Date of Completion

Fall 12-3-2022

Project Type

Research Project

Degree Name

Master of Science in Nursing - Educational Leadership



Committee Chair/First Advisor

Dr. Rachel Myers



Aim: One aim of this integrative review is to highlight workplace issues outpatient (ambulatory care) nurses experience, related to stress, burnout, and compassion fatigue. Another aim is to bring awareness to and discuss recently implemented tools and strategies to help alleviate these manifestations.

Background: Stressors in the outpatient setting date back to the 1970s when psychologist Herbert Freudenberger mentioned the burnout he experienced while in a Free Clinic. In modern-day, half of nurses experiencing workplace burnout, confess to feeling emotional exhaustion. Various studies discuss the challenges nurses endure in the inpatient setting, but only a few focus on ambulatory healthcare.

Method: Whittemore and Knafl's approach was used to conduct this integrative review. A comprehensive search was conducted using predetermined inclusion/exclusion criteria and search terms. Identified studies were evaluated and appraised using the Johns Hopkins Nursing Evidence-Based Practice Research Evidence Appraisal Tool. A thematic analysis was utilized, and emergent themes and sub-themes were extracted for the four research questions related to contributing factors, effects, measures, and tools and strategies.

Results: Six studies met the criteria. Collectively, 12 themes were identified across four research questions, such as the nurse's experience; workload/staffing issues; patient experiences, traumas, and transition phases; and interprofessional relationships. Seven sub-themes were identified.

Conclusion: This integrative review summarizes what is already known about stress, burnout, and compassion fatigue among nurses who work in the outpatient healthcare setting. It also suggests promoting additional research in this area and future services to help reduce these manifestations in the fast-growing nursing specialty.

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Other Nursing Commons