The Determinants of Emergency Nurses’ Burnout: A Systematic Review

Abstract

This PRISMA-informed systematic review synthesizes eligible primary evidence on factors associated with burnout among emergency nurses published from 2015 through 2025. A targeted evidence-selection workflow used MEDLINE via PubMed, PubMed Central, OpenAlex for supplementary discovery, publisher and DOI records for verification, and backward and forward citation chasing. Forty-seven primary studies met the operational eligibility criteria and were mapped across thirteen determinant domains using structured narrative synthesis and evidence mapping. The evidence positions burnout as a multilevel occupational outcome shaped by interacting demands, resources, relational conditions, personal capacities, and recovery opportunities rather than an individual coping failure. Work Environment was the most frequently examined domain (29 of 47 studies), followed by Experience/Demographics (26), Trauma/Stress (12), Workload (12), Organizational Support (11), and Social Support (9). Staffing, Shift Work, Leadership, Work-Family/Recovery, and Resilience were less uniformly examined, while Moral Distress and Violence remained comparatively sparse. Across settings, greater burnout was recurrently associated with high or poorly controlled demands and weaker organizational resources, although heterogeneous measures and predominantly cross-sectional designs limit causal interpretation. Job Demands-Resources theory organizes the demand-resource pattern, while Conservation of Resources theory explains cumulative depletion and constrained recovery. The review contributes an updated thirteen-domain taxonomy, evidence-attention map, and theoretically integrated account that distinguishes research frequency from causal importance. Future studies should prioritize longitudinal, multilevel, intervention, and implementation designs that test organizational changes and clarify underexamined ethical, safety, and recovery mechanisms. Evidence was most recurrent for work environment and occupational context, whereas newer studies broadened attention toward psychological safety, ethical strain, and violence.