Burnout, collective efficacy and the social network of an intensive care unit

The prevalence of burnout among critical care nurses is high. Burnout has been explored at the individual and system levels, with little research occurring at the unit level. Increased social support and self-efficacy are correlated with a decreased risk of burnout at the individual level; however, little is known in how collective efficacy and types of social support are protective against the development of burnout.

Explore the relationships between burnout, collective efficacy and social supports in an intensive care unit.

Using a descriptive design, health care professionals working in an intensive care unit (n = 39) were recruited to complete surveys measuring burnout, collective efficacy and four types of social support (emotional, instrumental, informational and advice-seeking). Data were analysed using Spearman's rank correlation and sociograms.

The unit displayed burnout with high levels of emotional exhaustion, moderate levels of depersonalization and high levels of personal accomplishment. The unit had high levels of collective efficacy. Collective efficacy demonstrated a significant and strong negative correlation with emotional exhaustion (r_s = -0.57, p < .001) and a significant strong positive correlation with personal accomplishment (r_s = 0.50, p < .005). The advice-seeking network was dense (67%) and advice-seeking social support had a significant negative association with personal accomplishment (r_s = -0.35, p < .01).

The results demonstrated that burnout develops sequentially from emotional exhaustion to depersonalization to lack of personal accomplishment. Social network analysis methods displayed a deeper understanding of community on a unit than prior quantitative research exploring burnout.

To decrease burnout, we recommend assessing burnout as a continuum and as a unit-level risk factor. Interventions should be identified that strengthen community on the unit as well as supporting unit leaders.