Workplace Stressors Associated With Burnout Among Emergency Nurses and Other Emergency Healthcare Professionals: A Convergent Parallel Approach With a Multilevel Design.

BACKGROUND

Burnout assessments yield results of up to 65% for all emergency healthcare professionals and 53% for emergency nurses. We conducted a mixed methods study using a convergent parallel approach and a multilevel design with emergency nurses and other healthcare professionals to identify workplace stressors associated with burnout and prioritize those stressors for improvement.

MATERIALS AND

METHODS

Emergency healthcare professionals were recruited from the emergency department of a large acute care hospital. Participants completed the abbreviated Maslach Burnout Inventory and a workplace stressor survey to contribute an overview of the current state of burnout and stress, participated in focus groups to provide context for identified stressors, and consented to contextual inquiries to nuanced in situ observation of stressors. From the survey, focus group, and contextual inquiry data, we employed a thematic analysis to develop an affinity model. Emergency healthcare professionals validated the stressors in the affinity model, prioritized potential improvement efforts, and rated the impact of and effort required for those improvements.

RESULTS

The participant sample was diverse in age, race, sex, shift time, and length of employment. Eighty-one percent of the 63 survey participants met the criteria for burnout. Six focus groups with 19 participants and 22 contextual inquiries identified key work stressors related to staffing levels, workflow, communication, and care coordination. Using the affinity model, participants prioritized workflows, patient safety, patient-related stressors, physical work environment, staffing, extrinsic motivation, technology, communication, and psychiatric patient procedures as areas for improvement.

CONCLUSION

We successfully completed surveys, focus groups, and contextual inquiries with emergency nurses and other healthcare professionals to identify workplace stressors and prioritize those stressors for improvement efforts. This appears to be a viable method to formally identify and prioritize the unique stressors contributing to burnout and guide efforts to reduce burnout among emergency healthcare professionals.