Using DEI to Address Nurse Burnout

Burnout is not a new issue in the nursing field, but it has become a major concern in recent years. In the 2023 Mental Health and Wellness Survey, 64% of nurses reported high stress levels, and 56% reported symptoms of burnout.

The numbers for nurses of color look even worse.

For example, 4% of all nurses reported complete burnout in the survey, while 42% of Asian nurses reported complete burnout in a 2023 JAMA study. In that study, three-quarters of U.S. nurses of Asian descent reported job harassment, unfair treatment, or feeling “invisible” in the workplace.

To combat nurse burnout, hospitals have tried various interventions, including yoga retreats, psychosocial programs, and workplace appreciation events. While these have yielded some positive results, they can’t solve the problem on their own, especially for nurses of color.

“Too many healthcare organizations have embraced feel-good summits, yoga classes, mindfulness, and meditation to address morale issues,” says physician and thought leader Dr. Sachin H. Jain. “Instead, they should address the underlying issues that are hurting their employees.”

For people of color in the field, that means attacking the roots of professional inequities — the same mission of the diversity, equity, and inclusion (DEI) movement. Even as DEI fatigue grabs hold in various corners of the country, authors of another JAMA report believe that these initiatives could be the key to addressing nurse burnout among the disproportionately burnt-out minority nurses.

“Within a culture of wellness, a central focus on health equity that is currently absent from many approaches addressing nurse burnout and suicide must drive solutions,” wrote Rosa M. Gonzalez-Guarda, Ph.D., MPH, RN, an associate professor with Duke University School of Nursing, in the JAMA report.

According to the McKinsey & Company, DEI describes “three values that many organizations today strive to embody to help meet the needs of people from all walks of life.” When organizations incorporate these three values, they are “better able to respond to challenges, win top talent, and meet the needs of different customer bases.”

Hospitals are no different. Here, investments in DEI can provide positive social environments and a sense of belonging for nurses of color who might otherwise feel alienated. A focus on DEI can lead to more racially diverse hospital leaders and a deeper connection with the communities they care for.

DEI also helps hospitals better address internal challenges, such as nurse burnout. To roll this out effectively, however, hospitals need to consider (and reward) the fact that DEI responsibilities often fall on the people who also rely on the initiatives — a burden Gonzalez-Guarda refers to as the “minority tax.”

“This adds to an environment that creates additional demands on the few nurses that are concordant with the populations they serve,” she wrote.

Until hospitals tackle inequities in the nursing field, they may never truly offer fulfillment for nurses of color — a concept that “includes the workplace factors of inclusion, antiracism, and pay justice, which all contribute to well-being.” Without professional fulfillment, minority nurses will likely continue experiencing high burnout rates.

To address this, hospitals need to recognize and qualify the effects of burnout on their various subpopulations. They must prioritize providing minority nurses with rewards and opportunities that align with their contributions. And they need to develop diverse burnout solutions that support a variety of people, cultures, and experiences.

“Healthcare leaders should consult with diversity, equity, inclusion, and belonging leaders to understand the demographics of their workforce,” Gonzalez-Guarda wrote. “Data collected from both approaches will determine what tailored interventions should be instituted at the individual level and what should be actuated at the system level.”

At the individual level, Gonzalez-Guarda suggests inclusive dance sessions, structured meals, and diverse employee and peer support groups. At the systemic level, she suggests liberal holiday policies, non-gendered parental leave, and staff protections and incentives for nurses of color.

By emphasizing DEI in their burnout remedies, hospitals can start to chip away at the foundation of this growing problem. Rather than alienating nurses of color further with “one-size-fits-all approaches,” hospitals can empower and energize them by proving that diversity is recognized and valued.

“A health equity lens is essential for making structural changes in the health care system to address nursing burnout and professional fulfillment,” writes Gonzalez-Guarda. “Tailored approaches must be offered that tap into the cultural strengths of minoritized nurses that are often ignored in strategies designed by and for a physician, male-dominated health care workforce.”