Nurse Worklife and Wellness

Nurse Worklife and Wellness

(2019 to 2021)

The Nurse Worklife and Wellness study is another venture in a line of research that has concentrated on studying work-related factors as they relate to nurses’ health.

In this recent study, 1,200 actively licensed RNs in 9 US states participated in a survey that assessed job demands (physical, psychological); difficult work schedules; availability of workplace wellness offerings (e.g., naps, exercise); substance use and other lifestyle factors. This study is providing data on the prevalence of occupational health and wellness issues among nurses that can be used for planning purposes, including to design interventions to support nurses and improve nursing working conditions. In addition, policy implications of the study findings include promotion of structural changes that facilities employing nurses can make to decrease job demands and promote nurses’ health and wellness. Additional papers are in preparation and forthcoming.

Each of the studies listed below used a different population-based sample of RNs, and data were collected using mailed surveys with good response rates.

Nurses' Worklife and Health Study III
(Part III; 2001 to 2006)

This longitudinal study of RNs was designed to obtain detailed information on work schedules, including long work hours, on-call and mandatory overtime requirements, working on scheduled days off, and shift rotation. The relationship of these scheduling factors to two important outcomes, musculoskeletal disorders (neck, shoulder and back) and needlestick injuries, was also examined. Mailed surveys were used to examine variables at baseline and at six and 15 months. This allowed the researchers to make inferences about the effect of these work patterns on the incidence of musculoskeletal disorders and needlestick injuries.

Nurses' Worklife and Health Study II
(Part II; 1998 to 2001)

This cross-sectional study of 1,428 RNs from diverse settings looked at patterns of neck, shoulder, and back injuries and disorders in relation to physical demands, work schedule, and health care changes that influence nursing work (for example, increased job responsibility, floating off unit, unfilled positions, layoffs, high patient loads and acuity, shorter lengths of stay, and use of unlicensed personnel).

Nurses' Worklife and Health Study I
(Part I; 1993 to 1998)

Twenty-five years ago, our team conducted the first nationwide survey of substance use and related problems among US RNs. This cross-sectional study examined various aspects of nursing, such as specialty, work schedule, and job strain, on patterns of substance use among more than 4,400 RNs.

The Nurses' Worklife and Health Studies and Nurse Worklife and Wellness Study have made a contribution to scientific knowledge in the following areas

Substance Use

New:

• Trinkoff, A. M., Selby, V. L., Han, K., Baek, H., Steele, J., Hephzibah, S. E., Yoon, J. M., & Storr, C. L. (2021). The prevalence of substance use and substance use problems in registered nurses: Estimates from the Nurse Worklife and Wellness Study. Journal of Nursing Regulation, 12(4), 35-46.
• Trinkoff, A. M., Yoon, J. M., Selby, V. L., Storr, C. L., Hephzibah, S. E., & Baek, H. (2021). Registered nurses’ awareness of workplace signs, actions, and interventions for nurses with substance use disorder. Journal of Nursing Regulation, 12(3), 20-29.
• Trinkoff, A. M., Selby, V. L., Baek, H, Storr, C., Steele, J., & Han, K. (2022). Workplace Exposures and Prescription Drug Misuse Among Nurses. The Journal of Nursing Administration, 52(11), 591-597. doi: 10.1097/NNA.0000000000001215

Previous:

• Trinkoff, A. M., Storr, C. L., & Lipscomb, J. A. (2001). Physically demanding work and inadequate sleep, pain medication use, and absenteeism in registered nurses. Journal of Occupational and Environmental Medicine, 43(4), 355-363. PMID: 11322096
• Storr CL, Trinkoff AM, Hughes P. (2000). Similarities of substance use between medical and nursing specialties. Subst Use Misuse. 2000 Aug;35(10):1443-69. Review. PMID: 10921434
• Trinkoff, A. M., Zhou, Q., Storr, C. L., & Soeken, K. (2000). Workplace access, negative proscriptions, job strain, and substance use in registered nurses. Nursing Research, 49(2), 83-90. PMID: 10768584
• Storr, C. L., Trinkoff, A. M., & Anthony, J. C. (1999). Job strain and non-medical drug use. Drug and Alcohol Dependence, 55, 45-51. PMID: 10402148
• Trinkoff, A. M., Storr, C. L., & Wall, M. P. (1999). Prescription-type drug misuse and workplace access among nurses. Journal of Addictive Diseases, 18(1), 9-17. PMID: 10234559
• Trinkoff, A. M., & Storr, C. L. (1998a). Substance use among nurses: differences between specialties. American Journal of Public Health 88, 581-585. PMID: 9550998
• Trinkoff, A. M., & Storr, C. L. (1998b). Work schedule characteristics and substance use among nurses. American Journal of Industrial Medicine, 34(3), 266-271. PMID: 9698996
• Trinkoff AM, Storr CL. (1994) Relationship of specialty and access to substance use among registered nurses: an exploratory analysis. Drug Alcohol Depend. 1994 Dec;36(3):215-9. PMID: 7889812
• Trinkoff AM, Eaton WW, Anthony JC. The prevalence of substance abuse among registered nurses. Nurs Res. 1991 May-Jun;40(3):172-5. PMID: 2030997

Fatigue/Sleep

New:

• Trinkoff, AM, Baldwin, C.M., Chasens, E.R., Dunbar-Jacob, J., Geiger-Brown, J., Imes, C., Landis, C.A., Patrician, P.A., Redeker, N.S., Rogers, A.E., Scott, L.D., Todero, C.M., Tucker, S.J., Weinstein, S.M. the Fatigue Subgroup of the Health Behavior Expert Panel, American Academy of Nursing. (2021). Nurses are more exhausted than ever: What should we do about it? American Journal of Nursing, 121 (12): 18-28. doi: 10.1097/01.NAJ.0000802688.16426.8d

Previous:

• Caruso CC, Baldwin CM, Berger A, Chasens ER, Landis C, Redeker NS, Scott LD, Trinkoff A. (2017). Position statement: Reducing fatigue associated with sleep deficiency and work hours in nurses. Nurs Outlook. 2017 Nov - Dec;65(6):766-768. doi: 10.1016/j.outlook.2017.10.011. PMID: 29216975
• Han K, Trinkoff AM, Geiger-Brown J. (2014). Factors associated with work-related fatigue and recovery in hospital nurses working 12-hour shifts. Workplace Health Saf. 2014 Oct;62(10):409-14. doi: 10.3928/21650799-20140826-01. PMID: 25199168
• Geiger-Brown J, Rogers VE, Han K, Trinkoff A, Bausell RB, Scharf SM. (2013). Occupational screening for sleep disorders in 12-h shift nurses using the Berlin Questionnaire. Sleep Breath. 2013 Mar;17(1):381-8. doi: 10.1007/s11325-012-0705-3. PMID: 22535196
• Trinkoff, A.M., & Geiger-Brown, J. (2012). Sleep-Deprived Nurses: Sleep and schedule challenges in nursing. Chapter in Koppel, R and, S. (Eds.) First, Do Less Harm: Confronting Inconvenient Problems of Patient Safety. Cornell University Press.
• Geiger-Brown J, Rogers VE, Trinkoff AM, Kane RL, Bausell RB, Scharf SM. (2012). Sleep, sleepiness, fatigue, and performance of 12-hour-shift nurses. Chronobiol Int. 2012 Mar;29(2):211-9. doi: 10.3109/07420528.2011.645752. PMID: 22324559
• Geiger-Brown J, Trinkoff A, Rogers VE. (2011). The impact of work schedules, home, and work demands on self-reported sleep in registered nurses. J Occup Environ Med. 2011 Mar;53(3):303-7. doi: 10.1097/JOM.0b013e31820c3f87. PMID: 21346638
• Geiger-Brown J, Trinkoff AM. (2010). Is it time to pull the plug on 12-hour shifts? Part 3. harm reduction strategies if keeping 12-hour shifts. J Nurs Adm. 2010 Sep;40(9):357-9. doi: 10.1097/NNA.0b013e3181ee4295. PMID: 20798617
• Geiger-Brown J, Trinkoff AM. (2010). Is it time to pull the plug on 12-hour shifts?: Part 1. The evidence. J Nurs Adm. 2010 Mar;40(3):100-2. doi: 10.1097/NNA.0b013e3181d0414e. PMID: 20485206

Personal Safety for Nurses

New:

• Baek, H., & Trinkoff, A. M. (2022). Bullying experience and the work environment in nurses: A cross-sectional data analysis. Journal of Nursing Management, 30(6), 1861–1868. https://doi.org/10.1111/jonm.13727

Previous:

• Geiger-Brown J, Trinkoff AM, Nielsen K, Lirtmunlikaporn S, Brady B, Vasquez EI. (2004). Nurses' perception of their work environment, health, and well-being: a qualitative perspective. AAOHN J. 2004 Jan;52(1):16-22.
• Brown JG, Trinkoff A, Rempher K, McPhaul K, Brady B, Lipscomb J, Muntaner C. (2005). Nurses' inclination to report work-related injuries: organizational, work-group, and individual factors associated with reporting. AAOHN J. 2005 May;53(5):213-7.
• Trinkoff, A. M., Geiger-Brown, J. M., & Caruso, C. C., Lipscomb, J. A., Johantgen, M., Nelson, A. L., Sattler, B. A., & Selby, V. L. (2008). Personal safety for nurses. Chapter in: Hughes RG, ed. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US).

 Musculoskeletal Injury/Disorders (neck, shoulder, back)

• Trinkoff, A. M., Le, R., Geiger-Brown, J., Lipscomb, J., & Lang, G. (2006). Longitudinal relationship of work hours, mandatory overtime, and on-call to musculoskeletal problems in nurses. American Journal of Industrial Medicine, 49(11), 964–971. PMID: 16691609
• Lipscomb J, Trinkoff A, Brady B, Geiger-Brown J. (2004). Health care system changes and reported musculoskeletal disorders among registered nurses. Am J Public Health. 2004 Aug;94(8):1431-5. PMID: 15284055
• Trinkoff, A. M., Lipscomb, J. A., Geiger-Brown, J., Storr, C. L., & Brady, B. A. (2003). Perceived physical demands and reported musculoskeletal problems in registered nurses. American Journal of Preventive Medicine, 24(3), 270–275. PMID: 12657347
• Trinkoff AM, Brady B, Nielsen K. (2003). Workplace prevention and musculoskeletal injuries in nurses. J Nurs Adm. 2003 Mar;33(3):153-8. PMID: 12629302
• Trinkoff, A.M., Lipscomb, J., Geiger-Brown, J., & Brady, B. (2002). Musculoskeletal problems of the neck, shoulder, and back and functional consequences in nurses. American Journal of Industrial Medicine, 41, 170-178. PMID: 11920961
• Lipscomb JA, Trinkoff AM, Geiger-Brown J, Brady B. (2002). Work-schedule characteristics and reported musculoskeletal disorders of registered nurses. Scand J Work Environ Health. 2002 Dec;28(6):394-401. PMID: 12539799

Needle-stick Injuries

• Trinkoff AM, Le R, Geiger-Brown J, Lipscomb J. (2007). Work schedule, needle use, and needlestick injuries among registered nurses. Infect Control Hosp Epidemiol. 2007 Feb;28(2):156-64. PMID: 17265396

 Work Schedules

• National Institute for Occupational Safety and Health (NIOSH) (2015). NIOSH training for nurses on shift work and long work hours. By Caruso CC, Geiger-Brown J, Takahashi M, Trinkoff A, Nakata A. Cincinnati, OH: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication No. 2015-115 (Revised 10/2019). https://doi.org/10.26616/NIOSHPUB2015115revised102019
• Han K, Trinkoff AM, Storr CL, Geiger-Brown J, Johnson KL, Park S. (2012). Comparison of job stress and obesity in nurses with favorable and unfavorable work schedules. J Occup Environ Med. 2012 Aug;54(8):928-32. doi: 10.1097/JOM.0b013e31825b1bfc. PMID: 22821072
• Trinkoff AM, Johantgen M, Storr CL, Gurses AP, Liang Y, Han K. (2011). Nurses' work schedule characteristics, nurse staffing, and patient mortality. Nurs Res. 2011 Jan-Feb;60(1):1-8. doi: 10.1097/NNR.0b013e3181fff15d. PMID: 21127449
• Geiger-Brown J, Trinkoff A, Rogers VE. (2011). The impact of work schedules, home, and work demands on self-reported sleep in registered nurses. J Occup Environ Med. 2011 Mar;53(3):303-7. doi: 10.1097/JOM.0b013e31820c3f87. PMID: 21346638
• Han K, Trinkoff AM, Storr CL, Geiger-Brown J. (2011). Job stress and work schedules in relation to nurse obesity. J Nurs Adm. 2011 Nov;41(11):488-95. doi: 10.1097/NNA.0b013e3182346fff. PMID: 22033319
• Trinkoff AM, Le R, Geiger-Brown J, Lipscomb J. (2007). Work schedule, needle use, and needlestick injuries among registered nurses. Infect Control Hosp Epidemiol. 2007 Feb;28(2):156-64. PMID: 17265396
• Trinkoff, A. M., Geiger-Brown, J., Brady B., Lipscomb, J.A., & Muntaner, C. (2006a). How long and how much are nurses now working? American Journal of Nursing, 106 (4), 60-71. PMID: 16575241
• Trinkoff, A. M., Le, R., Geiger-Brown, J., Lipscomb, J., & Lang, G. (2006b). Longitudinal relationship of work hours, mandatory overtime, and on-call to musculoskeletal problems in nurses. American Journal of Industrial Medicine, 49(11), 964–971. PMID: 16691609
• Lipscomb JA, Trinkoff AM, Geiger-Brown J, Brady B. (2002). Work-schedule characteristics and reported musculoskeletal disorders of registered nurses. Scand J Work Environ Health. 2002 Dec;28(6):394-401. PMID: 12539799

Alison M. Trinkoff, ScD, RN, FAAN, Professor, Principal Investigator (PI) has been at the University of Maryland, School of Nursing (UMSON) since 1991, where she has been studying the influence of nursing work environments, nurse injury, SU and related outcomes. Her first R01 as PI was funded by the National Institute on Drug Abuse (NIDA) for a nationwide survey of SU/SUDs in RNs, and she has been PI on 4 additional R01s and 6 NCSBN-funded regulatory research grants. Her experience includes mixed methods, analysis, and designing and implementing surveys. In addition, she teaches research design and analysis and mentors PhD students.

Victoria Selby, PhD, PMH-CRNP, PMHNP-BC, CARN-AP, Assistant Professor, Co-Investigator (Co-I), at UMSON, has been working as a psychiatric nurse practitioner since 2012, specializing in co-occurring substance use (SU) and psychiatric disorders. Clients come from diverse backgrounds and include healthcare professionals. Prior to this, she had experience as an RN in emergency and acute psychiatric settings. Dr. Selby also designed and implemented a post-baccalaureate certificate in substance use and addictions nursing (SUAN), and an undergraduate focus area in addictions at UMSON. She was the PI on two grants supporting this work from the Maryland Higher Education Commission and Directs the SUAN program. Dr. Selby adds first-hand clinical expertise, and has been instrumental in working to identify relevant RN SU/SUD research priorities.

Jodi Frey, PhD, LCSW-C, CEAP, Professor and Associate Dean for Research, UM School of Social Work (UMSSW), Co-I, chairs the Social Work in the Workplace and Employee Assistance sub-specialization at the UMSSW, an internationally recognized master’s program that prepares graduate-level SWs for the EAP field–the only program of its kind. As a senior researcher in workplace behavioral health, Dr. Frey has consulted with many workplaces–public and private, including healthcare organizations and studies the effectiveness of employee assistance, work/life, and related programs for adults and families, dedicating significant research and advocacy efforts to workplace suicide prevention and crisis response. This study relates to the work she does as Founder and Faculty Executive Director of the Behavioral Health and Well-Being Lab (BHWell Lab).

Jung Min Yoon, PhD, RN, Assistant Professor, Ewha Womans University, College of Nursing, Seoul, South Korea, and serves as Project Director for this study. Dr. Yoon previously was an Assistant Professor at Stony Brook School of Nursing, and earned her PhD in Nursing in 2021 from the University of Maryland. Dr Yoon’s patient-focused research is on addressing dementia-related behaviors, for which she was PI of a Sigma Theta Tau research grant, and currently as PI on an Alzheimer’s Association research grant, along with her ongoing interests in nurse mental health and well-being. 

Rob White, MA, LCPC, CEAP, Director of Behavioral Health, Expert Advisor, manages the University of Maryland, Baltimore EAP, is in the Department of Psychiatry, and has been with the EAP for over 30 years. He is board certified in addiction counseling and employee assistance and is a licensed professional counselor. Mr. White serves as an expert advisor on EAP systems to the team, and is the Maryland liaison for EAPA.org.

Jenell Steele, RN, MSN, PhD Student, UMSON, specializes in nursing workforce and resilience, and serves as Nursing Advisor to the project. Ms. Steele served on the Maryland Board of Nursing for 4 years. As a board member, she also served on the Maryland Advisory Board on Prescription Drug Monitoring Program. She has taught clinical nursing and laboratory coursework at the Johns Hopkins School of Nursing and Notre Dame of Maryland University. Ms. Steele began the PhD in 2019 and has been involved with our research team for the past year, working on nurse wellbeing.

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Former Team Members

Hyang Baek, PhD Candidate, UMSON has been working as a Graduate Research Assistant (GRA) on Dr. Trinkoff's research team since 2020. She focused on nurses' psychosocial factors and the work environment in Seoul, Korea prior to starting the UMSON PhD program, and has continued this emphasis in her PhD research.

Kihye Han, PhD, RN, Associate Professor, Chung-Ang University, Red Cross College of Nursing, Seoul, South Korea. Dr. Han has been working with the team since 2008, first as a graduate research assistant in the University of Maryland School of Nursing PhD program, and then as a post-doctoral fellow. She returned to UMSON spend 2019-20 as a visiting scholar. Her research interests include nurses’ health in relation to nurse and patient outcomes. She also conducted a novice nurse two-year follow-up study to explore health and job trajectory and factors associated with early career turnover among Korean nurses. This study incorporates biologic measures using updated technology. She has utilized complex quantitative designs with advanced statistical analysis techniques.

Carla Storr, ScD, MPH; Professor Emerita, UMSON, Carla Storr taught doctoral-level measurement and research methods at UMSON for more than 10 years. As a former team member, she shared considerable expertise in epidemiology and survey implementation, along with data management, and collaborated with Dr. Trinkoff on numerous occasions. Dr. Storr has her own line of research in behavioral mental health and served as PI on a National Institute on Drug Abuse (NIDA)-funded R01, She has been Co-PI on a longitudinal project at Johns Hopkins University, Co-Investigator on many others, and has an extensive collection of publications.

Free nursing wellness resources suggested by the Nurse Worklife and Wellness Study:

Well-Being Initiative, American Nurse Foundation
mental health support, online therapy, writing groups

Free Continuing Nursing Education, American Psychiatric Nurses Association
continuing education: mindfulness and mental health wellbeing (& CEUs)

COVID-19 Resource Center, American Nurses Association
information and nurse support

Coronavirus Sanity Guide, Ten Percent Happier
COVID-19 sanity guide, daily meditations, talks to address fear, worry, and anxiety

Employee Assistance Professional Association (EAPA)
EAPA is the world’s largest membership organization for employee assistance professionals. They have members in over 40 countries around the globe and are a relied-upon source of information and support for and about the employee assistance profession. 

Healthy Nurse, Healthy Nation, American Nurses Association
healthy lifestyle changes, blogs and support

988 Lifeline
The 988 Suicide and Crisis Lifeline is a national network of local crisis centers that provides free and confidential emotional support to people in suicidal crisis or emotional distress 24 hours a day, 7 days a week in the United States. The organization is committed to improving crisis services and advancing suicide prevention by empowering individuals, advancing professional best practices, and building awareness.