The Relationship Between Personal Coping Strategies, Social Support, Counseling Resources and Burnout Levels Among Emergency Room Nurses

Abstract

This cross-sectional study investigated how different coping resources and their sources are related to burnout among emergency room (ER) nurses in the United States. Specifically, the study assessed how personal coping strategies, social support, and professional counseling both individually and collectively mitigate burnout in ER nurses, evaluated if internal personal coping strategies are more predictive of burnout than external coping resources i.e. social support and counseling, and investigated the importance of workplace coping resources compared to non-workplace coping resources in burnout mitigation. Because the study took place during the COVID-19 pandemic and the 2020 Civil Rights Movement against recent social injustices, it also included a series of three likert-scale questions and one open-ended question to understand the impact of these circumstances on respondents’ sense of burnout and stress. From the 168 respondents, 119 ER nurses were included in the study based on inclusion and exclusion criteria, and 46 (38.7%) completed the open-ended question.

The study hypothesized that personal coping strategies, social support, and counseling would each individually be inversely correlated with nurse burnout. It was also predicted that the resources would have a stronger inverse correlation with burnout when assessed together than each resource alone. The study expected that the more coping resources an ER nurse had, the less burnout they would report, while the fewer coping resources an individual had, the higher burnout they would report. Of the three coping resources, personal coping strategies was expected to be the strongest predictor of burnout, followed by social support resources. Counseling resources were expected to be the least predictive. The final study hypothesis was that workplace sources of social support and counseling resources would be more strongly related than non-workplace sources on burnout levels.

Gender, age, years of nursing experience, and nursing title were all found to have a significant relationship with ER nurse burnout. Female participants reported higher burnout compared to males. Participants in the youngest age group reported higher burnout compared to their older counterparts, as did those with less nursing experience. Participants in RN and/or staff nurse positions also reported higher burnout than those in nurse practitioner or leadership roles. The study illuminated that personal coping strategies were most predictive of burnout and counseling resources were the least predictive. The more coping resources a nurse had, the less likely they reported high burnout and combined, coping self-efficacy and social support had a stronger relationship with burnout than each resource alone. Internal coping resources were found to be more predictive of nurse burnout than external resources, highlighting the importance of the self in burnout mitigation. The salience of workplace coping resources was also illuminated, particularly revealing the importance of support from immediate supervisors and organizational support. Findings about professional counseling also showed that perceptions about the availability of resources and support played a more crucial role in burnout management than the actual use of such resources. COVID-19 and the 2020 Civil Rights Movement were also found to have some influence on respondents’ questionnaire responses and sense of burnout. Common themes of impact described in participants’ open-ended responses included stress or distress, resources and job demands, burnout, COVID-19, Civil Rights Movement, medical and patient care, counseling, social support, organizational support and administrative policies, staff/team work dynamics, family and personal relationships, and safety. These free-text data responses provided insights into how the pandemics impacted ER nurses’ sense of stress and burnout.

This study is the first to specifically assess the relationship of personal coping strategies, social support sources, and counseling resources on levels of burnout in United States ER nurses. The study was also uniquely conducted during the COVID-19 pandemic and Civil Rights Movement of 2020, making it one of the first studies, if not the only study, to assess how such circumstances exacerbate stressors contributing to burnout in ER nurses. The study corroborated that individual, personal strategies can best manage burnout, especially when paired with social support, and it confirmed the value of workplace support. The study findings implicate that empowering ER nurses with personal coping strategies, fortified by managerial and organizational support, can most effectively facilitate burnout management.