Impact of Storytelling on Burnout and Nursing Expertise


Name: Susan Hall

Rank: Capt, USAF

Organization: Henry M. Jackson Foundation

Performance Site: David Grant USAF Medical Center, Travis AFB, CA; Malcolm Grow USAF Medical Center, Andrews AFB, MD

Year Published: 1993

Abstract Status: Final


The primary purpose of this study was to pilot test a procedure to evaluate the effectiveness of Benner's narrative exemplars of clinical nursing practice, "story telling." Specifically, this study was designed to measure the impact of storytelling on burnout and transformation of the novice to expert.The study employed a four-group pre- and post- test quasi-experimental design. Nurses from two medical centers were recruited (N= 102) and asked to complete a level of practice rating and Maslach Burnout Inventory. The experimental group was introduced to story telling and randomized to three treatment groups. Subjects in the treatment groups were asked to write three clinical exemplars, and then be further exposed to storytelling through: twice-monthly group meetings; written stories and audiotapes; or no further discussion. Data collection was repeated six months after the intervention.Data was analyzed using descriptive nonparametric, and parametric statistics. For this study, three new instruments were developed and tested. Validity and reliability were documented, and the majority of nurse managers agreed that the methodology was beneficial. The Level of Practice Rating Form may be of value to nurse managers to get feedback regarding a nurse's practice. The researchers found the Exemplar Rating Form to be helpful in focusing their thoughts regarding level of practice and documenting their findings. The storytelling questionnaire provided useful feedback regarding the effects that participating in the study had on the subjects.The level of burnout was not significantly different pre- and post-intervention (p > .05). An increase in the level of practice rating did occur in 82% of the subjects; however, neither this nor the level of practice, based upon the subjects' stories, were found to be related to group or treatment facility (p > .05, p > .61, respectively). However, the qualitative analysis did demonstrate that a significant number of subjects found that the reflection and/or sharing that occurred due to the study intervention had the following positive effects: a) enhanced career/job satisfaction, b) personal and professional growth, and c) helped nurses feel connected to other nurses. Six subjects specifically noted that they had a reduction in their level of stress by sharing stories.In summary, the process and findings of this study enhanced better understanding of what constitutes typical military nursing practice at each level (i.e., advanced beginner, competent, proficient, expert). The insights and information gained from this study would be very useful to supervisors and preceptors in the military nursing field.