Impact of Registered Nurse Staffing, Workload, and the Practice Environment on Burnout in Emergency Nurses

Burnout among registered nurses is an ongoing nurse workforce issue, yet there is no quantified evidence on the factors that contribute to burnout among registered nurses in emergency departments. We examined different aspects of the nurse practice environment in hospital-based emergency departments across New Jersey.

This cross-sectional study included a survey of emergency nurses. Using a publicly available list, an email invitation with a survey link was used to recruit potential study participants. Four self-reported measures were used. Burnout was a single-item measure, and registered nurse staffing was assessed as the number of patients assigned to a nurse on the last day worked. Additional measures included the perceived workload subscale of the Individual Workload Perception Scale and the Practice Environment Scale of the Nursing Work Index. Logistic regression models were used to estimate the odds of burnout.

A total of 188 emergency registered nurses completed the survey. Seventy-two percent of registered nurses reported moderate to complete burnout and 34% reported sustained or complete burnout. Perceptions of high workloads (odds ratio, 2.89; P = .04) and unsupportive practice environments (odds ratio, 8.02; P<.001) were associated with an increase in the odds of high burnout. An unsupportive practice environment significantly mediated the relationship between high perceived workload and high burnout.

There's an urgent need to reduce burnout among emergency registered nurses. Study findings point to a pressing need for hospital and emergency department leadership to implement strategies to improve the practice environment and decrease nurse workloads.