Managing Exposure: A Grounded Theory of Burnout and Resilience in Critical Care Nurses

Abstract

Critical care nurses encounter workplace adversity. This adversity can vary in scope across macro, meso, and micro levels, and negatively impacts nurses. This research study was conducted to learn more about nurse resilience in response to workplace adversity. The research question being investigated was, what is the process of critical care nursing resilience in workplace adversity? This grounded theory investigation was conducted at a large, multi-site urban hospital with 11 critical care nurses. The participants completed open-ended interviews, discussing resilience and burnout in critical care environments. The proposed, resultant grounded theory is entitled MANAGING EXPOSURE: A Grounded Theory of Burnout and Resilience in Critical Care Nurses. To address the problem of workplace adversity, nurses enact the process of MANAGING EXPOSURE. The core category of MANAGING EXPOSURE counters the basic social process of workplace adversity. The driver of MANAGING EXPOSURE is situational awareness. There are a variety of techniques that nurses use to manage exposure, which include protecting, processing, decontaminating, and distancing from workplace adversity. A nurse will experience a range of indicators for this process, identified here as a spectrum of resilience – survival – burnout. The findings of this study advance the understanding of burnout and resilience in critical care environments by demonstrating how nurses manage workplace adversity. Nurse leaders can intervene in critical care environments, in order to reduce workplace adversity and drive the process of MANAGING EXPOSURE toward resilience.