Emotional Resilience of Nurses and Effectiveness of Care Provided
1Assist Prof., Dept of Mental Health Nursing, College of Nursing, AFMC, Pune 40
2Prof & HOD, Dept of Mental Health Nursing, College of Nursing, AFMC, Pune 40
*Corresponding Author Email: radhikadas353@gmail.com
ABSTRACT:
Background: Its rarely ever that a person comes joyfully to a hospital and its the sad plight of the medical staff, to manage an individual who is unwell physically and maybe even mentally and emotionally. It requires yeoman efforts and immense physical and emotional resilience on the part of the care givers, to provide effective care to patients with a smile on your face. Nursing has been rated as one of the toughest professions to practise and resilience is a major determinant of the nurse’s wellbeing, having a major influence on the quality of care provided by them. Nurses in the Military perform their professional duties within the umbrella of the Armed Forces and face more complicated cases in patient care as well as professional challenges compared to their civil counterparts. Resilience is the capacity of the individual to recover quickly from difficulties. This quality equips the nurse to oversee the regular routine of disease and death among patients under her care and impart care, deemed effective by the patient. All nurses, especially those serving in Armed Forces have to be highly resilient to be able to provide effective care to patients under their care. Objective: Objective of the study was to assess the emotional resilience of the nurses and its correlation with effectiveness of care provided by nurses. Methods: A quantitative non experimental descriptive crosssectional study design was followed. 50 nurses and 100 patients cared by them were selected through non probability convenient sampling. Consent was taken and self administered structured questionnaire was administered, which were answered under supervision of researcher. The selected nurses answered the Resilience scale of 25 questions and the selected patients under the care of these nurses answered the Patient Satisfaction with Nursing Care Quality Questionnaire, which represented the Effectiveness of Care provided by the Nurses. Results: 43% of nurses showed Moderately High Resilience and 18 % and 10% showed High and Very High levels of Resilience. 56% patients reported good care, 42% reported that they were moderately satisfied with care and 2% reported receiving poor nursing care. Among the patients cared for by nurses with scores of moderately high resilience and more, 52% reported good care and 40 % were moderately satisfied with care. Conclusion: High level of resilience provides psychological empowerment and low job stress. Also predicts greater job satisfaction. Resilience of Nurses was positively related to Patient Satisfaction with Quality of Nursing care. Resilience is supportive factor helping nurses adapt to profession's difficult physical, mental and emotional nature thus contributing to organisational and patient well being.
KEYWORDS: Reslience, Emotional Resilience, Effective Care.
INTRODUCTION:
In today’s ever expanding world of technology and lifestyle changes, it has become imperative that we as humans adapt ourselves to make their best use. The changes have occurred not only in newer drugs being discovered, technology, and also in field of medicines. Newer machines have been introduced to diagnose and monitor patients, newer diseases have been discovered and newer modalities of treatment have become much more complicated. With everything now dependant on smart apps and gadgets there is decreasing human touch amongst each other. What enables survival in this fast changing world is ones resilience towards the challenges that they face. Resilience is defined as the process of adapting in the face of adversity, trauma, tragedy, threats of significant sources of stress1. Emotional Resilience is defined as one’s ability to adapt to stressful situations or crises. More resilient people are able to “roll with the punches” and adapt better to adversity. The dimensions of resilience which include self efficacy, self control, ability to engage support and help, learning from difficulties and persistence despite blocks to progress are all recognised as qualities that are important to clinical leaders2. A resilient nurse is one who is able to deliver effective care to her clients by balancing negative emotions, and gaining positive coping strategies. Resilient characteristics contribute to dealing with their depressive factors more efficiently, using problem solving skills, not losing control on events and adapting to depressive factors.3 To evaluate the effectiveness of care provided by Nurses, Inpatient satisfaction Index and Outpatient satisfaction Index can be considered as they are a part of the Key Performance Indicators (NABH) of a hospital4.
A military nurse faces more challenges as compared to their civil counterparts. Professional challenges include receiving complicated cases of battle wound casualty or a mine blast or gunshot injury at any given time of the day. Duty needs may require her to be working beyond her duty hours with no concept of an off or a break till the emergency seizes. A military Nurse may be away from family for prolonged period of time or may be posted to remote areas far away from her family and dear ones. Physical resilience and more importantly Emotional resilience is what can keep a Nurse in the Armed Forces going and making her a successful contributor to his/her nation.
RATIONALE OF THE STUDY:
Is to assess the emotional resilience of the nurses and the effectiveness of care provided by them in terms of patient satisfaction .
OBJECTIVES:
1.Asses the emotional resilience of the nurses of a selected hospital in an urban city. 2. To assess the patent satisfaction among the patients cared for by the selected nurses.
METHODS:
A tertiary care hospital in an urban area was selected and 50 nurses working in various fields of the hospital and two patients each cared for by these nurses were chosen for the study. A non experimental quantitative descriptive crosssectional research approach was adopted. Consent was taken and data was collected while the Nurses and patients were in the wards of the hospital. The nurses were administered with Resilience Scale – a self reported summated rating scale of 25 questions, patients were administered Patient Satisfaction with Nursing Care Quality Questionnaire (PSNCQQ) of 22 questions. Data collected was tabulated and analysed.
RESULTS:
Scoring on resilience scale revealed that 08% nurses showed low resilience, 22% had Mod Low levels of resilience, 42%, 18% and 10% had Mod High, High and Very High resilience.
Scoring of patients on PSNCCQ indicating effectiveness of Care provided is revealed in Fig 1.
Fig 1 - Scoring on PSNCQQ
Further correlation of the Resilience score of nurses and the Satisfaction of patients with nursing care quality was carried out. It was found that 35 (70%) Nurses had Mod High, High and Very High Resilience scores and among 70 (70%) patients cared by them, the Patient Satisfaction Scores were –37(53%) reported good care, 33(47%) reported Moderate care and 0% reported poor nursing care..
Among the 56(56%) patients who reported good care on PSNCQQ, the resilience of the nurses they were cared for were as Fig 2.
Fig 2- Resilience score
DISCUSSION:
The findings of the study reveal that resilience of the nurses and patient satisfaction scores are related to each other. Patients cared for by nurses with high resilience show better scores in PSNCQQ. A study by Cameron and Brownie5 says that resilience is the supportive factor that helps nurses adapt to their professions difficult physical, mental and emotional nature. A cross sectional study by Rushton HC and Batchellar J also states that Greater Resilience protected nurses from emotional exhaustion and contributed to personal accomplishment, and also there was a strong association between burnout and resilience. Higher levels of resilience were associated with increased hope and reduced stress6.
In a similar cross sectional study where 1061 nurses were studied, Burnout had significant negative correlations with Resilience of the nurses, highlighting the need for adaptable and effective interventions for improving resilience to relieve nurse’s burnout and workplace stress 7
Also it was found that patient satisfaction and health outcomes improve when they are provided by staff that is motivated and possessing strong coping skills. National Database of Nursing Quality Indicators (NDNQI) of 20168 states that higher nurse satisfaction resulted in an 87% decrease in infection rates over two years. In the article “What Patient really wants from hospitals” states that Healthcare workers who show compassion improve patient satisfaction9.
Study among health care professionals in 2013 states that Negative Stress of Care Giver can have an impact on the quality of care provided by the nurses.10
Emotional resilience for Nurses is a vital virtue which helps them to provide effective care to sick individuals and their families.. Building of resilience, both physical and emotional will benefit Nurses, who will then be equipped to contribute effectively to the needs of the services. Challenges are many, and it is only an Emotionally resilient nurse who can provide the required support and encouragement, so vital for a wounded or unwell patient soldier. Nursing is a profession which requires constant dedication and there is no scope for complacency. Withstanding the mental and emotional stress, duty needs, frequent moves and service requirements requires nurses who are physically and emotionally resilient.
CONCLUSION:
Resilience is a major individual characteristic which enables a nurse to adapt to various stressors faced at work in the form of work overload, long shifts, staffing issues, poor work related interpersonal relationships. An emotionally resilient nurse will show characteristics of coping, optimism, self efficacy, sense of humour, control and competence to name a few. These help not only the nurses, but also indirectly contribute towards betterment of health establishments and care given to patients. A military nurse who is resilient will be more confident in her work, have better interpersonal relationships and be able to cope better with traumatic situations, contributing efficiently to the patient services. It is upto the educators and administrators to identify the need and to ensure that this important trait is instilled into the young nurse, right from the starting of her career.
CONFLICT OF INTEREST:
Nil.
ACKNOWLEDGEMENT:
All those who supported and participated in the study.
REFERENCES:
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Received on 31.08.2019 Modified on 21.10.2019
Accepted on 30.11.2019 ©A&V Publications All right reserved
Asian J. Nursing Education and Research. 2020; 10(2): 157-159.
DOI: 10.5958/2349-2996.2020.00034.8