(p. 81) Managing ICU staff welfare, morale, and burnout 

Low morale, stress, and burnout are significant and under-recognized in critical care staff. The link between these conditions is complex and not fully only understood with burnout as a potential end result. Conflict and lack of clear protocols regarding end-of-life care appear to be particularly prone to generate stress and potentially burnout. We have little scientific basis to design interventions, but expert opinion suggests multiple approaches at individual, departmental, and organizational levels. Many are based on giving workers a degree of control and flexibility where possible, and a feeling that their contribution is valuable and valued. Engagement (with an organization and its aims) is now viewed as the antithesis of burnout and only staff who are engaged can deliver high quality care. It is increasingly recognized that organizations that actively manage staff welfare are more likely to provide care that is safe, effective, and patient-centred, and less likely to error and adverse events.