End-of-life decision making in the context of chronic life-limiting disease: a concept analysis and conceptual model.

BACKGROUND The National Academies of Medicine describes clinician burnout as a serious threat to organizational health, including employee turnover. PURPOSE To determine the relationship between resilience, burnout, and organizational and position turnover. METHODS We surveyed direct care nurses in three hospitals one year apart between 2018 and 2019; 1,688 nurses completed 3,135 surveys included in analysis. FINDINGS We find 54% of nurses in our sample suffer from moderate burnout, with emotional exhaustion scores increasing by 10% and cynicism scores increasing 19% after one year. The impact of burnout on organizational turnover was significant, with a 12% increase in a nurse leaving for each unit increase on the emotional exhaustion scale, though it was not a factor in position turnover. DISCUSSION These findings contribute to the growing body of evidence of nurse burnout and support policies and programs for annual measurement of burnout, increased employee wellbeing support, and improved work environments.