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Prevalence of and Factors Associated With Nurse Burnout in the US
No full textIMPORTANCE Clinician burnout is a major risk to the health of the US. Nurses make up most of the health care workforce, and estimating nursing burnout and associated factors is vital for addressing the causes of burnout.
OBJECTIVE To measure rates of nurse burnout and examine factors associated with leaving or considering leaving employment owing to burnout. DESIGN,
SETTING, AND PARTICIPANTS This secondary analysis used cross-sectional survey data collected from April 30 to October 12, 2018, in the National Sample Survey of Registered Nurses in the US. All nurses who responded were included (N = 50 273). Data were analyzed from June 5 to October 1, 2020.
EXPOSURES Age, sex, race and ethnicity categorized by self-reported survey question, household income, and geographic region. Data were stratified by workplace setting, hours worked, and dominant function (direct patient care, other function, no dominant function) at work.
MAIN OUTCOMES AND MEASURES The primary outcomes were the likelihood of leaving employment in the last year owing to burnout or considering leaving employment owing to burnout.
RESULTS The weighted sample of 50 273 respondents (representing 3 957 661 nurses nationally) was predominantly female (90.4%) and White (80.7%); the mean (SD) age was 48.7 (0.04) years. Among nurses who reported leaving their job in 2017 (n = 418 769), 31.5%reported burnout as a reason, with lower proportions of nurses reporting burnout in theWest (16.6%) and higher proportions in the Southeast (30.0%). Compared with working less than 20 h/wk, nurses who worked more than 40 h/wk had a higher likelihood identifying burnout as a reason they left their job (odds ratio, 3.28; 95%CI, 1.61-6.67). Respondents who reported leaving or considering leaving their job owing to burnout reported a stressful work environment (68.6%and 59.5%, respectively) and inadequate staffing (63.0%and 60.9%, respectively).
CONCLUSIONS AND RELEVANCE These findings suggest that burnout is a significant problem among US nurses who leave their job or consider leaving their job. Health systems should focus on implementing known strategies to alleviate burnout, including adequate nurse staffing and limiting the number of hours worked per shift
Personal and Work-Related Factors Associated With Nurse Resilience: An Updated Systematic Review Using Meta-Analysis and Narrative Synthesis
No full textBackground: Nursing shortages and increased workforce turnover have significantly increased nurses’ workloads, thus increasing the risk of burnout and stress, particularly during the COVID-19 pandemic. A systematic review published in 2019 suggested that resilience could act as a buffer to adversity; however, the factors associated with resilience during and after this global pandemic have not been identified.
Objectives: To identify personal and work-related factors associated with nurse resilience, including the period during and after the COVID-19 pandemic.
Design: Systematic review.
Data Sources: The search was conducted between January and February 2024 in the following databases: CINAHL Plus, MEDLINE (Ovid), PsycINFO, EMBASE, and Scopus, using the key terms ‘resilience’, ‘hardiness’, ‘work’, ‘employ’, ‘occupation’, ‘job’, and ‘nursing’.
Review Methods: Quantitative studies with English full text, published between 2018 and 2024, were selected if they assessed resilience and its associated factors among nurses providing direct patient care. Two authors independently completed the data selection process. Studies with quality assessment grades of 3 or above were included for final analysis. A meta-analysis was utilised for the mean resilience levels from studies using the same measures of resilience, and a narrative synthesis was performed for the demographic and work-related factors. Results: Fifty-nine cross-sectional studies with a quality assessment score of 3 or above were included. Forty- seven studies were included in a meta-analysis, which reported an estimated mean resilience level of 20.69 using a random-effects model (95 % CI [18.53, 22.85], z = 18.79, p \u3c 0.0001, I 2 =95.1 %). Twenty studies with the Connor Davidson Resilience Scale (CD-RISC)-25 and five with the CD-RISC-10 were meta-analysed for the mean resilience levels of 62.85 (95 % CI: [55.60, 70.10], z = 16.97, p \u3c 0.0001, I 2 CI: [20.85, 31.83], p \u3c 0.0001, I 2 =31.70 %) and 26.34 (95 % = 0 %), respectively. A low mean resilience level was identified. Sixteen demographic factors were identified as associated with resilience. Twenty job demand factors negatively associated with resilience were determined and categorised into exhaustion, psychological factors, and work challenges. Thirty-two job resource factors positively related to resilience were identified and classified into the following categories: psychological factors, leadership, work performance, well-being and quality of life, and social and organisational support.
Conclusions: Understanding the job demand and resource factors can help organisations minimise the risks and develop institutional strategies to protect nurses from the negative impact of COVID-19 or future pandemics on nurses’ well-being
The Relevance of Climate Change and Sustainability in Nursing Education: A Cross-Sectional Study of Students’ Perspectives
No full textBackground: As climate change continues to challenge global health, nursing education must evolve to prepare future nurses for the impacts on care delivery and promote sustainable practices within the healthcare system which is itself a contributor to the climate crisis through emissions and waste. In this study we aimed to i) explore undergraduate nursing students’ attitudes towards and awareness of climate change and sustainability issues and its inclusion in nursing education at a Swedish university, and ii) explore differences in awareness and attitudes across student groups in different semesters.
Methods: In this cross-sectional descriptive research study, nursing students from six groups (semester 1,2,3,4,5,6) of a three-year BSc Nursing programme were asked to complete the Sustainability Attitudes in Nursing Survey (SANS_2) questionnaire. Descriptive statistics were used to present mean scores for each item, and the Kruskal-Wallis test was used to identify differences in responses between different student groups. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement has been used to report this research.
Results: A total of 211 (32%) students completed the questionnaires. The findings showed that nursing students across the six semesters had relatively good awareness of, and positive attitudes towards, sustainability and climate change (no mean rating below 4 on a scale 1–7). Statistically significant differences between student groups were found in four out of nine items of the SANS_2 questionnaire, with students in their second semester consistently providing the highest ratings (p \u3c 0.05). Notably, the lowest ratings across these four items were provided by students in their last year of the programme.
Conclusions: This study found that whilst students initially felt equipped to address sustainability issues and climate change in practice, this confidence appears to diminish by the programme’s end, raising concerns about the preparedness of the future workforce. This underscores the urgency and importance of continuous reinforcement of sustainability concepts in nursing education, aligning with a spiral curriculum approach which advocates for reiterating themes throughout the curriculum to deepen understanding
Mediating Role of Lifestyle Factors in the Resilience–Job Satisfaction Relationship among nurses: A descriptive correlational study
No full textGiven the global nursing shortage and the increasing prevalence of workplace stressors, resilience has emerged as a crucial factor influencing job satisfaction, preventing burnout, and ensuring high-quality patient care. While previous research has established a connection between resilience and various occupational outcomes, the mediating effect of health-promoting behaviors—such as physical activity, diet, and sleep—remains largely unexplored, underscoring the need for further investigation in this area. Therefore, the objective of this study is to examine the effect of chosen lifestyle aspects on the connection between resilience and job satisfaction among nurses
Investigating the Knowledge, Attitudes and Practices Towards Type 2 Diabetes Mellitus in a Student Population in the United Kingdom: A Quantitative Study
No full textAim: To explore the knowledge on the risk factors, signs and symptoms, management, and complications of Diabetes, attitudes, and practices towards prevention of Diabetes Mellitus among university students in the United Kingdom.
Methods: The researcher utilised a quantitative study design in carrying out the study. The study was conducted at Cardiff Metropolitan University with Cardiff Met students being the target population. Thirty (30) participants were recruited through convenient sampling. Data was collected through questionnaires using closed ended questions. The Statistical Package for Social Science (SPSS) version 27 as used to analyse the data collected. Statics were performed to form a basis for discussion and represented in tables and figures for easy interpretation.
Results: The findings of the study indicated that majority of the study participant have knowledge on the Diabetes Mellitus. The knowledge scores of participants on risk factors, signs and symptoms, control and complications of Diabetes Mellitus were 73%, 94%, 68%, 85% and 58% respectively. Moreover, the results indicated that majority of the responses from study participants (69.1%) were positive attitudes towards Diabetes Mellitus. The results from the data depict 70% do not check their blood sugar regularly, 86.7% do sometimes or always exercise daily, only 36.7% do not take less junk foods and only 30% always take less refined sugars.
Conclusions: It was concluded that most study participants had knowledge on the risk factors, signs and symptoms, management, and complications of Diabetes Mellitus. Moreover, the study participants had an average level of attitude and practices towards diabetes prevention. It was recommended that other researchers should conduct similar studies using different study designs, bigger sample size and sampling technique. Few limitations noted were the smaller sample used and the use of convenient sampling which may affect generalisation
Nursing Leadership Strategies in a New Paradigm for Nursing\u27s Economic Value
No full textNursing leaders increasingly recognize that, in today\u27s complex healthcare environment, nurses are a crucial revenue-generating human capital asset, not just a costly labor input. In this article, the authors discuss nursing leadership strategies to amplify nursing\u27s economic value to healthcare organizations
AI-Assisted Tailored Intervention for Nurse Burnout: A Three-Group Randomized Controlled Trial
No full textBackground: High-stress environments, heavy workloads, and the emotional demands of patient care, which are common challenges faced by nurses, are factors that can lead to burnout. Shift work can make traditional burnout interventions costly and difficult to implement. Artificial intelligence (AI) could offer solutions that are less constrained by time, resources, and labor. Aim: To investigate the effectiveness of an AI-assisted intervention in reducing nurse burnout. Methods: A single-blind, three-group, randomized controlled trial of 120 nurses (40 per group) was conducted from June 2023 to July 2023. The AI-assisted tailored intervention included two 2-week programs, delivering one of four programs to the intervention group: mindfulness meditation, acceptance commitment therapy, storytelling and reflective writing, or laughter therapy. The experimental group received tailored programs based on demographic and work-related characteristics, job stress, stress response, coping strategy, and burnout dimensions (client-related, personal, and work-related). Control Group 1 self-selected their programs, while Control Group 2 was provided with online information on burnout reduction. Primary outcomes, client-related, personal, and work-related burnout, were measured at baseline, week 2, and week 4. Secondary outcomes, job stress, stress responses, and coping strategies, were assessed at baseline and week 4. Data were analyzed using ANOVA, repeated measures ANOVA, and the Scheffé test for post hoc analysis. Results: The experimental group showed significant reductions in client-related burnout (F = 7.725, p = 0.001) and personal burnout (F = 10.967, p \u3c 0.0001) compared to the other groups. Significant effects of time and time × group interactions were observed for client-related and personal burnout, with time effects noted for work-related burnout. Stress response reduction was highest in Control Group 1, followed by the experimental group and Control Group 2 (F = 3.07, p = 0.017)
Advanced Practice Registered Nurse Burnout in Magnet Hospitals: Opportunities for Organizational Intervention
No full textOBJECTIVE: To determine modifiable organizational factors associated with advanced practice RN (APRN) burnout in Magnet®-designated hospitals to guide organizational interventions to improve APRN well-being and retention.
METHODS: Cross-sectional study of work environments of 50 US Magnet hospitals and the associated well-being of 21 855 of their clinicians (APRNs, physician assistants, physicians [MDs], RNs).
RESULTS: Overall, 37%of APRNs experienced high burnout compared with 34% of MDs (P \u3c 0.05) and 49% of RNs (P \u3c 0.001); additionally, 32%of APRNs intended to leave their jobs. APRN burnout was significantly lower in organizations that minimized chaotic working conditions, provided APRNs more control over their workloads, involved APRNs in shared governance, improved clinician and management relations, and improved interprofessional teamwork.
CONCLUSIONS:Well-being and retention of APRNs in Magnet hospitals require their greater engagement in organization processes and systems that improve work environments
Sustainability in Undergraduate Nursing Clinical Simulation: A Mixed Methods Study Exploring Attitudes, Knowledge and Practices
No full textClimate change is among the greatest of threats to human health. Paradoxically the health system is a contributor to planetary degradation through emissions and waste. Climate change and sustainability are important issues for the nursing profession. We explored the impact of an education module with embedded sustainability principles in the context of clinical simulation. This mixed methods study used pre- and post-intervention waste audits and student surveys to explore attitudes, knowledge and practices relating to climate change and sustainability. The intervention, a digital clinical simulation education module, included three themes: 1) professional conduct, 2) work health and safety, 3) resource stewardship and sustainability. Quantitative data were analysed through descriptive statistics and comparison of pre- and post-intervention means and proportions. Qualitative data were analysed thematically to identify facilitators and barriers. We examined two weeks of simulation for the same cohort of 170 students preparing for clinical practice assessment. We found no significant difference in waste per student following the intervention. Most items targeted for re-use were actively diverted to the recycling station with proportional increases following the intervention. A total of 44 (30.3 %) and 80 (53.3 %) students completed the surveys and most agreed that climate change and sustainability are important issues for nurses. Students\u27 perceived application of sustainability during clinical simulation increased following the intervention (mean 4.8 to 5.4, p ≤0.01). Perceived application of sustainability in clinical practice, and of the principles \u27reduce\u27 and \u27re-use\u27 also increased. Barriers to sustainable practice included cognitive overload, knowledge deficit, time pressure, and desire for authentic practice. Clinical simulation generates substantial volumes of waste. Student nurses are motivated and capable of applying sustainability principles during simulation, however, often experience barriers. Embedding sustainability principles in simulation curriculum demonstrated positive impacts and ongoing efforts are needed to address barriers and increase opportunities for sustainable practice
Costs and Cost-Effectiveness of Improved Nurse Staffing Levels and Skill Mix in Acute Hospitals: A Systematic Review
No full textIncreasing registered nurse staffing and skill mix can be a net cost-saving solution to nurse shortages. Contrary to the strong policy push towards a dilution of nursing skill mix, investment in supply of RNs should become the priority