What’s the No. 1 Cause of NP Burnout?

— It’s probably not what you think

by Erica Dorn, FNP

Burnout among nurse practitioners (NPs) is at an all-time high. Many NPs (and healthcare providers in general) are struggling right now, feeling mentally, physically, and emotionally exhausted. Many are contemplating leaving healthcare altogether. The factors contributing to this burnout are multifactorial, stemming from a multitude of personal and work-related causes.

For advanced practice registered nurses (APRNs), however, there is one leading cause of burnout.

Before we delve into that, though, let’s explore how burnout can present, focusing on its signs and symptoms.

The main difference between stress and burnout for NPs is reaching the level of depletion. Many burned-out NPs begin to feel detached from their work and personal lives. These professionals no longer find passion or purpose in caring for patients and feel completely empty, like they have nothing more to give.

Signs and Symptoms

Here are some common signs and symptoms of NP burnout:

Mental, physical, and emotional exhaustion

Mental factors: poor clinical judgment, brain fog affecting productivity, negative thoughts

Physical factors: poor sleep, chronic fatigue, headaches

Emotional factors: chronic stress, anxiety, depression

Detachment from work, loved ones, and life in general

Feeling numb, loss of passion

Lack of purpose, lack of empathy and understanding

Imposter syndrome; restrictive, limiting beliefs

Difficulty processing trauma or challenging work experiences

What would you add to the list?

Back to the No. 1 cause of NP burnout. Let me first provide some background on how I discovered it.

After first overcoming healthcare burnout myself, I now help overwhelmed APRNs create a better work-life balance. While coaching and talking with NPs, I discovered that the leading contributor to burnout was not what I expected.

I figured the recent pandemic and added stress were the primary causes. I thought the modern healthcare system also played a significant role. I would have guessed that the lack of boundaries or a toxic work environment also were key contributing factors.

However, after working with NPs, I discovered that the No. 1 cause of burnout is a lack of work-life balance.

And the No. 1 cause of work-life imbalance is charting.

So many NPs are staying late at the office and bringing their charts home. This increase in time, energy, and stress disrupts the work-life balance.

Instead of having the energy to cook a healthy meal and eat with their families, NPs are depleted from a busy workday. Instead of having the time to enjoy the company of their children, NPs are thinking about how many open charts they still have to finish for the evening. Rather than relaxing and engaging in self-care activities, NPs have a pile of charts to sign — not to mention reviewing medical documentation, analyzing diagnostic data, responding to patient messages, and on and on.

The amount of charting and tasks NPs need to catch up on is insurmountable. Many spend an extra 10-15 hours of unpaid time just trying to stay caught up with charting. After a long workday, the only time to finish those tasks is at home. Talk about a work-life imbalance!

Yes, charting at home is the No. 1 culprit of work-life imbalance and is a strong indicator of developing burnout among NPs. The good news, though, is that there are ways to improve their time management and documentation so that charting at home is no longer necessary.


While there is no quick-and-easy solution (after all, we do still have to chart), there are many things we can do. For example, improving our charting and time management skills, setting boundaries with patients, ensuring we learn and utilize the electronic health record, and so much more!

But before implementing any of these charting and time management tips, we need to step back. We should focus on the personal and work-related factors contributing to our burnout and be honest with ourselves. It will be different for each NP, but we must focus on our challenges and struggles.

Also crucial is to find support. So many NPs and healthcare providers overall are struggling with burnout. We should be open and honest about our struggles, have hard conversations, bring awareness to the topic, and rally together during our burnout journey.

Acknowledging and addressing burnout is so important. If you realize you struggle with the No. 1 cause of NP burnout, work on improving charting. If you realize that your burnout is caused by toxic personal relationships, then focus on improving those. If you have completely lost your passion for healthcare, take a break to give you the opportunity to catch your breath.

Going through burnout is not easy, but we are not alone, and there are solutions.

Erica Dorn, FNP, is a nurse practitioner.

This post appeared on KevinMD.

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