As awareness of burnout in ICU providers continues to increase, data on effective solutions are beginning to emerge. A recent study paints a clear picture of the financial impact on hospitals if burnout goes unaddressed.

The participants were 198 ICU nurses at eight adult ICUs in France. One group of nurses that took part in a five-day program including education, role play exercises, and debriefing experienced a lower prevalence of job strain at six months compared to nurses who did not receive the intervention.1 Absenteeism was 1% in the intervention group, compared with 8% in the control group. Four nurses from the intervention group left the ICU during the six-month follow-up period, compared with 12 from the control group.

“The study showed some really impressive effects. As someone with a background in ICU nursing, this is an exciting finding,” says Jennifer Seaman, PhD, RN, an assistant professor in the University of Pittsburgh School of Nursing’s department of acute and tertiary care who co-authored a recent paper on this topic.2

The National Academy of Medicine recently launched a two-year collaborative to promote clinician resilience and well-being. “This is such a pressing and alarming problem in the U.S., for both ICU nurses and physicians,” says Seaman. “It is encouraging to see this issue moved to the forefront.”

Institutions are increasingly acting to address burnout, but lack of data on effective interventions remains a barrier for many. “It’s unclear if the French study’s outcomes would be duplicated in the U.S. setting,” says Seaman. One reason is that the participants had fewer years experience in the ICU than nurses typically have in the U.S., with a somewhat different role.

“It’s not clear if this would generalize to a more experienced workforce. But the findings give us food for thought,” says Seaman.

Nurses’ ability to participate in interventions is another obstacle, as most work 12-hour shifts. Whether individual interventions, shared activities, or a combination of both is best is not well-studied. “So much work needs to be done to better understand what works,” says Seaman.

For institutions weighing whether to commit time and resources, the promise of reduced turnover and absenteeism is a strong motivator. “When experienced people leave, there is a knowledge vacuum that affects others in the workplace, as well as patient care,” explains Seaman. “It’s a deleterious cycle.”

Hospital leaders, of course, are more comfortable implementing options that already have demonstrated effectiveness. “We are at the point now where we are looking to find those interventions that will be feasible and effective and sustainable,” says Seaman.

The mere fact that job strain — and resulting burnout — is now widely acknowledged and openly discussed is notable. “We are in a great place right now,” says Seaman. “There’s recognition that there’s a lot at stake if workplace stress is not addressed — beyond just that one clinician.”

REFERENCES

1. Khamali RE, Mouaci A, Valera S, et al. Effects of a multimodal program including simulation on job strain among nurses working in intensive care units: A randomized clinical trial. JAMA 2018; 320(19):1988-1997.

2. Seaman JB, Cohen TR, White DB. Reducing the stress on clinicians working in the ICU. JAMA 2018 Oct 24. doi: 10.1001/jama.2018.14285. [Epub ahead of print]

SOURCE

• Jennifer Seaman, PhD, RN, Department of Acute and Tertiary Care, University of Pittsburgh School of Nursing. Email: jbs31@pitt.edu.