Work System Factors in CRNA Burnout: A Macroergonomic Perspective

Abstract

Burnout is an occupational phenomenon with far-reaching consequences for both healthcare professionals and healthcare systems. Although widely recognized among nurses and physicians, burnout remains understudied among CRNAs, despite their high-risk, high-demand work environment. The purpose of this study was to describe the macroergonomic contributors, preventive factors, and consequences of burnout among CRNAs within the anesthesia work system. A qualitative descriptive design was used, with semi-structured interviews guided by the SEIPS 2.0 model to explore CRNAs’ experiences with burnout in relation to the anesthesia work system. Participants came from various practice settings and geographic areas across the United States. Thirty-eight participants completed the online survey fully and were invited to take part in a semi-structured interview, with fifteen completing it in August and September of 2025. Analysis revealed three primary findings: autonomy and respect, the ability to practice at full scope, and change, emerging as central conditions shaping burnout experiences. When autonomy, respect, and full-scope practice were supported, participants reported decreased burnout and improved satisfaction. Conversely, when these conditions were constrained, participants reported higher levels of burnout. However, unique to this population, burnout was not experienced as a static endpoint. Instead, in almost all cases, it served as a signal prompting CRNAs to reassess their lives and initiate change, including modifying their workload, transitioning practice settings, seeking different supervision models, or focusing on well-being initiatives. These findings suggest that supporting CRNAs' well-being requires attention to how the work system is structured, not just how individuals cope, and provide a foundation for future research and organizational efforts to improve sustainability in CRNA practice.