Please confirm that you would like to log out of Medscape.
If you log out, you will be required to enter your username and password the next time you visit.
Log outCancel
Roni Robbins | August 17, 2022 | Contributor Information
Burnout among nurse practitioners (NPs) has stayed steady throughout the pandemic, as our first Medscape Nurse Practitioner Burnout & Depression Report bears out.
More than 2000 NPs were surveyed between April and May about their experiences with burnout and depression. Far more were burned out than were depressed; yet, depression still afflicted a notable percentage.
"Throughout the pandemic, nurses, including NPs, have experienced sustained physical exhaustion, prolonged pathogen exposure, emotional turmoil and grief in losing patients, family and friends to COVID-19," says April Kapu, president of the American Association of Nurse Practitioners (AANP). "Working in crisis mode for months on end, now years, it has been really tough."
Roni Robbins | August 17, 2022 | Contributor Information
When it comes to comparing the present vs early in the pandemic, the majority of NPs are more burned out now than they were during the quarantine months after COVID-19.
"I think the pandemic, like other issues, not only magnified but intensified its grip on an already overworked and stressed-out nursing workforce," said Danielle McCamey, DNP, ACNP-BC, founder and chief executive officer of DNPs of Color and assistant professor and assistant dean for Clinical Practice & Relationships at Johns Hopkins School of Nursing.
Because of the pandemic, "the demands for providers at the bedside does not allow for adequate recovery and healing, which contributes to this vicious cycle of burnout that is totally unsustainable and really and truly inhumane," she said.
Roni Robbins | August 17, 2022 | Contributor Information
"Burnout comes from many external and internal factors, including prolonged work hours, poor workplace environments, lack of autonomy, lack of time away from work to allow for sleep and recovery, and absence of social support," said the AANP's Kapu.
Full-time NPs are more likely to report that too many hours at work contribute to their burnout (36%) as opposed to part-time NPs (17%). Part-timers more often cite the increasing computerization of practice (EHRs) as contributing to burnout than do full-time NPs (25% vs 14%).
When it comes to the age of NPs, those younger than 45 years (51%) are more likely to feel that insufficient compensation/salary contributes to their burnout compared with their peers aged 45 years or older (38%).
The chart does not show the 19% of respondents who attributed burnout to lack of control/autonomy; increasing computerization of practice (EHR), 16%; stress from treating COVID-19 patients, 14%; government regulations, 11%; or other reasons, 10%.
Roni Robbins | August 17, 2022 | Contributor Information
The majority of burned-out NPs feel that burnout has had negative effect on their personal relationships.
NPs younger than 45 years (73%) are more likely to feel their relationships have been negatively affected, owing to burnout, than are those aged 45 years or older (66%).
McCamey said that burnout experienced by NPs "creates a domino effect impact. When NPs aren't available, the distribution of work is placed on the providers who remain. And a large part of this distribution is placed on other providers and physicians," who also have some of the highest burnout rates.
Roni Robbins | August 17, 2022 | Contributor Information
"Greater respect for the job I do by the general public and health systems," said one respondent. "A physician can go anywhere, but if I change places or roles, I start all over at the bottom again."
Among those who cited ways to reduce burnout, NPs younger than 45 years are more likely to report the need for more support staff (42% vs 37%) and increased compensation (58% vs 44%) than are NPs aged 45 years or older.
More female NPs (16%) believe that greater opportunities for career growth would reduce burnout than do male NPs (7%).
Other factors mentioned as helping to reduce burnout include clearer role expectations from their employer; not having to treat COVID patients; more/easier access to personal protective equipment; and alternate ways to reduce burnout than the options offered.
Roni Robbins | August 17, 2022 | Contributor Information
NPs younger than 45 years are more likely to drink alcohol (33% vs 27%); use prescription drugs (10% vs 4%); exercise (50% vs 37%); sleep (54% vs 41%); and talk with family/friends (57% vs 46%) compared with their older counterparts.
Full-time NPs are more likely to binge-eat (28% vs 22%) and use prescription drugs (7% vs 4%) than are part-time NPs.
Further ways NPs deal with burnout include use of prescription drugs, 7%; use of cannabis products, 4%; smoke cigarettes/use nicotine products, 3%; other methods, 10%; or none of the above, 1%.
Roni Robbins | August 17, 2022 | Contributor Information
Among burned-out NPs, part-timers are more likely to reduce work hours (62% vs 21%) or change their work setting/get a new job (36% vs 22%) compared with full-time NPs.
NPs younger than 45 years are more likely to have requested workflow/staff changes (31% vs 24%), changed work setting/jobs (29% vs 21%), and participated in meditation or other stress reducing techniques (54% vs 45%) than are their peers aged 45 years or older.
Not included in the graph are the 19% who said that they spoke with their hospital/group administration about productivity pressure; 8% who sought help from their professional organization; 14% who listed other solutions; and the same percentage who chose none of the above.
Roni Robbins | August 17, 2022 | Contributor Information
About 1 in 5 NPs have used the services of companies, individuals, or coaches outside the workplace to reduce burnout.
Full-time NPs (61%) are more likely than part-time NPs not to use outside burnout reduction services.
NPs younger than 45 years are more likely not to be using outside burnout reduction services but would consider using them compared with those aged 45 years or older (63% vs 56%). Meanwhile, older NPs more often will not consider using these services at all compared with their younger peers (24% vs 18%).
Roni Robbins | August 17, 2022 | Contributor Information
The majority of NPs experiencing depression would describe their condition as colloquial, ie, feeling down, blue, and sad, rather than describing it as clinical depression.
Of those who were depressed, 39% said that they had a family member who was clinically depressed, not caused by a normal grief event, including severe depression lasting some time. And 26% said their family was colloquially depressed. In addition, 27% said that their family members were not depressed, and 11% were unsure.
The chart was rebased to exclude the 3% of respondents who chose the option "prefer not to answer."
Roni Robbins | August 17, 2022 | Contributor Information
Full-time NPs (68%) are more likely to attribute their depression to job burnout than are part-timers (55%).
NPs younger than 45 years are more likely to feel lack of self-confidence (31% vs 17%) and romantic relationships (18% vs 10%) contribute significantly to their depression compared with their peers aged 45 years or older. Older NPs more often attribute their depression to health compared with their younger counterparts (20% vs 12%).
The chart doesn't include the 23% who cited lack of self-confidence and insecurity; health, 17%; my personality, 14%; romantic relationships, 13%; and other, 7%.
Roni Robbins | August 17, 2022 | Contributor Information
Nearly half of respondents reported experiencing depression prior to becoming a healthcare professional.
NPs aged 45 years or older are less likely to have been depressed prior to becoming a healthcare professional compared with those younger than 45 years. (57% vs 43%)
NPs younger than 45 years (27%) are more likely to have experienced depression once prior to becoming a healthcare professional than are those aged 45 years or older (21%).
Roni Robbins | August 17, 2022 | Contributor Information
Depressed full-time NPs are more likely to express frustration in front of colleagues (45% vs 34%) and be easily exasperated with colleagues (38% vs 29%) compared with their part-time peers.
Part-time NPs (42%) are less likely to feel that depression affects interactions with patients or colleagues than are full-timers (31%).
NPs younger than 45 years are more likely to become exasperated with patients (37% vs 25%) and express frustration in front of colleagues (48% vs 39%) compared with NPs aged 45 years or older.
Roni Robbins | August 17, 2022 | Contributor Information
The majority of NPs with burnout and/or depression have not felt suicidal or attempted suicide (86%). Of those who have had suicidal thoughts (13%) or attempted suicide (1%), about half report mentioning their intentions to a therapist.
NPs younger than 45 years (52%) more often mention thoughts of suicide to a family member than do those aged 45 years or older (36%).
The vast majority of respondents, 91%, have not had any colleagues or peers share their suicidal thoughts with them.
Roni Robbins | August 17, 2022 | Contributor Information
Full-time NPs are more likely (41%) to report having access to a program meant to reduce stress and/or burnout at their place of work compared with part-time respondents (35%).
NPs aged 45 years or older are more likely to have a stress/burnout reduction program offered by their workplace than are their peers younger than 45 years (42% vs 36%).
Roni Robbins | August 17, 2022 | Contributor Information
Part-time respondents are more likely to take the following actions to keep up their happiness and mental health than are full-time NPs: exercising (67% vs 60%), doing hobbies/activities (77% vs 71%), and getting enough sleep (62% vs 55%).
NPs younger than 45 years are more likely to say spending time with family/friends (81% vs 69%) and therapy (23% vs 12%) compared with those aged 45 years or older.
The graph doesn't include the 9% who responded with other options or the 3% who responded "none of the above."
Roni Robbins | August 17, 2022 | Contributor Information
Almost one third of respondents are considering leaving the healthcare profession.
Kapu said AANP has been "seeing increasing numbers of clinicians — especially nurses and NPs — leaving the profession, particularly if there are no options for improvement of workplace environment, mental health support, or opportunities to make changes within their career."
McCamey shared similar sentiments. "It is documented that NPs are reconsidering their priorities and commitment in whether they will continue in advance practice or seek other opportunities outside of the nursing profession altogether."
Concerns Over Mandatory Overtime for Nurses Increased During Pandemic
More than half of states lack legislation prohibiting forced overtime for nurses; organizations urge reform as turnover and burnout create safe staffing challenges.
Commenting is limited to medical professionals. To comment please Log-in.
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Close
Contributor Information
Roni Robbins
Editor, Medscape
Close
References
Close
Image Zoom
Close
Feedback
Please do not use this form to submit personal or patient medical information or to report adverse drug events. You are encouraged to report adverse drug event information to the FDA.
Comments