Exploring the relationship between exposure to nature while at work and burnout among female nurses on day shift

Background: Registered Nurses working extended shifts in the hospital setting may report burnout, which reduces caregiver satisfaction, increases turnover, and potentially translates to delivery of suboptimal patient care. To align with the quadruple aim, efforts are needed to reduce nurse burnout. Limited literature suggests that visual access to nature, either via artwork or exterior landscaping, may reduce burnout. However, more research is needed to understand whether visual access to nature influences burnout among Registered Nurses delivering direct patient care. Purpose/Aims: The purpose of this study was to explore the relationship between visual access to exterior landscaping or nature artwork and burnout among Registered Nurses. Methods/Approach: This cross-sectional study recruited female nurses working dayshift in one large medical center to avoid potential confounders of gender and shift on burnout and exterior nature views. Participants were recruited from 6 different nursing units based on the pre-existing characteristics of unit break rooms: 1) exterior nature view and nature artwork(n=2 units; n=16 nurses);2) no exterior nature views but containing artwork of nature scenes (n=2 units; n=18 nurses); 3)no exterior nature view and no nature artwork (n=2 units; n=17 nurses).Nurses self-reported demographics as well as perceived frequency and duration of exterior nature views or nature artwork during an average shift at one point in time immediately following the end of a 12-hour shift. In addition, nurses provided burnout data by completing the Maslach Burnout Inventory (MBI),which characterizes burnout as emotional exhaustion, depersonalization, and personal achievement. Surveys were collected from February –March 2019. Data were analyzed descriptively and using a subset regression model to explore relationships between measured variables. Results: A total of 51 Registered Nurses working 12-hour day shift in the hospital setting reported on average low to moderate burnout. In the multivariable model, nurses who self-reported more time viewing natural light during a shift reported lower burnout subscales of emotional exhaustion and depersonalization compared to those reporting less time viewing exterior nature during the shift. The subscale of personal achievement was not significantly related to nurses’ perception of nature views. Conclusion: Our study supports that the amount of self-reported exposure to nature primarily through window views throughout 12-hour shifts may impact nurse burnout scores. However, the burnout subscale of personal achievement appeared to be independent of nature views, suggesting that future work should explore other factors that may support this nurse burnout sub-component. Implications for Practice: Our study provides preliminary evidence that increasing nurse-perceived exposure to nature through window views of exterior landscaping during a 12-hour day shift may mitigate the amount of burnout reported. Nurses could partner with therapeutic architects to advocate for work and break areas containing windows, balconies, alcoves and indoor/outdoor gardens to enhance opportunities for nurses to view exterior landscaping for greater frequencies during a shift to decrease burnout. Future studies are needed to test long-term outcomes related to nurse views of nature and burnout, acknowledging that solutions to support burnout may require multifactorial approaches.https://digitalcommons.psjhealth.org/prov_rn_conf_all/1027/thumbnail.jp