Association Between Perceived Stress and Burnout Among Neonatal Intensive Care Nurses

Background: High levels of nurse stress and burnout, including among Neonatal Intensive Care Unit (NICU) nurses, were documented prior to the pandemic. The pandemic increased stressors for NICU nurses although not all NICUs were affected in the same way. Purpose: To examine the relationship between NICU nurses’ perceived stress and burnout during a period of workforce strain. Methods: A secondary analysis of cross-sectional survey data collected from 259 nurses in 10 NICUs enrolled in a parent study between 2021 and 2023. A researcher-developed questionnaire captured nurses’ demographic and work characteristics at the time of parent study enrollment. Perceived stress was measured using the Perceived Stress Scale (PSS) and burnout was assessed using the Emotional Exhaustion (EE) subscale of the Maslach Burnout Inventory. Descriptive statistics and multivariable linear regression were used for the analysis. Results: The mean EE score was 19.7, and more than half of all participants reported a moderate or high degree of burnout. Higher PSS scores, more years of NICU experience, and more weekly hours in direct patient care were associated with higher EE scores. Variation in EE score distribution was observed between NICUs, and the relationship between perceived stress and burnout varied by NICU. Implications for practice and research: We observed high levels of stress and burnout with experienced nurses and those providing direct care most at risk. Strategies to reduce burnout include periodic reduction of direct patient care hours and support tailored to nurses’ career stages. Future research should focus on intervention development and testing.