An Exploration of Resilience and Burnout among Healthcare Workers in the United States

Healthcare workers (HCW) have historically suffered from high rates of burnout, and these rates have continued to rise during the pandemic (Sexton et al., 2022). Burnout among healthcare workers carries significant consequences for both HCWs (Davidson et al., 2018; Stathopoulou et al., 2011) and patients (Schlak et al., 2021). National organizations have focused their attention on this issue of improving HCW well-being. Greater clarity is needed to understand how best to optimize HCW well-being and to address the challenges of HCW burnout. The purpose of this dissertation was to generate knowledge on HCW burnout and resilience. Specifically, this dissertation used existing data from the Web-based Implementation of the Science for Enhancing Resilience (WISER) data set and encompasses three studies whose purpose was: (1) to describe the stressors that HCWs experience using a summative content analysis to determine the types and total numbers of stressors; (2) to identify subgroups of nurses with distinct profiles of well-being using a latent profile analysis to identify profiles of burnout (emotional exhaustion) and resilience (emotional thriving and emotional recovery); bivariate statistics were used to identify profile differences in nurse characteristics; and (3) to identify types of well-being behaviors and the total number of well-being behaviors associated with resilience among HCWs. Bivariate statistics were used to identify the relationship of each type of well-being behavior with emotional thriving and emotional recovery, and to identify the total number of well-being behaviors with emotional thriving and emotional recovery. General Linear Models using analysis of covariance was used to examine the relationships between the well-being behaviors and the total number of well-being behaviors, respectively, with emotional thriving and emotional recovery, after adjusting for covariates. The main findings of this dissertation included those regarding stressors, the co-occurrence of burnout and resilience, and findings related to well-being behaviors. First, stressors are experienced in HCWs’ work, personal life, and in ways that intersect both work and personal life. Second, we found that nurses experienced a combination of burnout (emotional exhaustion) and resilience (emotional thriving and emotional recovery) in four distinct profiles of “exhausted,” “exhausted with thriving,” “exhausted with thriving and recovery,” and “thriving and recovery.” Each profile was associated with unique nurse characteristics. Finally, we found that the well-being behaviors of exercise, yoga, meditation, spending time with a close friend, and going on a vacation were all significantly associated with greater emotional thriving while only exercise, and spending time with a close friend were significantly associated with greater emotional recovery (Rink et al., 2021). Findings from this dissertation will inform the development and testing of interventions to reduce burnout and strengthen resilience for HCWs. Specifically, understanding the full breadth of stressors experienced by HCWs can inform the strategies used in interventions to address stress and burnout among HCWs. Additionally, this dissertation identified the co-occurrence of burnout and resilience that extend beyond the previously known dichotomous relationship and underscored the importance of increasing resilience. Finally, findings also can inform future work on enhancing HCW resilience through well-being behaviors.