Burnout is a pervasive problem among healthcare professionals, including nurses. However, palliative care clinicians appear to be at less risk of burnout than other clinicians. Research into the effect of providing both primary palliative care and oncology care on nurse burnout is lacking.

Therefore, a team of researchers performed a secondary analysis of the Care Management by Oncology Nurses to Address Supportive Care Needs (CONNECT) study to learn whether providing primary palliative care in addition to oncology care would reduce the burnout experienced by nurses over time. Their findings were published in the Clinical Journal of Oncology Nursing.

The CONNECT study was a cluster randomized trial of a primary palliative care intervention for patients with advanced cancer that included 17 oncology practices, of which 9 practices selected some nurses to implement the palliative care intervention and 8 practices provided standard care only. The nurses were categorized into 3 groups:

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  • Nurses who provided primary palliative care through the CONNECT intervention,
  • Nurses who worked at the sites providing palliative care but did not implement the intervention,
  • Nurses who worked at standard care only sites.

Data was collected at study enrollment and at the 1-year mark using the 22-item Maslach Burnout Inventory (MBI) to assess burnout among the 3 groups of nurses. The MBI survey was completed by 89 nurses at baseline, and by 57 nurses at the 1-year follow-up.

Mean baseline score for emotional exhaustion was 17 (SD, 12) for all nurses. “Overall, these groups of nurses did not appear to experience high levels of burnout,” the researchers reported.

No significant differences were observed between baseline burnout scores of nurses who completed the 1-year follow-up survey compared with those who did not. Additionally, no significant decreases in burnout scores were observed after the intervention had been implemented for 1 year.

The researchers had hypothesized that the training the intervention nurses received might be protective against burnout. The CONNECT protocol focused on communications, and encouraged nurses to interact with patients in response to their distress. It also provided opportunities for nurses to come together to debrief and receive additional coaching.

However, implementing the CONNECT protocol intervention in addition to their typical duties may have offset any benefit to those nurses. Yet, emotional exhaustion was significantly higher among the nurses at the CONNECT sites who did not implement the intervention compared with nurses at the sites providing standard care only.

Although these results suggest that providing primary palliative care in addition to oncology care does not seem to affect burnout, the researchers suggest that clinical practice models should make sure to prioritize the well-being of the nurses.

Study limitations include a small sample size with a lack of diversity; plus it was a secondary analysis that did not allow for inferences of causality. Additionally, fewer nurses completed the survey at the 1-year mark than at baseline.

Disclosures: Some authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.


Cohen JB, Reiser VL, Althouse AD, et al. Burnout among oncology nurses: the effects of providing a primary palliative care intervention using CONNECT protocolClin J Oncol Nurs. 2022;26(4):391-398. doi:10.1188/22.CJON.391-398