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Nurse Resilience and Burnout Vary by Generation

Analysis  |  By Jennifer Thew RN  
   October 31, 2018

Nurse demographics such as generation, shift, and role influence development of resilience and burnout.

Burnout is hot topic in healthcare. But despite all the talk about it, burnout rates among nurses remain high. According to a 2017 Kronos survey of RNs employed in hospitals, up 63% report experiencing burnout.

Perhaps this is because burnout is a complex concept, and to make progress reducing it, healthcare leaders must delve into its many layers to find solutions that work for their specific organizations and nurses.

The newly published Press Ganey report, "Performance Insights: Resilience for a Multigenerational Nursing Workforce," teases out some of the variables of burnout, and its "antidote" resilience.

By analyzing engagement data to measure the key components of nurse resilience, the researchers found resilience varies according to nurse demographics such as generation, role, and shift.

Nurse leaders can use the findings to better understand who is at risk for burnout and to choose appropriate interventions for various groups of nurses at their organizations.  

Activation and Decompression

Press Ganey developed and validated an eight-item tool for measuring resilience within its employee engagement surveys.

The tool has two separate subscales that:

  • Measure the degree of respondents' engagement with work (activation)
  • Measure respondents' ability to disconnect from work (decompression)

With the tool, Press Ganey researchers reviewed the activation and decompression scores of 17,483 nurses from 145 hospitals who completed the Nursing Excellence module of their organization's 2017 Press Ganey Employee engagement survey.  Results were categorized according to generation (millennial, 1980 to 2000; Generation X 1965 to 1979; baby boomer 1946 to 1964) day or night shift, and manager status.

The activation subscale is based on the respondents' level of agreement with these statements:

1. I care for all patients equally even when it is difficult.

2. I see every patient as an individual with specific needs.

3. The work I do makes a real difference.

4. My work is meaningful.

The decompression subscale is based on respondents' level of agreement with these statements:  

1. I can enjoy my personal time without focusing on work matters.

2. I rarely lose sleep over work issues.

3. I am able to free my mind from work when I am away from it.

4. I am able to disconnect from work communications during my free time.

Activation and decompression were also assessed using 2017 NDNQI RN survey results from 161,451 nurses (643 hospitals). The following statements were proxies for activation and decompression.

  •  "I have what I need in my job so I can make a contribution that gives meaning to my life." (activation)
  • "Overtime hours in my last shift" (decompression)

These results were categorized by nurse role (charge nurse, nurse manager, staff nurse) and generation.

Differences Among Nursing Groups

The researchers found generational differences in activation and decompression among nurses. Additionally, activation and decompression varied by nurse manager status, nurse tenure, and shift.

Among the report's key findings: 

  • Millennial nurses have the lowest levels of activation
  • Millennial nurses working the night shift have an even further activation disadvantage
  • Nurse managers have better activation than non-managers
  • Non-managers have a greater ability to decompress than managers
  • Both nurse managers' and non-managers' ability to decompress highly correlates with their perception of stress and the organization's support of work–life balance
  • Across all generations, activation and decompression are highly correlated with nurses' intention to stay in their jobs
  • Drivers of activation and decompression vary by generation and manager status

For example, nurse managers may report higher levels of activation because they have a greater level of autonomy than do staff nurses. Conversely, they may have lower levels of decompression because of the added responsibilities that come with a managerial role, the researchers write.

Promoting Resilience

To promote activation and decompression, it is important for leaders to help nurses feel joy in their jobs, feel valued, and to provide the tools and support needed for healthy work–life balance.

The researchers suggest the following interventions to promote resilience.

  • Meaningful recognition
  • Interventions that meet the varying needs of different nursing groups like night shift nurses, millennials, and nurse managers.
  • Formal resilience training for nurses at all levels
  • Focusing on relationship-building activities and opportunities for enhancing nurse social support
  • Provide nurses on all shifts with resilience-focused support and resources
  • Include resilience-building burnout prevention strategies in the operational budget
  • Train nurse leaders to support staff nurses' alignment with professional purpose

Jennifer Thew, RN, is the senior nursing editor at HealthLeaders.


A large segment of nurses report burnout.

Activation and decompression contribute to resilience.

Different generations of nurses need different interventions to foster resilience.

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