TL;DR: Joyce University’s latest nurse survey data is a reminder that burnout is not a “wellness” issue. It is a system-level operational risk that shows up in missed breaks, mandatory overtime, safety concerns, and an ongoing intention to leave the profession. When those signals rise, patient experience and safety risk rise too.
Hospitals do not have a “burnout problem.”
They have an early-warning problem.
By the time patient experience scores drop, nurse turnover spikes, or safety events rise, leaders are working with lagging indicators. The question is how to surface risk earlier, while there is still time to intervene.
A recent segment featuring Joyce University on KUTV’s Fresh Living adds urgency to this conversation. Their research underscores a pattern many health system leaders already feel intuitively: burnout is not an individual resilience issue. It is a predictable outcome of how work is designed, staffed, and supported.
Joyce University’s survey data makes impossible to ignore nursing's “unsustainable work”
Joyce University’s national survey of 1,000 registered nurses quantifies what “unsustainable work” looks like in daily practice.
Here are a few of the findings that stand out:
- 74% of nurses reported feeling emotionally exhausted from work multiple times each week in the past month.
- 55% reported skipping meals or breaks on most shifts because they are too busy.
- 53% have seriously considered leaving nursing monthly or more in the past six months.
- 74% reported working mandatory overtime three or more times in the past month.
- Nearly half worry at least weekly that fatigue or overwhelm could contribute to a medication error or mistake.
- 49.5% felt unsafe due to verbal or physical aggression from patients or family members in the past year.
The most important insight is not any single statistic.
It is the pattern: these are not “bad days.” These are repeated conditions that make it harder for nurses to communicate clearly, respond quickly, and provide consistent, compassionate care.
Burnout is a system issue, and the system has downstream consequences
Dr. Shelley Johnson’s framing is the right one: burnout is tied to system levers such as:
- Staffing levels and staffing models
- Scheduling practices and reliance on mandatory overtime
- Break culture and ability to recover during a shift
- Leadership support and whether nurses can speak up early
- Workplace safety and violence prevention
When those levers are strained, hospitals do not just lose staff. They lose capacity to deliver a consistent patient experience.
That is why “burnout prevention” cannot stay siloed as a wellbeing program.
It is operational risk management.
The patient experience problem: HCAHPS is a lagging indicator
HCAHPS scores matter.
They shape public perception, influence competitive positioning in many markets, and factor into value-based reimbursement.
But HCAHPS is also inherently delayed. By the time leaders see a score trend, they are often looking back at issues that have already occurred.
This creates a gap:
- Leaders have real-time workforce signals today.
- Leaders receive patient experience outcomes weeks or months later.
To manage risk, hospitals need both views together.
A more useful operating model: detect, diagnose, intervene, learn
Joyce’s research points to a truth that should change how leaders manage burnout: the conditions create the outcome.
A practical operating loop looks like this:
- Detect rising risk early (burnout, missed breaks, mandatory overtime reliance, safety signals).
- Diagnose what is driving the trend (staffing, workflow, leadership practices, safety constraints).
- Intervene with targeted changes (break protection, scheduling adjustments, staffing model refinements, leadership training, safety enforcement).
- Learn whether interventions reduce risk and stabilize experience outcomes.
With HCAHPS data integrated alongside workforce insights, this loop becomes easier to operationalize and easier to defend with leadership.
What is your hospital’s level of risk?
Joyce University's research is not just data. It is a call to action. The workforce signals are already present, and they are predictive. The question is whether health systems will treat them as operational intelligence or wait for patient experience scores to confirm what nurses have been saying all along. Leaders who act early, integrate workforce and experience data, and close the loop between detection and intervention will be better positioned to protect both their teams and their patients. The rest will continue managing burnout as a lagging indicator, one survey cycle behind the problem.
If 55% of nurses are skipping breaks and 74% are working mandatory overtime multiple times a month, the system is already signaling elevated risk.
The next step is not another awareness campaign.
The next step is helping leaders see what is happening, where it is happening, and what it is likely to affect.Our HCAHPS data integration connects early workforce signals to patient experience risk. Learn more about how we help hospital leaders identify patient experience risk earlier by monitoring the workforce signals that predict it, instead of waiting for delayed scores by booking a meeting here.
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