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Assessing and addressing practitioner burnout

Results from an advanced practice registered nurse health and well-being study

Kapu, April N. DNP, APRN, ACNP-BC, FAANP (Associate Chief Nursing Officer)1; Borg Card, Elizabeth MSN, APRN, FNP-BC, CPAN, CCRP, FASPAN (Nursing Research Consultant)2; Jackson, Heather MSN, APRN, FNP-BC (Director of Advanced Practice)3; Kleinpell, Ruth PhD, RN, FAAN (Assistant Dean for Clinical Scholarship and Professor)4; Kendall, Jim LCSW, CEAP (Manager)5; Lupear, Buffy Krauser DNP, CRNA, APRN (Director of Professional Development)6; LeBar, Kiersten DNP, MMHC, APRN, CPNP-AC (Director of Advanced Practice)7; Dietrich, Mary S. PhD, MS (Professor, Statistics and Measurement)8; Araya, Wendy A. DNP, APRN, NNP-BC (Advanced Practice Manager)9; Delle, Janelle DNP, APRN, ACNP-BC (Nurse Practitioner)10; Payne, Kate JD, RN, NC-BC (Associate Professor of Nursing)11; Ford, Jaquelyn PA-C (Physician Assistant)12; Dubree, Marilyn MSN, RN, NE-BC (Executive Chief Nursing Officer)2

Journal of the American Association of Nurse Practitioners: November 05, 2019 - Volume Online Now - Issue - p
doi: 10.1097/JXX.0000000000000324
Research: Other: PDF Only

Background: Numerous nursing and physician studies have reported the effects of workload, environment, and life circumstances contributing to burnout. Effects may include job dissatisfaction, poor quality of life, and associated negative patient outcomes. Although assessing clinician burnout to determine effective interventions has become a topic of great importance, there are minimal studies specific to advanced practice registered nurses (APRNs).

Purpose: This single-center study was conducted to assess the prevalence and impact of APRN burnout and to recommend targeted interventions toward improvement of overall health and well-being.

Methods: A cross-sectional, mixed methods design was used. The voluntary, anonymous survey examined perceptions of wellness, inclusion, social support, personal coping mechanisms, and status of burnout.

Results: The 78-question survey was sent to 1,014 APRNs (94%) and PAs (6%), with a 43.6% response rate (n = 433); 76.4% were nurse practitioners. Participants were identified as currently experiencing burnout, formerly burned out, or never having experienced burnout. Profiles were developed, and similarities and differences between each group were compared. Of 433 respondents, 40.4% (n = 175) reported having never experienced burnout, 33.3% (n = 144) reported they had formerly experienced burnout, and 26.3% (n = 114) reported they were currently experiencing burnout.

Implications for practice: The results of the study identified that some APRNs report experiencing burnout at different times in their careers. Recommendations by participants to mitigate burnout included self-care, organizational promotion of health and well-being, career development, and leadership support. This study is one of the first to report on burnout among APRNs and potential interventions to build resilience; however, additional research is warranted.

1Advanced Practice, Vanderbilt University Medical Center and Professor of Clinical Nursing, Vanderbilt University School of Nursing, Nashville, Tennessee,

2Vanderbilt University Medical Center, Nashville, Tennessee,

3Outpatient Surgery, Vanderbilt University Medical Center, Nashville, Tennessee,

4Vanderbilt University School of Nursing, Nashville, Tennessee,

5Work/Life Connections-EAP, Vanderbilt University School of Nursing, Nashville, Tennessee,

6Office of Advanced Practice, Vanderbilt University Medical Center, Nashville, Tennessee,

7Vanderbilt Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee,

8Vanderbilt University Schools of Medicine and Nursing, Nashville, Tennessee,

9Neonatal Intensive Care Practitioners, Vanderbilt University Medical Center, Nashville, Tennessee,

10Trauma Surgery, Vanderbilt University Medical Center, Nashville, Tennessee,

11Center for Biomedical Ethics and Society, Vanderbilt University Medical Center, Nashville, Tennessee,

12Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee.

Correspondence: April N. Kapu, DNP, APRN, ACNP-BC, FAANP, 1161 21st, Avenue South, Medical Center North D2106, Nashville, TN 37232. Tel: 615-343-1465; 614-454-0469; Fax: 615-322-3490; E-mail:

Competing interests: The authors report no conflicts of interest.

Authors' contributions: The authors declare that all authors contributed to this project and that each meets the criteria for authorship.

Received April 09, 2019

Received in revised form August 02, 2019

Accepted August 08, 2019

© 2019 American Association of Nurse Practitioners
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