By Karen Schmidt, RN
Estelle Codier, PhD, MSN, RN, an associate professor at the University of Hawaii, Manoa, researches professional wellness and emotional intelligence. And that research has led her to conclude the reason some nurses thrive and others burn out is that those with emotional intelligence abilities are able to manage their professional wellness.
A large body of evidence, both in nursing and the broader workforce literature, she said, shows that EI abilities "correlate significantly with leadership performance, including fiscal performance, customer satisfaction, clinical nurse performance and retention and both stress perception and other wellness metrics."
Codier added that nurses cannot be professionally healthy while being personally unhealthy, or vice versa. "We do not surgically split ourselves into personal and professional and leave the appropriate half in our locker on arriving at or leaving work," she said. "I have come to believe that this myth is one causative factor in burnout." Codier also said that when nurses burn out, their performance is affected. "They start insulating themselves as a protective mechanism," she said, "and subtle patient care cues are unobserved."
Enhancing communication
Research is being done to help nurses with their professional wellness. Joy Goldsmith, PhD, assistant professor in the department of communication at University of Memphis, said she believes "[nurses] need a lot of support and tools for managing communication as a team. [They] lack training in communication, which allows them to examine structures and processes where they work."
Goldsmith and two colleagues studied how support groups could benefit nurses needing relief from the stress and tension of their work. The study, published in 2014, revealed oncology nurses who participated in a support group experienced "a reduction in end-of-life care stress, an increase in self-care and improved patient and team care." The study showed that "peer support groups for oncology nurses seem a promising and economical communication intervention for mitigating burnout, professional dissatisfaction, patient care distress, and interprofessional communication deficits."
Goldsmith said the support group, where nurses could interact about a difficult situation or challenging patient while enjoying an activity (yoga, cooking, art), was effective because it was on-the-clock time, protected by the organization.
A big part of communication training is mindfulness training, a piece of the self-care movement," she said. "The idea is that nurses don't have to fix everything, they don't have to take patient cares home. They can learn to be fully present, to deeply listen and not to feel that they have to work everything out for their patients."
Aromatherapy
Aromatherapy is also being tested as a self-care strategy. Kirsten Roblee, BSN, RN, OCN, and colleagues discovered positive outcomes when they studied the diffusion of essential oils on their acute leukemia unit/PCU at The Ohio State University Comprehensive Cancer Center.
Roblee said tension, worry and demands, three of the four measured subscales, showed significant improvement. "It just opened up a whole new world of people taking care of themselves and us being able to take care of our colleagues," Roblee said.
Curriculum
Learning how to care for oneself typically has not been part of nursing school curricula. Codier said certifying agencies are beginning to take steps in this direction. At Capital University in Columbus, Ohio, self-care content, which is threaded through the four-year BSN program, was added when the university applied for endorsement by the American Holistic Nurses Association, said David Shields, MSN, RN, AHN-BC, QTTT, assistant professor in the university's department of nursing.
The content teaches nurses how to assess their self-care needs and modify their behaviors, both while in school and in their future professional lives.
First year out
Shields said literature describes nurses' high stress in the first year after graduation. "If you're able to manage your stress and take care of yourself, if you take time to do things other than your work to help regenerate yourself, nurses are probably not going to burn out after the first year, not even after 20 years," he said.
Codier is adamant that nurses must be held accountable for developing emotional intelligence abilities, and suggests peer coaching is a process that offers simple accountability.
"We think of professional wellness as icing on cake for nurses," she said, "but consequences for patients are huge."
Karen Schmidt, RN, is a freelance writer.
