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Your Next Shift: A Nursing Career Podcast

Feb 16, 2018

The State of the Science

While there is a lot of evidence related to physician burnout (e.g. the prevalence, rates, and consequences of), this is not the case in the nursing literature. Not that there are no articles related to nursing burnout. Trust me, there are many. But the issue relates more to the fact that the science does not tell us one story.

In fact, the numbers are all over the place!

Don’t believe me? Head over to PubMed or your favorite scholarly search engine and type in the term “nurse burnout prevalence” and see what you find. In one of my recent keynote talks, here are the studies I have on my prevalence slide:

  • Oncology Nurses 21.5 % (Clinical Journal of Oncology Nursing, 2010)
  • Nurses in England 42% (BMC Nursing, 2011)
  • ICU Nurses in Portugal 31% (BMC Anesthesiology, 2013)
  • NICU Nurses 25.9% (BMJ Quality & Safety, 2014)
  • Nurses in Mainland China 34.9% (Nursing & Health Sciences, 2015)
  • Emergency Nurses 26% (International Journal of Nursing Studies, 2015)
  • Nursing Homes in France 40% (Journal of Clinical Nursing, 2017)

And then there is this recent systematic review on the prevalence of burnout which outlines that burnout does exist in various roles of healthcare professionals. But again, this is just one subset (palliative care). So yes. Nurse burnout statistics are all over the place, however maybe one thing that the literature can agree upon is that it does exist.

Evidence Requires Measurable Outcome Data

The nursing studies that are published related to nurse burnout have limitations such as low sample sizes and weak study designs. If we do not have the literature to support nurse burnout, then we will not get the support from decision makers in power.

Poor studies- do data. Without the outcome measures, there are little interventions that can be put into place. Healthcare decision makers need to see the data. They are all about the numbers. Whether we like it or not, healthcare has become likened to a business. Without money, new interventions that can help alleviate nurse burnout, will not be adopted.

I do think that we can agree that nurse burnout does exist. Again, if you go to your favorite search engine and type in the term, you will receive lots of articles related to the topic of burnout in nursing.

What I also think is that we do not need any more of these smaller, specialty specific studies. The ones where the team uses the Maslach Burnout Inventory to measure burnout in nurses pre- and post- some intervention. We get it. Nurses are burned out. In all jobs, all locations, and all over the world!

Meaningful Research Across Practice Settings

While I cannot start to give advice or suggestions related to specific study design (that is not the point of this blog or the Nursing from Within™ work), I do want to put a charge out there to anyone reading who is involved in world of scholarly work to look at nursing burnout.

We need robust evidence that nurse burnout is linked to patient safety and outcomes. Yes, process measures such as these are harder to measure and difficult to link in a one-to-one causation. For example, it is difficult to say that nurse burnout and burnout alone is what causes patients to fall (as an example), however we need study designs that do their best to look at burnout and the impact it has on patient safety and quality.

Nurse and researcher, Linda Aiken, PhD, FAAN, FRCN, RN, has published extensively on nurse and patient outcomes related to job dissatisfaction and burnout. In fact, in a 2012 article in the American Journal of Infection Control, study findings reported that “In a multivariate model controlling for patient severity and nurse and hospital characteristics, only nurse burnout remained significantly associated with urinary tract infection (0.82; P = .03) and surgical site infection (1.56; P < .01) infection.”

So, it can be done. And needs to be done more often, linking nurse burnout statistics to outcomes that healthcare administrators are interested in. Then, taken a step further.

Burnout is real. It exists and impacts nurses and patients we care about. Once we realize this, then we can start to measure the impact that we can have on nursing burnout. But again, we need to focus on implementation projects that study the barriers and facilitators to why interventions impact and relieve nurse burnout across the spectrum.

Work is to be done, but there is hope. Nurses across the world are doing great things to move the nurse burnout needle. Will you be one of them?

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Check out the blog post that accompanies this episode here: