The nursing profession can be challenging. According to the journal Chinese Nursing Research, many nurses report stress from situations such as work overload, role conflicts, experiences of aggression, lack of time, staffing issues, shift work, lack of self-care, and poor job-related interpersonal relationships. They also reported feeling powerless to provide quality care and struggling with competing demands. Difficulties ensuring excellent patient care, uncertainty concerning treatment, death and dying, conflict with doctors, peers and supervisors, and inadequate emotional preparation were issues as well.
These factors can lead to a host of physical and mental problems among nurses, including fatigue, irritability, lack of concentration, unhappiness, depressive sensation, depersonalization, and emotional exhaustion. These types of problems, states Chinese Nursing Research, “not only have an impact on nurses’ wellness but also their care-giving to patients.”
The cure lies, at least in part, in a characteristic called resilience. This quality can be defined as “the skill to overcome/become adapted to highly difficult circumstances.” Resilient nurses are better able to avoid burnout and they perform better on a day-to-day basis. Those who lack resilience are more likely to develop personal coping problems, and their professional effectiveness may suffer as well.
Although some people are naturally more resilient than others, research suggests that resilience is a learnable trait—so much so that today, many nursing programs are incorporating nurse resilience training into their curricula. Developing these programs, along with fostering a positive work environment, generally falls to nurse educators. The knowledge and background to deliver such training can be obtained through programs such as Duquesne University’s Online MSN in Nursing Education and Faculty Role. Also offering Post-Master’s Certificate programs to meet the needs of all healthcare providers, Duquesne’s online master’s in nursing can prepare nurse educators to boost their own resilience and lead others to do the same.
The Resilient Nurse
What are the characteristics of a resilient nurse? A recent study attempted to answer that question by surveying nurses high in resilience and contrasting them with nurses with post-traumatic stress disorder. The study found differences in four key areas:
- Social network
- Cognitive flexibility
Highly resilient nurses reported that they were able to cope with work stress through their spirituality, supportive social networks, optimism, and resilient role models. The nurses with PTSD, on the other hand, reported having a poor social network, lack of identification with a role model, disruptive thoughts, regret, and lost optimism.
“The highly resilient nurses had so many more positive coping skills to draw from,” says Meredith Mealer, RN, PhD. “In the group with poor resilience, on the other hand, there tended to be negative coping skills, such as worrying excessively and taking sleeping medications or drinking alcohol.”
Types of Resilience Training
The good news, according to Mealer, is that resilience can be learned. Many types of nurse resilience training are available, each with a different underlying theory. Although there is not yet any definitive data on which approach works best, the most popular types include:
- Cognitive-behavioral. From this perspective, stress-related mental dysfunctions such as depression, anxiety disorder, and substance abuse can be considered a result of dysfunctional thinking. Cognitive-behavioral interventions challenge the nurse’s unhelpful thoughts and teach new, healthier strategies for dealing with difficult situations.
- Stress inoculation therapy. This type of training exposes nurses to milder forms of stress. This may strengthen coping strategies and the individual’s confidence in tackling more challenging situations.
- Acceptance and commitment therapy. This intervention is based on the idea that people have trouble changing their outlook or behavior as needed to cope with changing circumstances. In acceptance and commitment therapy, nurses learn to be more mindful during challenging situations and more open to “going with the flow.” This approach may result in better resilience.
- Mindfulness-based therapy. Mindfulness is characterized by the non‐judging awareness of the present moment and its accompanying mental phenomena (such as body sensations, perceptions, thoughts, and emotions). Practitioners who learn to accept whatever occurs in the present moment are thought to adapt more efficiently to stress.
- Problem solving. Effective problem-solving skills can reduce the stress of difficult moments. Skills taught include analyzing the problem and setting goals, generating possible solutions, choosing the best solution and creating an action plan, implementing the solution, and reviewing the problem‐solving proces
Designing the Program
Whatever approach they choose, experienced nurse educators have discovered some factors that contribute to a resilience training program’s success or failure. Barriers to success include:
- Session timing, with some nurses preferring to attend programs on their days off work and others preferring to attend during or immediately after work hours
- Lengthy homework assignments
- Travel distance, particularly in urban areas where traffic and parking are difficult
Approaches that increase adherence include:
- A hybrid model, with a combination of online and face-to-face sessions
- Short exercises rather than long ones, particularly if they can be done during work hours
- Consistency of instruction, with one person—preferably a nurse rather than a doctor—presenting the majority of the material
- Creativity in teaching approach
Nurse educators should poll enrollees about their preferences in these areas rather than taking a one-size-fits-all approach. With flexibility and forethought, they will be able to design a program that meets everyone’s needs and maximizes results.
About Duquesne University’s Online MSN in Nursing Education and Faculty Role
As a leader in online nursing education, Duquesne University has helped RNs learn skills, strategies, and evidence-based practices to become leaders in their field. Coursework is presented entirely online, so students can maintain their careers and personal lives while pursuing their education goals. When pondering the question of why get a master’s in nursing, this convenience factor can be a powerful draw. Graduates can be prepared to successfully complete the American Academy of Nurse Practitioners Certification Board (AANPCP) and American Nurses Credentialing Center (ANCC) Family Nurse Practitioner certification examinations.
For more information, contact Duquesne University today.
Sources of stress in nursing – Chinese Nursing Research
Resilience definition – Chinese Nursing Research
Characteristics of resilient nurses – Cochrane Review
Types of resilience training – Cochrane Review
Designing the program – Cochrane Review