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1. Discuss how a healthcare organization’s culture is formed.

2. Discuss how you see the organizational culture of the institution impacting staff workers?

3. How do you see staff members impacting the organizational culture?

4. Do you think the culture of a healthcare organization can affect incivility, bullying, or compassion fatigue? Why or why not?

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Answer each question accurately with details and examples.

Cite 2 journal article sources in APA 7th edition format.

You may use the articles attached!

Understanding organisational culture for healthcare quality improvement | The BMJ

Reflecting on the Concept of Compassion Fatigue (nursingworld.org)

Prevent Compassion Fatigue and Burnout with a Magnet Culture 2019

Author Affiliation: Vice
President, Magnet Recognition
ProgramW and Pathway to
Excellence ProgramW,
American Nurses Credentialing
Center, Silver Spring,
Maryland.

The author declares no
conflicts of interest.

Correspondence: Ms Graystone, American
Nurses Credentialing Center, 8515 Georgia Ave,
Suite 400, Silver Spring, MD 20910 (rebecca.
graystone@ana.org).

DOI: 10.1097/NNA.0000000000000743

JONA � Vol. 49, No. 5 � May 2019

JONA
Volume 49, Number 5, pp 231-

233

er H

T H E J O U R N A L O F N U R S I N G A D M I N I S T R A T I O N

MAGNET® PERSPECTIVES

Prevent Compassion Fatigue and Burnout
With a Magnet Culture

Rebecca Graystone, MS, MBA, RN, NE-BC

Compassion fatigue and burnout are 2 of the most se-
rious issues facing the nursing profession today. Both
can lead to emotional exhaustion and job disillusion-
ment. Both contribute to lowered productivity and
quality of care. Healthcare providers around the world
are on the lookout for ways to prevent and mitigate
these critical issues. In this month’s Magnet Perspec-
tives column, we take a deep dive into the latest re-
search on nurse burnout and compassion fatigue,
examine contributing factors, and consider steps or-
ganizations can take to make sure their nurses are
not running on empty. We also explore how the fun-
damentals of a MagnetW culture, especially an auton-
omous practice environment, strong nursing leadership,
and meaningful recognition, can keep nurses engaged
and build a resilient workforce.

er H

It is no secret that nurses play host to a high level of
compassion fatigue. In hospitals and healthcare orga-
nizations around the world, nurses may struggle to
function in environments that present constant chal-
lenges. High patient acuity, intense work hours, safety
imperatives, workplace incivility, and violence all can
leave nurses feeling emotionally drained and raise their
risk for disengagement.

Compassion fatigue manifests itself in many ways.
Low job satisfaction, job-related stress, and burnout
are some of the most common consequences. Stressed
nurses put the entire healthcare organization at risk.
They are more likely to make poor decisions that can
lead to errors. They are less likely to interact with pa-
tients or each other, leading to strained relationships.
They are more apt to leave their jobs. Conversely, sat-
isfied nurses thrive in an environment that is safe,
empowering, and satisfying.1

In today’s increasingly complex healthcare sys-
tem, MagnetW recognition from the American Nurses
Credentialing CenterW addresses many of the elements
that can lead to compassion fatigue and burnout. Pur-
suing the credential helps bolster factors that create a
holistic, caring, and inclusive workplace—factors such
as a healthy environment; appropriate resources; strong,
supportive leadership; nurse engagement and recog-
nition; mutual respect; and a collaborative culture.2

Healthy Work Environments
In their study of burnout syndrome in hospital nurses,
Holdren et al3 found that a poor work environment
and heavy workload were major contributing factors.
They recommend that hospitals focus on creating an

231

mailto:rebecca.graystone@ana.org

environment in which nurses feel supported by co-
workers and management and implement lower
patient-to-nurse ratios.

Similar findings emerged from the international
setting. Sillero and Zabalegui4 explored the influence
of organizational factors on burnout among perioper-
ative nurses in Spain. The authors found that working
conditions increasingly impact job satisfaction and
burnout, with 3 areas in particular playing a signifi-
cant role: nurse leadership style, staffing, and support.
Positive, inspirational leaders who support nurses with
an engaging work environment, adequate resources,
and genuine recognition sustained a more resilient
workforce than those who did not. The study notes
that Magnet hospitals are able to provide this type
of environment because of their “capacity to attract
and retain professionals as they promote quality pa-
tient care, safety, interdisciplinary collaboration, pos-
itive communication, professional models of care
practice, opportunities for professional development,
and better practice environments than other hospitals.”4

Wei et al5 conducted an overview of studies on
healthy nurse environments in the United States. The
authors found a strong link between a positive work-
place and nurse outcomes such as psychological health,
emotional strain, job satisfaction, and retention. When
nurses perceived higher caring behaviors in the work
setting, they had significantly lower scores on compas-
sion fatigue, stress, and burnout and higher scores
on work relationships, job satisfaction, and compas-
sion satisfaction.

Examining burnout among emergency room nurses,
Abellanoza et al6 echoed the emphasis on workload
as a critical factor. Leaders must get creative to solve
this problem, including strategic scheduling and shift
management. The authors cite workplace engagement
as a critical buffer that gives nurses the energy and en-
thusiasm to remain on the job, despite a high work-
load. Similarly, research by Moloney et al7 found
that a high workload leads to higher burnout and is
the strongest predictor of a nurse’s intentions to leave.

Support and Recognition
Meaningful recognition of nurses, another Magnet
hallmark, can impact engagement and reduce stress.
Barnes et al8 found that recognizing compassionate

232

and extraordinary nursing care in a meaningful way
is a powerful tool that supports a healthy work envi-
ronment, engages nursing staff, and impacts the pa-
tient care experience.

A survey of intensive care unit nurses in US hospitals
with an established meaningful recognition program and
nurses in hospitals without such a program found that
recognition was a significant predictor of decreased
burnout and increased compassion satisfaction.9

A study of compassion fatigue and burnout among
new nurses transitioning to practice found that creating
awareness of the problem, and offering support, during
nurse orientation was a mitigating factor later on.10

Strong Leadership
In Magnet organizations, strong nursing leaders pro-
vide support and mentoring, while promoting a cul-
ture of teamwork that underscores a commitment to
care delivery excellence and a safe, respectful environ-
ment. Such transformational leadership is a positive
influence on the workplace environment. As noted
with Sillero and Zabalegui’s4 findings above, sup-
portive nurse managers can shape the workplace to
reduce many of the factors that lead to compassion
fatigue and burnout. Other recent research supports
this. In a study investigating the effects of nurse man-
agers’ leadership behaviors on job satisfaction and
patient safety outcomes, Boamah et al11 uncovered a
strong positive connection. The findings provide sup-
port for managers’ use of transformational leadership
behaviors as a useful strategy in creating workplace
conditions that promote better safety outcomes for
patients and nurses.

The Magnet Link
With burnout and compassion fatigue approaching
epidemic levels, it is more critical than ever for health-
care organizations to create a cultural environment
where nurses can thrive. The Magnet Recognition
Program’s value proposition centers on the link be-
tween a positive work environment and improved
outcomes, including nurse engagement and retention.
It not only advances the fundamental principles that
enhance nurse satisfaction, but also enriches nurses’
resilience so they continue to find joy in their work.

References

1. Dempsey C, Reilly BA. Nurse engagement: what are the contrib-
uting factors for success? Online J Issues Nurs. 2016;21(1):2.

2. Kutney-Lee A, Stimpfel WA, Sloane DM, Cimiotti JP,
Quinn LW, Aiken LH. Changes in patient and nurse outcomes

associated with Magnet hospital recognition. Med Care. 2015;
53(6):550-557.

3. Holdren P, Paul DP, Coustasse A. Burnout Syndrome in Hospital
Nurses. Paper presented at BHAA International, Chicago, IL;

JONA � Vol. 49, No. 5 � May 2019

2015. http://mds.marshall.edu/cgi/viewcontent.cgi?article=
1141&context=mgmt_faculty. Accessed February 14, 2019.

4. Sillero A, Zabalegui A. Organizational factors and burnout of
perioperative nurses. Clin Pract Epidemiol Ment Health. 2018;
14:132-142.

5. Wei H, Sewell KA, Woody G, Rose MA. The state of the sci-
ence of nurse work environments in the United States: a system-
atic review. Int J Nurs Sci. 2018;5(3):287-300.

6. Abellanoza A, Provenzano-Hass N, Gatchel R. Burnout in ER
nurses: review of the literature and interview themes. J Appl
Biobehav Res. 2018. https://doi.org/10.1111/jabr.12117. Accessed
February 13, 2018.

7. Moloney W, Boxall P, Parsons M, Cheung G. Factors predicting
registered nurses’ intentions to leave their organization and

JONA � Vol. 49, No. 5 � May 2019

profession: a job demands-resources framework. J Adv Nurs.
2018;74(4):864-875.

8. Barnes B, Barnes M, Sweeney CD. Putting the “meaning” in
meaningful recognition of nurses: the DAISY Award™. J Nurs
Adm. 2016;46(10):508-512.

9. Kelly LA, Lefton C. Effect of meaningful recognition on critical
care nurses’ compassion fatigue. Am J Crit Care. 2017;26(6):
438-444.

10. Lopez J. Compassion Fatigue and Burnout: Awareness and
Prevention for the Novice Nurse Population. Walden University;
2015. https://scholarworks.waldenu.edu/dissertations/5094.

11. Boamah SA, Spence Laschinger HK, Wong C, Clarke S. Effect
of transformational leadership on job satisfaction and patient
safety outcomes. Nurs Outlook. 2018;66(2):180-189.

http://mds.marshall.edu/cgi/viewcontent.cgi?article=1141&context=mgmt_faculty

https://doi.org/10.1111/jabr.12117

https://scholarworks.waldenu.edu/dissertations/5094

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