Work Aspects Related to and Protective of Nurse Burnout During the Pandemic: A Cross-Sectional Study

Abstract

Aim: To determine work conditions and reactions related to nurse burnout while exploring characteristics of favorable work environments among nurses without burnout. Design/Methods: The Coping with Covid survey, administered between April 14, 2020, and March 2021, was fashioned after the Mini Z, with 15 questions related to work conditions (fear/safety, work overload, anxiety/depression from work, feeling valued, and sense of purpose) and healthcare worker (HCW) reactions, including burnout, stress, and intention to leave (ITL) the job. Work conditions and reactions such as burnout were measured on 5-point scales and then dichotomized as present/high or absent/low. Multilevel regressions assessed burnout-related work conditions, adjusting for gender, race, and years in practice. Thematic analysis of comments from nurses without burnout identified protective factors. Results: Of 58,408 HCW respondents at over 200 organizations (median response rate 34%), 11,040 were nurses, with 10,873 at 43 organizations with over 10 nurses. More than half the nurses (56%) reported burnout, 42% intended to leave, and only 40% felt valued. Nurse burnout was significantly related to workload (adjusted odds ratio (aOR) 3.71 (95% CIs 3.26, 4.22), p < 0.001); anxiety/depression symptoms from work (aOR 2.96 (2.59, 3.39), p < 0.001), and fear of exposure to SARS-CoV-2 (aOR 1.38 (1.20, 1.59), p < 0.001). Those feeling valued had less than half the odds of burning out (aOR 0.40 (0.35, 0.46), p < 0.001). These variables explained 42 percent of burnout variance. Nurses without burnout identified additional positive influences, including teamwork, leader support, and timely communication. Conclusions: Nurse burnout may be prevented by addressing workload, mental health symptoms, and relationships with team members and leaders. Feeling valued is a strong mitigator of burnout. These strategies may be useful to nurse leaders in building sustainable workplaces. Implications: Almost half of nurse burnout may be addressed by a brief list of remediable variables.