Wellness check: Taking the pulse of burnout among nurses, physicians

More than halfway through 2024, burnout continues to threaten frontline healthcare providers across all disciplines and specialties.  

Both nurses and physicians face significant stresses in the clinic – and after hours – including emotional and physical challenges, lack of respect and autonomy, and poor work-life balance that are contributing to the ongoing mass exodus of qualified workers from the field. 

Two new industry surveys, one from the American Medical Association (AMA) and the other from Medscape.com, provide an updated benchmark on how physicians and nurses are coping with burnout and its widespread impacts on their daily wellness and future career plans. 

For physicians, burnout and “pajama time” remain unpleasant facts of life

In 2023, the AMA conducted an “Organizational Biopsy” that collected more than 12,400 responses from physicians from 81 health systems across 31 states. While overall rates of burnout dipped slightly in 2023 (48.2%) compared to 2022 (53%), nearly half of practicing physicians still feel like they are operating at their limits on a regular basis. 

“Pajama time,” or the amount of time spent outside of core working hours completing administrative tasks, is contributing to these feelings in a big way. 

In 2023, respondents reported an average 59-hour workweek, with specialties like hospital medicine (67.3 hours), internal medicine (59.8 hours), and OB/GYN (59.1 hours) among the busiest specialties. Early career physicians with one to five years of experience were most likely to report working more than 60 hours per week.  

On average, physicians spend just 27.3 hours on direct patient care. The remainder comprises 14.1 hours on indirect patient care and 7.9 hours on administrative tasks, with 20.9% of respondents stating they spend more than 8 hours a week in the EHR outside of typical business hours. 

While the AMA is celebrating the burnout rate sinking below 50% for the first time since the pandemic, alongside a slight increase in job satisfaction (68% in 2022 to 72.1% in 2023), burnout still costs the industry more than $4.6 billion a year as turnover and retirements puts strain on organizational culture and resources. 

A “silent struggle” among nurses to stay in the game

Physicians aren’t the only ones experiencing major challenges on and off the job. A staggering 70% of nurses confided to Medscape.com that they feel burned out, depressed, or both in 2024 with little to no improvement over the past three surveys. More than two-thirds said their burnout affects their personal relationships, and around 13% say their negative experiences may lead them to leave medicine all together. 

Nurses reported many of the same frustrations as their physician colleagues, including too many bureaucratic requirements and too many hours at work. But nurses may be more likely to face additional hurdles, such as lack of respect from bosses and peers, lack of respect from patients, and insufficient compensation for the amount of work they are asked to perform. More than half (54%) said their employers don’t adequately recognize the problem. 

Burnout often leads to poor emotional control, which can easily spill out into their interactions with staff and patients, nurses admitted.  

Around 40% say they express frustration and exacerbation with other staff, while 30% say they might snap at a patient when feeling overwhelmed. About a quarter say they are less thorough with documentation or more likely to make uncharacteristic mistakes when they are feeling depressed. 

The good news is that nurses are slightly more likely now than previously to seek out assistance for their mental wellness, with at least half saying they are currently engaged in professional help or have sought such services in the past. Similar numbers of respondents also reported using positive coping mechanisms, such as talking with trusted people in their lives, exercising, and getting adequate sleep to manage their mental wellness. 

Taking the next steps on burnout in an increasingly complex environment

Industry leaders have proposed many solutions for burnout, most of which don’t appear to be working fast enough to drive down the numbers significantly year over year.  

Some of the answers proposed by clinicians themselves, including the widespread reductions in administrative requirements favored by physicians and the measurable salary increases supported by 50% of nurses in the Medscape.com survey, aren’t likely to be implemented sufficiently at scale. 

But other changes, like shifting organizational culture to better respect and value the contributions of frontline staff, are easier to start with.  

Organizations can start by offering nurses the leadership opportunities they are actively seeking, which can help them feel more autonomous and engaged in their work. Executives can work to improve communication culture so that staff feel seen, heard, and valued enough to receive a response.  And of course, there is a huge variety of digital solutions and creative staffing strategies to improve efficiencies in the clinic and reduce that “pajama time” in the EHR afterwards. 

Success will start with acknowledging and embracing the fact that burnout is endemic in every organization, no matter how much they feel they are safe from the problem.  Leaders will need the courage to tackle the issue head-on, perhaps by establishing a Chief Wellness Officer or similar role to spearhead a coordinated effort to change the way the organization operates as a whole.  And they may need to come to terms to the fact that upfront financial and technical investments will be required to truly address the roots of burnout, potentially saving billions in the long run. 

There’s no question that burnout is hard to manage for both leadership and the people who are suffering from poor mental health every day. While these recent surveys provide glimmers of hope that clinicians might be starting on an upward trend, there is still much more to do before the numbers reach acceptable levels and staff members can feel good again about going to work. 

Jennifer Bresnick is a journalist and freelance content creator with a decade of experience in the health IT industry.  Her work has focused on leveraging innovative technology tools to create value, improve health equity, and achieve the promises of the learning health system.  She can be reached at jennifer@inklesscreative.com.