(870) Burnout Among Pediatric ICU Staff Nurses and Respiratory Therapists: A Mixed-Methods Study

Introduction: In a time when hospitals are already experiencing staff shortages and high turnover, staff burnout has the potential to be detrimental. While much of the research on burnout has focused on individual risk factors, there is a growing body of literature on the contagious nature of burnout in work environments. This suggests that interventions should be on a unit-wide basis, rather than an individual one. We therefore employed an explanatory sequential mixed methods study design to first quantify and subsequently characterize burnout at a single center, academic Pediatric Intensive Care Unit (PICU) among staff nurses (RNs) and respiratory therapists (RTs). We then aimed to identify potential unit-wide interventions to mitigate burnout.

Methods: Following IRB approval, the Maslach Burnout Inventory (MBI) was distributed to PICU staff RNs and RTs. The MBI is considered the gold standard of burnout identification and measures three components--emotional exhaustion, depersonalization, and lack of personal achievement. We then used the MBI results to develop a targeted, open-ended survey for our PICU staff.

Results: Forty staff RNs and RTs completed the MBI. The most common component of burnout was a lack of personal achievement, with 72.5% of participants scoring "high." Forty percent scored high for depersonalization and 25% for emotional exhaustion. Notably, a recent meta-analysis reported that 62% of PICU staff experience high burnout.

Subsequent open-ended surveys focused on the lack of personal achievement within our unit. Early survey responses suggest several key drivers, including underappreciation from providers, micromanaging, and poor staffing. Respondents noted that physicians did not seem to understand the complexities of nursing and respiratory therapy. They suggested that giving RNs and RTs the opportunity to teach physicians would help with inter-professional communication and respect.

Conclusions: We used the MBI to determine a burnout profile for our PICU and gained additional insight through open-ended surveys. Based on survey results, we implemented sessions with first year fellows during which they spent time with RNs and RTs. Further steps include additional teaching sessions and measuring the impact of these interventions.