Date of Completion of Thesis/SIP

5-6-2020

Document Type

Thesis

Degree Name

Master of Science in Nursing (MSN)

Department

Nursing

First Advisor

Jenny Prochnow

Abstract

Problem: Nurse leaders commonly experience stress and self-reported burnout. The associated negative consequences are compelling, yet few studies to date consider the nurse leader population. Stress is “a multidimensional phenomenon determined by a person’s perceptions and may be assessed as harm, loss, threat, or challenge” (Udod, Cummings, Care, & Jenkins, 2017a, p. 160). Burnout is a lack of professional fulfillment caused by emotional, physical, and psychological stress (Nurse Burnout, 2019). Drivers are associated and contributing factors which lead to stress and self-reported burnout.

Purpose: The purposes of this correlational study are to (a) identify drivers from the literature and adapt an existing model to nurse leader populations, (b) investigate associations between drivers of stress among two nurse leader groups: Nurse Mangers/Nurse Supervisors and Chief Nursing Officers/Nurse Directors, (c) investigate association between drivers and self-reported burnout among all nurse leaders, and (d) compare drivers identified in the literature to drivers from the Minnesota Organization of Leaders in Nursing (MOLN) study.

Conceptual Framework: The Job Demands-Resources (JD-R) Model of Burnout guided the literature review. We adapted our own model on stress leading to burnout in nurse leaders entitled Johnson, Nichols, and Sakhitab (JNS) Model of Stress Leading to Burnout in Nurse Leaders. The focus of the JNS model was to identify the drivers of stress leading to burnout in nurse leaders.

Literature Search: Eight drivers of stress leading to burnout from the literature were: administrative duties, organizational constraints, role overload, lack of control, preparation, personal characteristics, quality patient care, and social support.

Methods Data Analysis: The research method used for this thesis was a secondary analysis of the 2018 MOLN and the Minnesota Hospital Association Nurse Leader Burnout Survey. The Pearson product-moment correlation was used to assess relationships between drivers, stress, and burnout. The total sample included 210 nurse leaders.

Results Data Analysis: Results from this secondary analysis found statistically significant drivers of stress in Nurse Managers and Nurse Supervisors (n = 90) were time (r = -.500, p = .000), control (r = -.321, p = .002), and resources (r = -.254, p = .016). The statistically significant drivers of stress in Chief Nursing Officers and Nurse Directors (n = 74) were time (r = -.492, p < .000), resources (r = -.441, p = .000) control (r = -.387, p = .001), team efficiency (r = -.338, p = .003), and autonomy (r = -.250, p =.031). Drivers of self-reported burnout in nurse leaders (n = 210) in order of correlational strength were control, time, autonomy, resources, appreciation, team efficiency, value and quality (-.419 < r < -.181, p ≤ .009).

Implications for Practice: Nurse leaders carry a high degree of responsibility and are unable to achieve optimal work/life balance. One solution is to restructure leadership hierarchy to include a co-manager role. A second implication for practice relates to the lack of control driver of stress; nurse leaders desire the freedom, empowerment, and autonomy to make decisions without fear for retribution. Lastly, an implication for practice relates to the drivers of social support and appreciation. It will be prudent for health care administrators to re-focus energies on provision of appreciation and recognition to nurse leaders.

Implications for Research: The gap in longitudinal designed studies creates an opportunity for future research. We recommend replicating the MOLN study longitudinally and nationally to support findings from this secondary analysis. Future studies focusing on self-reported burnout need a standardized measurement tool. This will allow for direct comparison of data and stronger analysis of findings. Lastly, drivers of stress leading to burnout in nurse leaders must be universally defined.

Comments

Committee Member: Diane Forsyth

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