Burnout, Workplace Factors, and Retention Indicators Among Nurses in a Rural District Hospital in the Eastern Cape, South Africa

Résumé

Background Burnout-related symptoms among nurses are a growing concern globally and may affect workforce well-being, patient care, and health system performance. In resource-constrained rural stableettings, heavy workloads, staffing shortages, and limited organisational support may increase nurses’ vulnerability to burnout-related symptoms. Evidence from rural district hospitals in South Africa remains limited. Objective To examine burnout-related symptoms, workplace and organisational factors, and nursing workforce retention indicators among nurses at St Elizabeth Hospital in the Eastern Cape Province, South Africa. Methods A quantitative cross-sectional study was conducted among 210 nurses working in selected clinical departments at St Elizabeth Hospital. Participants were selected using stratified random sampling from an eligible population of 362 nurses. Data were collected using a structured self-administered questionnaire incorporating the Burnout Assessment Tool (BAT-12), selected Maslach Burnout Inventory personal accomplishment items, and workplace-related measures informed by the Job Demands–Resources (JD–R) model. In addition, aggregate nursing workforce and retention indicators were collected from Human Resources records using a structured data extraction tool. Descriptive statistical methods were used to summarise survey data, while Human Resources data were analysed separately. Results High frequencies of burnout-related symptoms were reported, particularly exhaustion. Mental exhaustion was reported often or always by 71.0% of participants, difficulty recovering energy after work by 71.9%, and physical exhaustion by 72.4%. Heavy workload (78.6%), inadequate staffing (68.6%), regular overtime (68.1%), inadequate equipment (67.1%), and limited access to wellness services (48.6%) were common workplace challenges. Human Resources records indicated a 12-month nursing workforce retention rate of 90,49% and a turnover rate of 9,51%. Conclusions Burnout-related symptoms were common among nurses in this rural Eastern Cape district hospital, driven by high workplace demands and limited resources. Organisational improvements, such as better staffing, stronger workplace support, and access to wellness services, could improve nurse well-being and workforce sustainability. The study also highlights the need for longitudinal research on burnout and staff retention while contributing context-specific evidence from an under-researched rural South African setting.

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