• Daniel Schwarzkopf, Hendrik Rüddel, Daniel O Thomas-Rüddel, Jörg Felfe, Bernhard Poidinger, Claudia T Matthäus-Krämer, Christiane S Hartog, and Frank Bloos.
• 1Center for Sepsis Control and Care, Jena University Hospital, Jena, Germany. 2Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany. 3Department of Work and Organizational Psychology, Helmut Schmidt University, Hamburg, Germany.
• Crit. Care Med. 2017 Mar 1; 45 (3): e265-e273.

ObjectivesPerceiving nonbeneficial treatment is stressful for ICU staff and may be associated with burnout. We aimed to investigate predictors and consequences of perceived nonbeneficial treatment and to compare nurses and junior and senior physicians.DesignCross-sectional, multicenter paper-pencil survey on personal and work-related characteristics, perceived nonbeneficial treatment, burnout, and intention to leave the job.SettingConvenience sample of 23 German ICUs.SubjectsICU nurses and physicians.InterventionsNone.Measurements And Main ResultsA total of 847 questionnaires were returned (51% response); 778 had complete data for final multivariate analyses. Nonbeneficial treatment was in median perceived "sometimes." Adjusted for covariates, it was perceived more often by nurses and junior physicians (both p ≤ 0.001 in comparison to senior physicians), while emotional exhaustion was highest in junior physicians (p ≤ 0.015 in comparison to senior physicians and nurses), who also had a higher intention to leave than nurses (p = 0.024). Nonbeneficial treatment was predicted by high workload and low quality collaboration with other departments (both p ≤ 0.001). Poor nurse-physician collaboration predicted perception of nonbeneficial treatment among junior physicians and nurses (both p ≤ 0.001) but not among senior physicians (p = 0.753). Nonbeneficial treatment was independently associated with the core burnout dimension emotional exhaustion (p ≤ 0.001), which significantly mediated the effect between nonbeneficial treatment and intention to leave (indirect effect: 0.11 [95% CI, 0.06-0.18]).ConclusionsPerceiving nonbeneficial treatment is related to burnout and may increase intention to leave. Efforts to reduce perception of nonbeneficial treatment should improve the work environment and should be tailored to the different experiences of nurses and junior and senior physicians.

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