The term "burnout" represents a significant perspective on how people respond to their work, but the attention paid to this phenomenon has largely been clinical and often anecdotal. In this article, the authors seek to expand the analysis of burnout in ways that permit comparative analysis, especially in large populations. This study specifically addresses three questions. First, does a paper-and-pencil instrument isolate domains of burnout that are relatively consistent between people-intensive work and the broader range of activities found in a commercial enterprise? Second, can we develop phases of progressive burnout? Third, can we test the efficacy of the burnout phases by searching for regularities in a panel of 22 variables commonly thought to tap the important facets of the work site? The author's analysis shows that we can answer these three central questions affirmatively, though occasionally with complex and potentially significant qualifications. The results of the analysis provide further evidence of the usefulness of a convenient instrument for measuring burnout and also suggest that behavioral scientists will find valuable a phase model that distinguishes regular and robust covariation by using a panel of variables thought to tap the important aspects of organizational life.

In 2003, The John A. Hartford Foundation Institute for Geriatric Nursing, New York University Division of Nursing, convened an expert panel to explore the potential for developing recommendations for the caseloads of advanced practice nurses (APNs) in nursing homes and to provide substantive and detailed strategies to strengthen the use of APNs in nursing homes. The panel, consisting of nationally recognized experts in geriatric practice, education, research, public policy, and long‐term care, developed six recommendations related to caseloads for APNs in nursing homes. The recommendations address educational preparation of APNs; average reimbursable APN visits per day; factors affecting APNs caseload parameters, including provider characteristics, practice models, resident acuity, and facility factors; changes in Medicare reimbursement to acknowledge nonbillable time spent in resident care; and technical assistance to promote a climate conducive to APN practice in nursing homes. Detailed research findings and clinical expertise underpin each recommendation. These recommendations provide practitioners, payers, regulators, and consumers with a rationale and details of current advanced practice nursing models and caseload parameters, preferred geriatric education, reimbursement strategies, and a range of technical assistance necessary to strengthen, enhance, and increase APNs' participation in the care of nursing home residents.