6. Cross-sectional survey of burnout in emergency and nonemergency nurses

      Purpose: Burnout syndrome is a pervasive and costly problem resulting in reduced productivity and job satisfaction and increased substance abuse, physical illness, and turnover. The purposes of this study were to (a) examine the relationship between burnout precursors (ie, appraisal of control over work, stressor frequency, coping, expectations of control over work, loss of control, commitment to work, and cognitive adaptation) and symptoms of burnout, and (b) determine the extent and cause for any differences among emergency and nonemergency nurses related to burnout.
      Design: A cross-sectional, descriptive design was used.
      Setting: Data were gathered at the 2000 ENA Scientific Assembly, the 2000 University of Colorado Nurse Practitioner Symposium, the Western Chapter of Pennsylvania ENA, and several US hospitals.
      Sample: A convenience sample of 254 registered nurses (RNs) working in emergency departments, 92 RNs working in hospital settings, and 88 nurse practitioners completed a set of questionnaires with a response rate of 25%. Participants ranged in age from 20 to 65 years (mean = 44, SD = 8.5), were 91% female, and 97% Caucasian. Approximately 75% of participants had a BSN or had graduate training, and over 50% had over 20 years experience.
      Methodology: Participants were either approached during conference breaks or on the hospital floor. Following consent, data were collected using 13 anonymous valid and reliable questionnaires that took approximately 30 to 45 minutes to complete and assessed appraisal, stressors, coping, control, commitment, cognitive adaptation, and burnout.
      Results: Data were analyzed using forward linear regression. Most burnout precursors including appraisal, stressor frequency, coping techniques, expectations of control, loss of control, commitment, and cognitive adaptation were significantly related to burnout (all P values ≤ .001). Emergency nurses showed significantly more burnout than all other nurses (all P values < .05). In exploring reasons for this disparity, emergency nurses showed the lowest expectations for control, benign appraisals, and optimism as compared to all other nurses (all P values < .05) and more stressors and threat appraisals than nurse practitioners (all P values < .05). Appraisal, stressor frequency, expectations of control, and optimism all provided partial explanations for emergency nurses' higher levels of burnout.
      Conclusions: Most of the proposed burnout precursors were related to burnout. Compared to other nurses, emergency nurses reported a higher degree of burnout, which was partially explained by the greater presence of precursors. Further studies are needed to examine how these precursors can be altered to provide much needed relief for emergency nurses.