Several factors lead to stress for ICU nurses, including high patient mortality and morbidity and ethical dilemmas. A pilot study in the November issue of the American Journal of Critical Care is demonstrating how a targeted program can foster coping mechanisms for stressful work environments and alleviate anxiety and depression among critical care nurses, according to a news release.
Feasibility and Acceptability of a Resilience Training Program for Intensive Care Unit Nurses documented several strategies important for successfully coping with the constant pressure in CCUs, which can contribute to nurses experiencing an increased prevalence of anxiety, depression, burnout syndrome and post-traumatic stress disorder, according to the release. The pressure also affects retention rates for CCUs, where the annual turnover rate is estimated to be between 25% and 60%.
Helping nurses develop stronger coping strategies may help reduce the high rate of turnover within the ICU, said lead author Meredith Mealer, PhD, assistant professor at the University of Colorado Anschutz Medical Center, Aurora, in the release. Resilience can be strengthened and taught, and this study is an initial step to learn how to structure training programs.
Nurses who develop healthy coping strategies to build resilience are able to adapt to stressful work experiences in a positive manner.
The study examined a multifaceted resilience training program that incorporated coping mechanisms, such as mindfulness-based stress-reduction techniques, cognitive behavioral therapy sessions, expressive writing and regular exercise over a 12-week period.
During weekly sessions, participants wrote about topics such as challenges faced at work and received feedback from expressive writing experts. These sessions identified four overarching themes:
Patient-centric, such as death and dying, justice and interactions with patients and families
Cognitive processing, such as rumination, guilt and regret
Work structure, including understaffing and cumulative stress
Workplace relationships, such as conflict with peers and personal and professional boundaries
Each participant also was asked to attend cognitive behavioral therapy sessions with a licensed counselor after a triggering event, such as a patient death, caring for patients with traumatic injuries or participating in end-of-life discussions with family members. The sessions focused on challenging negative thoughts and promoting resilience through cognitive flexibility and restructuring.
To access the study abstract and its full-text PDF, visit the AJCC website at http://www.ajcconline.org.