Professional Fulfillment, Burnout, and Turnover Intention Among US Dialysis Patient Care Technicians: A National Survey

Rationale & Objective: High professional fulfillment and low burnout and staff turnover are necessary for a stable dialysis workforce. We explored professional fulfillment, burnout, and turnover intention among US dialysis patient care technicians (PCTs). Study Design: Cross-sectional national survey. Setting & Participants: National Association of Nephrology Technicians/Technologists (NANT) members in March-May 2022 (N = 228; 42.6% aged 35-49 years, 83.9% female, 64.6% White, 85.3% non-Hispanic). Exposure: Likert-scale items (range, 0-4) related to professional fulfillment and 2 domains of burnout (work exhaustion and interpersonal disengagement) and dichotomous items related to turnover intention. Analytical Approach: Summary statistics (percentages, means, medians) were calculated for individual items and average domain scores. Burnout was defined by combined work exhaustion and interpersonal disengagement scores of ≥1.3 and professional fulfillment by a score ≥3.0. Results: Most respondents (72.8%) worked ≥40 hours per week. Overall scores for work exhaustion, interpersonal disengagement, and professional fulfillment (median [IQR]) were 2.3 (1.3-3.0), 1.0 (0.3-1.8), and 2.6 (2.0-3.2), respectively; 57.5% reported burnout, and 37.3% reported professional fulfillment. Important contributors to burnout and professional fulfillment included salary (66.5%), supervisor support (64.0%), respect from other dialysis staff (57.8%), sense of purpose about work (54.5%), and hours worked per week (52.9%). Only 52.6% reported that they plan to be working as a dialysis PCT in 3 years. Free text responses reinforced perceived excessive work burden and lack of respect. Limitations: Limited generalizability to all US dialysis PCTs. Conclusions: More than half of dialysis PCTs reported burnout, driven by work exhaustion; only about one-third reported professional fulfillment. Even among this relatively engaged group of dialysis PCTs, only half intended to continue working as PCTs. Because of the critical, frontline role of dialysis PCTs in the care of patient receiving in-center hemodialysis, strategies to improve morale and reduce turnover are imperative.