Work Unit Conditions and Emotional Exhaustion: A Multilevel Study of Healthcare Workers

This study aimed to examine how work unit-level job control (ie, decision authority and schedule control) modifies the association between psychological job demands and emotional exhaustion (a dimension of burnout) among nursing home staff.

We analyzed four waves of data from 1144 employees in 126 units at a long-term care organization. Emotional exhaustion was measured using the Maslach Burnout Inventory, with unit-level decision authority, schedule control, and demands derived from coworker responses. Quantile regression assessed associations across emotional exhaustion levels.

Higher unit-level demands increased exhaustion, whereas schedule control generally reduced it. However, decision authority and schedule control buffered the effect of job demands on exhaustion for less exhausted employees but intensified exhaustion for already exhausted workers.

Tailoring strategies accounting for initial employee exhaustion levels and considering work unit-level dynamics may increase capacity to enhance worker well-being and effectiveness.