In the nursing profession, resilience is required to mitigate burnout, with many interventions aiming to increase personal resilience in order to affect organizational culture and work environment ( Rushton et al., 2015). A growing trend has emerged to generally view resilience as a method to prevent burnout while evidence generally describes personal resilience building activities as support for decreasing stress, improving coping, and adapting ( Kamath et al., 2017 Rees, Breen, Cusack, & Hegney, 2015 Rushton, Batcheller, Schroeder, & Donohue, 2015). To fully understand clinician wellbeing, the role of resilience, or one's ability to overcome adversity, must be evaluated related to burnout and outcomes (NAM, 2018). Since studies confirm that up to one third of nurses leave their position in the first one to two years of employment ( Unruh & Zhang, 2014) and nationally turnover for nurses is approximately 18% ( Nursing Solutions, Inc., 2020), it is critical to evaluate the role of burnout in turnover. Moreover, virtually no attention has been given to position turnover or the associated contributing factors ( Kovner et al., 2016 Taylor & Covaleski, 1985). A recent physician study described the relationship between clinician's actual turnover and burnout, finding physicians and advanced practice providers to be 1.5 times more likely to turnover when they had high burnout ( Willard-Grace et al., 2019). In addition to the disruption to patient care, the loss of a nurse leaving their position is also associated with significant financial costs, estimated from $11,000 to $90,000 per nurse with up to $8.5 million in associated wider costs (e.g., unfilled vacancies, patient deferment, training and orientations) ( Halter et al., 2017).ĭespite the hypothesized link, few studies have evaluated burnout and actual job turnover in the nursing workforce, instead using an individual's intention to leave their position as a proxy for turnover. Nurses may feel reduced personal accomplishment and a lack of satisfaction in response to job-related stressors and eventually leave their position. The emotional toll on health care workers, especially nurses who care for patients through death, may impact nurses’ own emotions ( Wilson & Kirshbaum, 2011). When clinicians are burned out they feel they are not performing their job responsibilities at the highest levels, lack motivation, and have poor personal job related self-esteem. The burned out clinician may express cynicism in uncharacteristic negative behaviors, poor communication with others, and even incivility toward co-workers. Burned out individuals may become exhausted doing their best to care for patients, where the chances of recovery are minimal.

In this analysis, we examine the influence of nurses’ resilience on burnout, and how nurse burnout affects subsequent organizational and position turnover.īecause burnout is characterized through three classic symptoms of exhaustion, depersonalization (cynicism), and reduced personal accomplishment ( Maslach & Leiter, 2016), it stands that burnout contributes to employees leaving their positions. An increase in awareness, including the National Academy of Medicine's establishment of the Action Collaborative on Clinician Wellbeing and Resilience (National Academy of Medicine, 2020) has contributed to efforts to produce outcome data however, there is a paucity of quality research with the nursing workforce and organizational outcomes. As many as half of the nursing workforce are experiencing burnout, with likelihood of personal consequence, job dysfunction, and potential risk to patients ( Dyerbye et al., 2017).

Nursing burnout is a deleterious and consequential syndrome that affects not only the individuals, but also the organization and patients in which those nurses labor.

Nurse turnover definition