RELATIONSHIPS AMONG NURSES' IDENTITIES, PRACTICE ENVIRONMENTS, BULLYING AND BURNOUT

BACKGROUND AND RATIONALE: Burnout increases nurses’ risk of anxiety, depression, and suicide.  Stressful workplace environments and workplace bullying are associated with burnout, but it is unclear why some nurses are more likely to experience burnout than others who are exposed to similar environmental variables.  Motivations about work and shared goals in the workplace are identified as important to the development of burnout in the Existential Model of Burnout.  Through innovative application of the Social Identity Theory of Intergroup Behavior to the Existential Model of Burnout, we suggest that these goals and motivations are a result of identification with the nursing profession and with one’s team of coworkers on the unit. 

PURPOSE: The purpose of this study was to determine whether professional identification with nursing and team identification with coworkers were associated with the nursing practice environment, workplace bullying and burnout among Registered Nurses (RNs). 

METHODS: 1940 randomly selected RNs in a large American city received an invitation by mail to participate in an online survey that included the Practice Environment Subscale of the Nursing Work Index, the Workplace Bullying Measure, the Group Identification Scale, and the Burnout Measure. 

RESULTS: Of the 156 RNs who elected to participate, 72 met inclusion criteria of working in clinical staff RN roles in acute-care inpatient hospital settings. Being strongly identified with the profession and with one’s team of coworkers were both significantly associated with lower burnout (r. -0.57 and r. -0.56, respectively).  Professional identification and team identification were also significantly associated with less workplace bullying (r. -0.35 and r. -0.52, respectively) and many aspects of a healthy nursing practice environment [nurse manager leadership and support: r. 0.35, and r. 0.44, respectively; nursing as the foundation for care planning and delivery: r 0.40 and r. 0.36, respectively; collegial relationships with physicians: r. 0.37 and r. 0.38, respectively; and nurse participation in hospital affairs: r. 0.31 and r. 0.32, respectively)]. Nurses’ professional identity and team identity were not significantly associated with nurse staffing and resources (r. 0.20 and 0.20, respectively, with p>0.05).

IMPLICATIONS: Among staff RNs working in urban acute-care inpatient hospital settings, strong professional identification and team identification are both associated with more positive perceptions of the workplace environment, with less frequent workplace bullying and with lower nurse burnout.  These findings suggest that identification with the nursing profession and with one’s team of co-workers may be protective against burnout. Further studies should determine whether professional and team identity mediate or moderate the effects of known predictors (workplace bullying and unhealthy practice environment) on burnout.