CDC Study Finds Nurse Burnout Still On The Rise

Nurse burnout is still climbing. A CDC study found significantly more nurses and other health workers reporting burnout in 2022 than in 2018, and the problem outlasted the acute phase of the pandemic. The findings, published in the CDC's Morbidity and Mortality Weekly Report, draw on Quality of Worklife survey data collected in 2018 and 2022. Alongside them, the federal Impact Wellbeing campaign aims to build healthier workplaces. COVID-19 made burnout worse, but it did not create it, and it has not gone away with the surge.

Mental Decline During COVID-19

Health workers lost more ground on mental health over those four years than non-healthcare workers in the same survey. Of the 551 health workers who responded, 27% were nurses. The study started before the 2020 pandemic onset, which flooded the system with contagious, seriously ill patients and forced workers to adapt fast, often without adequate training or supplies, caring for patients in isolation for long stretches. The 2022 wave, two years into the pandemic, compared health workers, non-healthcare essential workers, and other workers, and found health workers reporting worse outcomes across mental health measures, including burnout.

Key Findings

• Nearly half of health workers reported feeling burned out often in 2022, up from 32% in 2018.
• 1 in 4 U.S. essential workers, including healthcare professionals, received a mental health diagnosis since the pandemic began.
• Trust in management and supervisor support were tied to lower odds of burnout and poor mental health overall.
• Health workers reported less burnout when they had enough time to finish their work and be productive.
• Reports of harassment, such as bullying and verbal abuse, more than doubled from 2018 to 2022.
• Harassment at work drove up anxiety, depression, and burnout.
• In 2022, almost half of surveyed health workers planned to look for a new job.
• Days of poor mental health in the prior 30 rose by 1.2, from 3.3 to 4.5.
• Health workers reporting burnout very often rose from 11.6% to 19.0%.

What Experts Recommend

NIOSH researcher Jeannie Nigam argues for working with staff to solve the conditions driving burnout rather than telling them to be more resilient. Prevention is the priority. NIOSH built prevention training for supervisors of public health workers and, in 2022, studied anxiety, depression, and burnout among health workers to design prevention strategies. The aim is to fix root causes inside hospitals, not to manage symptoms.

The Impact Wellbeing toolkit gives employers several ways to act:

• Administer the NIOSH Worker Well-Being Questionnaire to assess the whole person, including life outside work.
• Use the Dr. Lorna Breen Heroes' Foundation toolkit to strip intrusive questions from credentialing applications so staff can seek mental health care without penalty.
• Use the Fundamentals of Total Worker Health workbook to advance worker safety, health, and wellbeing.

Primary prevention also means giving workers a voice in department decisions, supportive supervision, and the psychological safety to speak up and ask for help without consequences.

Frequently Asked Questions

What causes nurse burnout?

The World Health Organization defines burnout as an occupational phenomenon from chronic workplace stress that has not been managed well. Burned-out nurses feel physical, mental, and emotional exhaustion from the job. Risk factors include younger age, weak social support, limited capacity among family and colleagues to cope with a pandemic, a higher perceived threat from COVID-19, longer hours in quarantine or isolation rooms, high-risk settings, and hospitals short on supplies and resources.

Is nurse burnout the same as compassion fatigue?

No. Compassion fatigue is the diminished ability to give empathetic care under the mental and emotional strain of caring for suffering patients. COVID-19 left many patients and families frightened and facing death, and nurses exposed to constant suffering can detach from patients and shrink into a tasks-only role.

Why did COVID-19 make burnout worse?

The pandemic forced extraordinary fear and risk onto health workers in the open. A systematic review and meta-analysis found that in the U.S., within the first year of the pandemic, 143 of 448 hospital health workers who died were nurses. Nurses exposed to suspected or confirmed COVID-19 patients reported more distress, and many feared carrying the virus home. They also reported anxiety, depression, psychological distress, sleep disturbance, insomnia, and PTSD.

How do we fix nurse burnout?

Psychologically safe, supportive workplaces help: health workers reported fewer mental health problems when they felt supported. Impact Wellbeing is one such intervention. Clinicians also rank these as helpful: uninterrupted breaks, more control over scheduling, added support for new-to-practice clinicians, less required documentation, a quiet space for reflection, better electronic health records, and stronger team communication.

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Sources: WHO, "Burn-out an occupational phenomenon: International Classification of Diseases" (2019); Galanis P, et al., "Nurses' burnout and associated risk factors during the COVID-19 pandemic: A systematic review and meta-analysis," NIH; Nigam J, et al. (2023), "Vital Signs: Health Worker-Perceived Working Conditions and Symptoms of Poor Mental Health, Quality of Worklife Survey, United States, 2018-2022," CDC MMWR (mm7244e1).