Exploring the Relationship Between COVID-19 Unit Designation and Nurse Burnout Syndrome

Background: The COVID-19 pandemic impacted healthcare due to surges in infected patient and respiratory failure. Nursing burnout syndrome (NBS) results from occupational factors leading to mental health problems. Nurses working in intensive care units (ICUs) dedicated to caring for COVID-19infected individuals may be even more susceptible to NBS due to increased burdens of futile care delivery and high mortality rates within overstretched healthcare systems. Identifying socio-demographic, work-related, and psychological predictors of NBS may help organizations mitigate, or at least minimize, the negative psychological impact on ICU nurses working during future pandemics. Purpose/Aims: The aim of this study was to compare burnout levels in ICU nurses providing direct care to COVID infected patients with nurses caring for non-COVID infected patients. Methods: An observational descriptive study was conducted using 1) a case-controlled prospective quantitative comparative design to compare neonatal and pediatric ICU to cardiac and medical ICU survey scores measuring nurse burnout, work-related, and psychological predictors of NBS and 2) across-sectional longitudinal quantitative causal and comparative study design comparing NBS scores for nurses working in a cardiac and medical ICU captured in 2019 prior to the COVID-19 pandemic to scores captured in the same units after conversion to dedicated COVID-19 ICUs in 2020. This study will explore the relationship between three subscales(Emotional Exhaustion, Depersonalization, and Personal Accomplishment) of the Maslach Burnout Inventory (MBI) as outcome variables and exposure to COVID-19 infected patients during 12-hour shifts worked as explanatory variables in a subset regression model. The study will also measure four subscales (Vocation, Finances, Health, and Social Relationships) associated with post-traumatic stress disorder using the Well Being Instrument(WBI) as control variables. A convenience sample of direct care registered nurses working in four ICUs in a large tertiary care hospital will be recruited to participate in the study. Female nurses working day shifts were surveyed in February and March 2019in two ICUs. In November 2020, four ICUs were used for sampling of both male and female nurses working either day or night 12-hour shifts based on designation as COVID-19 ICUs. Results: Researchers hypothesize burnout scores among nurses working in neonatal and pediatric ICUs will be less than burnout scores for nurses working in designated COVID ICUs. Additionally, investigators hypothesize nurse burnout measured in cardiac and medical ICUs in 2019 will be less than measurements obtained in 2020 after the same ICUs converted into COVID ICUs. This study will also analyze participant socio-demographic and work-related data for psychological predictors of NBS. Conclusion: NBS has been identified as a global problem facing ICU clinicians. Pinpointing associations betweenCOVID-19 infection and nurse burnout may lead to innovative strategies to mitigate burnout in those caring for the most critically ill individuals during future pandemics. Implications for practice: Further research is required to establish relationships between socio-demographic and work-related psychological predictors of NBS. Understanding relationships between these variables may guide development of strategies to build nurse resilience and decrease NBS in ICU settings impacted during pandemics.https://digitalcommons.psjhealth.org/prov_rn_conf_all/1009/thumbnail.jp