- This survey assessed the prevalence of burnout among neurointerventional nurses and radiology technologists in light of the increasing demands for mechanical thrombectomy
- Among 244 responding staff at 20 hospitals, the burnout rate was 51% (50% of nurses, 53% of technologists)
- Strong predictors of burnout were feeling under-appreciated by hospital or departmental leadership, having to work with difficult or unpleasant physicians and the interference of work with family life
- 56% of respondents said they had strongly considered resigning within the last two years, and the attrition rate among non-physician neurointerventional staff at the 20 hospitals was 25% over a one-year period
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With the expansion of the interventional time window for acute ischemic stroke, the volume of mechanical thrombectomy increased from one every five days in 2016 to one every two days in 2018, as previously reported in the Journal of Neurointerventional Surgery. These procedures involve frequent call burdens, overnight procedures and regular interruption of family life.
In 2019, researchers at Massachusetts General Hospital published a survey in the Journal of Neurointerventional Surgery of neurointerventional physicians nationwide in which 56% reported burnout. More recently, Joshua A. Hirsch, MD, vice-chair of procedural services and service line chief of NeuroInterventional Radiology, Thabele Leslie-Mazwi, MD, director of Endovascular Stroke Services and specialist in Neuroendovascular and Neurocritical Care in the Department of Neurology and Department of Neurosurgery at Mass General, and colleagues found similarly high rates of burnout among neurointerventional nurses and radiology technologists. Their findings appear in the Journal of Neurointerventional Surgery.
The researchers developed an online survey comprised of 19 questions addressing career and hospital specifics followed by the 22-question Maslach Burnout Inventory–Human Services Survey for Medical Personnel. This inventory captures scores in three domains, based on the frequency of symptoms:
- Emotional exhaustion because of one's work, scored 0–54
- Depersonalization, scored 0–30 ("an unfeeling and impersonal response toward recipients of one's service, care, treatment or instruction")
- Feelings of competence and achievement, scored 0–48
As in the study of neurointerventional physicians, burnout was defined as an emotional exhaustion score ≥27 and/or a depersonalization score ≥10.
20 hospitals participated and the survey was offered to 382 nurses and radiology technologists.
Incidence of Burnout
129 responses were obtained from nurses and 109 from technologists. 117 respondents (51%) met the criteria for burnout (50% of nurses, 53% of technologists).
56% of all respondents (56% of nurses and 57% of technologists) said they had strongly considered resigning from their position in the last two years.
Predictors of Burnout
Over half of respondents (54% of nurses, 62% of technologists) reported feeling under-appreciated by hospital or departmental leadership, and over two-thirds (71% of nurses, 69% of technologists) reported feeling inadequately compensated. Burnout was substantially more likely in those feeling under-appreciated (80% vs. 34%) or under-compensated (85% vs. 55%).
On multiple logistic regression analysis, strong predictors of burnout were feeling under-appreciated, having to work with difficult or unpleasant physicians and the interference of work with family life. Happiness in career choice was protective against burnout.
Stroke thrombectomy procedural volume, frequency of call, responsibilities during call and commute times had no significant influence on burnout.
Among the 20 centers, 94 members of the 382 nurses and technologists resigned, transferred or voluntarily retired over a one-year period, an attrition rate of 25%.
Recommendations for Administrators
Unless hospitals find ways to curtail the rapid turnover of neurointerventional non-physician staff, patient outcomes may begin to suffer. Turnover also imposes a heavy financial burden on health care systems. Strategies to improve employee appreciation, compensation and physician–staff relationships should be considered.
Refer a patient to the Department of Neurosurgery