Occupational Burnout in Nurses Is due to Long-Term Work Stress Rather Than COVID-19 Pandemic Event

This study aims to explore occupational burnout among Chinese nurses from two perspectives: first, by comparing changes in emotional exhaustion, depersonalisation and personal accomplishment before and after the COVID-19 pandemic; and second, by identifying long-term work-related stressors and structural factors contributing to burnout.

A mixed-methods approach was adopted, combining a systematic review with qualitative interviews. The qualitative component involved semi-structured interviews with 53 hospital-employed nurses from various departments and regions across China, focusing on the three core dimensions of occupational burnout.

The systematic review included both Chinese and English-language studies published between 2016 and 2023 that used the Maslach Burnout Inventory to assess burnout among nurses. A total of 22 studies met the inclusion criteria, selected independently by two researchers using the JBI critical appraisal tool. In parallel, the qualitative interviews explored nurses' subjective experiences and coping strategies related to work stress, emotional fatigue and professional identity.

Bayesian factor analysis indicated no significant differences in emotional exhaustion (BF₀₁ = 2.202), depersonalisation (BF₀₁ = 2.761) or personal accomplishment (BF₀₁ = 2.747) before and after the pandemic. Qualitative findings revealed that burnout was primarily driven by long-standing systemic stressors, including promotion pressure, clinical workload, organisational demands and work-family conflict. Although many nurses relied on self-regulation strategies to maintain psychological stability, they continued to experience ongoing physical and emotional exhaustion. Some reported emotional numbness, but most retained empathy and a strong sense of responsibility. Their sense of personal accomplishment often stemmed from patient recovery and recognition of professional value.

Occupational burnout among Chinese nurses remained largely stable before and after the COVID-19 pandemic. Its root causes stem from persistent work-related stressors and systemic issues, rather than the pandemic itself. Effective mitigation requires institutional strategies, including better staffing, clear career pathways and sustained emotional support.

Short-term crisis responses alone are insufficient to address enduring burnout. Nursing leadership should prioritise systemic reforms-such as optimising shift schedules, defining promotion channels and integrating regular psychological support-to enhance nurse well-being and care quality.

No patient or public contribution.