Lesly A. Kelly is a nurse scientist, CommonSpirit Health, and a clinical associate professor, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona.
Karen L. Johnson is the research director of nursing, Banner Health, Phoenix, Arizona.
Am J Crit Care. 2021 Mar 1;30(2):113-120. doi: 10.4037/ajcc2021775.
As the role of a health care system's influence on nurse burnout becomes better understood, an under-standing of the impact of a nurses' work environment on burnout and well-being is also imperative.
To identify the key elements of a healthy work environment associated with burnout, secondary trauma, and compassion satisfaction, as well as the effect of burnout and the work environment on nurse turnover.
A total of 779 nurses in 24 critical care units at 13 hospitals completed a survey measuring burnout and quality of the work environment. Actual unit-level data for nurse turnover during a 5-month period were queried and compared with the survey results.
Among nurses in the sample, 61% experience moderate burnout. In models controlling for key nurse characteristics including age, level of education, and professional recognition, 3 key elements of the work environment emerged as significant predictors of burnout: staffing, meaningful recognition, and effective decision-making. The latter 2 elements also predicted more compassion satisfaction among critical care nurses. In line with previous research, these findings affirm that younger age is associated with more burnout and less compassion satisfaction.
Efforts are recommended on these 3 elements of the work environment (staffing, meaningful recognition, effective decision-making) as part of a holistic, systems-based approach to addressing burnout and well-being. Such efforts, in addition to supporting personal resilience-building activities, should be undertaken especially with younger members of the workforce in order to begin to address the crisis of burnout in health care.
随着人们对医疗保健系统对护士职业倦怠影响的认识不断加深，了解护士工作环境对倦怠和幸福感的影响也变得至关重要。
确定与倦怠、二次创伤和职业满足感相关的健康工作环境的关键要素，以及倦怠和工作环境对护士离职的影响。
在 13 家医院的 24 个重症监护病房中，共有 779 名护士完成了一项测量倦怠和工作环境质量的调查。查询并比较了在 5 个月期间实际的护士离职单元数据和调查结果。
在样本中的护士中，61%经历中度倦怠。在控制包括年龄、教育水平和专业认可等关键护士特征的模型中，工作环境的 3 个关键要素成为倦怠的显著预测因素：人员配备、有意义的认可和有效的决策制定。后两个要素还预测了重症监护护士的职业满足感更高。与之前的研究一致，这些发现证实，年龄越小，倦怠程度越高，职业满足感越低。
建议在工作环境的这 3 个要素（人员配备、有意义的认可、有效的决策制定）上做出努力，作为解决倦怠和幸福感的整体系统方法的一部分。除了支持个人的弹性建设活动外，还应特别针对劳动力中的年轻成员开展这些努力，以开始解决医疗保健中的倦怠危机。
