[This is an excerpt.] In August 2021, at the height of the COVID Delta variant, a male patient in his early 50s visited the family medicine practice of Jacqui O'Kane, DO, at South Georgia Medical Center. "He complained of upper respiratory symptoms," said O'Kane. "Specifically, he had a dry cough, fever, headache, and malaise." She was concerned that he might have COVID or influenza. [To read more, click View Resource.]
Patients Who Harass Physicians: 5 Behaviors to Watch For
BACKGROUND: Health care executives and policymakers have raised concerns about the adequacy of the US nursing workforce to meet service demands. Workforce concerns have risen given the SARS-CoV-2 pandemic and chronically poor working conditions. There are few recent studies that directly survey nurses on their work plans to inform possible remedies. METHODS: In March 2022, 9150 nurses with a Michigan license completed a survey on their plans to leave their current nursing position, reduce their hours, or pursue travel nursing. Another 1224 nurses who left their nursing position within the past 2 years also reported their reasons for departure. Logistic regression models with backward selection procedures estimated the effects of age, workplace concerns, and workplace factors on the intent to leave, hour reduction, pursuit of travel nursing (all within the next year), or departure from practice within the past 2 years. RESULTS: Among practicing nurses surveyed, 39% intended to leave their position in the next year, 28% planned to reduce their clinical hours, and 18% planned to pursue travel nursing. Top-ranked workplace concerns among nurses were adequate staffing, patient safety, and staff safety. The majority of practicing nurses (84%) met the threshold for emotional exhaustion. Consistent factors associated with adverse job outcomes include inadequate staffing and resource adequacy, exhaustion, unfavorable practice environments, and workplace violence events. Frequent use of mandatory overtime was associated with a higher likelihood of departure from the practice in the past 2 years (Odds Ratio 1.72, 95% CI 1.40–2.11). CONCLUSIONS: The factors associated with adverse job outcomes among nurses—intent to leave, reduced clinical hours, travel nursing, or recent departure—consistently align with issues that predated the pandemic. Few nurses cite COVID as the primary cause for their planned or actual departure. To maintain an adequate nursing workforce in the United States, health systems should enact urgent efforts to reduce overtime use, strengthen work environments, implement anti-violence protocols, and ensure adequate staffing to meet patient care needs.
Patterns and Correlates of Nurse Departures From the Health Care Workforce: Results From a Statewide Survey
INTRODUCTION: Burnout is a major risk in healthcare professions and is a significant contributor to the current nursing shortage. Strategies to combat burnout of healthcare professionals are in desperate need. The purpose of this project is to introduce the clinical peer supervision model as a method to alleviate burnout in nursing professionals. APPROACH: Eight nurses from in-patient settings participated in a peer-supervision support group, modeled after existing European nursing and mental health provider-support protocols. To assess the effect of this intervention, qualitative data analysis was conducted on the transcripts of session and the results described. All participants reported statistically high levels of dissatisfaction at work (M= 30.75, SD = 7.57, p < 0.001) prior to the group study implementation. The transcripts of the subsequent group sessions were coded using a multi-phase coding scheme, generating themes related to Maslach’s burnout typology. The first-round coding resulted in 93 initial codes, which were further organized into 17 thematic categories, which were synthesized into five broad themes. Three of these themes deductively corresponded to Maslach’s theoretical concepts (emotional exhaustion, depersonalization, and personal accomplishment), the remaining two themes were summarized as ‘administrative stressors’ and ‘professional survival tactics’. Administrative decision making, depersonalization, and emotional exhaustion were noted as predominant causes for work-related stress and burnout. However, the participants valued the peer support group and were eager to continue meeting for peer-supervision. DISCUSSION: The peer support of the group showed promise in the relief of stress related to their helping profession. The clinical peer supervision model is frequently utilized in the United Kingdom and Europe, but rarely utilized in the United States. Based on these results, the authors recommend consideration for trial implementation of similar protocols by American nursing professionals as a mitigation to burnout.
Peer-Supervision of Nursing Professionals: A Shield Against Burnout
Nurses comprise the largest workforce in health care but lack power despite their numbers. Nurses have suffered short-staffing, burnout, job dissatisfaction, unsafe work settings, and cumbersome technology for decades. The dialysis nurse manager is an important component of the dialysis unit and plays a role in the retention and recruitment of nurses. Using a case study approach this qualitative, thematic analysis described dialysis nurse managers’ perception of power in dialysis units. A review of the current research revealed a gap involving dialysis nurse managers’ perception of power in the dialysis unit. The following research question was developed: • How do nurse managers perceive power in the dialysis unit? • Subquestions were developed using Kanter’s theory of structural empowerment, with specific attention to lines of support and productive power (Kanter, 1979). Kanter’s theory of structural empowerment (1979) guided this study as the role of the dialysis nurse manager as a liaison between the organization administrators and the nursing staff. The purpose of this study was to explore nurse managers’ perception of power or powerlessness in a managerial role in a dialysis setting. A qualitative case-study approach using thematic analysis was utilized and Zoom® interviews were conducted with select dialysis nurse managers in Forrest and Lamar County in Southern Mississippi which described the perception of power in the dialysis unit. Purposive sampling of dialysis nurse managers known to the researcher was used to recruit participants. Data analysis was conducted using Braun and Clarke’s (2012) thematic analysis to code and identify themes of the interview data. The study findings were perception of power (have or do not have), shared power (staff education, power over assignment, listen and learn), value (employee of the year, reward, bonus, verbal), and support (did the right thing, did my job). Overlapping themes developed from the data, which resulted in the following labeling of themes: Value, Shared Power, Support, Empowering Characteristics, and Perception of Power.
Perceived Power by Nurse Managers in Dialysis Units: A Qualitative Case Study
Burnout is well-documented among physicians and nurses before and during the COVID-19 pandemic. Little is known about how burnout affects physician associates (PAs). Due to the nature of our training, PAs can morph and adapt to different disciplines of medicine, as well as the ever-changing needs of the healthcare system. This narrative review discusses the background of burnout, the causes of burnout in PAs, and what can be done to combat and prevent future burnout.
Physician Associate Burnout
[This is an excerpt.] Academic medicine has been a refuge for professionals seeking fulfillment in research and teaching. However, physician commitment and institutional retention are increasingly being challenged by what some authors term burnout. All too often, moral injury is being identified as burnout, a confusion that is consequential and dangerous. To appreciate this, one needs a good grasp of what burnout and moral injury are and their consequences. It is precisely the grave consequences of moral injury that make its downgrading dangerous. [To read more, click View Resource.]
Physician Burnout Versus Moral Injury and the Importance of Distinguishing Them
Physician burnout has become a prevalent issue in intensive care units, and studies have shown it has become worse with the COVID-19 pandemic. Recognizing and reducing ICU physician burnout is important because of the potential effects on patient care, physician health, and the hospital. The most common symptoms of burnout include fatigue, callousness towards patients, inability to feel happy, anxiety, and depression. Causes of burnout can include work related factors, personal characteristics, and organizational factors. COVID has brought unprecedented work flow, increased number of critical and ethical decision making, and increase in death, all of which can lead to burnout. Strategies to combat burnout generally come in two different ways—organization based and individual based. This paper examines these current strategies and their efficacy in reducing burnout and proposes an implementation plan for the ICU to use based on current literature.
Physician Burnout in the ICU: The Importance and the Solution
[This is an excerpt.] The inpatient environment is much different now compared to the time when the term “hospitalist” was coined. In 1995, amidst a rapidly changing and complex inpatient medical environment, the field of hospital medicine was formally launched and gained traction.1 Gains made by hospitalists in the areas of patient care, patient throughput, and patient experience have been acknowledged and embraced by patients, outpatient providers, and other stakeholders within the broad healthcare system. Health management organizations (HMOs) have leveraged these potential benefits by operating their own hospitalist programs, although physician organizations and healthcare systems/hospitals are responsible for operating most groups. [To read more, click View Resource.]
Physician Wellness in the Changing World of Hospital Medicine
Disruptions in the hospital clinical workforce threaten quality and safety of care and retention of health professionals. It is important to understand which interventions would be well received by clinicians to address the factors associated with turnover. To determine well-being and turnover rates of physicians and nurses in hospital practice, and to identify actionable factors associated with adverse clinician outcomes, patient safety, and clinicians' preferences for interventions. This was a cross-sectional multicenter survey study conducted in 2021 with 21?050 physicians and nurses at 60 nationally distributed US Magnet hospitals. Respondents described their mental health and well-being, associations between modifiable work environment factors and physician and nurse burnout, mental health, hospital staff turnover, and patient safety. Data were analyzed from February 21, 2022, to March 28, 2023. Clinician outcomes (burnout, job dissatisfaction, intent to leave, turnover), well-being (depression, anxiety, work-life balance, health), patient safety, resources and work environment adequacy, and clinicians' preferences for interventions to improve their well-being. The study sample comprised responses from 15?738 nurses (mean [SD] age, 38.4 [11.7] years; 10?887 (69%) women; 8404 [53%] White individuals) practicing in 60 hospitals, and 5312 physicians (mean [SD] age, 44.7 [12.0] years; 2362 [45%] men; 2768 [52%] White individuals) practicing in 53 of the same hospitals, with an average of 100 physicians and 262 nurses per hospital and an overall clinician response rate of 26%. High burnout was common among hospital physicians (32%) and nurses (47%). Nurse burnout was associated with higher turnover of both nurses and physicians. Many physicians (12%) and nurses (26%) rated their hospitals unfavorably on patient safety, reported having too few nurses (28% and 54%, respectively), reported having a poor work environment (20% and 34%, respectively), and lacked confidence in management (42% and 46%, respectively). Fewer than 10% of clinicians described their workplace as joyful. Both physicians and nurses rated management interventions to improve care delivery as more important to their mental health and well-being than interventions directed at improving clinicians' mental health. Improving nurse staffing was ranked highest among interventions (87% of nurses and 45% of physicians). This cross-sectional survey study of physicians and nurses practicing in US Magnet hospitals found that hospitals characterized as having too few nurses and unfavorable work environments had higher rates of clinician burnout, turnover, and unfavorable patient safety ratings. Clinicians wanted action by management to address insufficient nurse staffing, insufficient clinician control over workload, and poor work environments; they were less interested in wellness programs and resilience training.
This resource is found in our Actionable Strategies for Health Organizations: Empowering Worker & Learner Voice (Worker & Learner Engagement).
Physician and Nurse Well-Being and Preferred Interventions to Address Burnout in Hospital Practice: Factors Associated with Turnover, Outcomes, and Patient Safety
This Medical News article discusses US initiatives to improve health care worker well-being as burnout and intent to leave to medicine reach record levels.
Physicians Are More Burned Out Than Ever—Here’s What Can Be Done About It
PURPOSE: Clinical pharmacists are recognized as valuable team members in primary care clinics due to the variety of patient care services they provide. This study examined nonpharmacist healthcare providers’ perceptions of how embedded clinical pharmacists impact the work environment in ambulatory care clinics. SUMMARY: This was an exploratory mixed methods study consisting of semistructured interviews and a subsequent survey. Participants included attending and resident physicians, and advanced practice providers (APPs) practicing in clinics with an embedded clinical pharmacist. Coded interview transcripts were analyzed to identify themes that were used to develop a survey. Interview participants were not asked to complete the survey. Survey responses were analyzed utilizing descriptive statistics. Subgroup analysis assessed for differences in responses based on provider type, gender, clinical practice area, years of practice, and pharmacy services utilization. Fourteen physicians and APPs participated in the semistructured interviews, and 43 other providers completed the survey. In the interviews, participants stated the clinical pharmacist contributed positively in terms of work environment, workload, work-related stress, and burnout. The major themes identified were sharing patient care responsibilities, saving provider time, and being a knowledgeable resource. Survey responses were consistent with interview statements; however, the positive impact differed between nonusers and moderate to high utilizers of clinical pharmacy services. The main barrier to collaborating with clinical pharmacists was their limited availability. CONCLUSION: Embedded clinical pharmacists positively impact the work environment in ambulatory care clinics by reducing provider workload, work-related stress, and burnout. Participants also noted clinical pharmacists are a trusted resource for patient care and drug information questions.
Physicians’ and Advanced Practice Providers’ Perceptions of the Impact of Embedded Clinical Pharmacists on the Work Environment in Ambulatory Care Clinics
The burnout rate among physicians is expected to be higher during COVID-19 period due to the additional sources of physical and emotional stressors. Throughout the current COVID-19 pandemic, numerous studies have evaluated the impacts of COVID-19 on physicians’ burnout, but the reported results have been inconsistent. This current systematic review and meta-analysis aims to assess and estimate the epidemiology of burnout and the associated risk factors during the COVID-19 pandemic among physicians. A systematic search for studies targeting physicians’ burnout was conducted using PubMed, Scopus, ProQuest, Cochrane COVID-19 registry, and pre-print services (PsyArXiv and medRχiv) for English language studies published within the time period of 1 January 2020 to 1 September 2021. Search strategies resulted in 446 possible eligible studies. The titles and abstracts of these studies were screened, which resulted in 34 probable studies for inclusion, while 412 studies were excluded based on the predetermined inclusion criteria. These 34 studies went through a full-text screening for eligibility, which resulted in 30 studies being included in the final reviews and subsequent analyses. Among them, the prevalence of physicians’ burnout rate ranged from 6.0–99.8%. This wide variation could be due to the heterogeneity among burnout definitions, different applied assessment tools, and even cultural factors. Further studies may consider other factors when assessing burnout (e.g., the presence of a psychiatric disorders, other work-related and cultural factors). In conclusion, a consistent diagnostic indices for the assessment of burnout is required to enable consistent methods of scoring and interpretation.
Physician’s Burnout During the COVID-19 Pandemic: A Systematic Review and Meta-Analysis
OBJECTIVE: The current research was performed to assess professional quality of life; identify factors associated with secondary traumatic stress, burnout, and compassion satisfaction; and evaluate the effectiveness of a peer support pilot intervention among air medical crewmembers. METHODS: Quantitative research methods were used to assess secondary traumatic stress, compassion satisfaction, and burnout among flight nurses and paramedics. Demographic variables and secondary traumatic stress, burnout, and compassion satisfaction scores using the Professional Quality of Life Scale were assessed. A comparison of survey scores obtained before and 16 months after the implementation of a piloted peer support program was performed. RESULTS: Crewmembers with less experience within an air medical program and those without a support system are at the highest risk of developing secondary traumatic stress, burnout, and impaired compassion satisfaction. Observed scores for secondary traumatic stress, burnout, and compassion satisfaction suggest that peer support may be an effective intervention among air medical crewmembers. No statistically significant differences in secondary traumatic stress, burnout, or compassion satisfaction were observed by clinical role, marital status, or years in their profession. CONCLUSION: Peer support after emotionally challenging or stressful transports may combat secondary traumatic stress, compassion fatigue, and burnout. This intervention would be most beneficial for crewmembers who are newer to the transport organization and lack social or familial support.
Piloting Peer Support to Decrease Secondary Traumatic Stress, Compassion Fatigue, and Burnout Among Air Medical Crewmembers
OBJECTIVE: To evaluate the association of politicization of medical care with burnout, professional fulfillment, and professionally conflicting emotions (eg, less empathy, compassion; more anger, frustration, resentment). PARTICIPANTS AND METHODS: Physicians in select specialties were surveyed between December 2021 and January 2022 using methods similar to our prior studies, with additional assessment of politicization of medical care; moral distress; and having had to compromise professional integrity, workload, and professionally conflicting emotions. RESULTS: In a sample of 2780 physicians in emergency medicine, critical care, noncritical care hospital medicine, and ambulatory care, stress related to politicization of medical care was reported by 91.8% of physicians. On multivariable analysis, compromised integrity (odds ratio [OR], 3.64; 95% CI, 2.31 to 5.98), moral distress (OR, 2.82; 95% CI, 2.16 to 3.68), and feeling more exhausted taking care of patients with coronavirus disease 2019 (COVID-19) (OR, 3.46; 95% CI, 2.63 to 4.54) were associated with burnout. Compromised integrity, moral distress, and feeling more exhausted taking care of patients with COVID-19 were also statistically significantly associated with lower odds of professional fulfillment and professionally conflicting emotions. Stress related to conversations about non-approved COVID-19 therapies (OR, 1.74; 95% CI, 1.08 to 2.89), patient resistance to mask wearing (OR, 1.84; 95% CI, 1.35 to 2.55), and working more hours due to COVID (OR, 0.66; 95% CI, 0.49 to 0.89) were associated with professionally conflicting emotions. CONCLUSION: Most physicians experienced intrusion of politics into medical care during the pandemic. These experiences are associated with professionally conflicting emotions, including less compassion and empathy, greater frustration, and resentment. COVID-19–related moral distress and compromised integrity were also associated with less professional fulfillment and greater occupational burnout.
Politicization of Medical Care, Burnout, and Professionally Conflicting Emotions Among Physicians During COVID-19
This systematic literature review (SLR) synthesized existing research regarding positive engagement techniques used by peer support mentors to build resilience, including an examination of how a positive police culture may impact the engagement levels in peer support programs. Peer support mentors in law enforcement provide much-needed support for police officers. Witnessing traumatic events and receiving ongoing job scrutiny can negatively impact police officers. In addition, officers may not be comfortable talking about struggles with people outside the profession. The findings of this applied doctoral project brought insight into the positive engagement techniques used by peer support mentors to build resilience and how a positive police culture affected the engagement levels in peer support programs. The analysis of the scholarly research literature revealed four themes: value and worth, trustworthiness, dependability, and support. The findings indicated the need for peer support mentors who demonstrate positive relationship skills and for administrations to support procedures outlining the agency’s peer support program and mentor responsibility. These factors contribute to positive police culture, laying the groundwork to support law enforcement officers in developing professional resiliency.
Positive Engagement Techniques in Peer Support Programs and Police Culture: A Systematic Literature Review
BACKGROUND: Health and social care professionals experience high-stress levels during end-of-life care. Various intervention programs have been proposed to reduce stress and prevent burnout among physicians and nurses, including arts-based activities that have shown potential. However, it is unclear how art programs can alleviate stress among healthcare professionals providing end-of-life care. This study aimed to explore the potential of Clinical Art programs to alleviate distress in professionals providing end-of-life care. METHODS: Two Clinical Art workshops, held in October and November 2020, were attended by local health and social care professionals. Focus groups were conducted with those who attended and consented to participate in the study. Verbatim transcripts were made, and a qualitative analysis of the text was conducted. RESULTS Thirteen health and social work professionals participated in the study. Perceived difficulties in end-of-life care included the complexity and uncertainty of end-of-life care services, the approaches to patients and families, and the difficulties due to human aspects of healthcare providers. The positive effects of Clinical Art included pure enjoyment of art, empathic communication with patients and families and the application of an ontological view of human beings, which were identified as reasons for Clinical Art's effectiveness and applicability to care. CONCLUSIONS: The results suggest that the Clinical Art program has a psychosocial moderating effect on health and social work professionals and can be used for empathic communication with patients and families in end-of-life care and for applying an ontological view of human beings in caring for patients.
Possibility of Alleviating Difficulties of Health and Social Care Professionals Engaged in End-Of-Life Care Through Clinical Art Program
INTRODUCTION: Clinician burnout is far-reaching and impact individuals, healthcare systems, and patient care, and has been declared an area of major priority by leading critical care societies. The unprecedented demands of the COVID-19 pandemic have exacerbated mental health issues, including anxiety and post-traumatic stress disorder for intensive care unit (ICU) staff who were already at increased risk, leading to subsequent increased burnout. Therefore, we explored the secondary role that post-ICU clinics may play in reducing the symptoms of ICU staff burnout. METHODS: We performed a qualitative secondary analysis of semi-structured interviews with multidisciplinary post-ICU clinician members of the Critical and Acute Illness Recovery Organization (CAIRO) between February and March 2021. The original study examined how clinicians perceived the COVID-19 pandemic changed post-ICU care delivery. Data were analyzed post-hoc through a constant comparative method. RESULTS: Twenty-nine multidisciplinary clinicians from 15 international sites (Canada, the United States, the United Kingdom) participated in the study. The sample was largely female (72.4%) working in academic clinical settings (69.0%). Median length of time in clinician role was 16 years (IQR 7, 21), and median length of time working with a post-ICU program was 3 years (IQR 1, 4). We identified two overlapping mechanisms by which participants perceived reduced symptoms of ICU staff burnout: 1) staff exposure to and expression of humanizing behaviors and 2) visualizing and communicating treatment successes. Practical examples included sharing videos, photographs, and written stories of survivors with the ICU team; directly staffing post-ICU clinics; and in-person contact between ICU staff and survivors and families after ICU discharge. CONCLUSIONS: Multidisciplinary clinicians in postICU clinics commonly perceived that a bidirectional compassionate relationship and authentic interaction and communication with ICU survivors reduced the symptoms of burnout. Interprofessional teams in the ICU and healthcare administration should consider how programs that facilitate interaction with critical illness survivors may reduce the symptoms of burnout in ICU staff.
Post-ICU Clinics May Reduce ICU Staff Burnout: Critical & Acute Illness Recovery Organization Report
[This is an excerpt.] Governors have prioritized addressing healthcare workforce shortages related to retirement and burnout from the COVID-19 pandemic, the “silver wave” of baby boom generation workers aging out of the workforce and other compounding factors. To support state efforts to address these shortages, the National Governors Association Center for Best Practices(NGA Center) launched a Learning Collaborative to work with states on implementing strategies to strengthen and grow the next generation of the healthcare workforce. The states in the Next Generation of the Healthcare Workforce project took a variety of policy approaches to address this challenge. Bringing project states together on this topic fostered discussion of best practices to address these challenges, and this paper summarizes these approaches and identifies best practices from the states’ efforts over the past year. [To read more, click View Resource.]
This resource is found in our Actionable Strategies for Government: Advancing Measurement & Accountability (Establish Health & Public Safety Workforce Analysis and Planning Bodies) AND Optimizing Workload & Workflows (Support & Ensure Safe Staffing) AND Fair and Meaningful Reward & Recognition (Support Career Development).
Preparing the Next Generation of the Healthcare Workforce: State Strategies for Recruitment and Retention
BACKGROUND: Graduate medical education is demanding, and many residents eventually experience a reduced sense of well-being. Interventions are in development, but knowledge gaps remain in terms of time commitment and efficacy. OBJECTIVE: To evaluate a mindfulness-based wellness program for residents—PRACTICE (Presence, Resilience, and Compassion Training in Clinical Education). METHODS: PRACTICE was delivered virtually by the first author in the winter and spring of 2020-2021. The intervention totaled 7 hours delivered over 16 weeks. An intervention group of 43 residents (19 primary care and 24 surgical) participated in PRACTICE. Program directors electively enrolled their programs, and PRACTICE was integrated into residents' regular educational curriculum. The intervention group was compared to a non-intervention group of 147 residents whose programs did not participate. Repeated measure analyses were conducted before and after the intervention using the Professional Fulfillment Index (PFI) and Patient Health Questionnaire (PHQ)-4. The PFI measured professional fulfillment, work exhaustion, interpersonal disengagement, and burnout; the PHQ-4 measured depression and anxiety symptoms. A mixed model was used to compare scores between the intervention and non-intervention groups. RESULTS: Evaluation data were available from 31 of 43 (72%) residents in the intervention group, and from 101 of 147 (69%) residents in the non-intervention group. Significant and sustained improvements were demonstrated in professional fulfillment, work exhaustion, interpersonal disengagement, and anxiety in the intervention group versus the non-intervention group. CONCLUSIONS: Participation in PRACTICE resulted in improvements in measures of resident well-being that were sustained over the 16-week duration of the program.
Presence, Resilience, and Compassion Training in Clinical Education (PRACTICE): A Follow-Up Evaluation of a Resident-Focused Wellness Program
BACKGROUND: Burnout is a significant public health problem among healthcare professionals. Burnout negatively impacts patient care, the health of the professional, and the healthcare system. While all healthcare professionals face burnout, it is important to explore burnout among healthcare staff who operate in unique settings, including staff who work on Mobile Health Clinics (MHCs). OBJECTIVES: The overall goal of this study is to describe burnout and the work-related factors associated with burnout among staff who work with patients on MHCs. This dissertation aims to (1) describe burnout, job demands, and job resources among MHC staff through key informant interviews, (2) describe burnout, job demands, job resources, and personal characteristics among MHC staff through a quantitative survey and (3) describe the impact of finding meaning in work on the relationship between workplace violence and burnout among MHC staff through a quantitative survey. METHODS: This study utilized a mixed-methods sequential exploratory study design. Key informant interviews were used to obtain qualitative data describing experiences of burnout and unique work environments on MHCs. An electronic survey collected data on prevalence of burnout and the job demands and job resources associated with burnout among staff who work with patients on MHCs. RESULTS: Aim 1: Interviews from 5 key informants identified the following key themes: working on an MHC, workplace violence, meaning in work, leader support, and teamwork. Aim 2: 35.6% and 39.7% of the sample (N=73) reported having personal or work burnout. Burnout was associated with age (<45), gender (female), leaders support, teamwork, and praise. Staff who had not experienced sexual violence or report having support from their leaders were more likely to report not having burnout. Aim 3: No associations were identified between meaningful work and burnout. IMPLICATIONS FOR PUBLIC HEALTH: Researching burnout levels can drive recommendations for interventions that seek to reduce burnout, especially those that reduce workplace violence or that increase leadership support and teamwork. It is paramount to understand, anticipate, and mitigate burnout among MHC staff to ensure MHCs continue to provide care directly in communities.
