurse-reported quality of care, and patient outcomes in Thai hospitals. J Nurs Scholarsh. 2016;48(1):83–90.

Poghosyan L, Clarke SP, Finlayson M, Aiken LH. Nurse burnout and quality of care: cross-national investigation in six countries. Res Nurs Health. 2010;33(4):288–98.

Zarei E, Khakzad N, Reniers G, Akbari R. On the relationship between safety climate and occupational burnout in healthcare organizations. Saf Sci. 2016;89:1–10.

Halbesleben JR, Wakefield BJ, Wakefield DS, Cooper LB. Nurse burnout and patient safety outcomes: nurse safety perception versus reporting behavior. West J Nurs Res. 2008;30(5):560–77.

Teng CI, Shyu YI, Chiou WK, Fan HC, Lam SM. Interactive effects of nurse-experienced time pressure and burnout on patient safety: a cross-sectional survey. Int J Nurs Stud. 2010;47(11):1442–50.

Cimiotti JP, Aiken LH, Sloane DM, Wu ES. Nurse staffing, burnout, and health care-associated infection. Am J Infect Control. 2012;40(6):486–90.

Antonakis J, Bendahan S, Jacquart P, Lalive R. On making causal claims: a review and recommendations. Leadersh Q. 2010;21(6):1086–120.

Maben J, Latter S, Clark JM. The sustainability of ideals, values and the nursing mandate: evidence from a longitudinal qualitative study. Nurs Inq. 2007;14(2):99–113.

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Dall’Ora, C., Ball, J., Reinius, M. et al. Burnout in nursing: a theoretical review. Hum Resour Health 18 , 41 (2020). https://doi.org/10.1186/s12960-020-00469-9

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What is Nurse Burnout? How to Prevent It

6 min read • April, 25 2024

Nurse burnout is a serious job-related condition that can have major consequences for nurses and their patients. Unfortunately, burnout in nursing is on the rise, making it more important than ever to understand how to manage and prevent this condition. It's important to remember that burnout or compassion fatigue is a result of working conditions — not a failure or a lack of compassion or work ethic on your part. 

What Is Nurse Burnout?

Burnout is caused by unmanaged, chronic workplace stress. It can occur in any job or sector and results in the following symptoms,  according to the World Health Organization :

• Mental and physical exhaustion
• Mental distance from the job
• Cynicism about the job
• Reduced efficacy in the workplace

It's easy to see why this phenomenon is so common in nursing. Nurses often work long hours  performing tasks that are both physically and emotionally demanding. What's more, the work nurses perform can have important and even life-or-death consequences for patients, significantly adding to workplace stress.

What Is the Burnout Rate for Nurses?

How common is burnout in nursing? Very. Results from a 2020 survey indicate that  almost two-thirds of nurses (62%) experience burnout . It's especially common among younger nurses, with  69% of nurses under 25 reporting burnout . This issue affects all hospitals and health care systems in the U.S.

What Leads to Burnout in Nurses?

There are many causes of nurse burnout. Some causes are inherent to the job: providing compassionate care, working long hours, changing shift schedules, and being on your feet for hours at a time can all place serious demands on nurses. Other causes of nurse burnout derive from systemic challenges facing the health care system. For instance, aging baby boomers and the pandemic have increased the demand for nursing professionals. A  shortage of nurses  has, in turn, led to more or longer shifts and placed greater demands on individual nurses during each shift.

The pandemic has increased stress on nurses in other ways, too. Witnessing patient deaths — and being asked to provide moral and emotional support for those who die without their families nearby — is an emotional burden that often falls on nurses. And coping with the day-to-day reality of the pandemic while hearing skepticism about its existence from outside people can be disheartening to those on the front lines of health care.

What is Moral Injury?

Burnout can also be caused by moral injury - which is a psychological wound that happens when a person feels they must take actions, or witness actions, that violate their deeply held moral beliefs. The term also describes the challenges of knowing what kind of care your patients need but being unable to provide that care due to factors beyond your control.  The pandemic has also led to an increased amount of repeated moral injury , which is contributing to burnout in nurses.

Nurse Burnout Prevention and Management

Fortunately, despite the serious consequences of nurse burnout, it's possible to manage this condition by paying attention to your mental and physical well-being. The best way to manage nurse burnout is through prevention. Learning to identify the early warning signs is the first step toward avoiding a problem that puts you and your patients at risk.

Signs of Nurse Burnout

Early warning signs to be aware of include the following:

• You feel constantly overworked
• You regularly feel too tired to go to work
• You don't look forward to your job
• You feel unappreciated or like your work doesn't matter

While these are some of the most common warning signs, you may have other nurse burnout symptoms like trouble sleeping, tension in the body, or even feelings of depression.

How to Prevent Nurse Burnout

If you notice any of the early warning signs of nurse burnout, a few strategies can help you resolve it before it becomes a more serious problem. If you're already suffering burnout, these strategies can help you alleviate your symptoms and get back to enjoying your job and providing the best patient care possible:

• Rest : Getting enough sleep between shifts is crucial for nurses. If your current schedule won't allow you to get enough sleep, talk to your supervisor or whoever plans the shift schedule. Nurse burnout and patient safety go hand in hand, so it's important to be clear with your co-workers when you're experiencing burnout.  Find night shift nursing tips, including ways to fit rest and sleep into your schedule .
• Ask for help : Emotional support can help with the stress of workplace demands and the mental load of patient care. Make sure you have a sound support system at work, like co-workers to who you can vent your feelings, and consider contacting a therapist before your burnout becomes hard to manage.
• Get exercise : Physical activity has proven stress-alleviating effects. And improving your strength and cardiovascular fitness can make the physical demands of nursing less strenuous.
• Eat well : Make sure you're getting enough to eat before and during shifts and that the food is healthy. It's easy to get caught up in patient care and skip meals or eat junk food to save time. Taking time to buy or prepare nutritious meals at home and at work can help you stay focused and perform at your best.
• Take a break : Periodically disconnecting from work is important. It gives you a chance to unwind, relax, and recharge your physical and emotional reserves. Despite that, 55% of Americans don't use all of their paid vacation time. Don't be one of them. If the idea of taking time for yourself makes you feel guilty for leaving work or patients behind, remember that avoiding burnout will help you perform better when you are at work.
• Request training : Speak with your supervisors about training that can help you better cope with the demands of the job.

Mindfulness techniques and  moral resilience  — "the courage and confidence to confront distressful and uncertain situations by following and trusting values and beliefs" — will help you keep a healthy perspective on your work. These techniques can prevent or manage burnout by reminding you of what's out of your control and making it easier to maintain a sense of self-worth in the face of challenges or discouragement.

Avoiding Burnout Begins With Awareness

Burnout is a serious issue among nursing professionals. Fortunately, there are plenty of warning signs that individuals can spot in themselves and their colleagues. If you suspect that you or a fellow nurse are experiencing burnout, communicate with your manager so that changes can be made to your work schedule and situation before there’s a serious problem.

Visit our  Healthy Nurse, Healthy Nation™ site  to find more wellness tips and resources.

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Nursing Burnout: A Concept Analysis

Info: 2684 words (11 pages) Nursing Essay Published: 27th Nov 2020

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• Burnout. (n.d.). Retrieved November 10, 2019, from https://www.merriam-webster.com/dictionary/burnout
• Filgueira Martins Rodrigues, C. C., Pereira Santos, V. E., & Sousa, P. (2017). Patient safety and nursing: interface with stress and Burnout Syndrome. Revista Brasileira De Enfermagem, 70(5), 1083-1088. doi:10.1590/0034-7167-2016-0194
• Gómez-Urquiza, J. L., De la Fuente-Solana, E. I., & Albendín-García, L., Vargas-Pecino, C., Ortega-Campos, E.M., & Canadas de la Fuente, G.A.  (2017). Prevalence of burnout syndrome in emergency nurses: A meta-analysis. Critical Care Nurse, 37(5), e1-e9. doi:10.4037/ccn2017508
• Heeb, J. & and Haberey-Knuessi, V. (2014). Health professionals facing burnout: What do we know about nursing managers? Hindawi Nursing Research and Practice, 2014 (681814 ), 1-7. dx.doi.org/10.1155/2014/681814
• Khamisa, N., Oldenburg, B., Peltzer, K., & Ilic, D. (2015). Work related stress, burnout, job satisfaction and general health of nurses. International Journal of Environmental Research and Public Health, 12(1), 652-666. doi.org/10.3390/ijerph120100652
• Manzano-García, G., & Ayala, J. (2017). Insufficiently studied factors related to burnout in nursing: Results from an e-Delphi study. Plos One, 12(4), e0175352. doi:10.1371/journal.pone.0175352
• Prapanjaroensin,A., Patrician, P.A. &Vance, D. E. (2017). Conservation of resources theory in nurse burnout and patient safety. Journal of Advanced Nursing, 73(11), 2558-2565 https://doi.org/10.1111/jan.13348
• Raferty, C. & Poole, L. (2015). Nurse practitioners: Do we care? The Journal of Nurse Practitioners, 11(6), 653.
• Salvagioni, D. J., Melanda, F. N., Mesas, A. E., González, A. D., Gabani, F. L., & Andrade, S. d. (2017). Physical, psychological and occupational consequences of job burnout: A systematic review of prospective studies. Plos ONE, 12(10), 1-29. doi:10.1371/journal.pone.0185781

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What Is Nurse Burnout?

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Nurses regularly help people recover from illnesses and injuries and witness the real and tangible impact they have on patients’ lives. While nursing is a fulfilling profession for many, the work has another side to it as well.

When the stress of the job causes physical, mental, and emotional fatigue, this phenomenon is called nurse burnout. The majority of nursing professionals experience nurse burnout at some point in their careers. In fact, a 2017 Kronos study found that 63% — that’s nearly two-thirds — of nurses in hospitals reported experiencing burnout.

Burnout can make you feel helpless. If you find out what causes your burnout and know how to manage and ultimately prevent nurse burnout, you can still have a successful nursing career.

Nurse Burnout vs. Compassion Fatigue

Although nurse burnout and compassion fatigue share some similarities, they are fundamentally different phenomena.

Nurse burnout involves the emotional and physical exhaustion that comes with the stressful responsibilities required for nursing. In comparison, compassion fatigue results when prolonged emotional strain culminates in detachment and difficulties in providing empathetic care.

Compassion fatigue comes from working with victims of trauma, although this is not necessarily the case for nurse burnout. Compassion fatigue can also appear more quickly than nurse burnout and can even cause anger or existential despair.

The two conditions do lead to some of the same consequences, including emotional and mental exhaustion, self-isolation, and a lack of feeling fulfilled or accomplished in professional settings.

Causes and Effects of Nurse Burnout

Burnout can occur in anyone’s career. If somebody experiences considerable long-term stress, they can find themselves in a state of mental and physical exhaustion.

For nurses, burnout is the result of a high-stakes, demanding job that frequently exposes them to human suffering. Nurses see death and grieving families every day and work with patients who are in physical and/or mental pain. Additionally, nurses work long shifts — often 12 or more hours within one day. All of those factors can lead to intense burnout on their own. Circumstances such as not having effective support or leadership within the workplace can exacerbate burnout even more.

Nurse burnout can cause irritability and checked-out behaviors, meaning nurses go through the motions of the job without really engaging . Not only can nurse burnout affect the nurses themselves, it can lead to less effective treatment for patients. Nurses might find themselves becoming forgetful or making mistakes due to their exhaustion, which can lead to discomfort or even harmful outcomes for patients.

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Nationwide Nurse Shortage and Burnout

Another factor contributing to nurse burnout is the nationwide nursing shortage in the U.S. The Bureau of Labor Statistics (BLS) projects that the number of registered nurses could increase from 3 million in 2019 to 3.3 million a decade later. That’s an increase of about 7.2%.

Even though that growth rate suprasses the national average, many studies still predict that the demand for nurses will outpace the supply. That’s in large part because of the aging population of the baby boomer generation, who need more medical attention as they grow older. In addition, many nurses themselves will become older and retire.

Nurses must increasingly take on larger workloads in order to make up for nurse shortages within the workplace. As many experts note , this greater workload can lead to prolonged stress and ultimately burnout. In fact, in a study in the February 2014 issue of the journal Lancet , researchers discovered that an increased workload for nurses could increase a patient’s chances of dying by 7% within a month of their hospital admission date.

One of the four major reasons nurses are taking on larger workloads are budget cuts of ancillary roles such as CNAs, housekeeping, and dietary. RNs are required to expand their roles to not only patient care , but to keeping the rooms clean, delivering meals, and other responsibilities, which results in higher burnout and stress and more room for mistakes made.

Areas with High Levels of Nurse Burnout

Nurses often see greater burnout in particularly intense or high-stakes healthcare departments, according to a 2013 study from the College of Dupage .

The study found that nurses endure higher levels of burnout and compassion fatigue in oncology units. They often work with patients who are dying without any chance of recovery and must communicate with anxious and grieving families.

According to the study, nurses who work in emergency rooms also experience more severe burnout. On average, emergency room (ER) nurses see 50 patients during their shifts — over 12 times more than nurses on a normal medical-surgical floor, who see an average of four patients.

The study suggests that oncology or ER nurses who feel that burnout or compassion fatigue can affect the quality of their job should request to move to a different department.

Managing Nurse Burnout

There are resources available for nurses experiencing burnout symptoms that can hinder their ability to effectively carry out job duties.

The Centers for Disease Control and Prevention (CDC) suggests several tips for nurses dealing with burnout: prioritize sleep, check in with your coworkers, and use relaxation or meditation apps. Experts also suggest self-care and self-reflection; that means eating a well-balanced diet, exercising, and reflecting on your feelings after particularly difficult days. Another way to combat nurse burnout involves drawing a clear line between your work and home lives. In other words, do not bring the stress of work back home.

If you want more in-depth information on how to manage nurse burnout, you can find several resources online. To start, you can read helpful advice from nursing experts on how to combat compassion fatigue and avoid nurse burnout .

Whether you’re looking to get your pre-licensure degree or taking the next step in your career, the education you need could be more affordable than you think. Find the right nursing program for you.

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Calling It Quits

Nurses Are Burned Out. Can Hospitals Change in Time to Keep Them?

The pandemic has pushed already stressed nurses away from a demanding field. Does the job need to be rethought?

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By Bradford Pearson

Bradford Pearson found subjects for this article from an online request from The Times asking readers, including nurses, for their quitting stories.

Calling It Quits is a series about the current culture of quitting.

One morning, in fall 2020, Francesca Camacho drove away from her 12-hour night shift as a critical care nurse at Rush University Medical Center in Chicago and tried to merge onto the highway. The day’s work, in her words, was “just very terrible.” This wasn’t uncommon at the time: The Cook County area was experiencing the highest levels of Covid hospitalization it had ever experienced, surpassed only by the Omicron variant wave the following year.

She was on the phone with her parents, a ritual she’d developed as a way to decompress after a shift, when she noticed what appeared to be a teenage driver in front of her.

“I remember thinking, What is this girl doing that justifies her not letting me in?” Ms. Camacho, now 27, recalled. “And I just felt this surge of rage.” She hung up the phone and screamed and cried for the rest of the drive home.

The next day, she asked her co-workers if anything similar had ever happened to them; they all said yes. Lunchtime therapy sessions with fellow nurses turned into professional therapy sessions. “It really was feelings of anger that I felt, and I think very deep underneath that was just terrible sadness about what I was seeing and what we were all going through,” she said recently.

Last August, she quit her job. She is now a first-year law student at Boston University and plans to use her law degree to advocate changes in the medical field.

Burnout has always been a part of nursing, an effect of long working hours in physically and often emotionally taxing environments. The Covid pandemic exacerbated those factors and added some of its own: understaffing, a rise in violence and hostility toward health care workers over masking mandates and an increase in deaths, particularly in the early months of the pandemic. In a study from the American Nurses Foundation , released last month, 57 percent of 12,581 surveyed nurses said they had felt “exhausted” over the past two weeks, and 43 percent said they felt “burned out.” Just 20 percent said they felt valued. (Those numbers were largely consistent throughout the pandemic.)

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The power of self-care: An ENERGY model to combat clinician burnout

It’s more important than ever for nurses to take care of themselves.

• Clinicians are experiencing alarming rates of burnout.
• Self-care is essential to maintaining a healthy relationship with oneself and others.
• The ENERGY model provides clinicians with practical self-care strategies to mitigate stress and job-related burnout .

Clinicians often experience considerable psychological distress related to work demands, and the COVID-19 pandemic has only added to that. Healthcare systems and organizations play an important role in promoting a healthy work environment to reduce distress, but changes coming from the top may be inadequate to meet individual needs. Nurses and other clinicians must take control of their own health, especially in a time populated with new challenges and obstacles. Self-care is vital.

A study by Wei and colleagues explains how clinicians can elevate six strategies into a self-care model using the ENERGY acronym: E nergy source, N urturing kindness, E motional hygiene, R efocusing purpose, G erminating positivity, and Y our uniqueness. (See ENERGY self-care model .) Consider incorporating these strategies into your daily routine to reduce stress and promote well-being.

Use this model to incorporate self-care strategies that can help reduce stress and mitigate burnout.

Energy source

To prevent feeling depleted, connect yourself to an energy source that helps you recharge physically and emotionally. Adequate sleep, balanced nutrition, and moderate exercise are fundamental for physical health, but you also must find sources of energy—such as family, friends, spiritual beliefs—to nourish your mind.

Social support and connectedness are critical to good health. People with strong social support and relationships have a lower risk of psychological issues than those who lack that support. Social support affects the hypothalamic-pituitary-adrenocortical system and central oxytocin pathways to help build resilience and mitigate detrimental events. People who are socially connected and supported have a heightened sense of companionship and belonging. These sensations can build your self-esteem and promote self-value, which, in turn, fuels the energy to love yourself and others.

Some of your social support and connectedness can come from your healthcare colleagues. The National Academy of Medicine reports that team-based healthcare is associated with improved patient outcomes and clinician well-being. A healthy work environment and amiable coworker relationships can help you reserve and fuel your energy.

During the pandemic, when many healthcare providers are isolated from family and friends, these positive relationships are even more crucial. Demanding patient care can easily drain your energy, but strong social connections and collaborative teamwork can foster trust, communication, and mutual goal-achievement, ultimately reducing burnout.

Nurturing kindness    

Nurturing kindness is fundamental to elevating your own happiness and brightening the mood of those around you. Acts of kindness help us create a caring-healing relationship with ourselves and others. The feeling of being kind not only increases life satisfaction and happiness but also promotes health. Reducing negative emotions—such as stress, anger, anxiety, and depression—improves the immune system. When we perform acts of kindness, our bodies release neurochemicals—such as dopamine, serotonin, and oxytocin—leading to a sense of happiness and well-being. Also, as more of our interactions are online, we need to ensure kindness—respect, caring, compassion, and em­pathy—within virtual communities and when providing remote care.

Emotional hygiene     

When we think of threats to our health, we frequently think about hazards that affect us physically, such as bacteria or viruses. But what about psychological hazards, such as rejection or loneliness? Emotional hygiene—practicing mindfulness, having a gratitude mentality, cultivating an optimistic attitude, self-valuing, shifting focus from adversities, and engaging in physical activities—can help you manage your feelings, handle everyday difficulties, and mend your psychological pain. (See Practicing emotional hygiene .)

Mindfulness practice and exercise can boost emotions and are powerful antidotes for psychological distress. Mindfulness practice can help you focus and reduce stress, anxiety, and depression and also help you release past negative or difficult emotions. Functional magnetic resonance imaging suggests that therapeutic mindfulness interventions may reduce the gray matter volume in the amygdala (the “fight or flight” center of the brain) and increase it in areas of the brain that are responsible for learning, memory, and critical thinking. During exercise, your body releases endorphins, which can activate the brain’s opioid receptors, making it a great remedy for emotional pain, stress, anxiety, and depression.

To alleviate the detrimental effects of the intense nature of healthcare, you must be diligent about your emotional hygiene. Here are some practical ways you can incorporate emotional hygiene into your daily routine:

• Find opportunities during the day to relax the brain and soothe the mind with a simple breathing exercise: Close your eyes and take three to five deep breaths. These two techniques can help:
• 4 × 4 breathing—Do a slow count of four for each inhale, hold, exhale, and hold.
• 4-7-8 breathing—Do a slow count of four as you inhale, hold for a slow count of seven, and exhale for a slow count of eight.
• Before going home, practice separation from work with purposeful and mindful handwashing. Use this practice to not only get rid of germs but also to “wash away” negative feelings and stress.
• On the way home, focus on green space and enjoy nature.
• Set aside 30 minutes each day to exercise outdoors for exposure to nature and sunshine.

Refocusing purpose   

Your life purpose is an inner compass that guides your actions during complex life situations; having a strong sense of purpose can positively affect your outlook and health. When you stray from your purpose and lose passion, you may need to pause, refocus, and reconnect with your purpose.

People with a strong sense of purpose show signs of better cognitive functioning, memory, mental health, and general well-being. Actively working and achieving a life goal creates a sense of fulfillment, which helps us feel satisfied. When we feel fulfilled, our brains can produce endorphins and serotonin, which are energizing.

For most nurses, the goal is to help others. When you face significant challenges, you may feel discouraged, stressed, or even burned out. However, if you can recall, refocus, and reconnect with your original purpose and passion, you may find joy and renewed energy.

Germinating positivity           

Geminating positivity is about cultivating a positive attitude and spreading it to others. Developing a positive attitude requires training your brain to focus on the positive aspects of events rather than the negative. Positivity training can help you change your behaviors and mindset to mitigate stressful situations and improve your well-being. Activities that can promote positivity include practicing daily gratitude (a gratitude journal or daily gratitude list), reframing the meaning of adversities, having a growth mindset, showing appreciation, and seeing difficult situations as temporary. (See Positivity research .)

In healthcare, promoting a positive work environment is vital for nurses and patients. You can promote gratitude and positivity at work in a variety of ways, including starting shift reports with positive events, recognizing and appreciating colleagues, and paying kindness forward. You also should try to view difficult situations as temporary and understand that hardships will pass.

Research shows that positivity and gratitude can change our brains. Wong and colleagues examined participants’ mental health and brain functions under three conditions:

• psychotherapy with gratitude expression (writing letters of appreciation to others)
• psychotherapy with expressive writing (writing about their deepest thoughts and feelings about stressful experiences)
• psychotherapy alone.

Gratitude group participants showed the most significant improvement in their mental health and brain function. Practicing gratitude improves brain function in the regions such as the hypothalamus, which secretes dopamine, oxytocin, and endorphin. These hormones are beneficial to our mental health and help us feel happier and less depressed.

Your uniqueness        

Each of us is a unique individual. When you know your uniqueness, you can appreciate your strengths and limitations and will be able to unleash your inner power. Two kinds of power guide you, external (authority given to you) and internal (confidence that grows within you). Internal (inner) power helps you love yourself and shape who you are. People and events (such as workplace incivility and bullying) can’t make you feel bad without your permission. When you acknowledge your uniqueness, you can appraise your capabilities, an essential step for making peace with yourself and ensuring you don’t feel depleted.

Tending to your inner power requires valuing yourself as a distinct individual and setting realistic goals. How you think about yourself can affect how you feel. Thinking about yourself positively and using uplifting words to describe yourself can promote your sense of self-worth. Setting realistic goals helps you feel accomplished. When you get things done in the way you desire, your brain releases dopamine, which elevates your confidence and happiness and encourages your brain to seek out these sensations.

In the current pandemic, you can’t save every life, but you can work to the best of your ability to save some lives. You’ll need to make peace with what you want to do and what you can achieve. Setting realistic goals may help you feel accomplished, releasing the dopamine that will help you feel good and mitigate burnout.

Replenish your energy

Using the ENERGY acronym may help you replenish your energy. Practicing self-care can help you activate or deactivate certain brain regions to benefit your health. All healthcare providers shoulder a mission and responsibility for the health of our communities. We’re like lifebuoys; only when we fill up ourselves, will we be able to lift others.

Holly Wei is an associate professor, graduate leadership concentration, in the advanced nursing practice & education department at the College of Nursing, East Carolina University in Greenville, North Carolina. Trent L. Wei is a physician at Duke University Medical Center in Durham, North Carolina.

Baixauli E. Happiness: Role of dopamine and serotonin on mood and negative emotions. Emerg Med. 2017;7(2). longdom.org/open-access/happiness-role-of-dopamine-and-serotonin-on-mood-and-negative-emotions-2165-7548-1000350.pdf

Gelinas L. Promoting clinician well-being. Am Nurse Today . 2019;14(4):4.

Ghosh SK. Happy hormones at work: Applying the learnings from neuroscience to improve and sustain workplace happiness. NHRD Network J . 2018;11(4):83-92.

Harandi TF, Taghinasab MM, Nayeri TD. The correlation of social support with mental health: A meta-analysis. Electron Physician . 2017;9(9):5212-22.

Melnyk BM. Burnout, depression and suicide in nurses/clinicians and learners: An urgent call for action to enhance professional well-being and healthcare safety. Worldviews Evid Based Nurs . 2020;17(1):2-5.

Smith CD, Balatbat C, Corbridge S, et al. Implementing optimal team-based care to reduce clinician burnout. National Academy of Medicine. September 17, 2018. nam.edu/implementing-optimal-team-based-care-to-reduce-clinician-burnout .

Tabibnia G, Radecki D. Resilience training that can change the brain. Consult Psychol J . 2018;70(1):59-88.

Wei H, Kifner H, Dawes ME, Wei TL, Boyd JM. Self-care strategies to combat professional burnout among pediatric critical care nurses and physicians. Crit Care Nurse . 2020;40(2):44-53.

Wong YJ, Owen J, Gabana NT, et al. Does gratitude writing improve the mental health of psychotherapy clients? Evidence from a randomized controlled trial. Psychother Res . 2018;28(2):192-202.

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Impact of Burnout in Nursing Shortage

This essay will discuss how burnout among nurses contributes to the nursing shortage crisis. It will explore factors leading to nurse burnout, including long hours, high-stress environments, and emotional demands. The piece will examine the consequences of burnout on patient care, staff turnover, and the healthcare system, and suggest strategies for mitigating these effects. More free essay examples are accessible at PapersOwl about Employment.

How it works

• 1 Role Strain and Burnout in Nursing
• 2 Causes, effects of role strain and Burnout among the nurses
• 3 Issues that lead to nurse burnout and their solutions
• 4 Stressing experience as a nurse

Role Strain and Burnout in Nursing

Causes, effects of role strain and burnout among the nurses.

Nurses face a lot of challenges in their work. Among the most common challenges is stress. Psychologists and other experts point out that stress in workplace is an occupational hazard. Despite this recognition, nurses still experience stress in their workplace. These professionals work for long and engage in different activities under difficult environment making the job to be a challenge.

Stress causes burnout among workers including nurses.

Burnout is a terminology that is used to describe how workers react to chronic stress that characterizes jobs which involve direct interaction with human beings (Callara & Callara, 2008). A worker suffering from burnout displays emotional exhaustion, reduced productivity, and depersonalization. Workplace problems sometimes spill over to personal life thus affecting families since a worker may have other responsibilities such maintaining marriage and caring for children. Majority of nurses universally are females who are forced to divide their time between performing their job duties and managing other responsibilities such as home and families, further leading to burnout among them.

Nurse burnout affects patients and the institutions as well as the nurses themselves. To begin with, stressed nurses provide substandard and inadequate patient care (Lindberg, Hunter, & Kruszewski, 2009). When nurses are exhausted, they tend to make wrong choices and poor decisions. It is also quite common to see burnt out nurses with changed bedside manners accompanied by cynicism, depersonalization, lack of compassion, insensitivity, and lack of empathy. A nurse who may have been vibrant can suddenly become rude to patients, and stop being helpful to patients needing help. The change in the nurse’s behavior may affect the recovery rate of the patients; the relationship between burnt out staff and patients deteriorate and the sick that get poor treatment may opt to seek medical attention elsewhere.

Secondly, burnout among nurses makes some of them resign and seek job elsewhere. The remaining nurses are forced to take more patients under their care. Statistics show that a high patient to nurse ratio leads to patients contracting infectious diseases, getting injuries, failing to get timely care, while some patients are discharged without proper plans of home care (Callara et all, 2008). Nurse burnout also affects the organizations since they are forced recruit new staff when some resign due to work challenges. Additionally, other staff working within the same institutions with the nurses may also suffer from the effects of the burnout due to poor relationship between them and the nurses. This inconsistent change in the workers due to resigning and burn out greatly affects proper care and recovery of the patients.

There are several ways through which nurses can control and reduce role stress and role strain. The nurses need to recognize the source of stress and make plans on the best ways of overcoming them. They need to also know how strike a balance between work and social life. The health professionals can also seek help from support groups such as family members, friends, and colleagues. Finding ways of releasing stress such as practicing art or other hobbies can assist in reducing work related stress. If all these options fail, considering other jobs options can also assist to manage stress and prevent escalation of the problem into depression.

Issues that lead to nurse burnout and their solutions

One of the leading causes of nurse burnout is gender and obligation to one’s family. Studies have shown that the rate of burnout is higher among female nurses than that of their male counterparts (May & Holmes, 2012). Furthermore, the females who worked for the number of hours against their wishes were more likely to develop burnout. Work-family conflict leads to burnout if one interferes with the other, particularly when work interfered with the family nurse of the health practitioner. Nurses with young children and elderly parents to take care of can sometimes project their stress to workplace.

This challenge can be countered by the management of the organization where the nurse works organizing a positive wellness program to handle the issues affecting the nurses. Incentives such as counseling, time off, and food program can assist the workers to know how to strike a balance between private and work life.

The second cause of nurse burnout is poor management style. How nurses and their managers relate directly affects the rate of nurse burnout in organizations. Factors such as inadequate leadership, absent supervisors, poor communications, inability to respond to problems of the health practitioners, and frequent leadership change raised stress level among the nurses (Daly, 2005) The adoption of participatory form of leadership in organizations where nurses work also reduces stress among the nurses. The position the nurse holds also determines the level of stress among the nurses with those in management positions suffering from stress more compared to the other nurses.

To overcome this challenge of leadership, organizations should appoint nurses with experience and knowledge to serve in managerial positions. Institutions can also lay down polices to guide the managers on how to treat the workers. Finally, an organization can adopt a method of gathering views from all the employees to make them feel as part of the company.

Stressing experience as a nurse

There was one time I was working in the hospital and served during the nightshift. The nurses were few in the organization so the ten employed nurses worked for twelve hour shift; five during the day time and the other staff during the night. On this particular day, I had served the night shift and exhausted, was ready to go home and catch sleep before preparing to resume later during my night shift. Just as I was preparing to leave, the head nurse summoned me to her office and said that two of our colleagues had resigned without giving any form of notice to allow for preparation. I was expected to serve for additional six-hour period until midday. My love for the patients and dedication to the hospital made me work for the extra six hours. The experience was unpleasant since I offered poor service due to fatigue and sleep.

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Reflective Learning and Nursing Burnout Essay

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Introduction/Background

Critical literature review.

The work pressures related to the daily Frontline role of staff nurses make them prone to stress and burnout. For this reason, reflective learning is increasingly becoming an effective intervention for enhancing resilience and understanding of professional practice for improved nurse and patient outcomes (Jack, 2017).

The purpose of this evidence-based project is to evaluate the impact of the adaptation of reflective learning on nursing burnout in managing cardiac patients in a coronary care unit of King Fahad Medical City (KFMC) in the Kingdom of Saudi Arabia. Anecdotal evidence based on the statements of student nurses undertaking a clinical placement at the unit formed the basis for this project. The student nurses often complained of stress and burnout during their placement at KFMC’s coronary care unit. High levels of stress and burnout can affect the students’ learning outcomes.

The genesis of nursing fatigue or burnout in nursing practice is ascribed to occupational stress, heavy workloads, low staffing ratios, and exposure to trauma/suffering (Khater, Akhu-Zaheya, & Shaban, 2014). Emotional/physical fatigue may arise due to heavy workloads. Burnout manifestations may be high in a coronary care unit because of the high exposure to trauma that causes emotional exhaustion (Khater et al., 2014). Therefore, the intensification of burnout among the student nurses in KFMC’s coronary unit may be related to adverse survival prognosis, exposure to patient pain/mortality, and age (Jack, 2017). Burnout manifestations among the student nurses included detachment and sadness.

It is crucial for student nurses and RNs to work in a positive clinical environment for their wellbeing and quality patient care delivery. A strong relationship has been established between nurse wellbeing and clinical outcomes (Romano, Trotta, & Rich, 2013).

This implies that occupational burnout or fatigue has adverse impacts not only for nurses but also for patients. Jenkins and Warren (2012) indicate that, in clinical settings, student nurses and staff nurses experience of trauma/suffering and heavy workloads reduce their performance and patient safety outcomes. Interventions that promote self-care have the potential of reducing nursing stress and burnout. Reflective learning, where nurses gain “new insights of the self and practice” from clinical experiences can ensure better preparation for similar situations (Henderson, Cooke, Creedy, & Walker, 2012, p. 302). As such, engagement in reflective learning could offer some protection to burnout, leading to improved nurse wellbeing and patient outcomes.

For student nurses, clinical experiences with cardiac patients; however, cardiovascular nursing can be demanding emotionally and physically. Reflective learning, i.e., meditating and analysing individual clinical experiences, can promote workplace resilience and professional development (Foureur, Besley, Burton, Yu, & Crisp, 2013). Nurses working with cardiac patients are exposed to trauma or distress on a daily basis related to poor survival prognoses. Further, in addition to attending to the patient’s clinical needs, they also provide family/patient emotional support – professional demands that often cause anxiety (Gomez-Urquiza et al., 2016).

Reflective learning is the key to better workplace resilience and coping with a stressful and intellectually demanding coronary care environment. In this paper, a critical review of relevant scholarly literature will be performed to establish the relationship between reflective learning and nursing burnout in a coronary care unit.

Studies Worldwide

Nurses can improve their practice by engaging in reflective learning. A study by Crawley, Ditzel, and Walton (2012) involving American first-year nursing students found that reflective learning via storytelling builds confidence, awareness, and empathy in handling practice challenges. The authors conclude that the approach could be used to lower emotional exhaustion related to death or grief within critical care settings by enabling nurse students to construct “personal concepts around human experience” (Crawley et al., 2012, p. 49). Reflective learning through verbalised experiences/reflections allowed the student nurses to be sensitive and empathic to the practice complexities.

A disconnect exists between the pedagogical approaches for building the capacity to deal with stress/emotional fatigue and actual practice experiences. An integrative review by Dwyer and Hunter (2015) found that although reflection was a widely adopted instructional tool for improving the affective domain, the concept is rarely utilised in the American practice context. Thus, there is a need for interventions that support pedagogical and clinical preparation for demanding practice to build emotional and physical resilience in student nurses.

Analytical and critical thinking skills are emphasised in nursing practice. The compilation of a portfolio of evidence (PoE) based on clinical experiences is one way of enhancing reflective learning (Ticha & Fakude, 2015). A qualitative study examined the perceptions of student nurses in a South African medical university on reflective learning based on PoE compilation (Ticha & Fakude, 2015).

The results indicated that reflections captured in PoEs allowed the students to identify practice and classroom challenges and benefit from clinical learning experiences. In addition, through the reflective learning strategy, the subjects were able to develop the self-confidence and critical thinking skills required in nursing practice. Reflective practice also led to improved self-directed clinical learning. Therefore, the adaptation of reflective learning based on clinical experiences can motivate nurses to become critical thinkers and self-directed learners.

Besides critical thinking, self-care is considered to give adequate protection against stressors in practice contexts. Therefore, guiding nurses and learners through a journey towards self-care can enable them to manage nursing stress and burnout and enhance their efficacy. Blum (2014) evaluated a nursing program initiative that involved self-care activities taught to students in an American university.

The self-care practice activities involved mindfulness meditation and reflection in enabling the participants to learn from their experiences. The study found that self-care activities inspired and challenged students to deal with the stresses in their practices, be empathetic to others, and gain clarity on their professional goals (Blum, 2014). Further, through shared interactive experiences, the participants were able to identify self-care activities they can apply in practice.

Reflective practice is not self-criticism, but rather a source of psychological support for improved performance in the future. One way nurses can be motivated to engage in reflective practice is through clinical supervision groups. McAvey and Jones (2013) explored the views of clinical supervision groups in a London hospital on reflective learning as a tool for dealing with stressful and emotional issues in critical care environments. Participation in clinical supervision groups was shown to decrease burnout resulting from physical and emotional exhaustion. In addition, the groups provided a platform for nurses to compare practice with their peers, receive psychological support, and acquire practice skills required in critical care (McAvey & Jones, 2013).

Reflection is an important emotion-focused tool for reducing burnout to achieve improved wellbeing of nurses. Reducing nursing burnout contributes to improved patient care. Stewart and Terry (2014) explored educational interventions that could decrease nursing burnout in clinical environments through a systematic review. Their findings were consistent with those reported by McAvey and Jones (2013). Clinical supervision and training on stress management methods were found to contribute to lower burnout levels in nurses. Therefore, supportive relationships can enable staff nurses to deal with stress and burnout. In addition, professional/personal growth achieved through reflective learning can offer protection against burnout in critical care environments.

Studies in the Middle East

Studies carried out in Middle Eastern countries establish that engagement in reflective learning ameliorates stress and burnout by staff nurses. These findings are consistent with those of similar studies performed elsewhere in the globe. Baraz, Memarian, and Vanaki (2014) examined the reflective learning styles employed by Iranian student nurses in hospital settings. The qualitative study surveyed 15 baccalaureate student nurses in their clinical placements. The results indicated that the students utilised a variety of reflective learning methods in their practice with the main ones being “thoughtful observation, learning by thinking, and learning by doing” (Baraz et al., 2014, p. 529). The implication of these findings for practice is that classroom and clinical learning can be enhanced through reflective practice.

Reflective learning is particularly important during ICU placements due to the complex treatments involved. As such, the risk of stress and burnout for nurses and students is high. Vatansever and Akansel (2016) explored students’ views on ICU placements to determine student impact after the program at a Turkish university hospital. One of the key themes identified was the “comprehension of communication and empathy with ICU patients” (Vatansever & Akansel, 2016, p. 1043). Further, the analysis of the students’ views indicated that exposure to complex clinical procedures triggers reflective or experiential learning, which acts as a buffer against stress and burnout. However, the ICU can be a very stressful environment for students in their first placement.

A comparable study explored the clinical decision-making patterns of critical care nurses in a Jordanian hospital (Maharmeh, Alasad, Salami, Saleh, & Darawad, 2016). The study’s aim was to assess the use of reflective learning in routine patient care decisions. ICU cases require complex decisions that emotionally, intellectually, and physically draining. In this study, autonomy, collaborative decisions, and experience were found to reduce stress/fatigue in ICU environments. The ICU nurses exhibited great sensitivity and empathy to the patients under their care. Further, the authors concluded that reflective practice and experience increase the efficacy and confidence of ICU nurses in managing complex cases.

The risk of burnout and emotional fatigue is high in nursing practice. Social support systems that promote reflective learning can reduce the prevalence of fatigue/burnout among staff nurses. Ariapooran (2014) evaluated the prevalence of fatigue/burnout in 173 Iranian nurses and how they correlated with clinical support. The study found out that lack of social support contributes to compassion fatigue among nurses. In addition, a lack of engagement in support systems that promote reflective practice and collaboration increased the risk of nurse burnout. Thus, support systems that promote collaborative practice can help decrease the prevalence of burnout/fatigue in clinical settings.

Studies in Saudi Arabia

The prevalence of burnout in critical care and its impact on nurse outcomes has also been investigated in locally. Alharbi, Wilson, Woods, and Usher (2016) explored the impact of burnout/fatigue on job satisfaction among ICU nurses in a cross-sectional survey. The study found that burnout levels among Saudi nurses range between moderate to high in domains related to “emotional exhaustion and de-personalisation” (Alharbi et al., 2016, p. 715). Further, burnout was strongly correlated with low job satisfaction. Therefore, strategies, such as reflective learning, should be adopted in clinical settings to help nurses cope with stress and burnout.

On their part, Al-Sareari, Al-Khalidi, Mostafa, and Abdel-Fattah (2013) sought to determine the factors that contributed to fatigue among clinicians in Saudi healthcare centres. The qualitative survey found higher levels of emotional exhaustion among younger clinicians than older ones. This implies that experience and reflective learning can ameliorate the effect of stress in busy clinical settings. In addition, high levels of depersonalisation were seen in the younger nurse, implying that emotional intelligence develops with practice experience. Further, longer vacations were associated with low emotional exhaustion scores (Al-Sareari et al., 2013). Thus, vacations and experience can reduce the prevalence of job-related burnout among Saudi clinicians.

Job-related demands can adversely affect nurse performance. Al-Homayan, Shamsudin, Subramaniam, and Islam (2013) surveyed nurses working in busy Saudi public hospitals to identify the physical and emotional demands that cause poor performance. The main response to the heavy work demands was stress. The nurses also suffered from sleep deprivation due to the demanding nature of the public hospital environment.

The stress was ameliorated by organisational support for the nurses and care coordination. In addition, interpersonal support through staff motivation, consultation/collaboration, empathy, and share experiences was associated with reduced stress (Al-Homayan et al., 2013). This shows that collective reflections on shared experiences enhance resiliency among nurses working in a demanding clinical environment. Collective reflective learning also offers protection against emotional and physical stress inherent in critical care settings such as cardiac care units.

Alharbi, J., Wilson, R., Woods, C., & Usher, K. (2016). The factors influencing burnout and job satisfaction among critical care nurses: A study of Saudi critical care nurses. Journal of Nursing Management, 24 (6), 708-717. Web.

Al-Homayan, M., Shamsudin, M., Subramaniam, C., & Islam, R. (2013). Impacts of job demands on nurses’ performance working in public hospitals. American Journal of Applied Sciences, 10 (9), 1050-1060. Web.

Al-Sareari N., Al-Khalidi Y., Mostafa O., & Abdel-Fattah M. (2013). Magnitude and risk factors for burnout among primary health care physicians in Asir province, Saudi Arabia . Eastern Mediterranean Journal, 19 (5), 426- 433. Web.

Ariapooran, S. (2014). Compassion fatigue and burnout in Iranian nurses: The role of perceived social support . Iranian Journal of Nursing and Midwifery Research, 19 (3), 279-284. Web.

Baraz, S., Memarian, R., & Vanaki, Z. (2014). The diversity of Iranian nursing students’ clinical learning styles: A qualitative study. Nurse Education in Practice, 14 (5), 525-531. Web.

Blum, C. (2014). Practicing self-care for nurses: A nursing program initiative. Online Journal of Issues in Nursing, 19 (3), 120-129. Web.

Crawley, J., Ditzel, L., & Walton, S. (2012). Using children’s picture books for reflective learning in nurse education. Contemporary Nurse: A Journal for the Australian Nursing profession, 42 (1), 45-52. Web.

Dwyer, P., & Hunter, R. (2015). Preparing students for the emotional challenges of nursing: An integrative review. Journal of Nursing Education, 54 (1), 7-12. Web.

Foureur, M., Besley, K., Burton, G., Yu, N., & Crisp, J. (2013). Enhancing the resilience of nurses and midwives: Pilot of a mindfulness based program for increased health, sense of coherence and decreased depression, anxiety and stress. Contemporary Nurse, 45(1), 114-125. Web.

Gomez-Urquiza, J., Aneas-Lopez, B., Fuente-Solana, E., Albendin-Garcia, L., Diaz-Rodriguez, L., & Fuente, G. (2016). Prevalence, risk factors, and levels of burnout among oncology nurses: A systematic review. Oncology Nursing Forum, 43( 3), 104-120. Web.

Henderson, A., Cooke, M., Creedy, D., & Walker, R. (2012). Nursing students’ perceptions of learning in practice environments: A review. Nurse Education Today, 32(3), 299-302. Web.

Jack, K. (2017). The meaning of compassion fatigue to student nurses: An interpretive phenomenological study. Journal of Compassionate Health Care, 4( 2), 1-13. Web.

Jenkins, B., & Warren, N. (2012). Concept analysis: Compassion fatigue and effects upon critical care nurses. Critical Care Nursing Quarterly, 35 (4), 388-395. Web.

Khater, W., Akhu-Zaheya, L., & Shaban, I. (2014). Sources of stress and coping behaviours in clinical practice among Baccalaureate nursing students. International Journal of Humanities and Social Science, 4 (6), 194-205. Web.

Maharmeh, M., Alasad, J., Salami, I., Saleh, Z., & Darawad, M. (2016). Clinical decision-making among critical care nurses: A qualitative study . Health, 8 , 1807-1819. Web.

McAvey, J., & Jones, T. (2012). Assessing the value of facilitated reflective practice groups. Cancer Nursing Practice, 11 (8), 32-38. Web.

Romano, J., Trotta, R., & Rich, L. (2013). Combating compassion fatigue: An exemplar of an approach to nursing renewal. Nursing Administration Quarterly, 37 (4), 333-336. Web.

Ticha, V., & Fakude, L. (2015). Reflections on clinical practice whilst developing a portfolio of evidence: Perceptions of undergraduate nursing students in the Western Cape, South Africa. Curationis, 38 (2), 1502-1510. Web.

Stewart, W., & Terry, L. (2014). Reducing burnout in nurses and care workers in secure settings. Nursing Standard, 28 (34), 37-45. Web.

Vatansever, V., & Akansel, N. (2016). Intensive care unit experience of nursing students during their clinical placements: A qualitative study . International Journal of Caring, 9 (3), 1040-1049. Web.

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60 Helpful Nursing Burnout Topics and Ideas

James colson dnp, rn.

• May 16, 2024
• Nursing Topics and Ideas

Nursing Burnout Topics and Ideas

Nursing Burnout is a state of emotional, physical, and mental exhaustion caused by prolonged and excessive work-related stress. It has profound implications for nurses’ well-being, patient care, and healthcare quality.

As you write your paper on nursing burnout, use this list of potential Nursing Burnout Topics and Ideas to help you craft a compelling nursing paper.

The topics below include Nursing Burnout Evidence-Based Practice Project Ideas, Nursing Burnout PICOT Questions Examples, Nursing Burnout Capstone Project Ideas, and Nursing Essay Ideas on Nursing Burnout.

Nurse burnout is a complex issue influenced by various factors, including long working hours, high patient-to-nurse ratios, emotional demands, and a lack of control over the work environment. Below is a list of nursing topics and ideas on nurse burnout

10 Nursing Burnout PICOT Questions Examples

• In medical-surgical units (P), how does a mindfulness-based intervention (I) compared to usual care (C) affect nurse burnout levels (O) within six months (T)?
• In critical care settings (P), what is the effect of nurse-led debriefing sessions (I) on emotional exhaustion (O) compared with no debriefing (C) following traumatic events (T)?
• Among newly graduated nurses (P), how does a mentorship program (I) compare to no mentorship (C) influence job satisfaction (O) within the first year of practice (T)?
• In pediatric oncology units (P), what is the impact of regular team-building activities (I) on perceived stress levels (O) in nurses compared to units without such activities (C) over three months (T)?
• For nurses working night shifts (P), how does exposure to natural light (I) compared to artificial lighting (C) during working hours affect sleep quality (O) within a two-week timeframe (T)?
• In outpatient clinics (P), what is the effect of workload reduction strategies (I) compared to standard workload (C) on nurse-reported burnout (O) over one year (T)?
• Among emergency department nurses (P), how does participation in resilience training programs (I) compared to no training (C) influence overall well-being (O) within six months (T)?
• In in-home healthcare settings (P), what is the impact of self-scheduling options (I) on nurse job satisfaction (O) compared to fixed schedules (C) over nine months (T)?
• Among nurses in rural hospitals (P), how does access to telehealth counseling services (I) compared to no access (C) affect perceived stress (O) within three months (T)?
• In psychiatric nursing units (P), what is the effect of regular team case reviews (I) compared to infrequent reviews (C) on emotional exhaustion (O) within four months (T)?

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10 Nursing Burnout Evidence-Based Practice Project Ideas

• Implementing mindfulness-based stress reduction workshops for nurses.
• Developing a resource toolkit for nurse self-care strategies.
• Introducing flexible scheduling options to address nurse work-life balance.
• Establishing peer support groups for nurses to share experiences and coping mechanisms.
• Designing a wellness campaign to promote healthy lifestyles among nurses.
• Creating a rewards and recognition program to acknowledge nurses’ hard work.
• Conducting regular surveys to assess nurses’ satisfaction and well-being.
• Designing stress-reduction spaces within healthcare facilities for nurse relaxation.
• Introducing education on burnout prevention during nurse orientation programs.
• Collaborating with healthcare institutions to provide mental health resources for nurses.

10 Nursing Burnout Nursing Capstone Project Ideas

• Evaluating the effectiveness of mindfulness interventions on reducing nurse burnout.
• Developing a comprehensive nurse well-being program for implementation in hospitals.
• Assessing the impact of leadership training on nurse manager support and burnout reduction.
• Investigating the relationship between nurse-patient ratios and nurse job satisfaction.
• Analyzing the effects of physical activity interventions on nurse burnout and job performance.
• Creating and implementing a mentorship program to support novice nurses.
• Examining the outcomes of implementing flexible work schedules on nurse retention.
• Investigating the role of workplace culture in nurse burnout and retention.
• Developing strategies to address emotional exhaustion in psychiatric nursing.
• Evaluating the effects of telecommuting options on home healthcare nurse well-being.

10 Nursing Burnout Research Paper Topics

• The Impact of Nurse Burnout on Patient Safety: A Systematic Review.
• Strategies for Preventing and Managing Nurse Burnout in Critical Care Settings.
• Exploring the Relationship Between Nurse-Patient Ratios and Nurse Burnout.
• Mindfulness Interventions for Nurse Burnout: Efficacy and Implementation.
• The Role of Nurse Managers in Mitigating Burnout and Promoting Well-Being.
• Work-Life Balance and Nurse Retention: A Comparative Study.
• Understanding the Unique Challenges of Nurse Burnout in Pediatric Units.
• Addressing Nurse Burnout Through Innovative Scheduling Approaches.
• The Effectiveness of Physical Activity Programs in Reducing Nurse Burnout.
• Exploring the Impact of Telecommuting on Home Healthcare Nurse Well-Being.

You can also check out Nursing Research Paper Topics About Infection Control

10 Nursing Burnout Research Questions for your Nursing Research Paper

• How does nurse burnout affect patient outcomes in different healthcare settings?
• What are the primary causes of nurse burnout in oncology units?
• How do nurse-patient ratios influence emotional exhaustion among critical care nurses?
• What are the most effective self-care strategies for reducing burnout among psychiatric nurses?
• How does leadership support impact nurse well-being and job satisfaction?
• What is the relationship between nurse burnout and geriatric care setting turnover rates?
• How can flexible scheduling options be implemented to address nurse work-life balance?
• What are the barriers and facilitators to implementing mindfulness interventions for nurses?
• How does mentorship programs impact career satisfaction and burnout among novice nurses?
• How does workplace culture contribute to nurse burnout in different specialties?

10 Nursing Burnout Essay Topic Ideas

• Exploring the Concept of Nurse Burnout: Causes, Effects, and Solutions.
• The Role of Self-Care in Preventing Nurse Burnout: Strategies and Challenges.
• Nurse-Patient Ratios and Nurse Burnout: Finding the Optimal Balance.
• Mindfulness Meditation as a Tool for Nurse Burnout Reduction: Evidence and Applications.
• Nurse Manager’s Role in Supporting Staff Well-Being and Combating Burnout.
• The Impact of Emotional Exhaustion on Nurse Job Performance: A Critical Analysis.
• Flexible Work Schedules: A Double-Edged Sword for Nurse Burnout and Retention.
• Burnout Among Specialized Nurses: A Comparative Study of Pediatric and Geriatric Care.
• The Effects of Physical Exercise on Nurse Burnout and Quality of Patient Care.
• Telecommuting in Nursing: Boon or Bane for Nurse Well-Being and Patient Safety?

Other readers also checked out Pain Management Dilemma Essay Topics Ideas

2 Nursing Burnout Essay Examples

• Role Strain And Burnout In Nursing
• Burnout or Compassion Fatigue: A Comparison of Concept

The Challenges of Nurse Burnout

Nurse burnout is a pressing issue that warrants attention at the individual and organizational levels.

Burnout affects nurses’ well-being and patient outcomes, as exhausted and stressed nurses might struggle to provide optimal care.

Recognizing and addressing nurse burnout is crucial for the sustainability of the healthcare workforce and the quality of patient care.

Strategies for Self-Care: Nurturing Resilience

Nurses can adopt various strategies to combat burnout and promote their well-being. These strategies encompass both individual-level actions and systemic changes within healthcare organizations.

Incorporating regular exercise, mindfulness, and relaxation techniques into their routines can help nurses manage stress.

Additionally, seeking social support from colleagues and engaging in hobbies outside of work can contribute to a healthier work-life balance.

Organizations can impl

As you work on your nursing paper, you can use the topics above to gain inspiration on the different ways of analyzing the prevalent nursing problem.

• “Nursing Burnout: A System’s Approach to Prevention and Resilience” by Suzanne Waddill-Goad
• “Nursing from Within: A Fresh Alternative to Putting Out Fires and Self-Care Workarounds” by Elizabeth Scala
• “The Nurse’s Guide to Self-Care: Navigating the Road to Well-Being” by Dianne Schadewald
• “Transforming Nurses’ Stress and Anger: Steps toward Healing” by Sandra P. Thomas
• “The Truth About Burnout: How Organizations Cause Personal Stress and What to Do About It” by Christina Maslach and Michael P. Leiter

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• Corpus ID: 270794496

Factors influencing the job embeddedness of new graduate nurses: A multicentre cross-sectional study.

• Ziling Song , Xin Yao , +3 authors Xiaoqiong Huang
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Assessing the mediation pathways: how decent work affects turnover intention through job satisfaction and burnout in nursing., prepared to learn but unprepared for work: a cross sectional survey study exploring the preparedness, challenges, and needs of newly graduated nurses entering a hospital-based transition program., the mediating role of psychological empowerment in perceptions of decent work and work immersion among chinese nurses: a cross-sectional study., are “outsiders” in exploring the impact of outsourced workers’ perceived insider status and job value status on job performance, servant leadership behaviour of head nurse assessment and its linkage with nurse work engagement in china., the interaction between job embeddedness and leader-member exchange (lmx) in predicting employee altruism and deviance., analysis of factors influencing the job satisfaction of medical staff in tertiary public hospitals, china: a cross-sectional study, validating the decent work scale incorporated with a social recognition component among young adult social workers, stress and coping experience in nurse residency programs for new graduate nurses: a qualitative meta-synthesis, umbrella review: newly graduated nurses' experiences of providing direct care in hospital settings., related papers.

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Cybersecurity Burnout Costing Firms $700m+ Annually

Phil Muncaster

UK / EMEA News Reporter , Infosecurity Magazine

• Follow @philmuncaster

British and US enterprises may be throwing away as much as $756m each year through lost productivity due to burned-out cybersecurity staff, according to a new study from Hack The Box.

The skills specialist calculated the sum by first working out the average daily wage for cybersecurity professionals, using Infosecurity Institute figures.

It then used its own stats revealing the average number of sick days taken per year per worker (3.4) and average number of days lost to poor productivity (5.1), assuming an eight-hour working day. The figures were then extrapolated out according to the number of cybersecurity professionals in the US and UK, and total number of days lost.

Hack The Box claimed UK employers may be losing a combined $130m annually, while their US counterparts could be down by as much as $626m due to lost productivity.

The research pointed the blame squarely at employee burnout. It claimed 84% of responding cybersecurity professionals are experiencing stress, fatigue and burnout due to the rapid pace of technological change, mounting threat volumes and being forced to perform outside their skillset.

It added that three-quarters (74%) have taken time off due to work-related mental well-being problems.

Read more on burnout: Stress and Burnout Affecting Majority of Cybersecurity Professionals

Interestingly, 90% of CISOs globally said they are concerned about the impact of stress, fatigue and burnout on their security team’s well-being, versus just 47% of CEOs.

“What we’ve discovered shows just how difficult the job is and that there is a significant gap of understanding between the board and the professionals,” said Haris Pylarinos, CEO at Hack The Box .

“We’re calling for business leaders to work more closely with cybersecurity professionals to make mental well-being a priority and actually provide the solutions they need to succeed. It’s not just the right thing to do, it makes business sense.”

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