Australian regional cancer nurses’ experiences of burnout during 2019–2021

Abstract

BackgroundCancer nurses are known to experience high rates of burnout. Despite cancer nurses being critical to providing care for people in rural and remote areas, there is limited research exploring the unique challenges and job demands experienced by regional cancer nurses, and the job demands which may act to buffer these stressors. AimThis study aims to identify antecedents of burnout among Victorian regional cancer nurses over a two-year period, by examining the job demands and resources prevalent in their work. We will build on existing literature by identifying specific job resources that can ameliorate job demands experienced by regional cancer nurses. MethodsA qualitative case study with participants located in regional Victoria, Australia was employed. Semi-structured interviews were conducted both prior to and during the COVID-19 pandemic. FindingsPatient aggression, emotional demands, unsupportive peers and management, and resource constrained work environments were reported as distinct job demands; while job significance, supportive peers and leadership, and connection to community were reported as job resources. ConclusionIn regional settings, patient aggression, workforce shortages, hazardous work environments and inconsistent digitisation of patient management systems are common characteristics of under-resourced workplaces. Despite these challenges, participants reported a strong desire to remain in the profession, mostly due to their commitment to their communities. Supportive peers and colleagues were also reported as an important job resource, particularly during the pandemic. Summaryof relevance Problem or issueCancer nurses in rural and regional areas experience unique job demands. There is limited existing literature on the stressors experienced by regional cancer nurses resulting from these job demands. What is already knownCancer nurses require specialised knowledge and skills to undertake emotionally demanding work. Nurses providing care to people with cancer in regional areas experience the additional pressure of dual relationships with patients, because of living and working in close-knit communities. What this paper addsThis study identifies the unique job demands experienced by cancer nurses in regional areas of Victoria, Australia. The findings identify several site-specific demands characteristic of an under resourced workplace, including the inconsistent digitalisation of medical records are new. Positive job factors that enable regional cancer nurses to manage their roles in a highly demanding work environment were attributed to the culture of rural communities. Understanding the importance of local culture to retention provides healthcare leaders with insights to improve staff health and wellbeing through increasing local engagement and connection, and buffer challenges associated with burnout in cancer nurses practicing in regional areas of Victoria.