Disclosures: Kareen A. Velez, MD: No financial relationships or conflicts of interest

Objective: To explore the relationship between moral distress (MD), workplace bullying (WB) and staff burnout (SB) and how these factors influence staff turnover (ST).

Design: Causality pilot study conducted from 9/30/2016 to 2/29/2020.Setting : Inpatient and Outpatient Rehabilitation Facility (RF)Participants : A total of 47 health care professionals (HCP) terminated employment at our RF from 9/30/2016 to 2/29/2020.

Interventions: N/A

Main Outcome Measures: Staff exit interviews were conducted to determine if MD, WB and SB were factors influencing the decision to terminate employment at the RF. Patient satisfaction surveys and chart audits were conducted to describe patient well-being and outcomes.

Results: Exiting HCP groups include nursing assistants (NA), registered nurses (RN), nurse practitioners, case managers (CM), medical support assistants, physical therapists, dietitians, social workers and psychologists. A turnover rate of 67% was observed among nursing staff (NA, RN, CM). Of the exiting staff interviewed, 54% reported that WB, SB, and MD influence their decision of terminating employment at the RF. Direct correlation between ST and patient outcomes was not observed.Conclusions: MD is a psychological response to a morally challenging situation experienced by HCP. When MD occurs repetitively and continues for an extended period of time, it causes an additive effect, known as moral residue (MR). A covert cause of MR is healthcare is WB. This is defined as repeated, health harming mistreatment of a target by one or more perpetrators, manifested as verbal abuse, non-verbal behaviors that are threatening, intimidating or humiliating, and work interference or sabotage. When MD, MR and WB are not addressed, it can lead to SB, characterized by emotional exhaustion, depersonalization, loss of personal accomplishment and lack of work fulfillment. The possible end results include increased stress related illnesses, adverse events due to unsafe patient care, ST, and increased healthcare cost. Additional studies are warranted to ameliorate the effects of MD, MR, WB and SB.

Level of Evidence: Level III

« Back to AAPM&R Annual Assembly 2021

PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/correlation-between-moral-distress-workplace-bullying-burnout-and-staff-turnover-a-causality-pilot-study/