Critical Care Nurse Burnout in Veterans Health Administration: Relation to Clinician and Patient Outcomes

Abstract

Background Critical care nurses have a burnout rate among the highest of any nursing field. Nurse burnout may impact care quality. Few studies have considered how temporal patterns may influence outcomes. Objective To test a longitudinal model of burnout clusters and associations with patient and clinician outcomes. Methods An observational study analyzed data from annual employee surveys and administrative data on patient outcomes at 111 Veterans Health Administration intensive care units from 2013 through 2017. Site-level burnout rates among critical care nurses were calculated from survey responses about emotional exhaustion and depersonalization. Latent trajectory analysis was applied to identify clusters of facilities with similar burnout patterns over 5 years. Regression analysis was used to analyze patient and employee outcomes by burnout cluster and organizational context measures. Outcomes of interest included patient outcomes (30-day standardized mortality rate and observed minus expected length of stay) for 2016 and 2017 and clinician outcomes (intention to leave and employee satisfaction) from 2013 through 2017. Results Longitudinal analysis revealed 3 burnout clusters among the 111 sites: low (n = 37), medium (n = 68), and high (n = 6) burnout. Compared with sites in the low-burnout cluster, those in the high-burnout cluster had longer patient stays, higher employee turnover intention, and lower employee satisfaction in bivariate models but not in multivariate models. Conclusions In this multiyear, multisite study, critical care nurse burnout was associated with key clinician and patient outcomes. Efforts to address burnout among nurses may improve patient and employee outcomes.

Caring for COVID‐19 infected patients admitted to redesignated coronavirus ICUs: Impact on nurse stress and burnout

“…In a longitudinal cohort study, ICU healthcare professionals demonstrated a change in self‐reported burnout symptoms from 23% before the COVID‐19 pandemic (October–December 2019) to 36.1% (May–June 2020) during the peak of the pandemic 3 . Burnout is not only damaging to clinicians, but studies also suggest burnout negatively impacts the delivery of care, patient outcomes, and nurse satisfaction 5,16–19 . Consequently, it is imperative to understand and prevent occupational burnout in critical care settings to protect both critically ill patients and those entrusted with providing their care.…”

“… 3 Burnout is not only damaging to clinicians, but studies also suggest burnout negatively impacts the delivery of care, patient outcomes, and nurse satisfaction. 5 , 16 , 17 , 18 , 19 Consequently, it is imperative to understand and prevent occupational burnout in critical care settings to protect both critically ill patients and those entrusted with providing their care.…”

Burnout and secondary traumatic stress in medical-surgical nursing

“…However, most nursing burnout studies have been completed in other nursing subspecialty areas, like critical care and the emergency department (ED). [1,3,4] This mixed-methods research aimed to analyze MS nursing perspectives on burnout and STS. The research questions are: (1) What are perceived levels of burnout and STS in medical-surgical nurses?…”

“…Longitudinal bivariate analysis of Veteran Affairs (VA) Critical Care facilities indicates that high-burnout levels correlate to longer patient stays, high employee turnover intention, and lower employee satisfaction. [3] Shah and colleagues completed a cross-sectional data analysis on a sample of over 50,000 nurses in the United States. [7] The nurses who left their job within the model reported burnout at a staggering 31.5%.…”

Navigating the Storm

“… 1 Nurses identified stress and burnout as salient occupational concerns before the pandemic, 2 and the World Health Organization 3 classified burnout as an occupational phenomenon rather than a medical condition in 2019. During a 5-year longitudinal study conducted from 2013 through 2017, Mohr et al 4 identified that most Veterans Administration staff nurses described their burnout as moderate. Reported burnout correlated with increased patient intensive care unit (ICU) length of stay and lower reported employee morale.…”