Organizational Traits, Care Processes, and Burnout Among Chronic Hemodialysis Nurses
Open accessAbstract
In light of evidence linking registered nurse (RN) staffing levels to patient outcomes in chronic hemodialysis facilities, U.S. government regulations have set minimum RN staffing requirements during dialysis. Consequently, facility administrators are focused on decreasing nurse attrition in this crucial practice setting. This study used a cross-sectional, correlational design to investigate the effects of workload, practice environment, and care processes on burnout among nurses in U.S. chronic hemodialysis centers and to determine the association between burnout and nurses' intentions to leave their jobs. Findings indicate that predictors were associated with an increased likelihood of nurse burnout and that nurses experiencing burnout were more likely to be planning to leave their jobs. Findings have important implications for retention of nurses, enhancement of patient safety, and adherence to new federal staffing requirements in chronic hemodialysis units.
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Only Emotional Exhaustion affects intentions to leave the job in four studies.
“four studies reported that only Emotional Exhaustion affected intentions to leave the job [21, 32, 37, 100]”
From Burnout in nursing: a theoretical review. (2020) · cites this paper as [32]
The Methods (Measures; page not provided) say burnout was measured using only the Emotional Exhaustion subscale. The Results (page not provided) report that nurses classified as burned out were more likely to intend to leave their position or employer. Because the study did not compare burnout subscales, it does not establish that only Emotional Exhaustion affects intentions to leave. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThe better rated the work environment, the lower the likelihood of experiencing Emotional Exhaustion.
“Five studies comprising diverse samples and settings concluded that the better rated the work environment, the lower the likelihood of experiencing Emotional Exhaustion [32, 47, 49, 51, 92]”
From Burnout in nursing: a theoretical review. (2020) · cites this paper as [32]
Emotional Exhaustion also affects intention to leave the organisation.
“with one of these indicating that Emotional Exhaustion affected also intention to leave the organisation [32]”
From Burnout in nursing: a theoretical review. (2020) · cites this paper as [32]
Missed care is a predictor of Emotional Exhaustion.
“Missed care was investigated in three studies, and it was found to be both predictor of Emotional Exhaustion [32], an outcome of burnout [20, 103].”
From Burnout in nursing: a theoretical review. (2020) · cites this paper as [32]
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Cites
Early predictors of job burnout and engagement.
Maslach, C., & Leiter, M. P. (2008) · Journal of Applied Psychology · doi:10.1037/0021-9010.93.3.498 · Cited by 2,397 · cited 1× · see citing works
“Consequently, burnout is characterized by feelings of emotional exhaustion, detachment from others, and diminished perceptions of personal accomplishment (Maslach & Leiter, 1997, 2008).”
BackgroundMelamed, S., Shirom, A., Toker, S., Berliner, S., & Shapira, I. (2006) · Psychological Bulletin · doi:10.1037/0033-2909.132.3.327 · Cited by 943 · see citing works
Relationships of Work and Practice Environment to Professional Burnout: Testing a Causal Model
Leiter, M. P., & Spence Laschinger, H. K. (2006) · Nursing Research · doi:10.1097/00006199-200603000-00009 · Cited by 253 · see citing works
Flagged first, then by citations
Research works printed but not linked: 29
- Ahola K Honkonen T Virtanen M Kivimaki M Isometsa E Aromaa A Interventions in relation to occupational burnout: The population-based health 2000 study Journal of Occupational and Environmental Medicine 2007 49 943 952 17848850
- Aiken LH Clarke SP Sloane DM Hospital staffing, organization, and quality of care: Cross-national findings International Journal for Quality in Health Care 2002 14 5 13 11871630
- Aiken LH Clarke SP Sloane DM Lake ET Cheney T Effects of hospital care environment on patient mortality and nurse outcomes The Journal of Nursing Administration 2008 38 5 223 229 18469615 PMC2586978
- Aiken LH Clarke SP Sloane DM Sochalski JA Busse R Clarke H Nurses’ reports on hospital care in five countries Health Affairs 2001 20 3 43 53 11585181
- Burke RJ Greenglass ER Hospital restructuring, work-family conflict and psychological burnout among nursing staff Psychology and Health 2001 16 83 94 22804500
- Cox KS Teasley SL Zeller RA Lacey SR Parsons L Carroll CA Know staff’s intent to stay Nursing Management 2006 37 13 15 16395045
- Dillman D Mail and internet surveys: The tailored design method 2007 2nd ed. Hoboken, NJ John Wiley and Sons, Inc.
- Ericson-Lidman E Standberg G Burnout: Co-workers’ perceptions of signs preceding workmates’ burnout Journal of Advanced Nursing 2007 60 2 199 208 17877567
- Figley CR Burnout in families: The systematic cost of caring 1998 Boca Raton, FL CRC Press
- Flood AB The impact of organizational and managerial factors on the quality of care in health care organizations Medical Care Review 1994 51 381 428 10139532
- Flynn L Extending work environment research into home health settings Western Journal of Nursing Research 2007a 29 2 200 212 17337622
- Flynn L Dickson GL Flynn L Workload, quality of care, and job satisfaction in home health nurses Nursing policy research: Turning evidence-based research into health policy 2008 New York Springer 143 150
- Flynn L Thomas-Hawkins C Bodin S Dickson GL Flynn L Using research to influence federal policy: The nephrology nurses’ experience Nursing policy research: Turning evidence-based research into health policy 2008 New York Springer 81 84
- Gardner JK Thomas-Hawkins C Fogg L Latham CE The relationship between nurses’ perceptions of the hemodialysis unit work environment and nurse turnover, patient satisfaction, and hospitalizations Nephrology Nursing Journal 2007 34 3 271 281 17644871
- Lacey SR Cox KS Lorfing KC Teasley SL Carroll CA Sexton K Nursing support, workload, and intent to stay in magnet, magnet-aspiring, and non-magnet hospitals The Journal of Nursing Administration 2007 37 4 199 205 17415107
- Lake ET Development of the practice environment scale of the nursing work index Research in Nursing & Health 2002 25 3 176 188 12015780
- Maslach C Burnout—The cost of caring 2003 Cambridge, MA Malor Books
- Maslach C Jackson SE Maslach burnout inventory 1986 2nd ed. Palo Alto, CA Consulting Psychologists Press
- Maslach C Schaufeli WB Leiter MP Job burnout Annual Review of Psychology 2001 52 397 422 11148311
- Melamed S Shirom A Toker S Shapira I Burnout and risk of type 2 diabetes: A prospective study of apparently healthy employed persons Psychosomatic Medicine 2006 68 863 869 17132837
- Murphy SA Duxbury L Higgins C The individual and organizational consequences of stress, anxiety, and depression in the workplace Canadian Journal of Community Mental Health 2006 25 2 143 157
- Rafferty AM Clarke SP Coles J Ball J James P McKee M Outcomes of variation in hospital nurse staffing in English hospitals: Cross-sectional analysis of survey data and discharge records International Journal of Nursing Studies 2007 44 2 175 182 17064706 PMC2894580
- Saleh P Shapiro C Disturbed sleep and burnout: Implications for long-term health Psychosomatic Research 2008 65 1 3 18582605
- Saran R Bragg-Gresham JL Rayner HC Goodkin DA Keen ML Van Dijk PC Nonadherence in hemodialysis: Associations with mortality, hospitalization, and practice patterns in DOPPS Kidney International 2003 64 254 262 12787417
- Schuitemaker GE Dinart MD Van der Pol GA Appeels A Assessment of vital exhaustion and identification of subjects at risk of myocardial infarction in general practice Psychosomatics 2004 45 5 414 416 15345786
- Sehgal AR Snow RJ Singer ME Amini SB DeOreo PB Sivler MR Barriers to adequate delivery of hemodialysis American Journal of Kidney Diseases 1998 31 4 593 601 9531174
- Shortell SM Kaluzny AD Health care management: A text in organizational theory and behavior 1988 New York John Wiley & Sons
- Sochalski J Is more better? The relationship between nurse staffing and the quality of nursing care in hospitals Medical Care 2004 42 Suppl. 2 67 73 14734944
- Thomas-Hawkins C Flynn L Clarke SP Relationships between registered nurse staffing, processes of nursing care, and nurse-reported patient outcomes in chronic hemodialysis units Nephrology Nursing Journal 2008 35 2 123 131 18472681 PMC2845981
Cited by
Sorted by citations
Burnout in nursing: a theoretical review.
Dall’Ora, C., Ball, J., Reinius, M., & Griffiths, P. (2020) · Human Resources for Health · doi:10.1186/s12960-020-00469-9 · Cited by 1,181 · see citing works
“Missed care was investigated in three studies, and it was found to be both predictor of Emotional Exhaustion [32], an outcome of burnout [20, 103].”
BackgroundResultBronkhorst, B., Tummers, L., Steijn, B., & Vijverberg, D. (2015) · Health Care Management Review · doi:10.1097/hmr.0000000000000026 · Cited by 137 · see citing works
- Authors
- Flynn, L., Thomas-Hawkins, C., & Clarke, S. P.
- Affiliations
- University of Maryland, College Park (US)
- Rutgers University
- University of Toronto (CA)
- Corresponding author
- Flynn, Linda
- Venue
- Western Journal of Nursing Research
- Publisher
- SAGE Publications
- Published
- 2009-03-06
- Volume
- 31
- Issue
- 5
- Pages
- 569-582
- ISSN
- 0193-9459 (ISSN-L)
- 1552-8456
- PMC
- PMC2746111
- OpenAlex
- W2099472309
- Cited by
- 74
- References
- 3
- Citations by year
- 2026: 1 · 2024: 2 · 2023: 3 · 2022: 4 · 2021: 3 · 2020: 4 · 2019: 5 · 2018: 4 · 2017: 1 · 2016: 5 · 2015: 9 · 2014: 12 · 2013: 6 · 2012: 9
- FWCI
- 13.29
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Western Journal of Nursing Research (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5p30nr005043-10)
- National Institute of Nursing Research (P30-NR-005043)
- Topics
- Health Sciences › Nursing › Research and Theory › Nursing education and management
- Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Burnout
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Keywords
- nurse burnout, maintenance hemodialysis, hemodialysis nurses, nurse staffing, nurse attrition, nurse retention, workload, practice environment, process of care
- MeSH terms
- Burnout, Professional, Renal Dialysis, Humans, Nurses
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