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Cited by 671Healthcare professionals’ stress and burnoutOccupational Health and BurnoutStress and Burnout Research

Prevalence of and Factors Associated With Nurse Burnout in the US

Open access
Shah, Megha K., Gandrakota, Nikhila, Cimiotti, Jeannie P., Ghose, Neena, Moore, Miranda, Ali, Mohammed K.·2021·JAMA Network Open
DOI 10.1001/jamanetworkopen.2020.36469PMC PMC7862989
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Abstract

Importance: Clinician burnout is a major risk to the health of the US. Nurses make up most of the health care workforce, and estimating nursing burnout and associated factors is vital for addressing the causes of burnout. Objective: To measure rates of nurse burnout and examine factors associated with leaving or considering leaving employment owing to burnout. Design, Setting, and Participants: This secondary analysis used cross-sectional survey data collected from April 30 to October 12, 2018, in the National Sample Survey of Registered Nurses in the US. All nurses who responded were included (N = 50 273). Data were analyzed from June 5 to October 1, 2020. Exposures: Age, sex, race and ethnicity categorized by self-reported survey question, household income, and geographic region. Data were stratified by workplace setting, hours worked, and dominant function (direct patient care, other function, no dominant function) at work. Main Outcomes and Measures: The primary outcomes were the likelihood of leaving employment in the last year owing to burnout or considering leaving employment owing to burnout. Results: The weighted sample of 50 273 respondents (representing 3 957 661 nurses nationally) was predominantly female (90.4%) and White (80.7%); the mean (SD) age was 48.7 (0.04) years. Among nurses who reported leaving their job in 2017 (n = 418 769), 31.5% reported burnout as a reason, with lower proportions of nurses reporting burnout in the West (16.6%) and higher proportions in the Southeast (30.0%). Compared with working less than 20 h/wk, nurses who worked more than 40 h/wk had a higher likelihood identifying burnout as a reason they left their job (odds ratio, 3.28; 95% CI, 1.61-6.67). Respondents who reported leaving or considering leaving their job owing to burnout reported a stressful work environment (68.6% and 59.5%, respectively) and inadequate staffing (63.0% and 60.9%, respectively). Conclusions and Relevance: These findings suggest that burnout is a significant problem among US nurses who leave their job or consider leaving their job. Health systems should focus on implementing known strategies to alleviate burnout, including adequate nurse staffing and limiting the number of hours worked per shift.

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  • Reducing emotional exhaustion and depersonalization may contribute to improved workforce retention, lower absenteeism, and enhanced patient safety and care quality.

    “Reducing EE and DP may also contribute to improved workforce retention and lower absenteeism, ultimately benefiting healthcare providers and enhancing patient safety and care quality [9,10,11].”

    From Effects of Third-Wave Cognitive Behavioral Therapy for Healthcare Professionals’ Burnout: A Systematic Review and Meta-Analysis (2025) · cites this paper as [11]

    The Results (page not provided) report that nurses identified burnout as a reason for leaving or considering leaving their jobs, supporting the workforce-retention part of the claim. The Discussion links lower burnout and supportive work environments with better patient-care quality. Our copy does not establish that reducing emotional exhaustion and depersonalization specifically lowers absenteeism or improves patient safety. (LLM, conf=0.84)

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  • Personnel fatigue and intent to leave are at high levels in healthcare services.

    “Healthcare services are at a breaking point, with personnel fatigue and intent to leave at high levels [1].”

    From Paramedics’ perceptions of job demands and resources in Finnish emergency medical services: a qualitative study (2022) · cites this paper as [1]

    The Discussion describes burnout as a substantial problem among healthcare professionals, and the Results report that 676,122 US nurses had considered leaving their positions. The paper supports concern about burnout and intent to leave, but its evidence on leaving is specific to nurses, not healthcare personnel generally; it also measures burnout rather than fatigue directly. (LLM, conf=0.83)

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Research works printed but not linked: 3

  1. [1]National Academies Press. Taking action against clinician burnout: a systems approach to professional well-being. National Academies Press; 2019. Accessed August 14, 2020. https://www.nap.edu/download/25521 31940160
  2. [12]National Academies of Sciences, Engineering, and Medicine; National Academy of Medicine; Committee on Systems Approaches to Improve Patient Care by Supporting Clinician Well-Being. Factors Contributing to Clinician Burnout and Professional Well-Being. National Academies Press; October 23, 2019 Accessed September 14, 2020. https://www.ncbi.nlm.nih.gov/books/NBK552615/
  3. [30]Spetz J. There are not nearly enough nurses to handle the surge of coronavirus patients: here’s how to close the gap quickly. Health Affairs. Published March 31, 2020. Accessed September 4, 2020. https://www.healthaffairs.org/do/10.1377/hblog20200327.714037/full/ · DOI

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Authors
Shah, M. K., Gandrakota, N., Cimiotti, J. P., Ghose, N., Moore, M., & Ali, M. K.
Affiliations
Emory University (US)
Corresponding author
Shah, Megha K.
ORCID
Venue
JAMA Network Open
Publisher
American Medical Association (AMA)
Published
2021-02-04
Volume
4
Issue
2
Pages
e2036469
ISSN
2574-3805 (ISSN-L)
DOI
10.1001/jamanetworkopen.2020.36469
PMC
PMC7862989
OpenAlex
W3129157447
Cited by
671
References
24
Citations by year
2026: 125 · 2025: 166 · 2024: 135 · 2023: 109 · 2022: 117 · 2021: 18
FWCI
106.43
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • JAMA Network Open (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Funders
  • Agency for Healthcare Research and Quality (R01 HS026232)
  • National Institute of Diabetes and Digestive and Kidney Diseases (P30DK111024)
  • National Institute on Minority Health and Health Disparities (K23MD015088)
Topics
  • Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
  • Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Burnout
  • Social Sciences › Psychology › Social Psychology › Stress and Burnout Research
Keywords
nurse burnout, nurses, job turnover, burnout prevalence, working hours, labor shortage, occupational stress, burnout prevention strategies, workplace health
MeSH terms
Adult, Burnout, Professional, Female, Hospitals, Humans, Male, Middle Aged, Nurses, Personnel Staffing and Scheduling, Risk Factors, United States, Prevalence, Workload

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