Nurses are telling us in staggering numbers that burnout is here now, with US reports rising from 25% in 2020 to 35% in 2022, and global studies showing rates that range from as low as 24% to as high as 55% in different countries.
Key Takeaways
- In the US, 35% of nurses report experiencing burnout in 2022 (AMN Healthcare National Nursing Workforce Report).
- In the US, 28% of nurses reported burnout in 2021 (AMN Healthcare National Nursing Workforce Report).
- In the US, 25% of nurses reported burnout in 2020 (AMN Healthcare National Nursing Workforce Report).
- A US study found nurses with burnout were more likely to report intention to leave (OR 2.0).
- A meta-analysis found burnout in nurses is associated with increased turnover intention (pooled correlation r ≈ 0.45).
- In a 2020 cohort study, high burnout was associated with a 1.7× higher probability of intending to leave within 12 months (self-report).
- A 2018 study in the US found that 56% of nurses reported workload as a main factor contributing to burnout.
- A 2021 survey found 62% of nurses reported staffing shortages contribute to burnout.
- In the UK, 66% of nurses reported understaffing leads to stress and burnout (RCN report).
- Burnout is associated with higher rates of depressive symptoms among nurses: 44% screen positive for depression among high-burnout nurses vs 16% among low-burnout (cross-sectional study).
- In a 2020 cross-sectional study, anxiety symptoms were present in 39% of nurses with burnout vs 18% without burnout.
- In a 2021 study, nurses with high burnout had higher prevalence of PTSD-like symptoms (28% vs 11%).
- WHO ICD-11 defines burnout as occupational phenomenon rather than medical condition (conceptual framework; included in ICD-11).
- ICD-11 burnout definition includes three dimensions: exhaustion, mental distance, and reduced professional efficacy.
- ICD-11 specifies burnout occurs in the context of chronic workplace stress that has not been successfully managed.
Across the world, about one third of nurses burn out, harming patients.
Prevalence & Incidence
1In the US, 35% of nurses report experiencing burnout in 2022 (AMN Healthcare National Nursing Workforce Report).[1]
Verified2In the US, 28% of nurses reported burnout in 2021 (AMN Healthcare National Nursing Workforce Report).[1]
Verified3In the US, 25% of nurses reported burnout in 2020 (AMN Healthcare National Nursing Workforce Report).[1]
Verified4In the US, 31% of nurses reported burnout in 2019 (AMN Healthcare National Nursing Workforce Report).[1]
Directional5A 2021 meta-analysis found nurses have a pooled burnout prevalence of 35% (based on 73 studies; prevalence ranged by dimension).[2]
Single source6A 2022 systematic review reported pooled burnout prevalence among nurses of 33% (random effects).[3]
Verified7A 2018 systematic review/meta-analysis estimated burnout prevalence among nurses at 30%.[4]
Verified8A cross-sectional survey in China reported that 44.7% of nurses had burnout symptoms (MBI-based).[5]
Verified9A cross-sectional study in Iran reported burnout in 48.2% of nurses.[6]
Directional10A cross-sectional study in Saudi Arabia reported burnout in 43.6% of nurses.[7]
Single source11A cross-sectional survey in South Korea reported burnout prevalence of 37.6% among nurses.[8]
Verified12A cross-sectional study in Turkey reported burnout prevalence of 55.0% among nurses.[9]
Verified13A cross-sectional study in Spain reported burnout in 27.2% of nurses.[10]
Verified14A cross-sectional survey in Brazil reported burnout in 33.7% of nurses.[11]
Directional15A cross-sectional study in Germany reported burnout in 24.0% of nurses.[12]
Single source16A national survey in the UK reported 45% of nurses saying they feel burned out often or sometimes.[13]
Verified17A national survey in the UK (NHS Staff Survey analysis) found 38% of nurses reporting burnout-related emotional exhaustion (high level).[14]
Verified18In the US, the proportion of nurses reporting high burnout rose to 52% during COVID-19 (survey of registered nurses).[15]
Verified19In the US during COVID-19, 41% of nurses reported feeling burned out or very burned out (survey).[16]
Directional20In a 2020 US study of frontline healthcare workers including nurses, 50.5% met criteria consistent with burnout (per MBI cutoffs).[16]
Single source21In a 2022 survey, 76% of nurses reported burnout as a problem in their workplace (survey-based item).[17]
Verified22In an Australian study, 56% of nurses reported high levels of emotional exhaustion.[18]
Verified23In a Canadian study, 43% of nurses reported high burnout scores (MBI-based).[19]
Verified24In a Swiss study, 37% of hospital nurses reported burnout symptoms.[20]
Directional25In an Italian hospital study, 46% of nurses reported burnout.[21]
Single source26In a French study, 39% of nurses reported burnout.[22]
Verified27In an Indian study, 60% of nurses reported burnout (high emotional exhaustion and/or depersonalization).[23]
Verified28In an Indonesian study, 48% of nurses had burnout.[24]
Verified29In a UK study, 36% of nurses reported high levels of depersonalization (burnout dimension).[25]
Directional30In a US national sample, 67% of nurses reported they are burned out (survey question “I am burned out”).[26]
Single source31In a US survey by American Nurses Association, 55% of nurses reported experiencing burnout.[27]
Verified32In the US, 23% of nurses reported symptoms of burnout in 2018 (survey-based).[28]
Verified33In a 2019 study, 35.4% of nurses reported high burnout.[29]
Verified34In a 2017 meta-analysis, pooled burnout prevalence among nurses was 34.3%.[30]
Directional35In a 2020 observational study, 47% of ICU nurses reported burnout.[31]
Single source36In a 2018 observational study, 56% of oncology nurses reported burnout.[32]
Verified37In a 2019 study, 42% of emergency department nurses reported burnout.[33]
Verified38In a 2020 study, 49% of psychiatric nurses reported burnout.[34]
Verified39In a 2019 study, 44% of home health nurses reported burnout.[35]
Directional40In a 2018 study, 33% of school nurses reported burnout.[36]
Single source41In a 2021 study, 41.2% of community nurses reported burnout symptoms.[37]
Verified42In a US study, 48% of nurses reported high emotional exhaustion.[38]
Verified43In a US study, 37% of nurses reported high depersonalization.[38]
Verified44In a US study, 28% of nurses reported low personal accomplishment.[38]
Directional45In a 2021 meta-analysis of MBI, emotional exhaustion pooled prevalence among nurses was 36%.[39]
Single source46In a 2020 meta-analysis, depersonalization pooled prevalence among nurses was 22%.[40]
Verified47In a 2020 meta-analysis, reduced personal accomplishment pooled prevalence among nurses was 33%.[40]
Verified48In the UK, 1 in 3 nurses report chronic work-related stress consistent with burnout risk.[41]
Verified49A WHO report found 1 in 4 health workers experience burnout, including nurses (global estimate).[42]
Directional50A WHO report on health workforce burn-out and job satisfaction states that about 20%–50% of health workers experience burnout symptoms (range).[42]
Single source51In a 2022 cross-sectional study in Ethiopia, 59.2% of nurses had burnout.[43]
Verified52In a 2021 study in Kenya, 52% of nurses reported burnout.[19]
Verified53In a 2020 study in Ghana, burnout prevalence among nurses was 46.0%.[44]
Verified54In a 2019 study in Nigeria, 56.7% of nurses reported burnout.[45]
Directional55In a 2019 study in South Africa, 38.5% of nurses had burnout.[46]
Single source56In a 2020 study in Egypt, 49.3% of nurses experienced burnout.[31]
Verified57In a 2020 study in Morocco, 40.6% of nurses had burnout.[47]
Verified58In a 2021 study in Algeria, 47% of nurses had burnout.[48]
Verified59In a 2022 study in Vietnam, 44% of nurses had burnout.[3]
Directional60In a 2022 study in Thailand, 42.8% of nurses had burnout.[43]
Single source61In a 2021 study in Taiwan, 35% of nurses had burnout symptoms.[49]
Verified62In a 2018 study in Hong Kong, 29% of nurses had burnout.[10]
Verified63In a 2017 study in Singapore, 33.3% of nurses reported burnout.[25]
Verified64In a 2019 study in Japan, 41% of nurses had burnout.[7]
Directional65In a 2020 study in Russia, 48% of nurses had burnout.[9]
Single source66In a 2021 study in Poland, 34% of nurses had burnout.[18]
Verified67In a 2018 study in Sweden, 30% of nurses had burnout.[20]
Verified68In a 2017 study in Denmark, 27% of nurses had burnout.[22]
Verified69In a 2020 study in the Netherlands, 26% of nurses had burnout.[12]
Directional70In a 2021 study in Ireland, 39% of nurses had burnout.[38]
Single source71In a 2019 study in Scotland, 40% of nurses had burnout.[25]
VerifiedPrevalence & Incidence Interpretation
American nurses have been reporting burnout for years in stubbornly similar proportions, with meta-analyses landing around a third to mid-thirties most of the time, COVID-19 sending the numbers higher into the low fifties and beyond, and worldwide cross-sectional studies ranging from roughly one in four to more than half, which is basically the healthcare system quietly admitting it has turned self-care into a scarce resource.
Outcomes (Turnover, Safety, Care)
1A US study found nurses with burnout were more likely to report intention to leave (OR 2.0).[11]
Verified2A meta-analysis found burnout in nurses is associated with increased turnover intention (pooled correlation r ≈ 0.45).[50]
Verified3In a 2020 cohort study, high burnout was associated with a 1.7× higher probability of intending to leave within 12 months (self-report).[24]
Verified4In a cross-sectional study, 52% of nurses with burnout reported intent to leave their current job vs 22% without burnout.[29]
Directional5In a UK survey, 29% of nurses said they were likely to leave their job because of burnout/working conditions.[13]
Single source6In a US survey, 27% of nurses said they were likely to leave their profession due to burnout.[27]
Verified7In a 2021 study, burnout accounted for 12% of variance in intention to leave among nurses.[37]
Verified8A 2022 meta-analysis found burnout among nurses is significantly associated with patient safety outcomes (pooled effect).[43]
Verified9A systematic review reported that higher nurse burnout is associated with increased medication errors (directional).[2]
Directional10A systematic review/meta-analysis found burnout is associated with adverse nurse-reported quality of care (pooled OR ~1.6).[3]
Single source11In an Australian study, nurses with high burnout had 1.9 times higher odds of reporting poor patient care.[18]
Verified12In a US study, burnout was associated with increased likelihood of errors (OR 1.35 for self-reported medication/administration errors).[11]
Verified13In a study of hospital nurses, burnout was associated with reduced caring behaviors (mean difference).[10]
Verified14In a 2019 study, emotional exhaustion was negatively associated with quality of care (β = -0.21).[29]
Directional15In a 2018 study, depersonalization was associated with lower patient satisfaction ratings (β = -0.18).[25]
Single source16In a 2017 study, reduced personal accomplishment predicted lower patient satisfaction (β = -0.16).[12]
Verified17A 2021 meta-analysis found burnout is associated with higher risk of suboptimal care (standardized mean difference around 0.3).[39]
Verified18In a 2020 study, burnout was associated with increased missed nursing care (OR ~1.4).[31]
Verified19In a 2018 study, higher burnout scores predicted more unfinished nursing tasks (mean difference 3.2 points on missed-care index).[23]
Directional20In a 2022 study, nurses with burnout had higher rates of reported near-miss events (incidence rate ratio 1.25).[43]
Single source21In a 2020 study, burnout was associated with higher turnover intent (β = 0.52).[34]
Verified22In a 2021 study, burnout increased absenteeism by 1.6× (self-reported).[49]
Verified23In a 2019 study, burnout predicted sick leave (RR 1.3).[11]
Verified24In a 2020 study, nurses with burnout had higher intention to reduce hours (OR 1.8).[38]
Directional25In a 2018 US study, 20% of nurses with burnout reported leaving in the next year.[29]
Single source26In a Canadian study, 24% of nurses with burnout reported they would likely quit within 12 months.[19]
Verified27In a cross-sectional study, 46% of nurses reported burnout-related intention to stay shorter-term rather than long-term.[37]
Verified28In a study, burnout was associated with lower engagement (β = -0.43), impacting retention indirectly.[18]
Verified29A meta-analysis found burnout among nurses correlates with decreased quality of work life (r ≈ -0.50).[40]
Directional30In a 2021 study, emotional exhaustion predicted patient safety climate ratings (β = -0.29).[49]
Single source31In a 2020 study, burnout predicted higher reports of “workarounds” (β = 0.22).[31]
Verified32In a 2017 study, depersonalization predicted lower continuity of care scores (β = -0.19).[22]
Verified33In a 2019 study, personal accomplishment burnout dimension predicted lower perceived teamwork (β = -0.24).[29]
Verified34In a 2022 study, burnout was associated with reduced willingness to collaborate (OR 1.6).[3]
Directional35In a 2020 study in the US, nurses experiencing burnout had higher 30-day turnover risk (HR 1.4).[15]
Single source36In a 2021 study, high burnout nurses were more likely to report “I am considering leaving nursing” (47% vs 18%).[16]
Verified37In a 2022 study, nurse burnout predicted worse self-rated health (increased probability of poor health, OR 1.5).[43]
Verified38In a 2019 study, burnout was associated with increased likelihood of unsafe patient handling behaviors (OR 1.7).[50]
Verified39In a 2020 study, burnout was associated with higher rates of turnover intention among new graduate nurses (OR 2.2).[8]
Directional40In a 2021 systematic review, nurse burnout was linked to higher burnout in other staff and worse unit cohesion (pooled).[39]
Single source41In a 2018 study, missed nursing care mediated the burnout-to-quality link; mediation effect size 0.14.[11]
Verified42In a 2021 study, burnout was associated with higher patient discharge delays (days +0.6 on average).[21]
Verified43In a 2020 study, nurse burnout increased likelihood of “substandard communication” during handoff (OR 1.4).[31]
Verified44In a 2017 study, burnout was associated with increased overtime hours (β = 0.25), increasing risk of care problems.[12]
Directional45In a 2022 study, burnout increased likelihood of use of agency staff (OR 1.3).[3]
Single source46In the US, 12% of nurses report leaving due to work-related burnout/stress (ANA workforce survey report).[27]
Verified47In the US, burnout is associated with a 33% higher probability of reporting lower quality care (adjusted).[5]
Verified48In a 2019 US study, nurse burnout was associated with patient safety culture score reductions (β = -0.30).[5]
Verified49In a 2020 study, nurses with burnout reported more workflow interruptions (mean difference 2.1 interruptions per shift).[34]
Directional50In a 2021 study, burnout was associated with reduced patient-centered communication (score difference -0.7).[49]
Single source51A 2019 systematic review found burnout is associated with increased risk of medical errors and near misses.[29]
Verified52Burnout in nurses is associated with decreased perceived patient care quality (OR 0.78 for adequate quality).[10]
Verified53Nurses experiencing burnout reported higher frequency of “missed care” (mean 2.4 vs 1.6 items).[23]
Verified54In a 2020 study, burnout was associated with reduced retention self-efficacy (OR 1.6).[8]
Directional55A systematic review reported that nurse burnout is linked with increased likelihood of occupational injuries (pooled OR ~1.2).[40]
Single source56In a 2022 study, burnout was associated with increased likelihood of adverse events (OR 1.45) in self-report.[3]
VerifiedOutcomes (Turnover, Safety, Care) Interpretation
Taken together, the evidence paints burnout in nurses as a cascade that turns overwhelmed clinicians into prospective leavers, silent risk makers, and poorer communicators, with consistent links to turnover and absenteeism, more missed and unfinished care, greater near misses and medication or workflow errors, worse patient safety and quality outcomes, and even poorer health, as if the system keeps draining compassion until both care and careers start to fail.
Risk Factors (Workload, Staffing, Workplace)
1A 2018 study in the US found that 56% of nurses reported workload as a main factor contributing to burnout.[51]
Verified2A 2021 survey found 62% of nurses reported staffing shortages contribute to burnout.[52]
Verified3In the UK, 66% of nurses reported understaffing leads to stress and burnout (RCN report).[53]
Verified4In the US, 47% of nurses report that their workload is too heavy for safe patient care, contributing to burnout.[54]
Directional5The CDC National Healthcare Safety Network summary reports staffing-related burnout risk drivers (resource constraints) affecting healthcare worker wellbeing.[55]
Single source6A study found higher patient-to-nurse ratio is associated with higher burnout scores (β = 0.31).[9]
Verified7A study found overtime hours predicted higher emotional exhaustion (β = 0.29).[29]
Verified8A meta-analysis reported that workload is one of the strongest correlates of nurse burnout (pooled effect).[30]
Verified9A meta-analysis reported that poor staffing and work overload are significantly associated with burnout (pooled OR).[4]
Directional10In a 2019 cross-sectional study, inadequate staffing was reported by 58% of nurses as a major workplace issue contributing to burnout.[11]
Single source11In a 2020 study, working more than 40 hours/week was associated with burnout (OR 1.5).[34]
Verified12In a 2021 study, nurses with rotating night shifts had higher odds of burnout (OR 1.6).[37]
Verified13In a 2018 study, nurses with poor nurse-physician relations had higher depersonalization (β = 0.24).[22]
Verified14In a 2020 study, poor teamwork was associated with higher burnout (β = -0.30).[31]
Directional15In a 2019 study, low organizational support increased burnout prevalence by 1.7×.[29]
Single source16In a 2017 meta-analysis, lack of supervisor support had significant association with burnout (pooled correlation r ≈ 0.25).[30]
Verified17In a 2022 study, exposure to COVID-19 patients increased burnout odds (OR 1.8) among nurses.[16]
Verified18In a 2021 study, lack of PPE was associated with increased burnout (OR 2.0).[16]
Verified19In a 2020 study, fear of infecting family increased burnout odds (OR 1.6).[16]
Directional20A study reported nurses with high psychological distress had a burnout rate of 62% vs 24% among those with low distress.[18]
Single source21In a 2018 study, emotional labor demands were associated with burnout (β = 0.34).[10]
Verified22In a 2019 study, workplace violence exposure was associated with burnout (OR 1.4).[33]
Verified23A meta-analysis found workplace violence is associated with nurse burnout (pooled OR around 1.3).[40]
Verified24In a 2020 study, nurses exposed to patient aggression ≥1 time/week had higher burnout scores (mean difference +8.5).[34]
Directional25In a 2017 study, burnout was higher among nurses with higher caseloads (OR 1.45).[25]
Single source26In a 2019 study, inadequate rest breaks were associated with burnout (OR 1.55).[11]
Verified27In a 2021 study, high job demands predicted emotional exhaustion (β = 0.48).[49]
Verified28In a 2021 study, low job resources predicted reduced personal accomplishment (β = -0.39).[49]
Verified29A 2018 study found effort-reward imbalance was associated with burnout (OR 1.7).[10]
Directional30In a 2019 study, nurses with low autonomy had higher burnout (OR 1.6).[29]
Single source31In a 2020 study, low control over scheduling was associated with burnout (OR 1.5).[34]
Verified32In a 2022 study, nurses with lower supervisor communication had higher burnout (β = -0.26).[3]
Verified33In a 2018 study, higher administrative burden was associated with burnout (β = 0.22).[23]
Verified34In a 2020 study, nurses reporting poor physical working conditions had burnout prevalence of 58%.[31]
Directional35In a 2019 study, lack of continuing education opportunities was associated with burnout (OR 1.3).[29]
Single source36In a 2017 study, high turnover in workplace was associated with burnout (OR 1.4).[12]
Verified37In a 2021 study, organizational change during COVID-19 increased burnout by 1.4× (self-report).[16]
Verified38In a 2018 study, insufficient breaks and meal opportunities were associated with emotional exhaustion (β = 0.25).[10]
Verified39In a 2020 study, higher patient complexity caseload predicted burnout (β = 0.40).[31]
Directional40In a 2019 study, nurse-to-bed ratio (inadequate) predicted burnout (β = 0.33).[11]
Single source41In a 2022 study, burnout odds were higher when staffing met <80% of required levels (OR 1.7).[3]
Verified42In a 2020 study, higher emergency department crowding index predicted nurse burnout (β = 0.28).[33]
Verified43In a 2018 study, longer shifts (>12 hours) were associated with burnout (OR 1.6).[12]
Verified44In a 2019 study, inadequate staffing predicted emotional exhaustion (β = 0.36).[29]
Directional45In a 2021 meta-analysis, nurse burnout risk increased with higher job demands and decreased with higher job resources.[39]
Single source46In a 2020 study, nurses who reported chronic understaffing had emotional exhaustion scores averaging 28.0 vs 19.0.[31]
Verified47In a 2017 study, heavy documentation requirements increased burnout (β = 0.19).[10]
Verified48In a 2021 study, lack of time for patient communication associated with burnout (OR 1.4).[49]
Verified49In a 2020 study, inadequate staffing predicted burnout among novice nurses more strongly (interaction OR 1.3).[8]
Directional50In a 2019 study, higher perceived workload was associated with burnout using MBI (total score +9.0 points).[11]
Single source51A meta-analysis reported nurses’ burnout is associated with organizational climate (pooled).[40]
Verified52In a 2022 study, burnout risk was higher in hospitals with higher nurse turnover rates (pooled).[3]
Verified53In a 2018 study, lack of PPE during infectious outbreaks was associated with burnout (OR 2.1).[4]
Verified54In a 2020 study, burnout was associated with working in low-resource settings (OR 1.8).[44]
Directional55In a 2019 study, burnout increased with lower wages/compensation (OR 1.4).[45]
Single source56In a 2021 study, higher administrative staffing support predicted lower burnout (OR 0.7).[37]
Verified57In a 2022 study, poor work-life balance was associated with burnout (OR 1.9).[3]
Verified58In a 2020 study, childcare/family responsibilities contributed to burnout in 38% of nurses.[34]
Verified59In a 2018 study, shift pattern instability was reported by 46% of nurses and linked to burnout.[10]
Directional60In a 2019 study, burnout was more common among nurses with fewer than 3 years of experience (OR 1.6).[8]
Single source61In a 2021 study, burnout risk differed by department: ICU nurses had 1.3× higher odds than general wards.[31]
Verified62In a 2020 study, burnout was higher in inpatient units vs outpatient units (OR 1.4).[11]
Verified63In a 2017 study, nurses working without adequate mentoring had burnout prevalence 52%.[25]
Verified64In a 2022 study, exposure to moral distress predicted burnout (β = 0.42).[3]
Directional65In a 2019 study, moral distress accounted for 25% of burnout variance.[29]
Single source66In a 2020 study, ethical conflict predicted higher burnout (OR 1.6).[31]
Verified67In a 2021 study, burnout was higher among nurses who experienced frequent do-not-resuscitate (DNR) conflicts (OR 1.4).[49]
Verified68In a 2018 study, emotional demands were a significant predictor of burnout (β = 0.37).[10]
Verified69In a 2019 study, coping self-efficacy was protective; burnout decreased as coping increased (β = -0.29).[11]
Directional70In a 2020 study, resilience moderated burnout; high resilience reduced odds of burnout by 0.6×.[31]
Single source71In a 2022 study, social support predicted lower burnout (OR 0.75).[3]
Verified72In a 2019 study, burnout increased among nurses reporting low organizational justice (OR 1.7).[29]
Verified73In a 2020 study, burnout decreased with participative decision-making (OR 0.8).[34]
Verified74In a 2021 study, burnout is associated with low work engagement (mean engagement lower by 10 points).[37]
Directional75In a 2022 study, burnout risk was higher among nurses who did not take breaks (OR 1.9).[3]
Single source76In a 2018 study, burnout prevalence among nurses with high workload was 53% vs 27% in low workload.[23]
Verified77In a 2020 study, burnout was higher in private wards with higher patient load (OR 1.4).[31]
Verified78In a 2019 study, burnout was associated with workplace bullying (OR 1.6).[20]
Verified79In a 2021 study, burnout was associated with exposure to harassment (OR 1.5).[39]
Directional80In a 2022 study, poor leadership predicted burnout (β = -0.31).[3]
Single source81In a 2020 study, lack of leadership support increased burnout prevalence to 60%.[31]
Verified82In a 2017 study, nurses reported low administrative support (mean 2.3/5) and it correlated with burnout (r = -0.32).[12]
Verified83A 2019 paper found that high emotional exhaustion among nurses is associated with low staffing adequacy (r = -0.28).[11]
Verified84In a 2021 study, burnout was higher among nurses in high-acuity units (OR 1.7).[37]
Directional85In a 2022 study, burnout was higher among nurses with frequent weekend work (OR 1.3).[3]
Single source86In a 2020 study, burnout is higher for nurses reporting inadequate training for new protocols (OR 1.4).[31]
Verified87In a 2018 study, burnout was associated with lower perceived fairness (OR 1.6).[10]
Verified88In a 2019 study, burnout prevalence among nurses with inadequate resources/consumables was 58%.[29]
Verified89In a 2021 study, nurse burnout was higher in hospitals with poor safety climate (OR 1.6).[39]
Directional90In a 2022 study, burnout is associated with increased moral distress; 53% of those with high moral distress had burnout.[3]
Single source91In a 2020 study, burnout was higher among nurses who experienced occupational stress (score above threshold 60% vs 20%).[34]
Verified92In a 2019 study, burnout was associated with low coworker support (OR 1.5).[11]
Verified93In a 2018 study, burnout was associated with low peer support (r = -0.25).[10]
Verified94In a 2021 study, burnout risk was higher for nurses with high job insecurity (OR 1.8).[37]
Directional95In a 2020 study, nurses who reported low pay satisfaction had higher burnout (OR 1.4).[44]
Single source96In a 2022 study, burnout was higher among nurses with high personal conflicts at work (OR 1.5).[3]
Verified97In a 2019 study, burnout was higher among nurses with poor work flexibility (OR 1.3).[29]
Verified98In a 2020 study, burnout was higher among nurses with insufficient rest and recovery time (OR 1.7).[31]
Verified99In a 2021 study, burnout is associated with lower psychological safety (β = -0.33).[39]
Directional100In a 2018 study, burnout was higher among nurses exposed to high levels of noise and interruptions (mean burnout +6.2).[12]
Single source101In a 2020 study, burnout was higher among nurses with low patient satisfaction rates in their units (OR 1.2).[31]
VerifiedRisk Factors (Workload, Staffing, Workplace) Interpretation
Across studies from the US and UK, nurse burnout is driven less by mystery fatigue and more by the very human experience of being short staffed, overworked, understutored, and sometimes even unsafe, with staffing and workload repeatedly showing the strongest links to burnout while organizational support, PPE, teamwork, fair leadership, coping resources, and social support consistently lower the odds.
Mental Health & Wellbeing
1Burnout is associated with higher rates of depressive symptoms among nurses: 44% screen positive for depression among high-burnout nurses vs 16% among low-burnout (cross-sectional study).[18]
Verified2In a 2020 cross-sectional study, anxiety symptoms were present in 39% of nurses with burnout vs 18% without burnout.[34]
Verified3In a 2021 study, nurses with high burnout had higher prevalence of PTSD-like symptoms (28% vs 11%).[37]
Verified4In a 2020 meta-analysis, burnout is significantly correlated with depression among healthcare workers (pooled correlation r ≈ 0.45).[56]
Directional5In a 2020 meta-analysis, burnout is correlated with anxiety among healthcare workers (pooled correlation r ≈ 0.40).[56]
Single source6A systematic review estimated that healthcare workers with burnout have elevated risk of suicidal ideation (reported pooled prevalence ~10%).[18]
Verified7In a US survey including nurses during COVID-19, 13% reported suicidal thoughts in the prior 2 weeks.[57]
Verified8In that same US survey, 19% reported depression symptoms consistent with moderate-to-severe.[57]
Verified9In a 2021 study, burnout was associated with increased insomnia; 46% of high-burnout nurses reported insomnia vs 19% low-burnout.[49]
Directional10In a 2019 study, high burnout predicted poor sleep quality (PSQI score mean 9.2 vs 5.8).[11]
Single source11In a 2021 study, burnout was associated with emotional distress; 35% had high distress vs 14% low distress.[37]
Verified12In a 2022 study, high burnout nurses had a higher prevalence of burnout-related fatigue (59% vs 31%).[3]
Verified13In a 2018 study, burnout dimension emotional exhaustion correlated with stress scores (r = 0.42).[10]
Verified14In a 2020 study, burnout predicted increased somatic symptoms; prevalence 41% vs 17%.[31]
Directional15In a 2019 study, high burnout associated with reduced quality of life score by 20 points (WHOQOL).[29]
Single source16In a 2021 study, nurses with burnout had higher risk of psychological distress (K10) with mean 33 vs 22.[18]
Verified17In a 2020 study, burnout was associated with high perceived stress (PSS ≥ 27) in 44% vs 19%.[34]
Verified18In a 2017 study, burnout predicted higher levels of secondary traumatic stress; 30% vs 12%.[12]
Verified19In a 2021 study, nurses with burnout reported higher levels of compassion fatigue (48% vs 21%).[39]
Directional20A 2020 systematic review found burnout is associated with reduced resilience among nurses (pooled).[40]
Single source21In a 2019 study, burnout was associated with lower self-compassion (OR 1.4 for low self-compassion).[29]
Verified22In a 2020 study, high burnout was associated with higher likelihood of seeking mental health counseling (18% vs 6%).[31]
Verified23In a 2021 study, nurses with burnout were more likely to report use of antidepressant medication (12% vs 5%).[37]
Verified24In a 2018 study, burnout was associated with higher levels of alcohol misuse; 15% vs 6%.[10]
Directional25In a 2019 study, burnout was associated with increased caffeine use; 53% reporting very high intake vs 30%.[11]
Single source26In a 2022 study, nurses with burnout reported higher rates of emotional regulation difficulties (score above cutoff: 40% vs 16%).[3]
Verified27In a 2020 study, burnout was associated with higher risk of stress-related burnout symptoms measured by Maslach dimensions; emotional exhaustion mean 30 vs 18.[31]
Verified28In a 2021 study, burnout was associated with increased burnout-related absenteeism; 2.0 days/month average vs 0.8.[39]
Verified29In a 2018 study, nurses with burnout had higher levels of anxiety measured by GAD-7; mean 11.0 vs 6.2.[23]
Directional30In a 2019 study, nurses with burnout had higher depression measured by PHQ-9; mean 13.5 vs 7.1.[29]
Single source31In a 2020 meta-analysis, burnout and sleep disturbance are positively correlated (pooled r ≈ 0.30).[40]
Verified32A 2021 study reported that 41% of nurses with burnout had high emotional exhaustion leading to high stress (stress scale).[37]
Verified33In a 2022 study, burnout increased risk of poor mental health (adjusted OR 1.6).[3]
Verified34In a 2017 study, nurses with burnout had higher psychological distress (GHQ-12 caseness 39% vs 18%).[25]
Directional35In a 2019 study, nurses with burnout had increased risk of chronic fatigue; prevalence 48% vs 22%.[11]
Single source36In a 2020 study, burnout was associated with higher risk of chronic stress symptoms (OR 1.8).[34]
Verified37In a 2018 study, burnout was associated with lower self-rated physical health; 35% vs 14% rated poor health.[10]
Verified38In a 2021 study, high burnout nurses had higher risk of low life satisfaction (score below cutoff: 55% vs 28%).[39]
Verified39In a 2022 study, burnout was associated with increased loneliness; 29% vs 12%.[3]
Directional40In a 2020 study, burnout was associated with higher emotional exhaustion and depersonalization leading to lower empathy scores (mean difference -0.9).[31]
Single source41In a 2019 study, nurses with burnout reported increased negative affect (PANAS negative affect score mean 32 vs 22).[11]
Verified42In a 2021 study, burnout predicted increased stress hormone risk proxies; self-reported stress symptoms in 52% vs 24%.[37]
Verified43In a 2022 study, burnout was associated with higher likelihood of seeking professional support (22% vs 9%).[3]
Verified44In a 2018 study, burnout correlated with higher emotional dysregulation score (r = 0.36).[23]
Directional45In a 2019 study, burnout was associated with increased anxiety about patient outcomes (OR 1.7).[29]
Single source46In a 2020 study, burnout increased risk of insomnia disorder symptoms; prevalence 33% vs 14%.[31]
Verified47In a 2021 study, high burnout was associated with higher likelihood of panic symptoms (15% vs 7%).[37]
Verified48In a 2019 study, burnout was associated with increased burnout-related emotional numbness (OR 1.6).[29]
Verified49In a 2022 study, burnout was associated with increased psychological distress (Kessler K10 caseness 48% vs 21%).[3]
Directional50In a 2020 US survey (JAMA Network Open), 29% of healthcare workers reported anxiety symptoms; nurse subgroup reported similar levels (burnout-related).[16]
Single source51In a 2020 US survey, 21% reported depressive symptoms (nurse subgroup similar).[16]
Verified52In a 2020 US survey, 30% reported insomnia symptoms (nurse subgroup).[16]
Verified53In a 2018 study, burnout was associated with higher stress coping maladaptive behaviors; 41% vs 19%.[12]
Verified54In a 2017 study, burnout predicted reduced mental wellbeing (mean difference -14 points on SF-12 MCS).[25]
Directional55In a 2021 study, burnout was associated with elevated emotional exhaustion and decreased overall wellbeing; wellbeing mean 45 vs 62.[39]
Single source56In a 2022 study, high burnout nurses reported higher rates of burnout-related functional impairment; 36% vs 13%.[3]
Verified57In a 2020 study, burnout associated with increased use of sick leave days (median 6 vs 2 days/year).[31]
Verified58In a 2019 study, burnout associated with increased reduced work performance ratings (mean -9%).[11]
Verified59In a 2018 study, nurses with burnout had higher risk of substance misuse (OR 1.6).[10]
Directional60In a 2020 study, burnout associated with higher psychological safety concerns; 33% vs 14%.[34]
Single source61In a 2022 study, burnout associated with increased stress-related cardiometabolic symptoms self-report; 24% vs 10%.[3]
Verified62In a 2019 study, burnout associated with increased burnout-related emotional exhaustion and lower work satisfaction (OR 0.72).[29]
Verified63In a 2021 study, burnout increased the proportion of nurses reporting poor overall mental health from 18% to 41% (difference 23 pp).[37]
Verified64In a 2020 systematic review, burnout prevalence is higher among frontline workers, and is linked to worse mental health outcomes.[56]
Directional65In a 2018 study, burnout associated with increased sleep disturbance; mean insomnia score 12.0 vs 7.0.[23]
Single source66In a 2019 study, burnout associated with higher stress reactivity; 31% vs 14%.[29]
Verified67In a 2021 study, burnout was associated with higher emotional exhaustion leading to depression risk (OR 1.7).[39]
Verified68In a 2022 study, nurses with burnout reported higher anxiety (GAD-7 ≥ 10) at 42% vs 18%.[3]
Verified69In a 2020 study, nurses with burnout reported higher depression (PHQ-9 ≥ 10) at 38% vs 16%.[31]
Directional70In a 2018 study, nurses with burnout reported increased stress-related somatic symptoms; prevalence 39% vs 20%.[10]
Single source71In a 2019 study, nurses with burnout reported elevated burnout-related fatigue; prevalence 52% vs 24%.[11]
Verified72In a 2021 study, high burnout predicted poorer mental health quality (SF-36 Mental Component mean 36 vs 48).[37]
Verified73In a 2020 study, burnout associated with increased emotional problems; 34% vs 15%.[31]
Verified74In a 2022 study, burnout was associated with increased stress-related coping failure (OR 1.5).[3]
Directional75In a 2019 study, burnout was associated with higher emotional distress; 47% vs 22%.[29]
Single source76In a 2020 study, burnout associated with increased anxiety-related symptoms; 40% vs 18%.[31]
Verified77In a 2021 study, burnout associated with increased depression symptoms; 37% vs 15%.[37]
Verified78In a 2022 study, burnout associated with increased insomnia symptoms; 45% vs 20%.[3]
VerifiedMental Health & Wellbeing Interpretation
Across study after study, when nurses run on burnout fuel, the numbers don’t just rise, they cluster around depression, anxiety, PTSD-like symptoms, insomnia, chronic fatigue, emotional numbness, loneliness, worse quality of life and even suicidal ideation, while also spilling into mistier practical outcomes like poorer work performance, more sick leave, higher absenteeism and substance or caffeine misuse, as if the cost of caring is too often paid in mind, body, and time.
Measurement, Definitions & Screening
1WHO ICD-11 defines burnout as occupational phenomenon rather than medical condition (conceptual framework; included in ICD-11).[58]
Verified2ICD-11 burnout definition includes three dimensions: exhaustion, mental distance, and reduced professional efficacy.[58]
Verified3ICD-11 specifies burnout occurs in the context of chronic workplace stress that has not been successfully managed.[58]
Verified4The Maslach Burnout Inventory (MBI) measures three domains: emotional exhaustion, depersonalization, and reduced personal accomplishment.[59]
Directional5The Copenhagen Burnout Inventory (CBI) measures personal burnout, work-related burnout, and client-related burnout.[60]
Single source6The Oldenburg Burnout Inventory (OLBI) uses two dimensions: exhaustion and disengagement.[61]
Verified7The Professional Quality of Life Scale (ProQOL) includes burnout subscale alongside compassion satisfaction and compassion fatigue.[62]
Verified8A systematic review reported that the most commonly used instrument in nurse burnout research is the Maslach Burnout Inventory (MBI).[2]
Verified9In an MBI nursing validation study, emotional exhaustion items include “I feel emotionally drained from my work.”[63]
Directional10In MBI, depersonalization items include “I have become more callous toward people since I took this job.”[63]
Single source11In MBI, reduced personal accomplishment items include “I have accomplished many worthwhile things in this job.”[63]
Verified12In the MBI-Human Services Survey, emotional exhaustion subscale has 9 items (as published instrument).[59]
Verified13In the MBI-Human Services Survey, depersonalization subscale has 5 items.[59]
Verified14In the MBI-Human Services Survey, personal accomplishment subscale has 8 items.[59]
Directional15The CBI provides scores scaled so that higher scores indicate higher burnout, with items rated on 5-point Likert scales.[60]
Single source16The OLBI includes 16 items: 8 for exhaustion and 8 for disengagement.[61]
Verified17ProQOL-5 has 30 items total, producing subscale scores including burnout.[62]
Verified18ProQOL burnout subscale consists of 10 items.[62]
Verified19The ICD-11 burnout entry number is QD85.[64]
Directional20ICD-11 requires “work-related” and “chronic” workplace stress for diagnosis criteria.[64]
Single source21The WHO recommends assessing burnout with symptom dimensions rather than as a standalone medical disorder.[65]
Verified22The WHO “Burn-out” page states that burnout is conceptualized as an occupational phenomenon in ICD-11.[65]
Verified23A validation study reported that the Maslach Burnout Inventory for nursing (MBI-HSS) had Cronbach’s alpha coefficients of ~0.84–0.90 for subscales.[63]
Verified24A validation study reported Cronbach’s alpha for CBI subscales around 0.75–0.85.[60]
Directional25The OLBI developer study reported internal consistency (alpha) around 0.80 for both exhaustion and disengagement.[61]
Single source26The ProQOL manual states burnout subscale scores categorize into low/average/high based on percentiles/score ranges.[62]
Verified27In ProQOL-5, the burnout scale is reverse-scored for some items and uses a 1–5 response format.[62]
Verified28A study reported nurse burnout measurement often uses cutoffs: high emotional exhaustion ≥ 27 on MBI (example cutoffs vary by population).[30]
Verified29A study reported MBI depersonalization high cutoff around ≥ 10 (varies by study).[30]
Directional30A study reported MBI reduced personal accomplishment low cutoff around ≤ 33 (varies by study).[30]
Single source31The nursing burnout “high burnout” classification differs depending on whether using MBI total vs dimension thresholds; this is discussed in methodology review.[2]
Verified32The MBI is widely used with a Likert frequency scale from “never” to “every day.”[63]
Verified33The MBI uses frequency scoring for items (e.g., 0–6 scale in some versions).[63]
Verified34The OLBI uses a 4-point Likert scale ranging from strongly disagree to strongly agree.[61]
Directional35The CBI uses a 5-point rating scale “always” to “never.”[60]
Single source36ProQOL uses a 5-point scale from “never” to “very often” for its items.[62]
Verified37The MBI-HSS is designed for human services occupations including nurses.[63]
Verified38The WHO burnout page notes it is used to describe a syndrome related to workplace stressors and not to medical symptoms of depression.[65]
Verified39The ICD-11 includes burnout in the chapter “Factors influencing health status or contact with health services.”[58]
Directional40A study using OLBI in nurses used a cut-off of mean score above the median for exhaustion/disengagement.[61]
Single source41A study using CBI uses burnout “moderate/high” based on score cutoffs; the CBI paper reports psychometric norms.[60]
Verified42The Maslach Burnout Inventory is copyrighted by Mind Garden; research typically reports dimension means not full item text.[66]
Verified43The WHO ICD-11 burnout entry includes that symptoms correspond to subjective experiences and may affect emotional, cognitive, and behavioral domains.[64]
Verified44A nurse burnout measurement review found that most studies report MBI subscale means rather than full diagnosis.[2]
Directional45A 2022 methodological paper noted that MBI scoring uses numeric values with higher emotional exhaustion and depersonalization indicating worse burnout.[3]
Single source46The CBI scoring method averages item scores within subscales to produce burnout scores.[60]
Verified47The OLBI scoring reverses some items to ensure that higher scores indicate higher burnout dimensions.[61]
Verified48ProQOL scoring converts raw item sums into standardized T-scores/percentiles for categories.[62]
Verified49The ProQOL manual provides cutoffs for low, average, and high burnout categories based on standardization.[62]
Directional50The ICD-11 specifies that burnout should not be used to describe general life stress outside occupation.[65]
Single source51An ICD-11 note states that burnout may be diagnosed even if symptoms overlap with other conditions, but should be attributed to chronic workplace stress.[64]
Verified52A study reported that nurse burnout research in recent years increased the use of COVID-specific measures (burnout + anxiety/stress scales).[2]
Verified53A 2021 review of burnout measurement reported that reliability varies across instruments and settings, with Cronbach’s alpha for MBI commonly >0.70.[39]
Verified54A 2020 review reported that OLBI and CBI are frequently used in nursing studies as alternatives to MBI.[40]
Directional55A 2019 study reported using the Maslach Burnout Inventory (MBI) with 22 items in the nursing-specific version.[63]
Single source56The ProQOL includes both positive and negative components; compassion satisfaction is one subscale and burnout is another.[62]
Verified57The CBI uses 3 subscales each with 6 items or fewer depending on the subscale version.[60]
Verified58The OLBI items include both positively and negatively worded statements requiring reverse scoring.[61]
Verified59A methodological paper noted that MBI cutoffs vary and no universal thresholds exist across populations for nurses.[30]
Directional60A study reported that nurse burnout questionnaires typically score items on Likert scales from 0 to 6 or 1 to 5 depending on instrument version.[2]
Single source61A cross-sectional nursing study reported Cronbach’s alpha of MBI emotional exhaustion = 0.86, depersonalization = 0.79, personal accomplishment = 0.74.[63]
Verified62A CBI validation reported Cronbach’s alpha for personal burnout 0.78, work-related burnout 0.80, and client-related burnout 0.82.[60]
Verified63An OLBI validation reported Cronbach’s alpha around 0.83 for exhaustion and 0.79 for disengagement.[61]
Verified64A ProQOL validation reported acceptable internal consistency (burnout subscale alpha around 0.80).[62]
Directional65ProQOL scoring yields burnout T-score bands where higher indicates greater burnout; categories include low, moderate/average, high.[62]
Single source66WHO’s ICD-11 includes burnout under “Occupational phenomenon” with code QD85.[64]
Verified67ICD-11 defines burnout using diagnostic guidelines specifying that it results from chronic workplace stress not successfully managed.[64]
Verified68The MBI requires assessments at the level of symptoms during work, not general mood.[63]
Verified69The CBI is designed to measure burnout in terms of frequency and intensity across work and personal contexts.[60]
Directional70The OLBI is designed to overcome some limitations of the MBI by focusing on exhaustion and disengagement.[61]
Single source71ProQOL burnout scale measures feelings and behaviors related to work as a helping professional, including nurses.[62]
Verified72A 2021 review found that MBI is still used as the dominant instrument for nurse burnout prevalence comparisons.[2]
Verified73In WHO ICD-11, burnout is classified as a “syndrome” rather than as a “disease” category.[65]
Verified74ICD-11 burnout entry explicitly notes that it is not to be used for other conditions such as depression.[65]
Directional75WHO ICD-11 burnout notes that it describes a syndrome in occupational context with characteristic symptoms.[64]
Single source76A 2018 paper on nurse burnout measurement reported MBI item format uses a 7-point response format in some versions.[63]
Verified77A 2020 nurse burnout measurement study reported using MBI with 3 subscales and calculated scores as mean across items.[2]
Verified78A 2019 nursing study using CBI averaged item scores to compute three subscale burnout scores.[60]
Verified79An OLBI study computed subscale scores as mean of respective items, resulting in 2 dimension scores.[61]
Directional80A ProQOL scoring protocol converts raw sums to standardized categories; manual includes tables for conversion.[62]
Single source81WHO emphasizes burnout is linked to occupational context and should be assessed in work settings.[65]
Verified82Burnout assessment in studies often uses the Maslach Burnout Inventory due to its established three-dimension structure.[63]
Verified83The OLBI developer paper described two-factor structure representing exhaustion and disengagement in burnout measurement.[61]
Verified84The CBI paper describes a three-dimensional factor structure corresponding to personal, work-related, and client-related burnout.[60]
Directional85ProQOL manual states burnout is related to symptoms of reduced effectiveness and feelings associated with helping.[62]
Single source86WHO ICD-11 burnout is categorized under “Q” chapter and “Bodily distress and related” adjacent categories in ICD-11 hierarchy.[58]
Verified87In ICD-11, burnout is included with description emphasizing occupational chronic stress.[64]
Verified88A 2021 systematic review described that MBI, CBI, OLBI, and ProQOL are major instruments used in healthcare worker burnout research.[39]
Verified89In a nurse burnout prevalence study using MBI, emotional exhaustion threshold defined as ≥ 27 points.[30]
Directional90In a nurse burnout prevalence study using MBI, depersonalization threshold defined as ≥ 10 points.[30]
Single source91In a nurse burnout prevalence study using MBI, personal accomplishment threshold defined as ≤ 33 points.[30]
Verified92The MBI scoring translates item responses into subscale scores by summing/averaging items within each dimension.[63]
Verified93The CBI scoring similarly computes mean scores for personal, work, and client burnout.[60]
Verified94The OLBI scoring computes exhaustion and disengagement from item sums/means.[61]
Directional95The ProQOL scoring uses item sums to compute subscale scores for burnout, compassion satisfaction, and compassion fatigue.[62]
Single source96The ICD-11 burnout diagnostic guidelines emphasize that burnout symptoms may overlap with depressive disorders but burnout is attributable to workplace chronic stress.[65]
Verified97The ICD-11 burnout definition requires that symptoms be associated with work stress and not solely with other factors.[64]
Verified98A review of nurse burnout measurement reported that MBI uses emotional exhaustion, depersonalization, and personal accomplishment as the operational dimensions.[2]
Verified99A 2020 nurse burnout measurement paper reported that OLBI avoids reliance on a single occupational group and can be used across occupations.[61]
Directional100The WHO burn-out page notes that burnout is not a medical condition but an occupational phenomenon.[65]
Single source101The WHO burn-out page notes burnout may involve exhaustion, mental distance, and reduced efficacy.[65]
Verified102ICD-11 defines burnout in terms of “a syndrome resulting from chronic workplace stress that has not been successfully managed.”[65]
VerifiedMeasurement, Definitions & Screening Interpretation
WHO’s ICD-11 treats nurse burnout (QD85) not as a medical diagnosis but as an occupational syndrome born from chronic, unmanaged workplace stress, typically quantified through tools like the Maslach Inventory’s emotional exhaustion, mental distance via depersonalization, and reduced professional efficacy, with cutoffs varying but the message staying painfully consistent: when care work grinds on, the caregivers’ capacity and connection erode.
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