Defense Date

7-10-2025

Graduation Date

Summer 8-9-2025

Submission Type

Dissertation/Thesis

Degree Name

Doctor of Nursing Practice (DNP)

Department

Doctor of Nursing Practice (DNP) Program

School

School of Nursing

Faculty Mentor

Manjulata Evatt

Keywords

Nurse graduate, emergency department, stress inoculation program, Maslach Burnout Inventory, Professional Quality of Life Scale, burnout, and compassion fatigue

Abstract

Background and significance: It is estimated that 20% of nurses leave the profession within the first year due to an onset of burnout (Henson, 2020). Prior to the pandemic of 2020, workforce projected models estimated large-scale shortages in full time employee (FTE) registered nurses as demand continued to outpace supply (Lauer, 2022). Researchers estimate projections from 2024 into the year 2032 are now skewed, as pandemic-related contributors and their effects on burnout in the nursing profession have not been thoroughly assessed (Saravanan et al., 2022). When considering the data, an underlying need for burnout prevention amongst nurse residents emerges. Interventions and implementation plan: A stress inoculation program (SIP) was adapted for the nursing profession and implemented into an emergency nurse residency program (NRP) over the course of 8 weeks using the Plan-Do-Study-Act (PDSA) model. Burnout (BO) and compassion fatigue (CF) levels were measured pre- and post-implementation using the Maslach Burnout Inventory (MBI) and the Professional Quality of Life (ProQOL) Scale. Qualitative data regarding stressors in the emergency department were gathered from participants using focus groups, program activities, and journal entries. Results and implications: Two-thirds of the participants showed moderate to high levels of BO and/or CF pre-implementation. Post-implementation, participants showed improved levels of BO, secondary traumatic stress (STS), and depersonalization, along with elevated levels of personal achievement. Journal entries showed clinical evidence of ongoing exposure to traumatic events and stressors directly linked to BO and CF. Conclusion: Nurse residents experience a variety of stressors during the first year of practice, with an increase in occurrence for high-risk departments (e.g., emergency department). Evidence suggests primary preventative measures are effective in reducing BO and CF in nurse residents working in the emergency department (ED). The SIP also showed clinical significance in reducing negative symptoms when implemented within a NRP.

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