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Ask just about anyone for three words that describe nurses, and you’ll get a list like this:

Caring
Compassionate
Trustworthy

Ask nurses, and the list might be different:

Stressed
Fatigued
Burnt out

Worn out nurses — RNs pushed nearly beyond their capacity by the high demands of their jobs — aren’t a new phenomenon. Studies have long tracked the relationship between rising workloads, burnout, and turnover of nurses at healthcare facilities.

Burnout among nurses, especially those new to the profession, remains high — and it appears to be worsening. The Robert Wood Johnson Foundation crunched the numbers in 2014 and found more than 17% of RNs leave nursing within their first year on the job. About 33% of nurses voluntarily leave the nursing workforce within two years of employment, the organization said. That’s one in every three newly minted RNs.

Nursing Solutions, Inc., a recruitment and retention firm, reported similar numbers in its 2016 National Healthcare Retention & RN Staffing Report, as well as an upward trend. It clocked RN turnover in 2015 at more than 17% — about one in five nurses — up from 16% reported the previous year.

Retirement represents a portion of rising turnover rates. A half million of the nation’s nurses are expected to retire within the next five years alone, according to the American Nurses Association.

Dissatisfaction on the job accounts for an alarming proportion of the reasons nurses and other healthcare professionals head for the exit. A 2017 survey by hospital management staffing firm, Leaders for Today, revealed a whopping 58% of the healthcare workforce — of which nurses represent the largest cohort — signaled they left their profession due to long hours, frustration, and burnout.

As healthcare organizations struggle to reverse a concerning opt-out trend among nurses, RNs might ask themselves what they can do to stem the stress, fatigue, and burnout that’s common to their profession and remain in jobs they love.

Hospitals and other healthcare facilities aren’t off the hook for creating work cultures and systems that promote satisfaction among nurses, of course. But a growing body of research suggests a fairly simple concept can help ward off burnout and improve health and happiness both on and off the job.

It’s called gratitude.

The Science of Gratitude

The life-improvement potential of gratefulness isn’t fluffy stuff. Solid science backs up the claim that gratitude offers healthy benefits.

A seminal study conducted by the University of California at Davis and University of Miami assigned random participants to one of three groups. Participants in each group were tasked with keeping a weekly journal for 10 weeks. The “gratitude” group kept track of five things for which they felt grateful for during the previous week. The “hassled” group described five events during the week that bothered them. The control group recorded five events each week that affected them, but refrained from assigning positive or negative characteristics to those events.

At the close of the study, participants in the gratitude group were 25% happier with their lives overall than their counterparts in the hassled group. In a follow-up study, researchers found participants who tracked ways in which they felt better off than others reaped even more happiness benefits. They reported more satisfaction with their lives, but they also signaled a ripple effect associated with gratitude. Recording their thankfulness appeared to increase participants’ positive feelings for, and goodwill toward others.

Studies have also demonstrated an inverse relationship between depression and gratitude, as well as thankfulness and aggression. Research from Eastern Washington University found clinically depressed individuals experienced half as much gratitude in their lives as a non-depressed control group. A University of Kentucky study linked feelings of gratitude to lower levels of aggressive behavior. Regularly practicing gratitude can keep impatience in check, according to another study.

Expressing gratitude yields physical benefits, too. Thankfulness reduces inflammation, promotes better sleep, boosts the immune system, and lessens dietary fat intake.

The physical and psychosocial benefits of routinely expressed gratitude can also be long lasting. A brain imaging study suggests that practicing gratitude rewires the brain.

In evaluating the study, psychologist Christian Jarrett, PhD, proposed that when it comes to gratitude and the brain, more is more.

“The more practice you give your brain at feeling and expressing gratitude, the more it adapts to this mindset — you could even think of your brain as having a sort of gratitude ‘muscle’ that can be exercised and strengthened,” Jarrett said.

The Art of Gratitude

Thankfulness, it seems, offers a remedy for a good deal of what ails nurses in the workplace, including job dissatisfaction and burnout.

Robert Emmons, PhD, a leading researcher on gratitude, explained to FastCompany that cultivating and practicing gratitude represents “the ultimate performance-enhancing substance” on the job.

So it works, and it’s free; but forming a gratitude habit isn’t always easy to accomplish, especially for busy nurses.

Emmons’ research, including the gratitude and hassled group studies, points to the value of keeping a gratitude journal in which at least once per week — better yet, daily for full benefit — the details of appreciated events, things, or people are recorded. Another tool, the Three Good Things exercise, similarly suggests taking time at the end of each day to write in detail about three positive things that occurred during the course of the day and reflect on why they happened.

These and similar gratitude stretchers sound great in theory. But for stressed and fatigued nurses, the very thought of putting pen to paper or fingertips to keyboard at the end of a long day (or night) of documenting patient care makes these practices seem, well, stressful and tiring.

While there’s science behind gratitude’s ability to benefit health and happiness, there’s also an art to practicing it. Beleaguered nurses might need to inject a little creativity into developing a habit of thankfulness. A realistic approach might involve a shortcut here and there.

Putting it in Practice

Consider these fast-track gratitude boosters; and look for other inventive ways, big and small, to practice gratefulness. Your healthier career will be thankful you did.

Take advantage of tech

No time to write a full explanation of things for which you’re grateful? As a nurse, remember that you have considerable expertise in notation. You probably also use a smartphone — a lot. Create an “I’m Thankful For” file in the Notes feature on your phone. Type in a word or two in a running list of experiences or people for which you feel especially grateful. Everyday things, like these, count. Set a reminder on your smartphone calendar to review and reflect on the list every few days, if not every day. Even a few minutes of mindful reflection every week on the things for which you’re grateful now can train your brain to spontaneously recognize healthful feelings of gratitude down the road.

Be social about it

Interrupt your automatic thumb scrolling on your Facebook feed to fire off a post on something or someone you appreciate. Your “Today I’m grateful for this or that” posts will be there on your home page, ready for your review and reflection the next time you pick up your phone. Plus, they’ll show up in your feed as helpful reminders if they score a Like, Love, or Share reaction among your network. You might even inspire people in your network to build socially based gratitude habits of their own.

Sneak it into unexpected places

Look for times and places to slip a little authentic gratitude into your daily nursing practice. The next time you give report, for example, why not replace a statement such as “Mrs. X’s blood pressure has stabilized” with “I’m thankful Mrs. X’s blood pressure has stabilized.” Don’t overdo it, of course; and make sure any such expression of thanks is genuine. If you’re truly grateful your patient has made progress in his or her care, say so — to yourself and your colleagues. Here again, you might inspire a healthful sense of gratitude in others.

Counter negativity with positivity

Attitudes breed: negativity tends to beget negativity, while positivity encourages more positivity. Unfortunately, as much as healthcare settings are known for caring attitudes, they can also host an equal measure of complaints — from patients, and colleagues, too. Start a personal mini rebellion against negativity with positive, thankful thoughts. When a colleague goes on about hospital administration, for example, shield yourself for a nanosecond or two by recognizing something that’s made your day better. Be thankful your coffee is still warm, or that your trusty stethoscope has been with you for years.

Give it away

When it comes to gratitude, it’s better to give and receive. Work with your employer to ensure employee recognition programs aren’t just available, but also meaningful. Real, heartfelt thanks motivates people far more than, say, earning points redeemable for prizes for securing high patient satisfaction scores. Also, make it a point to give credit where it’s due. Look your colleague in the eye and earnestly (though briefly!) express your thanks for stepping in to help with your patient while you take a call from your child’s school. Couple a genuine “thanks!” with a high-five for the tech who successfully inserted the IV you couldn’t quite manage, and show your authentic gratitude by swapping the casual phrase, “I appreciate it,” with a sincere “I appreciate you.”

Looking for a job with an employer that appreciates you? Eisenhower Medical Center fosters a work culture that celebrates collaboration, respect, and appreciation. Learn more on our Careers page.

Originally posted on 20/11/2017

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