Project Grant F31NR022428

UNCOVERING COMPONENTS OF BURNOUT AND INTENTION TO LEAVE IN NEWLY HIRED SHIFT WORKING NURSES - PROJECT SUMMARY/ABSTRACT NURSE TURNOVER IN HOSPITALS IS ASSOCIATED WITH DETRIMENTS TO PATIENTS' OUTCOMES (I.E., LESS NURSING TIME SPENT ON PATIENT CARE, LOWER PATIENT SATISFACTION WITH NURSING CARE, AND HIGHER RATE OF MEDICAL ERRORS) AND NURSES' WELL- BEING (I.E., DECREASED WORKGROUP COHESION, LOWER JOB SATISFACTION AND MENTAL HEALTH, AND HIGHER JOB DEMANDS AMONG NURSES) RESULTING IN A YEARLY LOSS OF ~$4.8 MILLION PER HOSPITAL. FURTHERMORE, ROUGHLY 30% OF NURSES LEAVE THEIR POSITION WITHIN ONE YEAR OF STARTING A NEW JOB, ACCOUNTING FOR OVER ONE THIRD OF ALL NURSE TURNOVERS. SHIFT WORK, DEFINED AS WORK OUTSIDE OF NORMAL DAY HOURS OF 0700 TO 1800, IS ASSOCIATED WITH HIGH TURNOVER RATES AMONG NURSES. ALTHOUGH THE DETRIMENTAL IMPACT OF NURSE TURNOVER IS WELL UNDERSTOOD, TURNOVER AND INTENTION TO LEAVE REMAIN HIGH AMONG NURSES MAKING THE IDENTIFICATION OF SPECIFIC MODIFIABLE HEALTH BEHAVIORS THAT CONTRIBUTE TO INTENTION TO LEAVE, ESPECIALLY DURING THE FIRST YEAR OF NURSING PRACTICE, IMPERATIVE. UNDERSTANDING THE SPECIFIC NUANCES OF INTENTION TO LEAVE IN TRANSITION TO PRACTICE (LESS THAN ONE YEAR EXPERIENCE) NURSES IS IMPORTANT TO INVESTIGATE, AS THERE IS A UNIQUE RISK FOR TURNOVER WITHIN THIS TIMEFRAME, AS EVIDENCED BY THE HIGH TURNOVER RATE. IN SITUATIONS SUCH AS THE 24-HOUR HOSPITAL SETTING, SHIFT WORK IS AN INEVITABLE REALITY FOR A PORTION OF THE WORKERS, ESPECIALLY NEW NURSES WITH THE LOWEST SENIORITY FOR SCHEDULING. THEREFORE, I PROPOSE A PROJECT TO EXAMINE THE IMPACT OF CIRCADIAN TIMING ON INTENTION TO LEAVE IN NEW NURSES DURING THE TRANSITION TO OVERNIGHT VERSUS DAYTIME WORK SCHEDULE. SPECIFICALLY, I WILL MEASURE MELATONIN TIMING (A MARKER OF CIRCADIAN TIME) IN THE LABORATORY DURING A PERIOD OF DAYTIME TRAINING (BASELINE) AND THEN LONGITUDINALLY MEASURE BURNOUT, SLEEP QUALITY, SOCIAL SUPPORT, AND OCCUPATIONAL SUPPORT FOR 12 MONTHS, AS A TIMEFRAME INFORMED BY DR. JUDY DUCHSCHER'S STAGES OF TRANSITION THEORY, AS NURSES (N=52) TRANSITION TO SHIFTWORK OR REMAIN ON A DAY SCHEDULE, THEREBY IDENTIFYING HOW CIRCADIAN TIMING AND SLEEP INFLUENCE INTENTION TO LEAVE IN THIS VULNERABLE TIME. ADDITIONALLY, WE WILL QUALITATIVELY MEASURE INTENTION TO LEAVE THROUGH AN OPEN-ENDED QUESTION ANALYZED LONGITUDINALLY. TRAINING PLAN: THE PROPOSED TRAINING AIMS TO BE ACHIEVED DURING THE AWARD PERIOD ARE: 1) EXPAND MY SLEEP AND CIRCADIAN KNOWLEDGE AND SCIENTIFIC APPLICATION; 2) ADVANCE MY QUANTITATIVE AND QUALITATIVE RESEARCH DATA COLLECTION, ANALYSIS, AND INTERPRETATION SKILLS; 3) DEVELOP AND APPLY MY KNOWLEDGE OF PSYCHOSOCIAL MEASUREMENT TOOLS AND USE ON TRANSITION TO SHIFTWORK WORKERS IN THE WORKPLACE; 4) DEVELOP MY TEACHING, MENTORSHIP AND TEAM SCIENCE SKILLS. ENVIRONMENT: THE OREGON HEALTH & SCIENCE UNIVERSITY SCHOOL OF NURSING IS DEDICATED TO MAKING DEFINITIVE CONTRIBUTIONS TO IMPROVING THE HEALTH OF PATIENTS, FAMILIES, COMMUNITIES, AND POPULATIONS THROUGH OUTSTANDING PROGRAMS IN RESEARCH AND EDUCATION AND IS NATIONALLY RANKED AMONG THE TOP NIH RESEARCH AND TRAINING GRANT FUNDED INTUITIONS. THE UNIVERSITY SUPPORTS STUDENTS THROUGH OPPORTUNITIES FOR RESEARCH, TRAINING, AND INTERDISCIPLINARY TEAM SCIENCE.