Burnout rate high among Michigan nurses, survey finds

Ninety-four percent of Michigan nurses report emotional exhaustion, with younger nurses significantly more likely to report burnout than colleagues over 45, according to a University of Michigan School of Nursing survey.

"I've been studying nurse burnout for 20 years and these are among the highest numbers I've seen," said principal investigator Christopher Friese, U-M professor of nursing and public health.

The study examined three outcomes among nurses: emotional exhaustion, a key component of burnout; thoughts of self-harm and overall wellness; and identified interventions. The findings appear in American Journal of Public Health.

"Findings from this study are a call to action to generate evidence-based system-level interventions to promote nurses' health, address emotional exhaustion and promote well-being of the nursing workforce," said lead author Marita Titler, U-M professor emerita of nursing.

Workplace is the main contributor to burnout

The study's data were collected from the Michigan Nurses' Survey in 2022. Among its findings:

• Inadequate staffing, lower psychological safety in the workplace and younger age were associated with emotional exhaustion.
• Physical abuse in the workplace was associated with thoughts of self-harm.
• Employer support, favorable practice environments, higher job satisfaction and positive coping strategies were associated with higher wellness scores.
• When nurses reported their workplace staffing and resources were adequate, they were 18% less likely to be burned out.
• About 10% of nurses reported thoughts of self-harm.
• Nurses who engaged in hobbies and spent time with family and friends had better outcomes, whereas those who slept more or watched TV did not.

The youngest nurses had the highest rates of burnout and thoughts of self harm, and the poorest overall well-being, Friese said. This supports findings from a study last year that found that more than half of nurses 35 and younger planned to leave their jobs.

"For burnout and overall well-being, the drivers were workplace, not personal characteristics," Friese said. "To me, this suggests that younger nurses do not perceive their workplaces as supportive as they could be. Employers likely need to adopt different strategies to support younger nurses, as they appear less likely to accept poor working conditions."

Respondents cited things such as safer staffing, more flexible roles and schedules, improved compensation and benefits, and stronger management support for their ideas.

"They are not interested in more pizza parties or yoga classes," Friese said. "They want their employers to address longstanding structural deficits in their workplaces."

Not a new problem

Michigan will consider staffing legislation for nurses this year, and passing limits on overtime and other working condition improvements could help, Friese said. Michigan Gov. Gretchen Whitmer recently signed legislation that mandated higher fines for violence against health care workers, but it remains to be seen whether it works, he said.

"Over a quarter of nurses had been physically abused in the workplace and just below half reported verbal or emotional abuse. And abusive events contributed to more burnout and self-harm thoughts," Friese said. "That's unacceptably high and calls for very specific strategies to curtail those harmful events."

In 2021, the team published findings that deaths by suicide were roughly twice as high among female nurses than the general female population in the U.S.

"Given the alarmingly high number of violent events reported, we are doing a deeper dive on that issue to see if we can identify opportunities for improvement," Friese said.