Why nurse burnout efforts need to target younger nurses

Nurse burnout has been on the radar of healthcare leaders for several years now, and there’s no doubt the Covid pandemic has turned a problem into a crisis. One aspect of nurse burnout that has come to the forefront is how it’s affecting younger nurses.

The current situation for nurses is difficult. A majority of nurses report symptoms of burnout – in one survey of nearly 12,000 nurses, participants reported stress (71%), frustration (69%), exhaustion (65%) and feeling overwhelmed (58%) in the previous 14 days.¹ This is leading to nurse turnover rates rising to 20-30%² and an alarming number of nurses reporting their intentions to leave bedside care positions or even the profession.

Younger nurses in particular are struggling with the effects of nurse burnout. Across the board, they report higher rates of stress, worse emotional health, and greater intentions to leave their jobs than their more senior counterparts. Of the respondents younger than 25 in the survey cited above, 69% say they have been suffering from burnout, which is more than double the rate of those older than 25 (30%).

What’s causing younger nurse burnout?

The biggest factor driving nurse burnout is growing workload demands on account of a serious nursing shortage. A recent nursing workforce analysis found that total supply of RNs decreased by more than 100,000 from 2020 to 2021 – the largest drop observed over the past four decades.³ This drop is coming primarily from younger nurses; compared with 2019, there was a 4% drop in RNs younger than age 35 by 2021.³ Among nurses who intend to leave their position in the next six months, insufficient staffing was cited as the number one reason.¹

Younger nurses have additional challenges because they started their careers in a “trial by fire” environment during the Covid pandemic, particularly in acute care settings. Many of them received less on-site training because clinical rotations were restricted during the pandemic, and they also had shorter orientations when they started their positions.

“New nurses have always had to adjust to the transition from learning to practicing, but today’s new nurses have added challenges that are making it harder for them to find their footing and be ready for the rigors of the profession,” says Heather Du Mez, RN, Clinical Editorial Manager for Micromedex.

Another factor that may be hitting younger nurses harder is the increase in incivility, bullying and even violence that healthcare workers are being subjected to. Attitudes toward healthcare workers have been deteriorating, and frontline healthcare workers are paying the price. Among surveyed nurses, 57% said they had experienced workplace bullying or incivility from patients and 53% have experienced it from families.¹

Everyone benefits from a healthy nursing environment

There are clear benefits for everyone when nurses can do their best work. This is particularly true for patients. Studies show a clear correlation between nurse-patient ratio and patient outcomes⁴ – when nurses are overloaded and overwhelmed, patients are at risk. But when nurses have a manageable workload and are equipped to work at the top of their license, patients receive the individualized, professional care they need.

Healthcare leaders also benefit by addressing nurse burnout. In addition to protecting the well-being of their staff and the safety of their patients, mitigating nurse burnout makes good economic sense. A recent cost analysis of nurse burnout-attributed turnover found that hospitals with burnout reduction measures in place spend about 30% less per nurse per year, and their nurses remain employed in their current hospital 20% longer, compared with hospitals with no burnout mitigation measures.⁵

It's particularly beneficial to prevent attrition in younger nurses. Because RNs tend to stay in nursing for their career, losing younger nurses could have long-term impacts on the workforce for a generation to come.

Solutions to nurse burnout can turn the tide

There are no quick fixes to nurse burnout. But there are concrete measures that organizations can take to improve the health and well-being of their nurses, particularly with younger nurses:

• Invest in staff nurses with competitive wages, meaningful raises and bonuses, and tuition reimbursement. An upfront financial investment is the most effective way to close staffing gaps, which in turn will increase satisfaction, decrease turnover, and ultimately save money.

• Offer support programs and resources, particularly for younger nurses. Incentivize experienced nursing staff to participate in mentor programs for their younger colleagues. “Peer support is crucial for younger nurses, because they know their more senior colleagues really understand what they’re going through” says Courtney Holmes, RN, Clinical Program Director for Micromedex.

• Work to remove the stigma of seeking mental health help for healthcare workers. It should be seen as standard self-care rather than a sign of weakness. Make mental health resources are not just available but encouraged.
• Make sure there are paths to advancement and professional development opportunities for nurses. Give them agency by making sure they have a seat at the table for organizational decision-making.

• Decrease administrative burden for nurses by sufficiently staffing support personnel and by implementing technologies that increase workflow efficiency and decrease busywork.

Tackling nurse burnout may not be easy, but it’s an effort well worth making — for the sake of nurses’ well-being, the organization’s bottom line and, most importantly, patient care and safety.

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Sources

1. American Nurses Foundation, Pulse on the Nation's Nurses COVID-19 Survey Series: COVID-19 Impact Assessment Survey – The Second Year, January 2022.

2. 2022 NSI National Health Care Retention & RN Staffing Report. Nursing Solutions Inc.  

3. A Worrisome Drop In The Number Of Young Nurses. David I. Auerbach et al. Health Affairs. April 13, 2022. 

4. The effect of nurse-to-patient ratios on nurse-sensitive patient outcomes in acute specialist units: a systematic review and meta-analysis. Eur J Cardiovasc Nurs. 2018 Jan;17(1):6-22. 

5. Evaluating the Costs of Nurse Burnout-Attributed Turnover: A Markov Modeling Approach. Journal of Patient Safety. 18(4):p 351-357, June 2022