Exploring why healthcare workers have moved from motivation to burnout through qualitative research in healthcare

This qualitative study adopts a Constructivist Grounded Theory approach to explore the transition from motivation to burnout among healthcare professionals in Malta. Drawing upon 27 in-depth interviews with nurses and other healthcare workers from various hospital departments, the study generated a theory grounded in participants’ lived experiences. The analysis revealed a gradual process through which motivation diminishes under persistent organisational strain, leading to burnout and, ultimately, resignation. Three themes emerged: the foundation of motivation, the erosion of support and recognition, and the escalation towards burnout and resignation.

Participants initially expressed strong intrinsic motivation, rooted in compassion, empathy, and professional pride. Many regarded their profession as a vocation rather than merely a job, deriving fulfilment from patient recovery, teamwork, and emotional connection. However, this motivation declined over time as participants encountered increasing workloads, staff shortages, and inadequate managerial support. They felt that management prioritised efficiency over emotional well-being, leaving them undervalued and unheard. The absence of meaningful recognition and open communication fostered frustration and disengagement.

The final theme, the escalation towards burnout and resignation, reflected symptoms consistent with Christina Maslach’s dimensions of burnout—emotional exhaustion, depersonalisation, and reduced personal accomplishment. Participants described feeling emotionally drained and detached, with some adopting emotional withdrawal as a coping mechanism. Crucially, burnout often preceded resignation, suggesting that departures were the result of prolonged neglect rather than sudden dissatisfaction.

Several participants observed that exit interviews rarely reveal the true causes of resignation, as these occur too late in the process. They stressed the need for management to identify and address early indicators of burnout—such as absenteeism, declining morale, and emotional withdrawal—before employees decide to leave. The findings highlight that burnout and resignation are interconnected outcomes of organisational neglect, reinforcing the need for proactive leadership, regular support, and genuine recognition to sustain motivation and improve staff retention.