Especially during the coronavirus disease 2019 (COVID-19) pandemic, healthcare providers experience high levels of burnout, but little is known about burnout and satisfaction with work-life integration (WLI) among advance practice nurses (APNs). In a survey of US APNs, researchers found that these providers have high levels of personal accomplishment and a favorable occupational health profile. Full results from the survey have been published in the Journal of the American Association of Nurse Practitioners.

To study the emotional health of healthcare workers, the research team obtained a random sample of 2075 APNs and a probability-sample of non-APN US workers and invited participants to complete a survey that asked about work hours, burnout, and satisfaction with WLI. In addition, the APN survey included additional items about demographic and practice characteristics.

Burnout was measured using the Maslach Burnout Inventory (MBI) Human Services Survey (HSS) that has 3 subscales: emotional exhaustion, depersonalization, and personal accomplishment. Response options range from never (0) to every day (6). Satisfaction with WLI was assessed by asking respondents to indicate their level of agreement with the following statement: “My work schedule leaves enough time for my personal/family life.” Respondents provided “strongly agree”, “agree”, “neither agree nor disagree”, “disagree”, or “strongly disagree” as answers.

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Of APNs who received the survey, 47% responded; the average age was 51.6 years, 91.6% were women, and 41% worked in an outpatient clinic. Most respondents were married and had children (82.4%); worked an average of 41.7 hours per week; and had an average of 26.4 years of experience. 

A total of 64% of APNs had a high sense of personal accomplishment, 32.3% had high emotional exhaustion, and 18.0% had high depersonalization. Nurses with symptoms of burnout worked more hours per week on average than those without burnout; the prevalence of high emotional exhaustion and high depersonalization also increased with greater work hours.

APNs with burnout, emotional exhaustion, and high depersonalization were more likely to work in an outpatient setting than other clinical settings. Younger nurses, those with fewer years of experience working in the field of nursing, and those without children had higher rates of burnout.

A total of 23.6% of APNs strongly agreed and 37.0% agreed that their work schedule left enough time for personal/family time. These nurses typically worked fewer hours per week on average, had children, and were less likely to be single than those not satisfied with their WLI.

Compared with US workers, APNs were more likely to be women, married, and work more hours per week (≥2 hours/week). Subtle differences were found in responses for emotional exhaustion and depersonalization items between APNs and US workers. However, no significant differences were found in the prevalence of high emotional exhaustion, high depersonalization, or overall burnout between the 2 groups. Results did find that APNs were slightly less satisfied with WLI than other US workers. 

Limitations of the study included the low response rate among APNs and the limited number of personal and work-related factors associated with burnout and WLI.

“Advance practice nurses in this cohort were not more likely to have burnout or struggle with their WLI than other US workers,” concluded the authors. Nonetheless, symptoms of burnout remain prevalent among APNs, particularly those in outpatient practice settings.”


Dyrbye LN, West CP, Kelsey EA, Gossard AA, Satele D, Shanafelt T. A national study of personal accomplishment, burnout, and satisfaction with work–life integration among advance practice nurses relative to other workers. J Am Assoc Nurse Pract. Published online October 23, 2020. doi:10.1097/JXX.0000000000000517.