We Are Not Heroes; Elevating the Discourse of Burnout in Hospice and Palliative Care Nurses (HPCNs) in the Pre/Post COVID Era: A Scoping Review (S504)

Abstract

Outcomes1. Describe results from a scoping review related to personal factors, organizational and workplace factors, and nursing professional development factors related to hospice and palliative care nurses2. Recognize characteristics of hospice and palliative care nurses (HPCNs) that are associated with burnout and strategies to mitigate burnoutBackground and ObjectiveBurnout among HPCNs has been rising throughout the COVID-19 pandemic and threatens patient safety and quality of care. The extant literature provides insight into burnout within the interdisciplinary hospice and palliative care team, but little attention has been given among HPCNs specifically. We conducted a scoping review to examine burnout among HPCNs and unify disparate findings.Study IdentificationUsing the Arksey and O'Malley framework, we systematically searched 8 major databases from 2015 to 2020. Studies were included if they focused on HPCN experiences of burnout, were published in English within the last 5 years with the exception of seminal works, and were discoverable in electronic databases. Exclusion factors included articles that were not focused solely on hospice and palliative nursing, specifically focused on burnout (ie, depression, compassion fatigue, workplace environment), or research articles.Data Extraction and SynthesisTwo authors extracted data from the full-text inclusion studies. Results were presented in tabular summary and descriptive summary of quantitative findings.ResultsAmong 1,893 studies, 8 met inclusion criteria. All studies were quantitative, classified as level IV within the rating system for hierarchy of evidence for literature, and spanned across 6 countries. HPCNs working across settings such as inpatient, outpatient, community, and inpatient hospice were represented. Results of studies were coalesced into 3 overarching categories: personal factors, organizational or workplace factors, and nursing professional development factors. Each of these categories was then divided into three cross-cutting subcategories: contributory and noncontributory factors, mitigating factors, and workplace issues.Conclusions and Implications for Practice, Policy, and ResearchBurnout among HPCNs may not be entirely preventable, but the recognition of contributory and mitigating factors should be taken into consideration by professional nurses and organizations. Additional research is needed to test workplace interventions suggested in the literature, including whether resilience or self-care measures affect burnout in HPCNs. Qualitative research is needed to capture HPCN experiences of burnout, especially in a post-COVID-19 era.