Millennial nurses have the lowest levels of activation and nurses on the night shift are especially at risk, according to a new white paper from Press Ganey.
The report used a measure to identify generational differences in "activation and decompression" among nurses and variation based on nurse manager status, nurse tenure and shift.
Nurse burnout can cause multiple problems for hospitals. Press Ganey argues that because nurses usually have frequent direct interactions with patients, nurse burnout may pose a risk to "patient and organizational outcomes."
Health systems may see nurses as a way to bridge a physician shortage, but burned out nurses pose safety, quality and patient experience risks. Nurse burnout is a complex issue that can't be solved by a one-size-fits-all approach either, Press Ganey said.
The nurse's perception of stress and the organization's support of work-life balance are key parts of whether they can decompress. Resilience is an important factor when determining whether someone is vulnerable to burnout. Activation and decompression are pieces of resiliency.
Press Ganey found that nurse managers are more engaged than non-managers. However, non-managers have a better ability to decompress than managers.
Hospitals need to measure each nurse individually and rely on myriad levers to find how best to engage, motivate and help nurses deal with stress, according to the paper.
"By measuring nurse engagement and resilience and mining the data to understand the factors that might compromise nurses' ability to meet the demands of their profession, healthcare organizations can develop strategies for addressing burnout head-on and helping their nurses enjoy productive, rewarding careers," they authors wrote.
Nurse burnout costs $9 billion for hospitals annually and $14 billion from the healthcare system overall. Multiple research point to overworked and stressed out nurses. A 2017 Kronos Incorporated survey showed that 90% of nurses are thinking about leaving their hospital for another job because of a poor work/life balance. Most of the surveyed nurses (83%) said hospitals are losing good nurses because other employers offer a better work/life balance.
One problem is that nurses are taking on more than they were five years ago. A University of Phoenix College of Health Professionals 2016 poll found that four out of five nurses say they're playing a larger role in patient care management than in 2014. Future physician shortages may only exacerbate those burnout problems.
There are ways hospitals can help. Some experts point to lower nurse-to-patient ratios, though that can be costly for hospitals and the healthcare system in general. A Massachusetts ballot question that would implement a nurse-to-patient staffing ratio could cost nearly $950 million annually, according to a recent study from the state's health policy commission.
Another idea that's not as costly is to implement hourly or purposeful rounding. A study on hourly rounding in inpatient care found it can "improve patients' perceptions of nursing staff responsiveness in units where this may have been a problem, reduces patient falls and call light use and improves patient satisfaction scores."