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Association Between Perceived Stress and Burnout Among Neonatal Intensive Care Nurses.

Sooyoung Kim1, Jin Jun, Adam C Carle

  • 1Author Affiliations: College of Nursing (Drs Kim, Jun, Hall, and Tubbs-Cooley), The Ohio State University, Columbus, Ohio; James M. Anderson Center for Health Systems Excellence (Dr Carle), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; and Department of Pediatrics, College of Medicine (Dr Carle), Department of Psychology, College of Arts and Sciences (Dr Carle), University of Cincinnati, Cincinnati, Ohio.

Advances in Neonatal Care : Official Journal of the National Association of Neonatal Nurses
|October 16, 2025
PubMed
Summary

Neonatal Intensive Care Unit (NICU) nurses experience high stress and burnout, particularly experienced nurses and those in direct patient care. Reducing direct care hours and providing career-stage-specific support can mitigate burnout.

Keywords:
emotional exhaustionneonatal intensive care unitsneonatal nursesprofessional burnoutpsychological burnoutpsychological stress

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Area of Science:

  • Nursing
  • Healthcare Management
  • Occupational Health

Background:

  • Pre-pandemic nurse stress and burnout were high, with Neonatal Intensive Care Unit (NICU) nurses particularly affected.
  • The COVID-19 pandemic exacerbated stressors for NICU nurses, though impacts varied across different NICUs.

Purpose of the Study:

  • To investigate the association between perceived stress and burnout among NICU nurses during a period of workforce strain.
  • To understand the factors contributing to stress and burnout in this critical care nursing population.

Main Methods:

  • Secondary analysis of cross-sectional survey data from 259 nurses across 10 NICUs (2021-2023).
  • Utilized the Perceived Stress Scale (PSS) for stress and the Maslach Burnout Inventory (Emotional Exhaustion subscale) for burnout.
  • Employed descriptive statistics and multivariable linear regression to analyze relationships.

Main Results:

  • Over half of participating NICU nurses reported moderate to high burnout (mean Emotional Exhaustion score: 19.7).
  • Higher perceived stress, increased NICU experience, and more weekly direct patient care hours correlated with higher burnout.
  • Burnout levels and the stress-burnout relationship varied significantly between NICUs.

Conclusions:

  • High stress and burnout are prevalent among NICU nurses, with experienced staff and those providing direct care at greatest risk.
  • Strategies such as reducing direct patient care hours and offering career-stage-tailored support are recommended.
  • Future research should prioritize the development and validation of interventions to combat NICU nurse burnout.