Staffing Shortages, Less Direct Patient Care and the COVID-19 Pandemic: Key Factors in Nurse Burnout
When you ask children these days what they want to be when they grow up, many say an astronaut, firefighter or teacher. The most popular answer used to be doctor or nurse.
The nursing profession has changed markedly over the past couple decades. Less time is spent on direct patient care, while more consists of numerous administrative tasks.
The United States healthcare industry employs almost 4.2 million registered nurses (RNs), 950,000 licensed practical nurses (LPNs) and 325,000 nurse practitioners (NPs). A reported 15.6 percent of those nurses have reported feelings of burnout.
Nurse Burnout Defined
Nurse burnout is a work-related stress syndrome characterized by emotional exhaustion, depersonalization and reduced personal accomplishment. It’s a very serious issue that often doesn’t get nearly as much attention as physician burnout.
It should, though. A recent study conducted by the University of Michigan School of Nursing shows that female nurses are 70 percent more likely to take their own lives than female physicians.
The Reasons Behind Nurse Burnout
What’s the reason for such high levels of burnout among U.S. nurses? Unfortunately, there’s not just one.
These healthcare professionals are experiencing higher workloads than ever before due to understaffed facilities, increased overtime and reduction in patient length of stay. They’re burdened with fatigue, a chronic lack of sleep and feelings of being constantly overworked but unappreciated.
Nurse burnout doesn’t only affect the individuals in this career. Higher levels of nurse burnout are associated with increased rates of both patient mortality and dissemination of hospital-transmitted infections. Evidence shows that in hospitals with higher rates of RN burnout, patient safety is threatened. and patients have higher odds of dying.
The COVID-19 pandemic did nothing to mitigate this burnout. An American Association of Critical-Care Nurses (AACN) survey found that 92 percent of nurses believe the pandemic has depleted nurses at their hospitals, and 66 percent feel their experiences during the pandemic have caused them to consider leaving nursing.
The Unfortunate Effects of Nurse Burnout
A lack of nurses is part of the overall healthcare labor shortage, an issue negatively affecting the entire industry. One widely cited study projects a shortfall of 510,394 registered nurses by 2030. Some reports predict that 1.2 million new registered nurses will be needed to address that deficit.
In nursing, shortages lead to errors and higher morbidity and mortality rates. The impact of the nursing shortage on patients includes risk of over- or under-medicating patients, lapses of continuity in treatment and risk of infections and compromised data security. 
The nursing shortage resulting from high levels of burnout is affecting the industry financially. Hospitals and health systems across the country are paying $24 billion more per year for qualified clinical labor than they did before the COVID-19 pandemic.
Another area being impacted by these shortages is nurse-to-patient ratio. A survey from the American Nurses Association (ANA) reported that more than half of its nurse respondents said they didn’t have sufficient time to spend on each patient.
Nurses with greater than a 1:4 nurse-to-patient ratio have a higher risk of burnout, with each additional patient raising the risk by 23 percent. These ratios vary based on the acuity of the patients in their care – a lower nurse-to-patient ratio typically results in greater job satisfaction, decreased turnover and higher patient satisfaction.
Conversely, adequate nurse staffing can reduce medical and medication errors, patient mortality, hospital readmissions, length of stay and the number of preventable events, including patient falls, healthcare-associated infections (HAIs), pressure ulcers and central line infections. It also may reduce patient care costs by avoiding unplanned readmissions.
How Digital Health Tools Can Help Minimize Nurse Burnout
For nursing care managers and other healthcare professionals involved in direct patient care, these issues have to be addressed. The adverse consequences they precipitate can easily decrease patient satisfaction — and patient outcomes.
Although it might seem as though digital health tools add to the tasks for which nurses are responsible, they assist them by streamlining administrative workflows, leaving more time for patient care. For example, they can utilize secure and HIPAA-compliant two-way texting to clearly communicate with patients in between visits, for post-discharge follow-ups and pre-procedure education and to respond to routine requests — without having to pick up the phone. They can even deliver test results electronically in seconds via secure text.
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