Mid-career nurses, defined as those with five to 15 years of experience, are now the most burned-out group, a finding that comes as no surprise to nurse leaders.
At about three to five years of experience, nurses become very comfortable in their practice, but “that poses the question of whether they’re in the right spot in their career,” Betty Jo Rocchio, DNP, RN, executive vice president and chief nurse executive of Charlotte, N.C.-based Advocate Health, told Becker’s.
Mid-career nurses are the backbone of care teams, nurse leaders said.
“They are mentoring the next generation of nurses, leading quality improvement, adopting new technologies, caring for increasingly complex patients and serving as the trusted resource for the entire interdisciplinary team,” Cathy Stankiewicz, DNP, RN, chief nursing officer of AdventHealth Central Florida in Altamonte Springs, told Becker’s.
Simultaneously, mid-career nurses are also navigating more complex responsibilities in their personal lives, such as raising children, caring for aging parents, pursuing advanced degrees, Dr. Stankiewicz and Maribeth McLaughlin, MPM, BSN, RN, FAAN, chief nurse executive at the system, told Becker’s.
“My sense is that mid-career nurses are often the go-to person — everybody’s coming to you,” Ms. Mclaughlin said.
Being that go-to person in personal and professional life, as well as dealing with increased workload, workload inefficiencies, pace of change and complexity of care is a recipe for burnout. This is further compounded by the fact that many nurses entering mid-career were in school during the COVID-19 pandemic, which led many to feeling overwhelmed and unprepared as they entered the field.
“Following the pandemic, our leaders made a commitment to every team member that we would ‘see the whole you,'” Dr. Stankiewicz. “That philosophy continues to shape how we approach well-being across our organization.”
How systems are combating mid-career burnout
Although the mid-career nurse burnout looks similar across systems, their approaches to combating it vary.
Salt Lake City-based Intermountain Health has several dedicated programs such as Stress First Aid to help clinicians overcome burnout, but one of the system’s most impactful tools against burnout has been redesigning its care model. The system conducted a study to find how nurses spend their time and made adjustments to the workflow based on the data. This included switching the EHR to Epic across all hospitals and leveraging documentation tools. One tool was able to cut 53 minutes of documentation out of a nurse’s 12-hour shift. The system has also made a commitment to increase nurses’ time at the bedside to 41% of their total time.
“It’s a top priority for the organization. It’ll take us three years to fully implement and hardwire everything, but we’re very excited about what it means for preventing burnout,” Mandy Richards, DNP, RN, chief nursing executive and president of Intermountain Children’s Health, told Becker’s. “Our goal — and I know we’ll get there — is to have our nurses spend almost double the time at the bedside than they do today. The intent is not just to change a metric; it is to help our nurses feel less rushed and overburdened, give them more time to connect with patients, and bring the joy back in nursing. Looking at the rest of the country, our Intermountain nurses are already at 38%; the only study we found, from McKinsey, measured nurses’ perception of their bedside time at 30%. So we know we’re already spending more time than most, but we know we can do better.”
AdventHealth Central Florida has 53 full-time chaplains and 12 licensed mental health consultants who regularly check in on staff and provide support as they round the hospital. The system has also invested in evidence-based approaches to well-being through programs like RISE that’s designed by the AdventHealth Research Institute specially for nurses and nurse ladders. Team members also have access to free, confidential counseling by phone or in-person 24/7; advanced simulation centers to train nurses of all experience levels in new techniques and technologies; and offering flexible scheduling and meaningful career development.
“For mid-career nurses especially, burnout isn’t always driven by a single difficult shift,” Dr. Stankiewicz said. “It’s often the cumulative weight of years spent caring for others while balancing growing responsibilities outside of work. That is why our approach isn’t centered on resilience alone — it is centered on building an environment where nurses feel supported, connected and cared for throughout their careers.”
UPMC recently hired its first nurse scientist to study the workforce and well-being programs. The system also created a new role: workplace safety clinical program manager. This DNP nurse, who has a background in behavioral health, works closely with Ms. McLaughlin and the system’s vice president of enterprise safety and security to address workplace violence and workplace safety.
Four graduate nurses have also created and launched a RAISE US program, designed for charge-nurses — who often are mid-career nurses — to give them skills and tools to manage moral distress, de-escalate difficult situations, and build their leadership and well-being practices. It also teaches them how to recognize signs in their teams and advocate for staff members.
“Sometimes we forget — because you’ve been a nurse for five years, we assume, ‘you’ve got this,'” Ms. McLaughlin said. “But you really have to keep coming back to these groups and making sure they have what they need. That’s what RAISE US is about. It’s how we’re trying to sustain them, build resilience, and help them think about their own well-being.”
Advocate Health launched its “Care Out Loud” ambient listening program for nurses this year. It allows nurses to speak about the assessment while they’re with the patient, which reduces documentation time and allows the patient to benefit from hearing about their case in real-time, Dr. Rocchio said. To date, 65% of caregivers use ambient AI documentation six or more times per shift, and 80% of nurses report meaningful time savings.
The system also invests heavily into its career development programs. Currently, 8,000 teammates participate in its Advance Clinical Advancement Program, which allows them to contribute in meaningful ways and advance their careers while staying at the bedside. The system also allows nurses to use education dollars to participate in national professional organizations American Nurses Association and American Organization of Nurse Leaders; 9,000 of the system’s nurses have used this perk.
“[Mid-career nurses are] in that sweet spot of their career — enough experience, but wanting to look at what other opportunities are out there,” Dr. Rocchio said. “It’s up to leadership to make sure those opportunities for people at the bedside are robust enough that people feel empowered in their careers and stay with the organization.”
At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.