A study on hospital clinician wellbeing found that physicians and nurses — even at hospitals known to be good places to work — experienced adverse outcomes during the pandemic and want hospital management to make significant improvements in their work environments and in patient safety.
The solutions to high hospital clinician burnout and turnover, they say, are not resilience training for clinicians to better cope with adverse working conditions but organizational improvements that provide safe workloads and better work-life balance.
Researchers at Penn Nursing’s Center for Health Outcomes and Policy Research (CHOPR) in collaboration with the U.S. Clinician Wellbeing Study Consortium sought information in 2021 from 21,050 physicians and registered nurses practicing in 60 Magnet-recognized hospitals in 22 states. Their study was published in JAMA Health Forum.
Forty-seven percent of nurses and 32 percent of physicians experienced high burnout. Twenty-three percent of physicians and 40 percent of nurses said they would leave their jobs if possible. Less than 10 percent of physicians and nurses reported experiencing joy in their work. Not having enough nurses to care for patients, having little control over workloads, lack of confidence in management to resolve problems in patient care, and concerns about patient safety were all associated with higher burnout, job dissatisfaction, and intent to leave among both nurses and physicians.
“Physicians and nurses largely agree about what hospital management could do to address their burnout, job dissatisfaction, and plans to leave their current jobs; they want improved staffing, modern working conditions in which they can spend more time in direct patient care, greater control over their workloads and work schedules, and a higher priority on patient safety,” said lead author Linda Aiken, Ph.D., professor of nursing and sociology at Penn, in a statement. Aiken is founding director of CHOPR and a policy research and senior fellow of the Leonard Davis Institute for Health Economics.
Eighty-seven percent of nurses and 45 percent of physicians said improving nurse staffing was very important to their own mental health and wellbeing. Other high priorities for clinicians were health breaks without interruption and reduced time spent on documentation. Aiken added, “Many clinicians are downright hostile to programs—like resilience training—that are designed to adapt them to poor work conditions; clinicians want the working conditions improved.”
Half of physicians and nurses surveyed lack confidence that their patients can safely manage their care after discharge, highlighting the need for improvement in discharge planning. Patient safety remains a concern with 26 percent of nurses and 12 percent of physicians giving their own hospitals an unfavorable patient safety grade. Thirty-nine percent of nurses and 33 percent of physicians feel mistakes are held against them contrary to recommendations of the National Academy of Medicine to search for and correct system deficiencies that cause most medical errors.
The study took place in 2021 during the COVID-19 pandemic, a time when all U.S. hospitals were severely challenged. Previous research has shown that clinicians in hospitals like Magnet hospitals with better work environments prior to the pandemic had better outcomes during the pandemic. The consortium committed to this study to learn from their experiences during the pandemic how to sustain and further improve their favorable work environments to better withstand external threats and to rebound rapidly.
