Emergency nurses are much more likely to report high burnout, job dissatisfaction, and intent to leave compared to inpatient nurses, according to a recent analysis of nurses practicing in 60 U.S. hospitals.1
“Understanding why emergency nurses wouldn’t recommend their workplace to other future employees may inform strategies to recruit and retain nurses in emergency departments,” says K. Jane Muir, PhD, FNP-BC, a postdoctoral research fellow at the University of Pennsylvania’s Center for Health Outcomes and Policy Research.
Muir and colleagues set out to learn the reasons why emergency nurses would not recommend their hospital as a good place to work.
The researchers analyzed survey responses of ED nurses in New York and Illinois. Nurses were asked, “Would you recommend your place of employment as a good place to work?”2 The 142 nurses who answered “probably not” or “definitely not” to the survey question were prompted to provide an open-text response to offer a rationale. The researchers analyzed these responses and found an overarching theme of employer-based factors contributing to the nurses not wanting to recommend their hospital.
Nurses reported these issues:
• insufficient staffing;
• unresponsive unit management;
• unsafe working conditions;
• workplace violence;
• a sense of being undervalued.
“It is not surprising that the reasons emergency nurses don’t recommend their workplace are employer-based, given two decades of evidence from nurses demonstrating unsafe working conditions as a key reason for their intent to leave the job,” says Muir. Muir was lead author of another recent study surveying 1,887 nurses who left their jobs from 2018-2021.3 Of these nurses, 26 indicated burnout or emotional exhaustion and 21% indicated insufficient staffing as contributing factors to their decision to leave.
In their free-text responses, nurses reported concerns that their licenses were in jeopardy because of the poor working conditions in which they were operating. “Despite hospital administrators’ willingness to staff nurses at razor-thin staffing margins, nurses are not willing to compromise high-quality and safe patient care. That nurses are fearful of losing their license sends a strong signal that patient care is in jeopardy in our nation’s emergency departments,” says Muir. Many nurses also reported concerns about workplace violence. “Hospital administrators should listen to the concerns of emergency nurses and support them with adequate staffing and actionable policies that address the workplace violence that is heightened in EDs,” argues Muir.
Overall, the study findings demonstrate the need for adequate resources to allow ED nurses to provide quality patient care in a safe environment. “The built environment in hospital triage should allow nurses to quickly access safeguards (such as hospital security and increased staffing) to assist nurses when needed,” says Muir.
ED nurses also should have reporting mechanisms for workplace violence events and hospital administrators who are accountable to follow up on these issues. Overall, there is a pressing need to address any and all factors that contribute to ED violence, says Muir. “These include overall hospital crowding, which drives prolonged patient wait times, and the use of hallway beds,” Muir says.
REFERENCES
- Turnbach E, Coates L, Vanek FD, et al. Emergency nurses’ well-being in Magnet hospitals and recommendations for improvements in work environments: A multicenter cross-sectional observational study. J Emerg Nurs 2024;50:153-160.
- Muir KJ, Merchant RM, Lasater KB, Brooks Carthon JM. Emer-gency nurses’ reasons for not recommending their hospital to clinicians as a good place to work. JAMA Netw Open 2024;7:e244087.
- Muir KJ, Porat-Dahlerbruch J, Nikpour J, et al. Top factors in nurses ending health care employment between 2018 and 2021. JAMA Netw Open 2024;7:e244121.
Emergency nurses are much more likely to report high burnout, job dissatisfaction, and intent to leave compared to inpatient nurses, according to a recent analysis of nurses practicing in 60 U.S. hospitals.
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