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While burnout among health care workers has been well studied, little is known about the extent to which burnout among health care workers impacts the outcomes of their care recipients. To test this, we used a multi-year (2014?2020) survey of care aides working in approximately 90 nursing homes (NHs); the survey focused on work-life measures, including the Maslach Burnout Inventory (MBI) and work-unit identifier. Resident Assessment Instrument Minimum Data Set (RAI-MDS 2.0) data were obtained on all residents in the sampled NHs during this time and included a unit identifier for each resident. We used multi-level models to test associations between the MBI emotional exhaustion and cynicism sub-scales reported by care aides and the resident outcomes of antipsychotics without indication, depressive symptoms, and responsive behaviors among residents on units. In 2019/2020, our sample included 3,547 care aides and 10,117 residents in 282 units. The mean frequency of emotional exhaustion and cynicism across units was 43% and 50%, respectively. While residents frequently experienced antipsychotics without indication 1,852 (18.3%), depressive symptoms 2,089 (20.7%), and responsive behaviors 3,891 (38.5%), none were found to be associated with either emotional exhaustion or cynicism among care aides.

BACKGROUND: Burnout among health care professionals contributes to high job turnover. Within the United States, burnout among specialty palliative care (PC) providers will accentuate provider shortage problems. OBJECTIVES: This systematic review was conducted to answer the question "what is known about burnout among specialty PC providers practicing in the United States?" More specifically, it was designed to identify the rate of burnout and factors that influence or mitigate it among PC nurse practitioners (NPs), physician assistants (PA), and physicians and to inform future research. DATA SOURCES: An electronic literature search of studies conducted in the United States between 2012 and September 2022 was completed in Embase, PubMed, CINAHL, and PsycINFO. CONCLUSIONS: Analysis of 14 studies showed that there are five primary themes related to burnout among PC providers: (1) the rate of burnout, (2) the physical, psychological, and clinical manifestations of burnout, (3) predictors of burnout, (4) factors of resiliency, and (5) interventions piloted to decrease burnout. The majority of studies have delineated the physician role but have failed to determine the rate and factors of burnout among PC NPs and PAs. IMPLICATIONS FOR PRACTICE: As NPs and PAs are integral to the PC provider workforce, future research should be designed to understand more clearly how burnout affects these two PC roles to inform efforts to sustain the PC workforce.

Psychiatry residency training includes unique characteristics that can predispose trainees to burnout, including vicarious traumatization, prevalence of patient suicide and violence in the workplace, and social stigma surrounding mental health. For the purposes of this article, the authors examine these contributing factors and address how psychiatry residency training programs, specifically the Kaiser Permanente Oakland program, are responding to these unique challenges with wellness initiatives. Initiatives to promote wellness at Kaiser Permanente Oakland include a resident and faculty–led wellness committee, work-hour limits, reasonable call schedules, a robust mentorship program, funded social and networking events programs, and comprehensive mental health services.

PURPOSE OF REVIEW: To craft an approach to thwart early triggers of symptoms on the burnout continuum for trauma surgeons based on an understanding of drivers of burnout, second victim syndrome, peer-to-peer support, and trauma-informed care. RECENT FINDINGS: Trauma surgeons are particularly vulnerable to risk factors of burnout such as work–life imbalance, higher risk of adverse events, and more exposure to emotionally distressing work events such as witnessing abuse, neglect, and high rates of death among younger patients. Evidence supports the benefit of peer support for the personality style of physicians who often feel unable to show vulnerability as leaders of medical teams. Trauma-informed care allows for optimizing interventions by minimizing triggers from prior distressing events. SUMMARY: An ABCDE (Acknowledge; Bear Witness; Offer Coping Support; Debrief; Enlighten, Engage, and Educate) algorithm for surgeons is an early first step in ameliorating the triggers on the continuum of burnout.

BACKGROUND AND OBJECTIVE: The Pediatric Resident Burnout and Resilience Consortium (PRB-RSC) has described the epidemiology of burnout in pediatric residents since 2016. We hypothesized burnout rates during the pandemic would increase. We explored resident burnout during the COVID-19 pandemic and its relationship to resident perception of workload, training, personal life, and local COVID burden. METHODS: Since 2016, PRB-RSC has sent an annual, confidential survey to over 30 pediatric and medicine-pediatrics residencies. In 2020 and 2021, seven questions were added to explore the relationship of COVID-19 and perceptions of workload, training, and personal life. RESULTS: In 2019, 46 programs participated, 22 in 2020, and 45 in 2021. Response rates in 2020 (n = 1055, 68%) and 2021(n = 1702, 55%) were similar to those of previous years (P = .09). Burnout rates in 2020 were significantly lower than in 2019 (54% vs 66%, P < .001) but returned to pre-COVID levels in 2021 (65%, P = .90). In combined 2020–2021 data, higher rates of burnout were associated with reported increased workload (Adjusted Odds Ratio (AOR) 1.38, 95% CI 1.19–1.6) and concerns regarding the effect of COVID on training (AOR 1.35, 95% CI 1.2–1.53). Program-level county COVID burden in combined 2020–2021 data was not associated with burnout in this model (AOR = 1.03, 95% CI 0.70–1.52). CONCLUSIONS: Burnout rates within reporting programs decreased significantly in 2020 and returned to prepandemic levels in 2021. Increased burnout was associated with perceived increases in workload and concerns regarding effect of the pandemic on training. Given these findings, programs should consider further investigation into workload and training uncertainty on burnout.

CONTEXT: Physicians face a high rate of burnout, especially during the residency training period when trainees often experience a rapid increase in professional responsibilities and expectations. Effective burnout prevention programs for resident physicians are needed to address this significant issue. OBJECTIVE: To examine the content, format, and effectiveness of resident burnout interventions published in the last 10 years. DESIGN: The literature search was conducted on the MEDLINE database with the following keywords: internship, residency, health promotion, wellness, occupational stress, burnout, program evaluation, and program. Only studies published in English between 2010 and 2020 were included. Exclusion criteria were studies on interventions related to the COVID-19 pandemic, studies on duty hour restrictions, and studies without assessment of resident well-being postintervention. RESULTS: Thirty studies were included, with 2 randomized controlled trials, 3 case-control studies, 20 pretest and posttest studies, and 5 case reports. Of the 23 studies that used a validated well-being assessment tool, 10 reported improvements postintervention. These effective burnout interventions were longitudinal and included wellness training (7 of 10), physical activities (4 of 10), healthy dietary habits (2 of 10), social activities (1 of 10), formal mentorship programs (1 of 10), and health checkups (1 of 10). Combinations of burnout interventions, low numbers of program participants with high dropout rates, lack of a control group, and lack of standardized well-being assessment are the limitations identified. CONCLUSIONS: Longitudinal wellness training and other interventions appear effective in reducing resident burnout. However, the validity and generalizability of the results are limited by the study designs.

AIMS AND OBJECTIVE: To identify the prevalence and severity of impostor phenomenon and burnout in newly licensed registered nurses, map the current literature on impostor phenomenon in nursing, and identify related factors affecting the new nurse's transition to practice. BACKGROUND: Impostor phenomenon is an internalised intellectual phoniness resulting in persistent self-doubt despite prior success. It can evoke feelings of emotional exhaustion associated with burnout, negatively affecting employee retention. Due to changes in nursing education resulting from COVID-19, self-doubt and uncertainty among new nurses are expected to be heightened, leading to burnout which adversely effects nurse well-being, patient care and retention. DESIGN: The scoping review follows the methodological framework developed by Arksey and O'Malley (2005) and the Reporting Checklist for Scoping Reviews (PRISMA-ScR) guidelines. METHODS: The literature search was conducted utilising PubMed, CINAHL and PsycINFO. Inclusion criteria were studies published between 2011 and 2021, written in English, peer-reviewed, and focused on newly licensed registered nurses. Eighteen articles were reviewed. RESULTS: Studies on impostor phenomenon in nursing are limited to nursing students and clinical nurse specialists. Prevalence of impostor feelings in these populations range from 36% to 75%, and 12.3% to 46% of new nurses report burnout. Impostor feelings arise from role ambiguity, lack of self-compassion, transitions, and minimal clinical experience. Burnout was associated with stress, feeling unprepared, inadequate socialisation, and lack of self-compassion. Overlap in these factors could increase impostor feelings and burnout in new nurses. CONCLUSIONS: Effects of impostor phenomenon and burnout can negatively impact the well-being of the new nurse. Currently, no studies simultaneously examine impostor phenomenon and burnout in new nurses. Further research on the relationship between these phenomena should be conducted. RELEVANCE TO CLINICAL PRACTICE: Understanding the impact of impostor phenomenon and burnout on new nurses could help mitigate challenges they face transitioning into practice.

OBJECTIVE: Burnout has detrimental consequences for health care organizations, clinicians, and the quality of care that patients receive. Prior work suggests that workplace incivility (negative interpersonal acts) contributes to burnout. While workplace incivility is linked to EMS practitioner job dissatisfaction, absenteeism, and planned attrition, the relationship between workplace incivility and burnout has not been evaluated among EMS practitioners. This study aimed to characterize the prevalence and association of burnout and workplace incivility among EMS practitioners. METHODS: A cross-sectional survey of EMS personnel in King County, Washington was performed in January to March of 2021 with burnout as the primary outcome and workplace incivility as a secondary outcome. Multivariable logistic regression was used to evaluate associations between outcomes and EMS practitioner factors that included age, sex, race/ethnicity, years of EMS experience, and current job role. RESULTS: 835 completed surveys were received (response rate 25%). The prevalence of burnout was 39.2%. Women were more likely to have burnout than men (59.3% vs. 33.7%, aOR 2.2, 95% CI 1.3–3.7). Workplace incivility was experienced weekly by 32.1% of respondents, with women more likely to experience incivility compared to men (41.9% vs. 27.2%, aOR 2.0, 95% CI 1.2–3.3). Respondents who experienced frequent workplace incivility were more likely to have burnout than those who did not experience frequent incivility (61.9% vs. 38.1%, OR 4.0, 95% CI 3.0–5.5). CONCLUSIONS: The prevalence of burnout and workplace incivility were concerning among EMS practitioners, with women more likely to experience both compared to men. EMS practitioners who experienced frequent workplace incivility were also more likely to have burnout than those who did not experience frequent incivility.

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This resource is found in our Actionable Strategies for Public Safety Organizations: Drivers (Relational Breakdown)

The prevalence of burnout is much higher in physicians than in other occupations. Academic physicians serve important functions, training future physicians and advancing medical research in addition to doing clinical work. However, they are particularly vulnerable to burnout for reasons including low compensation for teaching, pressure to publish despite a lack of time and declining research funds, and a redistribution of clinical workload due to restrictions on trainee work hours. Junior faculty, women, and marginalized groups are the most affected. Beyond poor physician health and worse patient outcomes, burnout is strongly associated with reduced work effort and an intent to leave the profession. Moreover, physicians are leaving the workforce in record numbers, further increasing the stress on remaining physicians. Combined with a worsening of quality of patient care, this increased rate of physician burnout threatens the viability of health care organizations. This review discusses the causes and consequences of faculty burnout, as well as interventions undertaken for its mitigation.

Burnout is a feeling of exhaustion that leads to negative effects for those experiencing it. These feelings of exhaustion and depersonalization are common in social workers, and were only exacerbated by the Covid-19 pandemic. Feelings of burnout can lead to health problems for the social worker, and increased odds of a negative outcome for their clients. This study aimed to answer the question: does the average Masters of Social Work (MSW) student experience burnout? Using the Maslach Burnout Inventory for students, 36 respondents were found, on average, to not be suffering from burnout. One limitation of this study may be its small sample size. Implications of these findings are discussed.

[This is an excerpt.] In the last decade, there has been a heightened awareness of burnout in medicine, particularly in medical education. It has garnered further attention during the COVID-19 pandemic, with healthcare workers facing a tremendous amount of pressure to care for patients with an unknown illness, while working long hours in personal protective equipment and putting themselves and their families at risk. Similarly, the pandemic precipitated burnout in medical students as many started and completed their clinical rotations during the height of the pandemic, all while preparing and applying for residency. While the pandemic may have accentuated the issues faced by healthcare workers and medical students and brought public attention to them, the concept of burnout remains unclear and difficult to define despite being referenced on a regular basis. [To read more, click View Resource.]

After reviewing a substantial amount of published data on academic physician burnout, we were left pondering the question, “Are we on the right track with combating burnout?” This point–counterpoint manuscript details two opposing viewpoints: 1) the current approach to fighting burnout is working, and 2) resources should be diverted and focus placed on other areas because current interventions are failing physicians. In addressing these points, we discuss four poignant questions that we discovered researching this multifaceted issue: 1) Why do current burnout interventions have limited effects on prevalence over time? 2) Who benefits from the current health care structure (is burnout a profitable and desirable consequence of our work environment)? 3) What organizational conceptual frameworks are most beneficial to improve burnout? 4) How do we take responsibility and seize the ground for our own well-being? Though these differing viewpoints provoked an engaging and lively conversation among our writing team, we all agree on one point. Burnout is an immense problem that affects physicians, patients, and society; therefore, it demands our attention and resources.

AIM: To reflect on how characteristics inherent in the nursing profession might be related to burnout syndrome among the nursing collective. BACKGROUND: Most people are unaware of the tasks and responsibilities of the nursing profession, as well as the burnout rates suffered by nurses. The nursing profession is a feminized profession, and this feminization may lead to the assignment of gender stereotypes and roles traditionally attributed to women. Much of the care provided by nurses is unrecorded, “invisible” and could be seen as an extension of their role as caregivers. METHODS: This is a discussion paper. The literature on gender stereotypes, unrecorded (invisible) care in nursing and burnout are the argumentative basis of this work. DISCUSSION: Stereotypes and gender roles may explain the lack of recognition of some of the carework carried out by nurses. Care, which is the essence of the profession, continues to be largely invisible and is not valued. This lack of recognition of invisible care, coupled with gender stereotypes, may help to understand burnout syndrome in nursing. Impact for Nursing: Health organizations should take into account the history of the nursing profession and the stereotypes associated with it. It is necessary to recognize and make visible much of the care provided by nurses which are not recorded (invisible care), since this would facilitate the visibilization of the workload and could reduce the possibility of suffering burnout. If we want quality care and staff who enjoy the greatest possible well-being, it will be necessary to take these variables into consideration. One purpose should be: to care for them so that they can provide quality care to others. No Patient or Public Contribution This is a discussion paper.

BACKGROUND: The authors sought to identify the prevalence of burnout in oral medicine (OM) and orofacial pain (OFP) residents and investigate potential contributing factors. METHODS: A cross-sectional questionnaire-based study was conducted. An anonymous 22-item online survey was emailed to the residents of all Commission on Dental Accreditation–accredited OM and OFP residency programs in the United States. Abbreviated Maslach Burnout Inventory was included to gauge the following details of burnout: emotional exhaustion (EE), depersonalization (DP), and personal accomplishment. Questions also addressed the impact of residency program characteristics, work-life balance, and possible discrimination or abuse on burnout. RESULTS: Six OM and 12 OFP programs (72 residents) were contacted, and 46 residents responded (response rate, 64%). Overall prevalence of burnout was 35% (29% in OM residents, 40% in OFP residents). High EE burnout was noted in 57% of residents, high DP burnout in 11% of residents, and high personal accomplishment burnout in 59% of residents. Working for fewer than 40 hours per week was significantly associated with low DP burnout (P < .05). Moderate to high DP burnout was more prevalent in men and unmarried residents (whether in a relationship or not) were more likely to experience moderate to high EE burnout (P < .05). CONCLUSIONS: Burnout among OM and OFP residents is an emerging concern due to its detrimental effect on the physical and mental well-being of the residents. To the authors’ knowledge, this study is the first to report burnout prevalence in the 2 most recent dental specialties recognized by the American Dental Association in 2020. Practical Implications Early detection of signs of burnout among residents would allow program faculty and administrators to provide required support and resources.

This commentary, compiled by the EPA-UNEPSA social pediatrics working group in collaboration with the European Confederation of Primary Care Pediatricians (ECPCP) and the Italian Federation of Primary Care Pediatricians (FIMP), briefly discusses the growing frequency of burnout in primary care and in primary care pediatrics, and debates how to reduce the risk of burnout and mitigate stress caused by this condition.

Burnout is prevalent throughout medicine. Few large-scale studies have examined the impact of physician compensation or clinical support staff on burnout among hematologists and oncologists. In 2019, the American Society of Hematology conducted a practice survey of hematologists and oncologists in the AMA (American Medical Association) Masterfile; burnout was measured using a validated, single-item burnout instrument from the Physician Work-Life Study, while satisfaction was assessed in several domains using a 5-point Likert scale. The overall survey response rate was 25.2% (n = 631). Of 411 respondents with complete responses in the final analysis, 36.7% (n = 151) were from academic practices and 63.3% (n = 260) from community practices; 29.0% (n = 119) were female. Over one-third (36.5%; n = 150) reported burnout, while 12.0% (n = 50) had a high level of burnout. In weighted multivariate logistic regression models incorporating numerous variables, compensation plans based entirely on relative value unit (RVU) generation were significantly associated with high burnout among academic and community physicians, while the combination of RVU + salary compensation showed no significant association. Female gender was associated with high burnout among academic physicians. High advanced practice provider utilization was inversely associated with high burnout among community physicians. Distinct patterns of career dissatisfaction were observed between academic and community physicians. We propose that the implementation of compensation models not based entirely on clinical productivity increased support for women in academic medicine, and expansion of advanced practice provider support in community practices may address burnout among hematologists and oncologists.

This resource is found in our Actionable Strategies for Health Organizations: Aligning Values (Invest/Advocate for Patients, Communities, & Workers) and Improving Workload & Workflows (Optimizing Teams).

Workplace related burnout is rampant in medicine. Prevalence is even higher in surgical specialties, higher during various stages of training, and higher still in women in these specialties. There has been a concerted effort by various deliberative bodies to institute policies to combat this. Efforts at institutional levels as well as community levels are encouraged. Some guidelines about techniques individuals can use have been reviewed recently in literature, i.e., resilience training, actively seeking mentorship, advocating for time for self-care, attention to medical needs etc. However, most of the published literature tackles different singular aspects of burnout. For women surgical trainees, we propose a comprehensive approach to tackling burnout. This paper outlines the various causes and the solutions currently in practice and hopes to act as a guide for women surgeons at various stages of their professional lives.

GOAL: Research has highlighted psychological distress resulting from the COVID-19 pandemic on healthcare workers (HCWs), including the development of posttraumatic stress symptoms (PTSS). However, the degree to which these conditions have endured beyond the pandemic and the extent to which they affect the entire healthcare team, including both clinical and nonclinical workers, remain unknown. This study aims to identify correlates of PTSS in the entire healthcare workforce with the goal of providing evidence to support the development of trauma-informed leadership strategies. METHODS: Data were collected from June to July 2022 using a cross-sectional anonymous survey in a large academic medical center setting. A total of 6,466 clinical and nonclinical employees completed the survey (27.3% response rate). Cases with at least one missing variable were omitted, for a total sample size of 4,806, the evaluation of which enabled us to understand individual, organizational, and work-related and nonwork-related stressors associated with PTSS. Data were analyzed using ordinal logistic regression and dominance analyses to identify predictors of PTSS specific to clinical and nonclinical workers. PRINCIPAL FINDINGS: While previous studies have shown that HCWs in different job roles experience unique stressors, our data indicate that the top correlates of PTSS among both clinical and nonclinical HCWs are the same: burnout, moral distress, and compassion fatigue. These three factors alone explained 45% and 44.4% of the variance in PTSS in clinical and nonclinical workers, respectively. PTSS was also associated with a lower sense of recognition and feeling mistreated by other employees at work in the clinical workforce. Concerningly, women and sexual minorities in the clinical sample exhibited a higher incidence of PTSS. In nonclinical workers, social isolation or loneliness and lower trust and confidence in senior leadership were associated with PTSS. Nonwork-related factors, such as exhaustion from caregiving responsibilities and financial strain, were also significantly associated with PTSS. Even after controlling for discrimination at and outside of work in both samples, we found that non-White populations were more likely to experience PTSS, highlighting a deeply concerning issue in the healthcare workforce. PRACTICAL APPLICATIONS: The primary objective of this article is to help healthcare leaders understand the correlates of PTSS across the entire healthcare team as organizations recover from the COVID-19 pandemic. Understanding which factors are associated with PTSS will help healthcare leaders develop best practices that aim to reduce HCW distress and strategies to circumvent trauma derived from future crises. Our data indicate that leaders must address the correlates of PTSS in the workforce, focusing attention on both those who work on the frontlines and those who work behind the scenes. We urge leaders to adopt a trauma-informed leadership approach to ensure that the entire healthcare workforce is recognized, supported, and cared for as each HCW plays a unique role in the care of patients.

This Viewpoint discusses the consequences of physician burnout and offers insights for its prevention.

PURPOSE: We hypothesize burnout has failed to improve and certain demographics may be disproportionately affected. MATERIALS AND METHODS: The AUA Workforce Workgroup examined work from the annual AUA Census over the past several years. Particular to this study, relevant burnout-related data were examined from the past 5 years. RESULTS: In 2021, 36.7% of urologists reported burnout compared to 36.2% in 2016. Burnout in men decreased from 36.3% to 35.2%, but increased in women from 35.3% to 49.2%. When examined by age, the largest increases in burnout were seen in those <45 years old, increasing from 37.9% to 44.8%, followed by 45-54 years old, increasing from 43.4% to 44.6%. When asked about the effect of COVID-19 on burnout, 54% of urologists didn't feel COVID-19 impacted burnout. Beyond burnout, only 25.0% of men and 4.6% of women reported no conflict between work and personal responsibilities, while 25.7% of men and 44.7% of women resolved these conflicts in favor of work or were unable to resolve them. Of respondents, 22.5% of men and 37.1% of women were "dissatisfied" with work-life balance. Similarly, 33.6% of men reported their work schedule does not leave enough time for personal/family life, compared to 57.5% of women. CONCLUSIONS: Overall, urologists have higher burnout now when compared to 2016. The gender discrepancy has vastly widened with women experiencing burnout at an increased rate of 14% compared to 2016, while burnout in men decreased by 1%. Burnout has increased the most in those <45 years old. Further action is needed to substantiate the causes of burnout.