Is Burnout Causing Nurses to Become Less ‘Engaged’ In Their Work? A New Study Says So.

• A recent report shows less than half of nurses are fully engaged at work.
• Autonomy, teamwork and collaboration, and responsive leadership are the three driving factors of nurse engagement.
• Nurse engagement is closely tied to burnout, one of the largest factors contributing to poor nurse retention.

A new report has revealed potentially concerning results about nurse engagement in the workplace. According to the 2023 PRC National Nursing Engagement Report, less than half of nurses surveyed reported being “fully engaged” at work, while nearly 15% reported being “unengaged.”

But what does “engagement” actually mean? Are nurses really becoming less willing to do their jobs, either entirely or to the best of their ability? Let’s take a closer look.

Nurse Engagement Study: Key Findings

PRC, a market research and consulting firm, surveyed nearly 2,000 nurses from 37 hospitals across the country. The nurses answered 34 questions about engagement, nurse burnout, and retention.

According to the study, “fully engaged” nurses are those who “are emotionally and intellectually connected to their hospitals” and thus invested in the hospital’s success. In comparison, “engaged” nurses like their hospital but often play it safe within their job role. Meanwhile, “unengaged” nurses only do the bare minimum and are “ambivalent toward the success of their hospital,” the study states.

The report ultimately determined that:

• 45.1% of nurses were “fully engaged”
• 40.5% of nurses were “engaged”
• 14.4% of nurses were “unengaged”

Researchers also found a significant difference in engagement levels based on the nurses’ generation, shift, and unit. For example, millennials, night shifters, and emergency room nurses were more likely to report being unengaged than other groups.

There was also a notable decline in engagement among nurses who were only 1-2 years into their nursing careers, perhaps underscoring a previous finding that 43% of newly licensed nurses leave their jobs or the profession within the first 3 years.

The report determined there were three main drivers of nurse engagement:

• Autonomy: Nurses who believed they could actively participate in decision-making and their opinions were valued by leadership were more likely to report being fully engaged.
• RN-to-RN teamwork and collaboration: Nurses who felt they were part of a respectful, supportive team were more likely to report being fully engaged.
• Leadership access and responsiveness: Nurses who felt their leadership team was accessible, trustworthy, and responsive to their needs were more likely to report being fully engaged.

There was a significant correlation between engagement and feelings of burnout: 41.9% of unengaged nurses reported feeling burnt out, compared to 14.9% of engaged nurses and 7.6% of fully engaged nurses.

One of the most interesting findings was the connection between engagement and the nurses’ patient care delivery. According to the report, fully engaged nurses demonstrated behaviors that helped them connect better with patients, such as empathy and positive presence. This resulted in improved awareness of patient needs and response time.

Is Nurse Engagement Really Going Down?

So, is it true? Are nurses truly becoming less engaged and more complacent in their work?

The short answer is: It’s complicated.

First, you have to consider the various definitions of “engagement.” The concept of nurse engagement is quite multifaceted, but can include:

• Job commitment
• Job satisfaction
• Employer commitment
• Professional commitment

The PRC study had a much narrower definition of engagement, which focused largely on the nurses’ commitment to the hospital rather than their own fulfillment and satisfaction.

Still, previous research strongly suggests that nurse engagement directly impacts patient safety, care quality, and patient outcomes. In other words, nurses who are engaged in their work tend to provide better, safer care than those who are not.

But is a lack of engagement alone a fair way to characterize nurses? You could argue that lack of engagement is only one piece of the much larger, more complicated puzzle of nurse burnout.

Burnout is exacerbating the already crippling nursing shortage and has reached crisis levels across the United States. In 2018, over one-third of nurses cited burnout as the reason they left their jobs, and a 2020 survey indicated that nearly two-thirds of nurses experience burnout.

Many factors can contribute to nurse burnout, including:

• Emotional strain
• Inadequate staffing
• Increased workloads
• Lack of leadership support
• Poor teamwork
• Bullying
• Lack of work/life balance

Employers wishing to improve nurse engagement must also address the contributing factors to nurse burnout. For example, mandated staffing ratios are currently being fought for by striking nurses across the country, and these nurses believe implementing staffing ratios is the key to reducing burnout and improving patient safety. Safe staffing legislation is just one part of a necessary, multifaceted solution to the nurse burnout issue.

The PRC report makes an important point: Nurses are less engaged, but it is for a valid reason. Despite strong evidence that nurses need better working conditions to decrease burnout and convince them to stay in the profession, little has changed about the role of registered nurses or about healthcare delivery as a whole. If anything, nurses are expected to do more with less support.

Employers must be willing to implement revolutionary changes to address nurse burnout and, by extension, nurse engagement.

Sources

Dempsey C, et al. (2016). Nurse Engagement: What are the Contributing Factors for Success? OJIN

PRC National Nursing Engagement Report: Utilizing the PRC Nursing Quality Assessment Inventory. (2023). PRC

Schlak A, et al. (2021). Leveraging the Work Environment to Minimize the Negative Impact of Nurse Burnout on Patient Outcomes. NIH

Shaffer F, et al. (2020). Nurse turnover: Understand it, reduce it. My American Nurse

Shah M, et al. (2021). Prevalence of and Factors Associated With Nurse Burnout in the US. NIH