Nursing Outcomes and Nurses' Wellbeing.

INTRODUCTION Substantial research over several decades has documented high burnout rates among hospital nurses globally. However, improvements in nurses' work environments to reduce burnout have been lacking. The Covid-19 pandemic has generated renewed interest in how to reduce nurse burnout. AIMS To determine the extent to which high burnout being observed among nurses during the Covid-19 pandemic is primarily the result of increased numbers of critically ill patients or conditions that predated the pandemic. METHODS A two-wave email survey was undertaken of all active registered nurses (RNs) in two large U.S. states of New York and Illinois. The first survey was administered between December 16, 2019 and February 28, 2021 before Covid-19 had been identified in the U.S.; the second survey was between March 1 and June 1 of 2021 during continuing Covid-19 surges in critically ill hospitalized patients. An additional survey using many of the same items was administered from January to June of 2021 to physicians and nurses practicing in Magnet Recognized hospitals located nation-wide . RESULTS Some 46% of direct care hospital nurses experienced high burnout immediately prior to the identification of Covid-19. When measured in the midst of the Covid-19 pandemic, that number had increased to 50%. The increase in nurse burnout was greatest in critical care rising from 47% pre-Covid to 62% during Covid. High burnout among hospital physicians measured during the pandemic was 30%. Overall, 20 % of hospital nurses reported they intended to leave their jobs within the coming year pre-Covid which increased to 25% during Covid; that rate was 24% for critical care nurses prior to Covid rising to 29% during Covid. CONCLUSIONS The very high rates of nurse burnout and intent to leave their jobs in hospitals predated the Covid-19 pandemic. Thus solutions to clinician burnout must address the root causes that have been evident and not addressed in hospitals for decades. This is not a short term problem caused by the surge of critically ill Covid-19 patients but the result of chronic mismanagement of the nurse workforce through chronic nurse understaffing in hospitals and poor work environments. Doctors are also being negatively affected by poor work environments. It would be a very big mistake to return to the same human resource policies after the pandemic has diminished.