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Small Patients but a Heavy Lift: Workload and Burnout of Advanced Practice Providers and Physicians in a Level IV
M Eva Dye1, Patti Runyan, Theresa A Scott
1Author Affiliations: Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee (Drs Dye, Runyan, Hatch, and Alrifai); Department of Pediatrics, Division of Neonatology, Vanderbilt University Medical Center, Nashville, Tennessee (Drs Dye, Hatch, and Alrifai); Vanderbilt Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee (Ms Scott and Dr Dietrich); School of Nursing, Vanderbilt University, Nashville, Tennessee (Dr Dietrich); The Center for Child Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee (Dr Hatch); Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee (Dr France); Center for Research and Innovation in Systems Safety, Vanderbilt University Medical Center, Nashville, Tennessee (Dr France); and Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee (Dr Alrifai.
Objective:
This study explored the association between workload and the level of burnout reported by clinicians in our neonatal intensive care unit (NICU). A qualitative analysis was used to identify specific factors that contributed to workload and modulated clinician workload in the NICU.
Study Design:
We conducted a study utilizing postshift surveys to explore workload of 42 NICU advanced practice providers and physicians over a 6-month period. We used multinomial logistic regression models to determine associations between workload and burnout. We used a descriptive qualitative design with an inductive thematic analysis to analyze qualitative data.
Results:
Clinicians reported feelings of burnout on nearly half of their shifts (44%), and higher levels of workload during a shift were associated with report of a burnout symptom. Our study identified 7 themes related to workload in the NICU. Two themes focused on contributors to workload, 3 themes focused on modulators of workload, and the final 2 themes represented mixed experiences of clinicians' workload.
Conclusion:
We found an association between burnout and increased workload. Clinicians in our study described common contributors to workload and actions to reduce workload. Decreasing workload and burnout along with improving clinician well-being requires a multifaceted approach on unit and systems levels.
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