Understanding Burnout among Oncology Nurse Practitioners

As 10,000 baby boomers reach the age of 65 each day, the incidence of cancer is estimated to increase by 67% between 2010 and 2030.  The IOM predicts that since the entire oncology workforce, including nurse practitioners, is not growing at the rate of expected need, there will be a serious shortage of oncology physicians, nurse practitioners and nurses by 2020 (Institute of Medicine [IOM], 2008). The American Society of Clinical Oncology (ASCO) workforce suggests that increasing the role of nurse practitioners and physicians assistants in an oncology practice is one effective way to address the projected oncology workforce shortage and to ensure continuous delivery of high-quality cancer care (Erikson, Salsberg, Gaetano, Bruinooge, & Goldstein, 2007). Health care providers in oncology are considered to be at risk of a work-related stress syndrome, termed ‘burnout,’ due to the constant and some­times overwhelming emotional stress resulting from issues of patient death and dying. Among oncologists/hematologists, 61.7% report feelings of burnout, with the top three signs being frustration (78%), emotional exhaustion (69%), and lack of satisfaction with their work (50%) (Allegra,  Hall,  & Yothers,  2005).

Approximately 40% of oncology/hematology nurses experience burnout (Aiken, et al., 2001). Burnout can lead to decreased job satisfaction and depersonalization of patients, as well as changing professions (Dougherty, et al., 2009;  Spinetta, et al., 2000).

Burnout in oncologists/hematologists and oncology/hematology nurses has been well documented, however there is paucity of information regarding burnout in oncology/hematology nurse practitioners. In order to retain experienced oncology/hematology nurse practitioners, burnout needs to be identified and addressed. Given the magnitude and the potential severity of nurse practitioner shortage in this field, determining the burnout prevalence, psychological morbidity, and job satisfaction and job stress is urgently needed.  The purpose of this study is to measure the prevalence of burnout, psychological morbidity, job satisfaction and job stress in oncology/hematology nurse practitioners.

Using the data base obtained from Oncology Nursing Society (ONS), emails with a link to the surveys were sent to members with a forward link to other oncology/hematology NPs who may not be ONS members.  The initial email included the introductory letter and the link to the survey. A follow-up email was sent 8-10 days after the initial mailing. A final personalized and signed letter was sent three weeks after the first notice. The survey period was 8 weeks in total.

Data collection instruments included the 22 item, 3 factor structure Maslach Burnout Inventory, the General Health Questionnaire (GHQ) to measure psychological morbidity, Hospital Consultants Job Stress and Satisfaction Questionnaire ( HCJSSQ) to measure job satisfaction and job stress,  and finally and the investigator developed Intent to Leave instrument, along with demographic data.

A sample of 350 members received emails with 143 respondents after 8 weeks.

Early findings suggest participants indicated a moderate level of exhaustion and sense of personal accomplishments with a low sense of personal accomplishment. These are coupled with a high number of responses indicating a plan to remain in the field, working for prolong periods of time, and many don’t have time to do the work that must be done. Recommendations include exploration of factors which support the high retention rate in this field when compared to other groups.