Individuals’ risk of professional burnout may be decreased by a higher ratio of female nurses among intensive care teams, according to investigators in Switzerland who researched the factors connected to burnout in the high-stress setting of the intensive care unit (ICU).

The study was published online in the articles-in-press section of the American Thoracic Society’s American Journal of Respiratory and Critical Care Medicine.

It is thought burnout is a psychological response to chronic stress. Burnout can lead to emotional instability, feelings of failure and low production or an urge to leave the job.

Paolo Merlani, MD, attending physician at the University Hospital of Geneva said:

“Avoiding and understanding burnout is especially important now, given the projected shortage of ICU caregivers, in addition to the intensity and costliness of training these specialized professionals.”

Investigators used a self-administered questionnaire that recorded demographic data, personal characteristics, subjective stress and risk of burnout, in order to assess the risk of burnout among different people in different settings. Over 3,000 people in 72 Swiss ICUs were evaluated. As well as individual characteristics, they analyzed center-level factors (e.g., proportion of female caregivers among nurses and physicians) and patient-related factors.

On top of discovering that a higher ratio of female nurses reduced overall risk of burnout, they also discovered more gender-related differences. Female caregivers were more likely to say they experienced stress, however, they were more resistant to burnout in comparison to their male colleagues.

Dr. Merlani said:

“This could be due to a methodological bias. Indeed, female caregivers may have found it easier to admit their distress than did males. Men may be less inclined to express their distress.”

Interestingly, the investigators also discovered that stress was not always connected with burnout. One reason may be that being burned out may reduce the resistance to stress and therefore may contribute to a vicious cycle where the role of each factor might be confounding, noted Dr. Merlani.

Nurse-assistants had the greatest risk for burnout out of all the professionals examined. Dr. Merlani explained, since the participation to end-of-life and post-mortem care is known in the literature to increase the psychological burden and the risk of burnout and since these caregivers are usually less numerous in ICUs, the unavoidable consequence is that they are more frequently confronted to these difficult situations than others. This could be one of the causes of the increased risk of burnout in nurse-assistants.

They also discovered that women caregivers that were young, single and without children were at the highest risk for burnout.

Dr. Merlani said:

“our investigation could open a new frontier regarding burnout in ICUs, highlighting the importance of the team composition. Our results should of course be confirmed in a prospective multicenter, multinational investigation. Whether the results can be exported to additional medical settings where team-working is pivotal remains for the time being an interesting question to be researched.

ICU heads should ascertain that personnel at higher risk would be especially taken care of, and that resources should be provided to afford psychological support and promote a team culture. This could finally also increase the number of women staying in ICUs, thereby reducing the overall risk of burnout.”

Written by Grace Rattue