Need for recovery and physician well-being in emergency departments: national survey findings

Background and importance Need for recovery (NFR) describes an individual's need to physically and psychologically recuperate following a period of work. Physicians working in emergency departments (EDs) have higher NFR scores than other occupational groups. Increased NFR may precede occupational burnout and identification provides opportunities for early interventions. Objective To identify the incidence of well-being characteristics for ED physicians and to determine if NFR score is associated with these characteristics, whilst adjusting for potential confounders. Design This is a secondary analysis of a survey study. Responses to 11 items were summated into the NFR score, from 0 (lowest NFR) to 100. Additional items (n = 44) explored well-being, demographic and occupational characteristics. Setting and participants Physicians working within 112 EDs in the UK and Ireland were surveyed in June-July 2019. Outcome measure and analysis The outcome measure was self-perceptions of well-being including; current burnout, risk of future burnout and feeling overwhelmed at work. Descriptive statistics are presented alongside findings of a multiple regression analysis. Main results In 4365 participants, the self-perceived incidence of current burnout, high risk of future burnout and feeling overwhelmed at work more than once a week was 24.8, 62.7 and 45.1%, respectively. For every unfavourable response of the NFR scale there was an increase in odds of 34.0% (95% CI, 31.0-37.1) for frequency of feeling overwhelmed; 53.8% (95% CI, 47.5-60.4) for current burnout; 56.2% (95% CI, 51.1-61.6) for high risk of future burnout. Conclusion This study confirms an association between increased NFR score and self-perceived well-being characteristics. Factors previously reported to reduce NFR could therefore be important initiatives to improve well-being of the ED workforce.

Automated summary

This study highlights the association between increased Need for recovery (NFR) score and self-perceived well-being characteristics among emergency department physicians. Higher NFR scores may lead to occupational burnout and feeling overwhelmed at work. Identification of NFR could provide opportunities for early interventions to improve well-being in this workforce.