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emotional exhaustion, medication administration, work-arounds, work process



  1. Halbesleben, Jonathon R. B.
  2. Rathert, Cheryl
  3. Williams, Eric S.


Background: Burnout is very common and has significant negative outcomes for both nurses and patients. However, this literature has only recently begun to address the processes that explain why health care provider burnout leads to negative patient outcomes. This article extends that literature by examining how satisfaction with work processes impacts the link between nurse burnout and work-arounds.


Purpose: The purpose of this study was to examine the relationships between emotional exhaustion and potentially unsafe work practices (work-arounds) in the context of nursing administration of medication.


Methodology/Approach: The data were collected using online survey software and pencil-and-paper surveys returned directly to the researchers. The study was conducted among nurses in 2 acute care hospitals in the Midwestern United States. For one of the samples, data on work-arounds were provided by the nurses' supervisors. For the other sample, data were collected at a 6-month interval. The survey included measures of emotional exhaustion (the Maslach Burnout Inventory), work-arounds, and nurse satisfaction with medication administration processes.


Findings: We found that exhaustion was associated with greater use of work-arounds of medication administration processes. We also found that when nurses were more satisfied with the medication administration process, exhausted nurses were less likely to engage in work-arounds.


Practice Implications: The findings suggest that although exhaustion in nurses can lead to potentially unsafe practices, satisfaction with the work process can either exacerbate or reduce the problem.