• Lesly A Kelly, Karen L Johnson, R Curtis Bay, and Michael Todd.
• Lesly A. Kelly is a nurse scientist, CommonSpirit Health, and a clinical associate professor, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona.
• Am. J. Crit. Care. 2021 Mar 1; 30 (2): 113-120.

BackgroundAs the role of a health care system's influence on nurse burnout becomes better understood, an under-standing of the impact of a nurses' work environment on burnout and well-being is also imperative.ObjectiveTo identify the key elements of a healthy work environment associated with burnout, secondary trauma, and compassion satisfaction, as well as the effect of burnout and the work environment on nurse turnover.MethodsA total of 779 nurses in 24 critical care units at 13 hospitals completed a survey measuring burnout and quality of the work environment. Actual unit-level data for nurse turnover during a 5-month period were queried and compared with the survey results.ResultsAmong nurses in the sample, 61% experience moderate burnout. In models controlling for key nurse characteristics including age, level of education, and professional recognition, 3 key elements of the work environment emerged as significant predictors of burnout: staffing, meaningful recognition, and effective decision-making. The latter 2 elements also predicted more compassion satisfaction among critical care nurses. In line with previous research, these findings affirm that younger age is associated with more burnout and less compassion satisfaction.ConclusionsEfforts are recommended on these 3 elements of the work environment (staffing, meaningful recognition, effective decision-making) as part of a holistic, systems-based approach to addressing burnout and well-being. Such efforts, in addition to supporting personal resilience-building activities, should be undertaken especially with younger members of the workforce in order to begin to address the crisis of burnout in health care.©2021 American Association of Critical-Care Nurses.

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