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Study explores burnout among APRNs, physician assistants

Dec. 12, 2019, 10:55 AM



by Matt Batcheldor

In one of the first studies to document burnout among advanced practice registered nurses (APRNs) and physician assistants (PAs), Vanderbilt researchers examined causes and solutions.

The results were recently published in the Journal of the American Association of Nurse Practitioners. Researchers sent surveys to every APRN and PA at Vanderbilt — 1,014 of them, said April Kapu, DNP, APRN, associate nursing officer for VUMC Advanced Practice and director of the Office of Advanced Practice.

The 78-question survey “examined perceptions of wellness, inclusion, social support, personal coping mechanisms and status of burnout.”

Forty-four percent responded. Of those, 59% said that they either experience burnout or formerly experienced burnout. Forty percent said they weren’t burned out, and 33% said they were.

The study found two leading causes of burnout — workload and limited opportunities for professional growth and development. Patient volumes and acuity are increasing at a rate higher than staffing, putting more stress on clinicians.

“It is definitely something that we’re seeing more and more as health care institutions are more and more economically challenged,” Kapu said. “We’re seeing a lot of the workload fall to clinicians, and advanced practice nurses are a big part of that clinician workforce.”

Many previous studies have shown the deleterious effects of burnout, including job dissatisfaction and poor quality of life, leading to a decline in patient outcomes.

Survey participants were asked to identify solutions to burnout, which fell in four main categories — supporting self-care, career development, leadership support and creating community.

The task force that organized the study is now addressing potential interventions to build resilience, Kapu said.

The Nursing Executive Board recently voted to approve a clinical advancement model for advanced practice professionals, and provider/patient ratios are being studied to align those with best practices.

“We looked for opportunities to see where we could work together with the physician groups and others on interprofessional approaches to address burnout,” Kapu said.

One of those was a website with resources developed by Jim Kendall, LCSW, CEAP, manager of Work/Life Connections.

It can be found at

Other suggested solutions include creating “Zen spaces where people could go and take a break from the stress that they’re experiencing and just have a moment of calm in a quiet room,” along with yoga breaks, massages and pet therapy, Kapu said.

The study said that more research is needed on the factors of burnout for advanced practice professionals.

“Nurses provide compassionate care to our patients and families, but we must not forget that self-care is also a very important priority,” said Marilyn Dubree, MSN, RN, NE-BC, Executive Chief Nursing Officer.

“This research will help leadership to bolster our efforts to better support our fellow nurses and encourage resilience throughout our careers.”

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