2020 has been deemed The Year of the Nurse in honor of the 200th anniversary of Florence Nightingale’s birth. And, as we all know, 2020 ushered in the pandemic, calling on nurse leaders to guide their nursing teams through some of the darkest and most challenging times of their profession. Overwhelm and exhaustion are the norm.
WWFD (What Would Florence Do)?
It would seem the same healthy and supportive environment Florence Nightingale insisted on for her own patients’ health and healing is greatly aligned with the environment nurse leaders are looking to create for the health and healing of their nurses, their patients AND themselves.
The current health care environment requires nurse leaders to practice positive leadership to transcend difficult and challenging times, especially as the uncertainty and novelty of the situation are still unfolding. Positive leaders recognize the fundamental human need for all employees to be acknowledged for their existence and contributions, that status quo thinking is fraught with limitations and that their actions must be noble and courageous. A 2019 study published in the Journal of Positive Psychology examined how receiving expressions of gratitude predicts physical health outcomes for acute care nurses over time.
The study revealed frequent expressions of gratitude result in nurse satisfaction with the care they provide and subsequently predicted better sleep, healthier eating and improved nurses’ work satisfaction.1
THE TIME IS NOW
Today, more than ever, nurse leaders need to develop a sustainable practice of gratitude for themselves; so, in turn, they can begin to foster a more grateful, positive and psychologically safe work environment for their nurses. An added sense of urgency comes as health care institutions see evidence of moral injury across the clinical spectrum of physicians, nurses and essential support staff.
Moral injury is described as “perpetrating, failing to prevent, bearing witness to, or learning about acts that transgress deeply held moral beliefs and expectations.”2
Recent statistics are discouraging:
3 out of 5 are likely to leave their position as a result of COVID-19
67% will likely leave their facility or industry
3% have already resigned
$137B cost estimate of nurses leaving in the wake of COVID-19
We are fortunate to have research and evidence- based practices in gratitude and the associated correlates of neuroscience to bolster positive leadership development. This provides benefits of retaining nurses and generating greater outcomes for leaders and their nursing teams who together are looking for best practices during these unprecedented times.
Designing and implementing gratitude interventions can begin the healing process. Creating a safe space to reflect on what one is grateful for in oneself, colleagues and the professions offers an opportunity to focus on personal healing while building moral resilience. Positive leadership ensures employees have support for their overall health and well-being as they deal with the stress and anxiety of COVID-19. But, first, the healing, health and well-being benefits of gratitude must be practiced by the nurse leader him/herself.
Nurse leaders can start these strategies by:
Gaining a greater understanding of positive leadership and tenants of positive psychology
Embracing current research in gratitude and neuroscience to enhance personal physiological, emotional and mental well-being
Broadening knowledge to build inspiration, trust and respect in the nursing environment to ultimately create and transform greater health and positivity in the culture of care delivery
To offset the mental, physical and emotional distress associated with the current health care environment, leaders must fully embrace a more positive and appreciative work environment to offer much needed hope and appropriate coping techniques to nurses. Creating a culture of gratitude leads to important improvements in what scholars call positive psychological capacities—the positive and developmental state of employees—leading to greater hope, self-efficacy, resilience and optimism.
Chief nursing officers, nurse directors and nurse managers desiring to influence true culture change through a strengths-based program can get more information on coaching programs here.
1. Starkey, A. R., Mohr, C. D., Cadiz, D. M., & Sinclair, R. R. (2019). Gratitude reception and physical health: Examining the mediating role of satisfaction with patient care in a sample of acute care nurses. The Journal of Positive Psychology, 14(6), 779–788. https://doi.org/10.10 80/17439760.2019.1579353
2. Litz BT, Stein N, Delaney E, Lebowitz L, Nash WP, Silva C, Maguen S. Moral injury and moral repair in war veterans: a preliminary model and intervention strategy. Clin Psychol Rev. 2009 Dec;29(8):695-706.