Better nurse staffing linked to lower physician burnout worldwide

A landmark international study finds that hospitals with better nurse staffing and work environments not only benefits nurses but is significantly associated with less physician burnout and job dissatisfaction. The research, published in JAMA Network Open, provides a clear solution to the global crisis of physician burnout.

A research team, led by Penn Nursing's Center for Health Outcomes and Policy Research (CHOPR), surveyed more than 6,400 physicians and 15,000 nurses across the United States and six European countries (Belgium, England, Germany, Ireland, Norway, and Sweden). The findings show that hospitals with better nurse staffing, supportive work environments, and effective interdisciplinary teamwork had substantially lower rates of physician burnout, job dissatisfaction, and intent to leave.

"Physician burnout is a global crisis, but few actionable solutions have been identified," said Linda H. Aiken, PhD, RN, FAAN, FRCN, Professor of Nursing and Sociology and Founding Director, CHOPR. "Our study provides evidence that investing in nurses is a 'two-for-one' solution-improving both nurse and physician wellbeing while also strengthening patient care."

Key findings include:

• In US hospitals, a modest 10% improvement in the nurse work environment including staffing adequacy was associated with a 22% reduction in physician intent to leave, a 25% reduction in physicians unwilling to recommend their hospital as a place to work, a 19% reduction in physician job dissatisfaction, and a 10% reduction in physicians experiencing high burnout.
• In European hospitals, a 10% increase in nurse staffing adequacy was linked to 20% lower physician intent to leave, 27% lower odds of not recommending their hospital, 15% lower physician job dissatisfaction, and 12% lower odds of high burnout.
• Hospitals with stronger physician-nurse teamwork consistently reported better physician outcomes.

The results come at a critical time, as both physicians and nurses face unprecedented levels of stress, burnout, and turnover. According to the study, between 20–44% of physicians surveyed reported intentions to leave their hospital positions due to dissatisfaction, and up to 45% reported high burnout.

"These findings highlight a path forward that hospital leaders can act on immediately," said Karen B. Lasater, PhD, RN, the Jessie M. Scott Term Chair in Nursing and Health Policy, Associate Professor, and Associate Director, CHOPR. "Improving nurse staffing and creating supportive work environments are organizational reforms that are feasible, evidence-based, and capable of retaining both nurses and physicians."

The research was conducted by the Magnet4Europe Consortium in collaboration with the U.S. Clinician Well-Being Study Consortium, with support from the National Institute of Nursing Research and the European Union's Horizon 2020 program. The full study, "Informing Hospital Physician Wellbeing Interventions in Europe and the United States: A Cross-sectional Study," is available open access in JAMA Network Open.