Nurse burnout and nursing resources within safety-net and non-safety-net hospitals a mixed methods study Alexandra Maye

Format:

Book

Thesis/Dissertation

Author/Creator:

Maye, Alexandra, author.

Contributor:

University of Pennsylvania. Nursing., degree granting institution.

Language:

English

Subjects (All):

Nursing.

Public health.

0569.

0573.

0769.

Local Subjects:

Nursing.

Public health.

0569.

0573.

0769.

Genre:

Academic theses

Physical Description:

1 online resource (188 pages)

Contained In:

Dissertations Abstracts International 87-12B

Place of Publication:

Ann Arbor : ProQuest Dissertations and Theses, 2026

Language Note:

English

Summary:

Clinician burnout poses a serious risk to public health. More than 62% of nurses across the U.S. report experiencing burnout, with rates exacerbated during the COVID-19 pandemic. With over 4 million nurses in the healthcare workforce, burnout among these professionals threatens the delivery of high-quality care and optimal health outcomes of patients. These challenges are especially pronounced for the millions of Americans who are uninsured or underinsured. Safety-net hospitals (SNHs) disproportionately serve uninsured, underinsured, and Medicaid patients, operating under a mission to provide care to all patients, regardless of their insurance status. Ensuring a robust nursing workforce among this group of hospitals is critical for improving the health of vulnerable populations. While previous research has shown associations between nursing resources and burnout, no research has focused on distinguishing differences in burnout between nurses in SNHs and non-safety-net hospitals (non-SNHs). Furthermore, existing literature has been primarily quantitative in nature, leaving the lived experiences of nurses working in these settings largely unexplored. This mixed methods study employed a sequential explanatory approach, combining statistical analysis with qualitative insights from nurses to provide a comprehensive understanding of burnout across SNHs and non-SNHs. The analysis revealed that nurses in SNHs, defined as having the largest share of uncompensated hospital care (the total unreimbursed and uncompensated care costs as a proportion of operating expenses), have 14% lower odds of burnout compared to non-SNH nurses, challenging the assumption that burnout would be higher in safety-net hospitals which typically have substantial resource challenges. Notably, SNHs had a more racially and ethnically diverse nursing workforce than non-SNHs, a characteristic that may warrant further exploration as a potentially protective factor. Burnout remained high for both hospital types. Qualitative responses from nurses in both settings, SNHs and non-SNHs via side-by-side matrix, revealed similar patterns and themes, with nurses identifying the work environment and staffing levels as common contributors to burnout. These findings highlight the pervasive nature of burnout, suggesting that system-level interventions targeting key organizational and structural factors at both SNHs and non-SNHs, such as the work environment and staffing, may be necessary to durably address the challenge. The mixed methods design strengthened this study by pairing quantitative measurement with nurses' own words, capturing not just the extent of burnout but the human experience behind it

Notes:

Source: Dissertations Abstracts International, Volume: 87-12, Section: B.

Advisors: McHugh, Matthew D.; Brooks Carthon, Margo Committee members: Chatterjee, Paula

Ph.D. University of Pennsylvania 2026

Vendor supplied data

Local Notes:

School code: 0175

ISBN:

9798247981985

Access Restriction:

Restricted for use by site license