Background: Work in palliative care can be a rewarding experience in helping those suffering with complicated illnesses, it can also expose those involved to significant work stress, potentially leading to burnout. Palliative medicine is a medical specialty wherein clinicians provide care for the medical, psychosocial and spiritual needs of seriously ill patients, and facilitate their understanding and coping skills through the illness progression. These clinicians are especially vulnerable to frequent exposure to traumatic situations due to the high density of complicated patients under their care, placing them at risk for burnout.
Objective: The objective of this quality improvement project was to better understand burnout levels in palliative nurse practitioners and nurses in a large inpatient, academic hospital system and to determine the feasibility and effectiveness of implementing mindfulness meditation to reduce burnout levels.
Design: The Maslach Burnout Inventory (MBI) was used to assess burnout pre and post implementation of a brief, self-guided mindfulness intervention via smartphone application. The intervention was performed individually, remotely, and asynchronously with volunteers.
Setting/participants: A total of 12 palliative care nurse practitioners and nurses volunteered from an inpatient palliative care group within a large healthcare system in North Carolina. Results: MBI domains analysis revealed a statistically significant decrease in emotional exhaustion (Pre: 2.2; Post: 1.5; p=.016). The depersonalization domain (emotional disconnect) score did not show a statistically significant decrease in the post-intervention score, but a numerical decrease was reported (Pre: 0.82; Post: 0.65). The personal accomplishment domain score did not show any significant change (Pre: 4.6; Post: 4.5). The reflective questions indicated that many participants felt the mindfulness exercise was feasible, tended to feel calmer, were more relaxed, and were satisfied with the intervention. This correlates to the statistically significant result on the emotional exhaustion subscale, leading to the conclusion that the mindfulness intervention was valuable to those who participated and had efficacious results.
Conclusion: The information gained from this project is vital to better understanding burnout in palliative clinicians given its consequences are detrimental to healthcare systems, patient care and clinicians themselves. By developing evidence-based interventions and training, burnout could be prevented, thereby promoting longevity and satisfaction of clinicians in palliative care. If burnout can be eased, seasoned clinicians can be retained, leading to reduced financial burden on the healthcare system and improved patient care and satisfaction.