Abstract
In the wake of a global pandemic and societal stressors, clinician wellbeing and the threat of burnout are commanding increasing attention. Burnout contributes to nurse turnover and is threatening the ability of health systems to provide safe, high-quality care for patients (Dyrbye et al., 2017). The National Academy of Medicine (NAM) recommends a systems approach to prevent clinician burnout and promote professional wellbeing as healthy professionals are essential for achieving positive health care outcomes (NAM, 2019). Meaning and joy in nursing practice are contributors to professional wellbeing and are part of the solution for achieving the quadruple aim. One of the recommendations of the NAM report is the use of validated measurement tools to assess the current state of burnout, professional wellbeing, and stress to identify and implement interventions to enhance nurse wellbeing.
This descriptive, cross-sectional, mixed-methods study used online survey data from nursing staff in one academic health system related to their experiences and recommendations to improve wellbeing. The Professional Quality of Life Scale (ProQol) is a validated tool that measures compassion satisfaction, burnout, and secondary traumatic stress (Stamm, 2009/12). Previous studies have explored burnout using this tool (Hicks, 1999; Ilhan et al., 2008; Kanste, 2008; Kanste e al., 2007). The subscale of Pro-Qol consists of Likert items. Meaning and Joy in Work Questionnaire (MJWQ) in nursing is also a validated tool (i.e., α .94) that measures value/connections, meaningful work, and caring (Rutledge et al., 2018). This tool has a total composite score with a range of one=low to five=high rating, validated for use with nurses (Deetz et al, 2020; Hahn et al., 2021). During a 3-week period, nursing personnel were invited by email to complete a voluntary, anonymous, 15-20 minute online survey inclusive of study information, access to the Pro-QoL 5 Scale, an optional MJWQ, a qualitative section with 3 semi-structured questions and a demographics section (N= 562 complete responses). Participant demographics were analyzed using descriptive statistics including frequencies, means, and standard deviations. Independent t-test and ANOVA were used to analyze differences in mean scores of the Pro-QoL subscales and MJWQ across nursing demographic profiles (SPSS, version 26). Thematic analysis was used for qualitative data.
Preliminary data analysis of Pro-QoL responses revealed moderate compassion satisfaction (mean 27.98 +/- 7.91), low compassion fatigue (burnout mean 17.97 +/- 7.36, secondary traumatic stress mean 16.19 +/- 7.89). MJWQ response means ranged from 2.24-2.32. Results serve as baseline data and repeat surveys will be used to evaluate the impact of interventions. Some significant differences based on demographic profile were identified and will be used to inform targeted interventions. Thematic analysis identified job-related factors creating stress for nurses and participant recommendations to reduce job-related stress and cultivate healthier practice environments. Recommendations have been incorporated into a nurse-driven action plan.
A systematic approach to measuring nurse wellbeing using validated instruments will allow nurse leaders partnering with clinical nurses to lead meaningful, data-driven change to reduce job-related stress, create healthier practice environments, prevent clinician burnout, reduce turnover and ultimately achieve better healthcare outcomes.
Notes
References:
Deetz, J. M., Davidson, J. E., Daugherty, J., Graham, P., & Carroll, D. M. (2020). Exploring correlation of nurse manager meaning and joy in work with employee engagement. Applied Nursing Research, ANR, 55, 151297. https://doi.org/10.1016/j.apnr.2020.151297
Dyrbye, L. N., Shanafelt, T. D., Sinsky, C. A., Cipriano, P. F., Bhatt, J., Ommaya, A., ... & Meyers, D. (2017). Burnout among health care professionals: a call to explore and address this underrecognized threat to safe, high-quality care. NAM perspectives.
Hahn, J., Galuska, L., Polifroni, E. C., & Dunnack, H. (2021). Joy and Meaning in Nurse Manager Practice: A Narrative Analysis. The Journal of Nursing Administration, 51(1), 38–42.https://doi.org/10.1097/NNA.0000000000000964
Hicks, C. (1999). Incompatible skills and ideologies: the impediment of gender attributions on nursing research. Journal of Advanced Nursing, 30(1), 129-139.
Ilhan, M. N., Durukan, E., Taner, E., Maral, I., & Bumin, M. A. (2008). Burnout and its correlates among nursing staff: questionnaire survey. Journal of Advanced Nursing, 61(1), 100-106.
Kanste, O. (2008). The association between leadership behaviour and burnout among nursing personnel in health care. Vård I Norden, 28(3), 4-8.
Kanste, O., Kyngäs, H., & Nikkilä, J. (2007). The relationship between multidimensional leadership and burnout among nursing staff. Journal of Nursing Management, 15(7), 731-739.
National Academies of Sciences, Engineering, and Medicine (2019). Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being. Washington, DC: The National Academies Press. https://doi.org/10.17226/25521
Rutledge, D. N., Wickman, M., & Winokur, E. J. (2018). Instrument validation: Hospital nurse perceptions of meaning and joy in work. Journal of Nursing Measurement, 26(3), 579-588.
Stamm, B. H. (2009/12). Professional Quality of Life: Compassion Satisfaction and Fatigue Version 5 (ProQOL). www.proqol.org.
Sigma Membership
Mu
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Cross-Sectional
Research Approach
Mixed/Multi Method Research
Keywords:
Organizational Culture, Well-being, Burnout, Stress and Coping, Turnover
Recommended Citation
Galuska, Lee; Phillips, Jessica; and Anderson, Kelley, "A Health System Approach to Evaluating Nurse Well-Being and Designing Interventions" (2025). Creating Healthy Work Environments (CHWE). 40.
https://www.sigmarepository.org/chwe/2023/presentations_2023/40
Conference Name
Creating Healthy Work Environments
Conference Host
Sigma Theta Tau International
Conference Location
Austin, Texas, USA and Virtual
Conference Year
2023
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2025-10-15
A Health System Approach to Evaluating Nurse Well-Being and Designing Interventions
Austin, Texas, USA and Virtual
In the wake of a global pandemic and societal stressors, clinician wellbeing and the threat of burnout are commanding increasing attention. Burnout contributes to nurse turnover and is threatening the ability of health systems to provide safe, high-quality care for patients (Dyrbye et al., 2017). The National Academy of Medicine (NAM) recommends a systems approach to prevent clinician burnout and promote professional wellbeing as healthy professionals are essential for achieving positive health care outcomes (NAM, 2019). Meaning and joy in nursing practice are contributors to professional wellbeing and are part of the solution for achieving the quadruple aim. One of the recommendations of the NAM report is the use of validated measurement tools to assess the current state of burnout, professional wellbeing, and stress to identify and implement interventions to enhance nurse wellbeing.
This descriptive, cross-sectional, mixed-methods study used online survey data from nursing staff in one academic health system related to their experiences and recommendations to improve wellbeing. The Professional Quality of Life Scale (ProQol) is a validated tool that measures compassion satisfaction, burnout, and secondary traumatic stress (Stamm, 2009/12). Previous studies have explored burnout using this tool (Hicks, 1999; Ilhan et al., 2008; Kanste, 2008; Kanste e al., 2007). The subscale of Pro-Qol consists of Likert items. Meaning and Joy in Work Questionnaire (MJWQ) in nursing is also a validated tool (i.e., α .94) that measures value/connections, meaningful work, and caring (Rutledge et al., 2018). This tool has a total composite score with a range of one=low to five=high rating, validated for use with nurses (Deetz et al, 2020; Hahn et al., 2021). During a 3-week period, nursing personnel were invited by email to complete a voluntary, anonymous, 15-20 minute online survey inclusive of study information, access to the Pro-QoL 5 Scale, an optional MJWQ, a qualitative section with 3 semi-structured questions and a demographics section (N= 562 complete responses). Participant demographics were analyzed using descriptive statistics including frequencies, means, and standard deviations. Independent t-test and ANOVA were used to analyze differences in mean scores of the Pro-QoL subscales and MJWQ across nursing demographic profiles (SPSS, version 26). Thematic analysis was used for qualitative data.
Preliminary data analysis of Pro-QoL responses revealed moderate compassion satisfaction (mean 27.98 +/- 7.91), low compassion fatigue (burnout mean 17.97 +/- 7.36, secondary traumatic stress mean 16.19 +/- 7.89). MJWQ response means ranged from 2.24-2.32. Results serve as baseline data and repeat surveys will be used to evaluate the impact of interventions. Some significant differences based on demographic profile were identified and will be used to inform targeted interventions. Thematic analysis identified job-related factors creating stress for nurses and participant recommendations to reduce job-related stress and cultivate healthier practice environments. Recommendations have been incorporated into a nurse-driven action plan.
A systematic approach to measuring nurse wellbeing using validated instruments will allow nurse leaders partnering with clinical nurses to lead meaningful, data-driven change to reduce job-related stress, create healthier practice environments, prevent clinician burnout, reduce turnover and ultimately achieve better healthcare outcomes.
Description
Summary: The purpose of this study was to: (1) evaluate compassion satisfaction, burnout, and trauma-induced stress among health system nursing personnel; (2) examine meaning and joy in nursing practice and explore nursing staff-reported stressors; and (3) provide recommendations to manage stress and improve practice environments.
Topic: Organizational culture
Abstract Pertains To: Clinical
Work Setting: Urban/city/metropolitan
Topic Category: Acute care
Target Group: Clinical, Leaders and Researchers
Topic Subject: Adult
Topic Demographics: Nurses
Is Body System / Disease Process: No
Completed: Completed Work/Project