Early Career Burnout Among Nurses Associated With Chronic Symptoms of Stress

Examining whether an early career episode of burnout has long-term consequences on cognitive functions, symptoms of depression, and insomnia for nurses a decade after graduation.

Burnout early in the career of a nurse was associated with increased rates of cognitive dysfunction a decade later. These results, from a longitudinal observational study, were published in EClinical Medicine.

Students (N=2423) graduating in 2002, 2004, or 2006 from 26 nursing programs in Sweden were recruited by researchers from the Karolinska Institutet for this study. Signs of burnout were assessed annually for the first 3 years after graduating and again at 11-15 years post-graduation. Burnout was assessed by the Oldenburg Burnout Inventory (OLBI).

At follow-up the participants were aged under 39 years (41%), between 40 and 49 years (35%), or over 50 years (26%), 90% were women, and 57% were specialist-trained nurses.

Signs of burnout were observed among 5.2%, 5.4%, and 4.7% of nurses during the first 3 years of their career, respectively. The proportion of participants who experienced burnout symptoms at least once during their first 3 years was 12.3%.

At follow-up, 42.2% reported symptoms of insomnia, 11.4% of participants experienced 4 or more cognitive problems, and 5.7% fit the clinical criteria for depression. Nurses who experienced burnout during their first 3 years were over 3 times more likely to have cognitive problems or depression.

After controlling for potential cofounders, burnout early in their career predicted cognitive problems (odds ratio [OR], 2.185; 95% CI, 1.519-3.142) and insomnia (OR, 1.723; 95% CI, 1.315-2.258) but depression was no longer significantly associated (OR, 1.038; 95% CI, 0.631-1.706).

This study was limited by the fact that all reported symptoms were self-assessed and therefore may be biased by perceptive insufficiency or the desire to give socially acceptable responses.

The study authors concluded that chronic stress symptoms may be caused by overwhelming stress at the onset of a nurse’s career. These data indicated that preventive measures should be introduced early or as a part of training in order to assuage chronic symptoms of stress among nurses.


Rudman A, Arborelius L, Dahlgren A, Finnes A, Gustavsson P. Consequences of early career nurse burnout: A prospective long-term follow-up on cognitive functions, depressive symptoms, and insomnia [published online October 5, 2020]. EClinicalMedicine. doi: 10.1016/j.eclinm.2020.100565.