Digital Repository Masters Projects Spring 2023 Burnout: A Secondary Endemic Amber Langi Weber State University Follow this and additional works at: https://dc.weber.edu/collection/ATDSON Langi, A. 2023. Burnout: A secondary endemic. Weber State University Masters Projects. https://dc.weber.edu/collection/ATDSON This Project is brought to you for free and open access by the Weber State University Archives Digital Repository. For more information, please contact scua@weber.edu. WSU REPOSITORY MSN/DNP Burnout: A Secondary Endemic Project Title by Amber Langi Student’s Name A project submitted in partial fulfillment of the requirements for the degree of MASTERS OF NURSING Annie Taylor Dee School of Nursing Dumke College of Health Professions WEBER STATE UNIVERSITY Ogden, UT April 1, 2023 Date Amber Langi RN, BSN, MSN Student Student Name, Credentials (electronic signature) 4/1/2023 Date 4/1/2023 MSN Project Faculty (electronic signature) Date 05/25/2023 Melissa NeVille Norton (electronic signature) DNP, APRN, CPNP-PC, CNE Graduate Programs Director Note: The program director must submit this form and paper. Date 1 Burnout: A Secondary Endemic Amber Langi, BSN, RN, MSN Student Weber State University Annie Taylor Dee School of Nursing Heather Clark, DNP-L, MSN-Ed, RN 2 Abstract Burnout in nursing has been increasing since the beginning of the COVID-19 Pandemic. Evidence shows that some nurses are unaware of the symptoms of burnout and the possible repercussions of not addressing burnout. Burnout can affect mental health and the musculoskeletal system and cause adverse patient outcomes. The Burnout Prevention Program (BPP) aims to assist nurses in self-assessing burnout and to give suggestions for treating it according to their preferences. During a staff meeting, the BPP will be presented and include information to bring awareness of the problem and address the items that are perceived to cause burnout. Additionally, the presentation will discuss resources on how to mitigate burnout at the personal level. One of these personal resources is the self-assessment tool. Another tool is to build coping and resiliency strategies via various suggested activities known as mindfulness minutes. Monthly follow-up reminders for these activities will be included in the staff newsletters. Keywords: nursing burnout, burnout, burnout prevention, self-care, self-assessment for burnout 3 Burnout: A Secondary Endemic Wei et al. (2020) reported that nurses are experiencing burnout in higher numbers than before the Covid-19 Pandemic and that 54.3% of nurses have admitted to experiencing burnout. While researching, three categories of burnout emerged: emotional exhaustion, physical symptoms which range from emotional and physical exhaustion and musculoskeletal disorders., and job-related issues. Job-related burnout can range from disinterest to absenteeism, resulting in medical errors and poor patient outcomes (Ayyala et al., 2020). The more a nurse feels burnout, the more the rating of the quality-of-life declines (Khatatbeh et al., 2022). The reduced quality of life and increased burnout may express anger, anxiety, compassion fatigue, and in some individuals, suicidal ideation. According to Ayyala et al. (2020), mental health issues and suicide are witnessed at higher rates among health professionals than in the general population. The imaging nurses at Intermountain Health expressed an elevated burnout level while completing their caregiver engagement surveys. A project has been created to help provide a tool for nurses to self-assess burnout and suggest self-care activities to reduce burnout (Klatt et al., 2020). This project will be called the Burnout Prevention Program (BPP). The caregiver survey scores will be monitored as an evaluation tool to monitor the project’s success. Statement of Problem Among the imaging nurses that work for Intermountain Health, the staff has rated burnout high on the annual caregiver survey. At the beginning of the Covid-19 Pandemic, all non-essential procedures were canceled and rescheduled later, increasing the number of scheduled cases each day Dall’Ora et al. (2020) suggested that the causes of burnout are workload demands, lack of autonomy, feelings of isolation, and lack of recognition. 4 With the decrease in the workforce and increased patient imaging, nurses were asked to work more hours than expected which caused the burnout rating on the unit too. Burnout can include disinterest, inadequacy, cynicism, and exhaustion (Green et al., 2020). Burnout can lead to unintended errors, decrease the number of positive patient outcomes, and cause patients to give lower Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores, which can affect reimbursement for the unit’s services. Ways Project Contributes to Intended Recipients Correction of root causes of burnout lies within three spheres: the organization, the unit or department, and the personal level. Patient-to-nurse ratios and wages need to be addressed at the hospital system level. The imaging department can address stressors such as schedules, communication between management and caregivers, and recognizing positive influences that caregivers bring. The final sphere of influence is personal. Nurses need to realize that they need to perform self-care activities. Reducing some of the stress that they are having in their personal life. Reducing burnout, nurses feel, will improve the overall care given to the patients. The BPP intends to show that nurses are integral to the imaging nursing team. The intention of bringing awareness of burnout and its impact on the quality of life of each caregiver will aid in the project implementation. Allowing nurses to answer the questions anonymously will encourage more honest answers regarding their experience with burnout. Nurses tend to give the energy they possess to others in the process of care, which leaves them empty when it is time for self-care (Wei et al., 2020). To address this, the activities discussed in this project will encourage caregivers to take time for themselves. 5 Along with the presentation of the program, the goal is to encourage nurses to implement the practices into daily life. Klatt et al. (2022) showed that the retention of information is better when periodic reminders exist. For sustainability, emails will be sent monthly with different activities for self-care for nurses to perform. The suggested activities sent in emails will include physical activity, seeing a mental health professional, and discussing coping strategies. There will also be suggestions for other activities, such as taking time to take care of physical needs and improving the nurse’s self-image. The rationale for the Importance of the Project The end goal of the BPP is to address the causes of burnout and provide self-care activities for nurses to utilize to prevent burnout. As burnout increases and there is an emotional disconnection from work, there is an increased risk of medical error, which can cause damage to the hospital system, the patients, and the nurses (Santos Da Fonsêca et al., 2018). In a healthcare system that just went through a stressful period, more caregivers experience burnout. The more hours a caregiver works, the more likely they are to experience burnout (Parikh et al., 2020). It is also essential to let caregivers know they are not alone, as 6.5% of nurses have experienced suicidal ideation related to burnout, the problem must be addressed and solutions provided (Melnyk, 2020). Workload has been a cause of burnout; the healthcare system cannot afford to lose caregivers at the current rates. Addressing this problem will also help to retain the 21.8% of nurses that intend to leave the field within the next two years (Lea & Mahoney, 2022). Creating a more positive environment in the workplace will assist in reducing the burnout rating; this can be accomplished with better communication, fostering better interpersonal connections, and rewarding caregivers when they are going above and beyond what is being 6 asked of them (Green et al., 2020). Leadership recognizing that a caregiver is a valuable part of the team will help connect caregivers and reduce feelings of isolation. Addressing burnout causes and making appropriate changes in the department will help create a healthier work environment and align the department with Intermountain Health’s mission of “Helping People Live the Healthiest Lives Possible.” This project will improve leadership strategies and assist imaging nurses in working on their burnout. It will enhance the overall well-being of the nurses in Intermountain Health’s imaging nursing department. Literature Review and Framework A review of the current literature was performed to explore the evidence supporting the need for a program to reduce the burnout rating of imaging nurses at Intermountain Health. The information gathered supports that burnout affects as much as 50% of nursing professionals, characterized as a reduction in energy that manifests as disengagement from work, exhaustion, difficulties completing tasks, and depression (Melnyk, 2020). The COVID-19 Pandemic has accentuated systemic burnout problems (Gee et al., 2022). The literature review included quantitative and qualitative evidence to support a burnout prevention program. Implementation of this MSN project will utilize Lewin’s Change Theory of unfreezing, changing, and refreezing to inform intended changes. Framework This project will unfreeze the current process of not having a burnout program, which requires forgetting the old methods that have not been effective (Saleem et al., 2019). During the second phase of Lewis’s framework, the nurses will be introduced to the burnout prevention program and provided a rationale explaining the program’s intent (Li & Xie, 2022). The change will be implemented over the following month and frequently reevaluated to assess if the 7 program is decreasing staff’s self-reported levels of burnout. The last and final stage of the change is refreezing, which will take place over the following year. During this time, educational modules, including reminders to self-assess burnout and suggested self-care activities for each month, will be disseminated to the imaging nurses through the current monthly staff newsletter. Once the program has been implemented and shows improvement in burnout levels, the Burnout Prevention Program will be refrozen into the process. Strengths and Limitations The framework will encourage a program buy-in, allowing employees to share ownership of the project and the results (Li & Xie, 2022). Nurses will be asked to attend the program launch and complete the follow-up activities. The BPP will allow them to recognize and take control and self-treat in ways they deem necessary. It will also allow freedom to implement and change the process in the unfreezing and change phases of the framework. While the Lewin framework has several strengths in assisting with the implementation of change, one limitation of this framework is that most of the change happens in the first two stages and may not encourage reassessment and implementation of evidence-based practice once it is refrozen. Analysis of Literature A literature review found several articles that indicated that burnout is a significant problem that was accentuated by the stress from the Covid 19 Pandemic. Burnout and depression have similar signs; furthermore, burnout can accentuate the effects of depression on an individual (Melnyk, 2020). Burnout results from several factors that the nurse perceives as not optimal conditions. Often nursing staff does not feel they have a say in processes that affect patient care. Furthermore, being understaffed can make nurses feel rushed and not allow the necessary time to give the quality of care they would like. When nurses feel rushed, it is easier to make a mistake, 8 which could result in long-term consequences for the nurse and the patient. The effect of burnout has become more apparent since the Pandemic’s beginning when nursing units were chronically understaffed and needed supplies were unavailable (Green et al., 2020). Reducing burnout and preventing the symptoms from worsening is essential for nurses and can also affect patient safety (Dall’Ora, 2020). Many nurses are unaware of burnout and its effects, so raising awareness is necessary to correct the problem (Santos Da Fonsêca et al., 2018). Search Strategies For this literature review, there was a search using CINAHL, Google Scholar, PubMed, and Weber State University’s Stewart Library’s Advanced Search, which looked at several databases. The literature search was narrowed to include articles written from 2018 to 2022. The phrases used in the search had Nursing burnout, causes of nursing burnout, Burnout healthcare, Imaging Burnout, Interventions for burnout Self-care, and Compassion Fatigue. The inquiry also contained several combinations of the abovementioned keywords to access the appropriate information. Nurse Burnout Burnout can be experienced in different ways with differing severities, which, if not addressed, can lead to compassion fatigue. The physical symptoms of burnout are exhaustion, headaches, and insomnia (Melnyk, 2020). The emotional drain can lead to impaired judgment, memory issues, anxiety, desire to leave the nursing field, and substance abuse (Melnyk, 2020). Khatatbeh et al. (2022) state that as nurses perceive burnout to worsen, there will also be a decrease in the quality of life and job satisfaction. Other noted physical signs are insomnia, tension, anger, memory problems, and decreased attention to detail. These symptoms can cause caregivers to make mistakes that can have adverse effects on the lives of others (Melnyk et al., 9 2020). Descriptive statistical analysis using Maslach’s burnout inventory-general survey showed a correlation between feeling depressed and completely drained at the end of a shift (Wu et al., 2021). Lee et al. (2022) found that up to 80% of caregivers reported feeling disengaged from their work tasks and that 21.8% of participants in a study of 155 CRNAs intended to leave their position in less than two years. Additionally, burnout can cause nurses to withdraw from work by absenteeism and disengaging from work when they are there (Fonsêca et al., 2018). The effects of burnout on a personal level can impact the nurse’s physical and mental well-being. Workplace Factors Associated with Nurse Burnout The nursing work environment is one of the most significant causes of burnout (Dall’Ora et al., 2020). Literature suggests a correlation between hours worked, patient acuity, and reported burnout (Khatatbeh et al., 2022). Lea and Mahoney (2022) reported in a correlational study of 155 CRNAs that 56.8% reported a lack of supplies to perform their job duties, 60.3% said they lacked proper personal protective equipment, and only 64.3% were aware of how to use the equipment correctly. Working long hours is also related to the amount of burnout that a nurse can feel; the more overtime and on-call shifts a nurse works, the more likely they are to experience higher levels of burnout (Parikh et al., 2020; Lea & Mahoney, 2022). Another contributor to burnout is the lack of recognition for hard work and a decreased feeling of accomplishment (Green et al., 2020). When a nurse feels that they are not adequately being recognized for the work that they are doing, it can make them feel like they are not essential and can increase the feeling of burnout (Parikh et al., 2020). Feeling undervalued can also be accentuated when nurses feel inadequate compensation for their work (Wu et al., 2021). These concerns must be addressed as they can all have an additive effect and increase a nurse’s burnout. 10 Solutions to Burnout Organizational, departmental, and personal are the three levels of responsibility for burnout. Burnout solutions must be implemented at each level utilizing a cohesive approach to improving the caregiver experience (Wei et al., 2020). Addressing wages and staffing ratios is the responsibility of the organizations. Adequately compensating workers for their time and effort will show caregivers that they are an integral and valued portion of healthcare (Wu et al., 2021). Organizations can also have mental healthcare professionals readily available to caregivers experiencing acute onset PTSD related to work stressors (Rigdon & Winters, 2022). Departmental interventions may include adjusting scheduled shifts, allowing staff input on their desired schedule, and accommodating the requests as best as possible will enable the caregivers to feel valued on the team (Green et al., 2020). Implementing The BPP will bring awareness to caregivers and allow them to assess and implement any self-care items they feel are necessary to reduce burnout (Klatt et al., 2022). It is crucial to involve nurses when making changes, as this will allow them to have control and ownership of their workflow. Caregivers shoulder the primary responsibility of burnout. It is essential that nurses selfassess their level of burnout. Once the nurse is aware of the level of burnout they are feeling, and they can then participate in self-care activities catering to the level of burnout they are experiencing (Santos Da Fonsêca et al., 2018). Self-care may include seeing a mental health professional assist in dealing with trauma experienced at work (Rigdon & Winters, 2022). Caregivers need to decompress after work and practice good work-life balance. Self-care is the best way that a nurse can address burnout. It is essential to address personal and patient needs (Klatt, 2022). Summary of Literature Review Findings and Application to the Project 11 Identifying the root cause of burnout and providing education on burnout is essential in treating it (Fonsêca et al., 2018). Burnout affects the individual and the organization that employs them (Melnyk, 2020). Three areas of burnout that affect the individual include emotional, physical, and job performance (Wu et al., 2021). Literature shows untreated burnout can lead to suicidal ideation and suicide attempts (Melnyk, 2020). Work is not the only stressor in the lives of nurses, Fonsêca et al. (2018) suggested that home life may influence the burnout experienced. Improved self-care and coping skills can help nurses become more resilient and experience less burnout (Klatt, 2022). In addition, nursing departments and hospitals can focus on adequate staffing and pay, implementing daily huddles, and improving communication with leaders. Departments must take action and enact programs where caregivers are taught about burnout and given ideas to help compensate. These enacted programs have a more significant impact when maintenance reminders are sent out periodically after the implementation of the program, Klatt et al. (2022), showed that these reminders should be sent over a long period to have a more substantial and lasting effect on the caregiver. Giving nurses this information will give caregivers some ideas on addressing self-care needs (Wei et al., 2020), including seeing a mental health professional, which has also decreased burnout (Green et al., 2020). Addressing the issues and attempting to reduce burnout will be safer for caregivers and patients, which is always a goal for healthcare organizations. The limitation of this literature review is a lack of current information about burnout in imaging nurses. Burnout statistics for higher acuity settings such as Labor and Delivery, Critical Care, and Intensive Care Units are readily available. This MSN project will focus on bridging the gap in awareness and resources for nurses in the imaging department. 12 Project Methodology This MSN project addresses the burnout experienced by the nurses in the Imaging Department within Intermountain Health. It will prepare nurses to assess the level of burnout they feel, even if they are unaware of it. It will also give them the tools to self-treat the burnout they are feeling. The deliverables of this project have been designed to bring awareness to burnout and provide tools to use as interventions to alleviate burnout. These deliverables include (a) a meeting where the team will address the burnout score from the last caregiver survey and discuss the causes of burnout and what can be done with them. (b) An introduction to the “Assess Yourself… What is your level of burnout?” Quiz. (c) A discussion and handout on suggested activities for each level of burnout. (d) Monthly activity suggestions will be sent out to reinforce the Burnout Prevention Program. (e) A discussion of the employee survey results from the following year after implementing the Burnout Prevention Program. Description and Development of Project Deliverables This burnout prevention program aims to bring better awareness to the individual about the symptoms they may be experiencing, such as exhaustion and lack of engagement in the care they provide to the patients. Besides knowing about burnout, nurses need help putting effort into adequate self-care (Rigdon & Winters, 2022). Burnout Presentation In the staff meeting, there will be a presentation (Appendix A) on burnout data from last year’s survey. The presentation will unfold common causes of burnout and symptoms, including exhaustion, depression, and compassion fatigue (Rigdon & Winters, 2022). In addition to the personal effects of burnout, there will also be a discussion of the professional repercussions that can be caused by not addressing burnout. Some professional repercussions may include paying 13 less attention to the patients and being abrupt and dismissive when co-workers and patients raise concerns. Not addressing burnout can lead to a lack of trust in the nurses’ abilities and adverse patient outcomes (Melnyk, 2020). Introducing the self-assessment of burnout quiz The Burnout quiz created to assess individual burnout will ask those taking the quiz to rate 15 burnout indicators with a 1-10 on how that indicator affects their work. The quiz then breaks the score into intervals that indicate the level of burnout that the nurses are experiencing (Appendix B). Five intervals have been chosen to indicate burnout 15-30, equivalent to zero burnout to mild that is being experienced. A score of 31-60 is indicative of some burnout, but it is not affecting daily functions or job requirements. A score of 61-90 indicates burnout is felt nearly half of the days and may have slight impacts on daily functions. A score of 91-120 indicates that there is a significant amount of burnout that is experienced each day. This level of burnout is affecting the work that is being done. A score of 121-150 indicates that burnout is experienced constantly and has noticeable effects at work. Personal interventions that focus on self-care There are many causes of burnout that the individual cannot control, such as pay and staffing. However, nurses can focus on performing self-care. Increasing resilience in the nursing workforce will help to decrease the burden that is being felt by burnout (Klatt et al., 2022). The self-care handout will have different burnout levels with appropriate suggested activities. The activity suggestions can range from taking a micro-break to address needs to taking a walk to remove the individual from the situation for a short time. The middle levels can include buying a favorite treat, listening to music, or reading a book for an uninterrupted block after the scheduled shift. Seeing a mental health professional is also essential to treat depression symptoms that can 14 coexist with burnout. Mental health professionals may also provide essential tools to combat burnout and decrease the effects that may reach the patients (Appendix C). Monthly emails sent as a reminder of the Burnout Prevention Program There will be a monthly focus with suggested activities to combat burnout. The activities will be included in the monthly staff newsletter “Mindfulness Minutes.” They will include suggested activities that have a theme for each month and are aimed at creating a way to redirect negative energy. The Mindfulness Minutes in the monthly newsletter will address topics that will help reduce burnout. There will be suggestions for improving the nurses’ physical environment, such as organizing their life, planning a vacation, and creating a safe space. Suggestions for mental health include seeing a professional, rewarding yourself, and taking time to center yourself. Suggestions will help connect the nurse with others, such as reconnecting with friends and family, developing a new hobby, and looking for the good in others. The final set will include suggestions to improve themselves by learning something new, getting physical activity, reflecting on what is going well, and the changes they have made in the last year. (Appendix D) Plan and Implementation Process Intermountain Health Imaging Nurses have been rating burnout high in annual reviews. The high scores led to the creation of the burnout prevention program. To accomplish the program, the burnout committee met with leadership and discussed reducing burnout in the department. The goal of the Burnout Prevention Program will be discussed with the burnout team and leadership. The first step is to gain approval for the intervention before it is presented to the nurses. Once it has leadership approval, the next month’s program will be presented at the and reminders to take the quiz to assess the level of burnout they are feeling during that month. 15 By suggesting small goals for each month, A year after the program has been implemented, there will be a discussion of the latest employee engagement results and the program’s success. Interdisciplinary Teamwork The Burnout Prevention Program implementation will include several individuals who will assist in the program’s success. Management team members have reviewed the results from the annual survey and have decided that there is a need to address the burnout affecting the unit. Additionally, they have created a burnout team that discusses tools and resources that can be utilized to address burnout. The employee engagement committee chair will assist in distributing the questionnaire and monthly mindful minutes. The individual nurses will be responsible for taking the quiz and self-treat for the level of burnout they have self-assessed. It is also essential that the team members work together to reduce the effects of burnout on the team. It is important to remind each member to assist in any way they can in reducing the overall burnout on the team. Timeline After the latest caregiver survey results are published, leadership will meet with the burnout committee. At this meeting, there will be an introduction to the Burnout Prevention Program, and those present will be asked to assist in the program’s rollout. A week after the meeting, the program will be introduced to the nurses at a staff meeting. The committee will discuss burnout and its effects on individuals and patients. The staff will have time to discuss the causes of burnout in the department and what can be done to change those. Nurses will be given time to take the quiz and will be given the handout of suggested activities. The committee will include a mindfulness minute in the monthly newsletter a month after the introduction. At the end of the year, the caregivers will retake the engagement survey, and the committee and the leadership will discuss the results (Appendix E). 16 Plan for Evaluation of Project The program’s effectiveness will be evaluated by comparing this unit’s previous and new scores from the engagement survey. The burnout committee will also obtain feedback from the nurses on how they feel the program is going and what they want to improve. The burnout committee will then discuss the results from the survey and the comments from the nurses, and suggested improvements will be considered and implemented as appropriate. This feedback will be given to the management team to sustain the burnout prevention program. Ethical Considerations While implementing the Burnout Prevention Program, it is essential to address several ethical considerations. The program aims to improve individual nurses’ overall well-being and patient outcomes. This program is not intended to treat anxiety, depression, or PTSD. The goal is to bring awareness to the individuals experiencing these and encourage them to seek treatment from a qualified professional. The goals of the suggested activities are to enhance the program and not to make those who cannot participate in any activity feel as if they are purposely not included. There will be many suggestions, some that will require money and some that will require time. The program will also stress that they are optional if they are uncomfortable participating in the activities. It is also essential to address the causes of burnout that the burnout committee cannot control. Those items must be turned over to be addressed appropriately with leadership. The burnout prevention program aims to improve nurses’ quality of life and the far-reaching effects that burnout can have on patient outcomes. It is crucial to address those that choose not to participate. The program may be perceived as unessential or beneficial to the individual nurse. 17 An explanation that this program is voluntary and accentuating the potential benefits of participation will address this concern. Discussion Burnout in nursing has become more prevalent since the Covid-19 Pandemic began. The Burnout Prevention Program was designed to help nurses self-assess burnout and provide tools to assist in reducing the burnout that the nurses of the Intermountain Health Imaging department are experiencing. Preventing burnout will assist in reducing the number of nurses intending to leave the field. This program will also give them tools to use when feeling overwhelmed. Preventing burnout will also assist in ensuring that patients are getting the highest quality of available care. The BPP will assist the imaging nurses at Intermountain Health and will be helpful in many other departments. Evidence-based Solutions for Dissemination The program results will be shared during the poster presentation to MSN faculty and students. Additionally, the employee engagement survey results will be shared with imaging nursing staff in a staff meeting one year after the initiation of the Burnout Prevention Program. At the meeting, there will be a discussion of the program’s results and the items that nurses feel helped, so there will be time to discuss the things that are not as helpful in reducing staff burnout. Significance to Advance Nursing Practice The burnout prevention program can improve the quality of nursing care given to patients by ensuring that nurses take care of themselves. This project will enhance the quality of life the nurses are experiencing by teaching them resilience and coping mechanisms to address burnout. Lastly, nurses can share what they have learned from this program with those they will contact in their future careers. 18 Implications This program intends to bring awareness to burnout and support nurses as they navigate the repercussions of the Pandemic. It is essential to show nurses that management is attempting to address the problem. It is vital to offer nurses tools to help lessen burnout, give them tools in future situations, and share this knowledge and resources with other nurses. By bringing awareness to what management is doing to address the problem, it will show nurses that organizations intend to support them and provide ways for them to have resiliency in the future. It is also essential for nurses to recognize that there are things that only they can do to better their mental health and provide much-needed relief. Recommendations The literature review showed that a significant amount of research addresses the nursing burnout witnessed since the Pandemic’s beginning. Additional research is needed to evaluate possible solutions for understaffing in the hospital and ways to support nurses better. Research emphasizes that organizations need transparency regarding awareness and resources for burnout prevention. Lastly, the research discusses the need for organizations to improve support for their nurses’ mental health care needs. A current burnout prevention program is a valuable foundation, but access to mental health providers is vital. Conclusions Addressing the known causes of burnout is essential to improving healthcare systems. In addition to this burnout prevention program, organizations should address concerns with pay and staffing (Dall’Ora et al., 2020). Additionally, organizations should use strategies to improve nurse retention, especially for seasoned nurses. The knowledge that can only be gained through experience is essential to share with future generations of nurses. Next, organizations should 19 monitor for burnout and seek feedback from staff regarding the causes of burnout in their unit. Improving communication between management and nurses will assist in having an open environment. This will allow for an understanding of the processes in the company to reduce burnout. Lastly, praise and recognition are essential to giving nurses the confidence and selfesteem they need to improve (Khatabeth, 2022). The implementation of this program will assist in improving the quality of care that the nurses of Intermountain Health’s Imaging Department can provide for the patients. By giving the nurses tools to reduce burnout, there will also be an increase in the quality of life of nurses. 20 References American Public Welfare Association. (n.d.). Burnout Questionnaire - OneLegacy. One Legacy.org. https://www.onelegacy.org/docs/BurnoutQuestionnaire_PublicWelfare1981_Modified2013.pdf Ayyala, R. S., Baird, G. L., Sze, R. W., Brown, B. P., & Taylor, G. A. 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I do not feel that I am not treated as an essential team member. I do not have access to the tools needed to accomplish daily tasks. I do not have anyone that I trust to talk to at work. It is difficult to accomplish my goals. I am not treated as well as other team members. We are adequately staffed each shift for the unit’s needs. I need help with focusing on tasks during the day. I find it difficult to sympathize with the patients I care for. The structure and culture of the organization make it difficult to accomplish daily job tasks. I cannot plan out my workday as I would like. My ideas and concerns are not taken seriously. TOTAL SCORE The total score adds the score for each question together. The total of your score indicates the following levels of burnout: 15-30: Little to no burnout. 31-60: Some burnout. 61-90: Burnout half of the time. 91-120: Frequently feel burned out. 121-150: I feel burned out every day. This quiz was created in Microsoft Word and based on other burnout quizzes from MindTools.com, Maslach Burnout Inventory, and OneLegacy Burnout Questionnaire. 28 Appendix C 29 Appendix D 30 All Mindfulness Minutes were created in Canva using the available stock images 31 Appendix E