C56-21 How Do Medical Intensive Care Unit (MICU) Nurses Utilize Their Time at Work?

Abstract Introduction For nurses working in a Medical Intensive Care Unit (MICU), stress and trauma are common features of the job and may lead to symptoms of burnout. Burnout may also arise from a discrepancy between one’s anticipated perception versus the actual responsibilities of the position. Therefore, we sought to better define the actual distribution of job-related tasks performed by nurses during a typical MICU shift. Methods 16 MICU nurses at a large academic hospital were enrolled. Before their shift, the study participants completed the Maslach Burnout Inventory. For approximately half of their 12-hour shift, a trained research coordinator observed the nurses and recorded the start and end time for each specific task/activity, using the WorkStudy + (Quetech, Ltd.) program. Activities were categorized as: 1. Direct clinical care, which was sub-grouped into: A. Patient care (e.g., performing patient assessments), and B. Time with staff/others (e.g., participating in bedside rounds); 2. Desk work (e.g., documentation/charting); and 3. Personal time (e.g., eating lunch, using the restroom). Normally distributed data are presented as means and standard deviations, and non-normally distributed data are presented as medians and 25-75% quartiles. Results Participants were predominantly female (75%), with a mean age of 32.5 ± 9.5 years. They had a median of 6.0 2.75-10.5 years of nursing experience and 3.5 2-9.25 years of ICU experience. All participants worked in a MICU with a 2:1 nurse-to-patient ratio and were observed for a median of 5:48:38 hours 5:39:58-5:54:22. Overall, 62.5% (10/16) were positive for at least one symptom of burnout. Nurses allocated less than half of their shift time to patient care (46.5% 43-53%). Most of their shift was spent on desk work and personal time (53.5% 47-57%), with desk work alone accounting for 27.5% 24.25-34% of total shift time. The most time-consuming direct clinical care task was medication administration, comprising 15% 8.1-20.5% of total shift time, while only 2% 1-4% of shift time was spent on patient/family communication. On average, nurses switched tasks every 45 seconds. Those who were positive for symptoms of burnout had slightly higher task rate changes (81.2/hour ± 7.4) than nurses who did not have symptoms of burnout (75.7/hour ± 7.9, p = 0.19). Conclusions ICU nurses spend a significant amount of time performing activities other than direct patient care. Reducing the amount of time required for non-direct patient care could be one strategy to align expectations of the job and reduce burnout in MICU nurses. This abstract is funded by: None