Provider Spotlight: Dr. Mandel, ER Maverick & Locum Tenens Physician

Dr. Ken’s Corner: Nurse Burnout Prompts Growing Concern

Shockingly, 50% of nurses have thought about leaving their profession, according to a recent study by RN Network. Simply stated, they’re burning out. Up until now, it’s been a malady that’s been hidden from view, despite it’s negative impact on the quality of patient care. Whether one is referring to physicians or nurses, the signs and symptoms of burnout are the same: emotional exhaustion, detachment, cynicism, and a lack of a sense of personal accomplishment.

Since nurses are the largest staff component in hospitals, they’re an easy target for aggressive cost-cutting. Accounting for 55% of the clinical hospital employees, “it has been this area most reformers have chosen to focus efforts to reduce costs,” says a study by Marshall University. “These efforts have considered nurses and the cost of their labor as an expense that can easily be cut back by increased hours and a decreased labor force.” The resulting adjustment in the nurse-patient ratio has had “risky consequences, including high stress levels and mental exhaustion among nurses and has led to an increase in mistakes and accidents, and resulted in a surge in malpractice suits.” The study concluded that the “nurse-patient ratio is a direct determinant of nurse performance and patient health status.”

Research funded by the Agency for Healthcare Research and Quality (AHRQ) reveals that ”Hospitals with low nurse staffing to high patient ratios have higher rates of poor patient outcomes.” As reported at “The quality of care a nurse can administer is limited in relation to the amount of patients they are responsible for treating. Higher nurse to patient ratios have been confirmed to not only reduce the risks involved in patient care, but also have had a direct correlation with the well-being of the nurse. This is critical. When a nurse feels less overwhelmed, self-esteem and confidence in the care they are providing is dramatically increased. The patient is going to reap the rewards.”

Hospitals and health care systems need to become more aware of the significance of maintaining appropriate nurse to patient ratios.To this end, physicians and other hospital staff members must provide a support system for nurses, so that they can provide the quality of care patients deserve.

The burden of having to care for a larger number of patients is not the only reason nurses are burning out. Sometimes the job of being a nurse is simply different from what a nurse might have expected, says nurse educator Ingrid Flanders of Portland, Oregon. “Maybe they don’t have a full understanding of the role and responsibilities that go with it,” said Flanders, adding that they need to be prepared “physically, mentally, and emotionally for the work involved” ( One approach, led by the University of Iowa Hospitals and Clinics, is to encourage recent nursing school graduates to participate in nurse residency programs that focus on expectations and overall self-confidence before they enter that first job. Results, so far, indicate that the University of Iowa program has been successful in reducing the amount of stress endured by recent graduates — a significant step in the right direction.