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Objectives. To examine nurses' well-being and identify individual and workplace factors associated with adverse outcomes.
Methods. We administered an e-mail survey to registered nurses In Michigan in March 2022. Outcomes included the Oldenburg Burnout Inventory-Exhaustion scale, self-harm thoughts (yes/no), and overall wellness on a 0 to 10 visual analog scale. Covariates included practice environment, psychological safety, workplace abuse, staffing adequacy, stress coping strategies, and demographics. We examined associations between covariates and exhaustion, thoughts of self-harm (both via logistic regression), and overall wellness (via linear regression).
Results. Among surveyed nurses, 93.63% reported significant exhaustion, 9.88% reported self-harm thoughts, and the mean (SD) overall wellness score was 6.2 (2.3). Factors associated with exhaustion included inadequate staffing, lower psychological safety, and younger age. Factors associated with self-harm thoughts included recent workplace physical abuse and younger age. Factors associated with higher wellness scores included employer support, favorable practice environments, higher job satisfaction, and positive coping strategies.
Conclusions. Negative well-being outcomes were prevalent among registered nurses and were associated with correctable workplace deficits. Nurses' well-being is a national public health problem that warrants comprehensive interventions at individual, workplace, and community levels. (Am J Public Health. 2024; 114(52)5180-5188. https://doi.org/10.2105/AJPH.2023.307376)
Clinician negative well-being is a major public health problem in the United States. Numerous professional organizations, government officials, and health system leaders have raised collective concerns about the emotional well-being of clinicians.1,2 The COVID-19 pandemic and associated workplace stressors have exacerbated these concerns.3 Registered nurses are at great risk for poor mental health given their high workloads, long hours, and unfavorable working conditions4 Deaths by suicide are notably higher for female nurses than for both female physicians and the US female population.5 The National Academy of Medicine's "National Plan for Health Workforce Well-Being" cited a dearth of recent, multisite data to inform interventions and policy strategies.6
Despite these concerns and calls for action, surprisingly little recent research has been reported on these phenomena. Specifically, few studies are available In large, representative samples besides single Institutional studies about the frequency of mental well-being outcomes.7,8 From a public health standpoint related to prevention, there are sparse reports to Identify individual, workplace, and community factors that place nurses at risk for poor outcomes.9 These gaps hinder the development and testing of preventive strategies and...