Amy Witkoski Stimpfel


Amy Witkoski Stimpfel Headshot

Amy Witkoski Stimpfel


Assistant Professor

1 212 992 9387
Accepting PhD students

Amy Witkoski Stimpfel's additional information

Amy Witkoski Stimpfel is an assistant professor at NYU Rory Meyers College of Nursing and the Program Director of the doctoral training program in occupational and environmental health nursing, part of the NY/NJ ERC, funded by the National Institute for Occupational Safety and Health (NIOSH) (T42-OH-008422). Broadly, her research expertise centers on how to optimize nurses’ work environments to improve nurse well-being and clinical outcomes. Specifically, her program of research seeks to identify how the organization of work related to shift work, scheduling, and sleep influences nurses’ health and well-being, patient safety, and organizational outcomes. Her scholarship is rooted in theories and methods used in health services research, occupational health and safety, sleep/circadian science, and nursing. Dr. Witkoski Stimpfel’s research has been funded by the American Nurses Foundation, the National Council of State Boards of Nursing, and others and published in leading interprofessional journals such as Health Affairs, Health Services Research, and The International Journal of Nursing Studies. Prior to joining the Meyers faculty, Dr. Witkoski Stimpfel completed a post-doctoral fellowship at the University of Pennsylvania in the Center for Health Outcomes and Policy Research. Dr. Witkoski Stimpfel earned a PhD and MS at the University of Pennsylvania and a BSN, cum laude, from Villanova University.

PhD - University of Pennsylvania (2011)
MS - University of Pennsylvania (2009)
BSN - Villanova University (Cum Laude, 2006)

Nursing workforce
Health Services Research

American Association of Occupational Health Nurses
American Nurses Association
Eastern Nursing Research Society
Sigma Theta Tau International
Sleep Research Society

Faculty Honors Awards

Excellence in Nursing Research Award (2022)
Connelly-Delouvrier Scholarship for International Nursing in Ireland
At-large member, Advisory Committee of the Interdisciplinary Research Group on Nursing Issues (IRGNI)
Inducted into Sigma Theta Tau International Honor Society
T01 Pre-doctoral fellowship, National Institute for Occupational Safety and Health
T32 Post-doctoral fellowship, National Institute of Nursing Research


Nurses, Psychological Distress, and Burnout: Is There an App for That?

Murali, K. P., Brody, A. A., & Stimpfel, A. W. (2023). Annals of the American Thoracic Society, 20(10), 1404-1405. 10.1513/AnnalsATS.202307-629ED

Psychosocial Factors Associated With Alcohol Use Among Nurses: An Integrative Review

Mercer, M., Stimpfel, A. W., & Dickson, V. V. (2023). Journal of Nursing Regulation, 13(4), 5-20. 10.1016/S2155-8256(23)00032-7
Background: Understanding alcohol use among nurses may inform interventions related to the coping mechanisms nurses use for workplace stress and trauma. Alcohol use can be caused by a variety of factors and has serious implications on a nurse's personal health and professional practice. Understanding psychosocial factors and preventive measures may assist in the development of interventions to improve coping mechanisms and reduce the incidence of alcohol misuse. Purpose: To review the psychosocial factors and preventive measures associated with alcohol use among nurses. Methods: For this integrative review, systematic searches were conducted in CINAHL, PubMed, PsychNet, and ProQuest Central. Included studies were peer-reviewed and addressed alcohol use among nurses in the United States. Articles were appraised using methods-specific tools indicated by the Whittemore and Knafl framework. Data were extracted and themes identified using constant comparison. Results: Of 6,214 nonduplicate articles screened, 78 were selected for full-text review and 13 were included after application of inclusion criteria. Synthesis resulted in four themes: (1) occupational stress and trauma, (2) workplace characteristics, (3) mental health implications, and (4) protective factors. The data show that workplace stress and trauma contribute to alcohol use among nurses. Night shifts, rotating shifts, and shift length are factors related to alcohol use, as are mental health problems such as anxiety, depression, trauma, and suicide. Protective factors that reduce alcohol use among nurses include faith, resilience, and perceived organizational support. Conclusion: Alcohol use among nurses presents challenges for the nursing profession and regulatory bodies with specific and interrelated phenomena related to the role and identity of nurses. A better understanding of these factors through research will facilitate a healthier nursing workforce that is better prepared to take on the rewards and challenges of a nursing career.

Dimensions of Being a Midwife and Midwifery Practice in the United States: A Qualitative Analysis

Thumm, E. B., Stimpfel, A. W., & Squires, A. (2022). International Journal of Childbirth, 12(2), 84-99. 10.1891/IJC-2021-0025
BACKGROUND: Midwives are a vital component of addressing maternal mortality crisis in the United States (US); however, there is scant understanding of the elements of midwifery practice that affect patient outcomes and the stability of the midwifery workforce in the country. This study investigates US midwives’ perceptions of factors influencing their practice and willingness to stay in the profession. METHODS: We applied a pragmatic qualitative design using summative content analysis techniques to code 1,035 comments from a national sample of 2,887 certified nurse-midwives and certified midwives. Two coders identified categories and themes of midwives’ perceptions of their practice environments, which were confirmed by an independent auditor. RESULTS: Eight themes emerged from the data: I love midwifery but…; feeling valued and respected…or not; workload; time and its consequences; the multilevel geography of midwifery practice; changes at odds with quality midwifery care; midwives withdrawing from practice to cope; and the ambiguity of “I just want to practice like a midwife.” CONCLUSION: Midwives readily identified aspects of their practice environment that negatively impact quality of care and stability of the midwifery workforce, including not valuing midwives, high workload, regulatory restrictions, and moral distress; however, respondents expressed strong commitment to the profession of midwifery. The findings also demonstrated the lack of a universally accepted definition of midwifery care within respondents’ professional communities and among respondents. Initiatives to increase integration of midwifery into the US perinatal health system will benefit from taking these findings into consideration.

Individual and Work Factors Associated with Psychosocial Health of Registered Nurses During the Covid-19 Pandemic: A Mixed Methods Study

Witkoski Stimpfel, A., Ghazal, L., Goldsamt, L., & Vaughan Dickson, V. (2022). Journal of Occupational and Environmental Medicine, 64(6), 515-524. 10.1097/JOM.0000000000002495
Objective To describe the initial influence of the Covid-19 pandemic on U.S. nurses' psychosocial health, and to identify factors associated with poor psychosocial health outcomes. Methods We conducted a convergent (QUAN+qual) mixed methods study. From June to August 2020, we administered surveys (N = 629) and conducted semi-structured interviews (N = 34) among nurses working across healthcare settings in 18 states. We developed separate multivariable logistic regression models for three psychosocial outcomes (anxiety, depressive symptoms, insomnia). We used content analysis to process and analyze qualitative data, and integrated results in the final analysis step. Results Nurses reported high rates of depressive symptoms (22%), anxiety (52%), and insomnia (55%). Disturbances to sleep were both a contributing factor to, and an outcome of, poor psychosocial health. Conclusions Evidence-based interventions addressing work stress and sleep, and proactive monitoring of nurses' psychosocial health by employers are urgently needed.

The intellectual capital supporting nurse practice in a post-emergency state: A case study

Ridge, L. J., Liebermann, E. J., Stimpfel, A. W., Klar, R. T., Dickson, V. V., & Squires, A. P. (2022). Journal of Advanced Nursing, 78(9), 3000-3011. 10.1111/jan.15282
Aim: To explore the resources supporting current nurse practice in the post-emergency country of Liberia, using the nursing intellectual capital framework, as nurses work to meet the targets set by Government of Liberia's Essential Package of Health Services. Design: Case study. Methods: Data were collected in Liberia February–June 2019. Direct observation, semi-structured interviews and photographs were used to investigate how nurse practice is supported. Field notes, transcripts and photographs were coded using both directed and conventional content analysis. Reports were then generated by code to triangulate the data. Results: Thirty-seven nurses at 12 health facilities participated. The intellectual capital supporting inpatient and outpatient nurse practice differs in important ways. Inpatient nurse practice is more likely to be supported by facility-based protocols and trainings, whereas outpatient nurse practice is more likely to be supported by external protocols and trainings, often developed by the Liberian government or non-governmental organizations. This can lead to uneven provision of inpatient protocols and trainings, often favouring private facilities. Similarly, inpatient nurses rely primarily on other nurses at their facilities for clinical support while outpatient nurses often have external professional relationships that provided them with clinical guidance. Conclusion: Much has been accomplished to enable outpatient nurses to provide the primary- and secondary-care target services in the Essential Package of Health Services. However, as the Liberian government and its partners continue to work towards providing certain tertiary care services, developing analogous protocols, trainings and clinical mentorship networks for inpatient nurses will likely be fruitful, and will decrease the burden on individual facilities. Impact: Nurses are often expected to meet new service provision targets in post-emergency states. Further research into how best to support nurses as they work to meet those targets has the potential to strengthen health systems.

Original Research: Losing the Art and Failing the Science of Nursing: The Experiences of Nurses Working during the COVID-19 Pandemic

Stimpfel, A. W., Ghazal, L., Goldsamt, L. A., Zhanay, J., & Dickson, V. V. (2022). American Journal of Nursing, 122(4), 22-29. 10.1097/01.NAJ.0000827324.34143.7a
Purpose:RNs have served as the bedrock of the response to the COVID-19 pandemic, working under unprecedented and difficult conditions. In this study, we sought to understand the experiences of nurses working across a range of care settings in the United States during the first six months of the pandemic, and to learn more about barriers to and facilitators of their work.Methods:This is a qualitative descriptive study. We recruited participants online through regional professional nursing membership listservs, program directors of occupational health nursing training programs, and social media. After completing a survey, potential participants were invited to complete an individual semistructured interview via the Zoom platform. From June through August 2020, we conducted 34 interviews. Content analysis was performed using ATLAS.ti software.Results:The overarching theme - "Losing the art and failing the science of nursing" - underscored the barriers nurses faced in the early months of this pandemic. It reflected the deeply painful disruptions in the care nurses were accustomed to providing their patients. Themes that reflected barriers included disrupted nurse-patient connection, lack of personal protective equipment and fear of infection, lack of evidence-based guidance, and understaffing, all of which drastically altered the delivery of nursing care. Themes that reflected facilitators to nurses' work included camaraderie and strength and resourcefulness.Conclusions:The study findings give important direction to nurse leaders, researchers, and organizations concerning potential areas of support that nurses need during and after this pandemic. Future research should investigate the long-term impact of COVID-19 and similar public health crises on nurses, as well as interventions that could support the workforce after an extended crisis.

A Pilot Observational Exploratory Study of Well-Being in Hospice Interdisciplinary Team Members

Schneider, C., Bristol, A., Ford, A., Lin, S. Y., Brody, A. A., & Stimpfel, A. W. (2022). American Journal of Hospice and Palliative Medicine, 39(3), 264-269. 10.1177/10499091211023480
Introduction: Well-being and turnover intent represent key aspects to the promotion of a healthy workforce. Alarming levels of burnout and low levels of well-being have been documented in health professionals across care settings. Not only do high levels of burnout, low well-being and high turnover affect health professionals, but they are associated with poor patient care. However, limited research has investigated this topic specifically in hospice interdisciplinary team (IDT) members, nurses, chaplains, social workers. Thus, the purpose of this study was to explore hospice IDT members’ well-being, and turnover intent. Methods: This observational, pilot study used quantitative surveys to examine the well-being, and turnover intention at baseline and at 3 months. Twenty-five hospice IDT members at one site participated. Results: Paired t-tests and percent change demonstrated significant decreases in compassion satisfaction (44.5 vs. 42.1, p = 0.04) and secondary traumatic stress score (18.5 vs. 13.3, p = 0.0001) and a significant increase in burnout score (17.6 vs. 20.5, p = 0.03) from baseline to follow up. Employee turnover slightly decreased from baseline to follow-up. Conclusions: In this pilot study, hospice IDT members had low levels of well-being at baseline that worsened over 3-months indicating a higher potential risk for burnout. Moreover, given the COVID-19 pandemic, this may be an ominous sign of what lies ahead for hospice providers regarding turnover, leading to significant long-term staffing problems in the field. If these results hold true in a larger sample, it could necessitate developing and testing further strategies to ensure a healthy and stable workforce.

Vaccine hesitancy in American healthcare workers during the COVID-19 vaccine roll out: an integrative review

Caiazzo, V., & Witkoski Stimpfel, A. (2022). Public Health, 207, 94-104. 10.1016/j.puhe.2022.03.017
Objective: The purpose of this integrative review is to examine the literature on vaccine hesitancy among American healthcare workers during the COVID-19 vaccine rollout. Methods: A review of quantitative literature on acceptance, intention, refusal, or hesitation to accept the COVID-19 vaccine was conducted, searching in PubMed, Cumulative Index for Nursing and Allied Health Literature, PsycINFO, and Web of Science. Because of the immediacy of the topic, research letters were included in addition to articles. The 18 publications were appraised for quality using the Critical Appraisal Checklist for Cross-Sectional Studies by the Center for Evidence-Based Management. Results: Estimates of vaccine hesitancy among healthcare workers were similar to the general population. The literature indicates demographic characteristics associated with vaccine hesitancy, including being younger, female, Black, Hispanic, or Latinx. However, examination of the demographic data also points to gaps in the understanding and implications of those characteristics. The newness or perceived rush of vaccine development and implementation were the most cited sources for hesitancy. Conclusion: The studies in this review give clear areas of need for translational research on dissemination and implementation relating to the correlational data, including in areas of comorbid, diasporic, and reproductive health concerns. However, with the gravity of the pandemic and quick arrival of the COVID-19 vaccine happening in the midst of an infodemic, adjunctive interventions could be warranted to combat hesitancy.

Work Organization Factors Associated With Nurses’ Stress, Sleep, and Performance: A Pre-pandemic Analysis

Stimpfel, A. W., Goldsamt, L., Liang, E., & Costa, D. K. (2022). Journal of Nursing Regulation, 13(3), 4-12. 10.1016/S2155-8256(22)00085-0
Background: The COVID-19 pandemic put extreme stress on an already strained healthcare workforce. Suboptimal work organization, exacerbated by the pandemic, is associated with poor worker, patient, and organizational outcomes. However, there are limited qualitative studies exploring how the interconnections of work organization factors related to shift work, sleep, and work stress influence registered nurses and their work performance in the United States. Purpose: We sought to understand how nurses perceive work organization factors that impact their performance. Knowledge in this area could direct efforts to implement policies and design tailored interventions to support nurses in the post-pandemic period. Methods: We used a qualitative descriptive design with the Work, Stress, and Health framework as an overarching guide to understand the interconnectedness of work organization factors, work stress, and outcomes. Participants were randomly assigned to one of two anonymous, asynchronous virtual focus groups (i.e., threaded discussion boards) in 2019. Registered nurses (N = 23) working across the United States were recruited and engaged until data saturation was achieved. Directed content analysis was used to analyze the data. Results: Findings aligned with the Work, Stress, and Health framework and revealed three themes: (1) “Our Voice Should Matter” (nurses’ desire to have their voices heard in staffing policies); (2) “Tired But Wired” (the harmful cycle of work stress, rumination, and poor sleep); and (3) “We're Only Human” (nurses’ physical, emotional, and mental exhaustion linked to critical performance impairments). Conclusion: These findings underscore that high work stress and poor sleep were present before the pandemic and impacted nurses’ perceptions of their performance. As leaders look forward to recovery and work redesign efforts, these findings can guide decision-making and resource allocation for optimal nurse, patient, and organization outcomes.

How clinicians manage routinely low supplies of personal protective equipment

Ridge, L. J., Stimpfel, A. W., Dickson, V. V., Klar, R. T., & Squires, A. P. (2021). American Journal of Infection Control, 49(12), 1488-1492. 10.1016/j.ajic.2021.08.012
Background: Recommended personal protective equipment (PPE) is routinely limited or unavailable in low-income countries, but there is limited research as to how clinicians adapt to that scarcity, despite the implications for patients and workers. Methods: This is a qualitative secondary analysis of case study data collected in Liberia in 2019. Data from the parent study were included in this analysis if it addressed availability and use of PPE in the clinical setting. Conventional content analysis was used on data including: field notes documenting nurse practice, semi-structured interview transcripts, and photographs. Results: Data from the majority of participants (32/37) and all facilities (12/12) in the parent studies were included. Eighty-three percent of facilities reported limited PPE. Five management strategies for coping with limited PPE supplies were observed, reported, or both: rationing PPE, self-purchasing PPE, asking patients to purchase PPE, substituting PPE, and working without PPE. Approaches to rationing PPE included using PPE only for symptomatic patients or not performing physical exams. Substitutions for PPE were based on supply availability. Conclusions: Strategies developed by clinicians to manage low PPE likely have negative consequences for both workers and patients; further research into the topic is important, as is better PPE provision in low-income countries.