RNliveoak

Nursing is an important and essential profession, and nurses serve as the backbone of the healthcare system. As such, various types of frequent large and complex demands are placed on this population on a continual basis. Challenges within the healthcare industry can create significant social (i.e., absence of fairness) and organizational (i.e., work overload) sources of chronic stress and burnout for the nurse. These sources have been found to be the largest contributors to nursing burnout. Sensory Processing SensitivityIndeed, nursing is a stressful profession with high levels of burnout. Hence, researchers have been investigating other associations to stress and burnout as well. From an individual perspective, personality has also been found to play a partial role in the experience of stress and burnout. Dispositional variables such as the Five Factor Model (FFM; i.e., extraversion, openness, negative emotionality, etc.) personality types have been researched within the context of nursing to gain a deeper understanding of their impact on one’s chronic stress. The inclusion of those such as the FFM has helped this research along, but recent evidence suggests that the unique and innate personality trait of Sensory Processing Sensitivity (SPS) may also provide further insight into this issue. Having this trait increases one’s potential to be overwhelmed by certain aversive stimuli both internally and environmentally, thereby leading to emotional and behavioral difficulties. Examples of aversive stimuli might be negative social situations, rapidly changing or unpredictable environments, or certain or personally overwhelming noises, lights, smells, or odors. Thus, overwhelming or aversive stimulation can lead to increased stress, placing those with SPS at risk for occupational stress and burnout. This may be important to consider, given that it is estimated that approximately 20% of all people have the SPS trait. According to Gray, the three most common nursing stressors are workload, death and dying and inadequate preparation. Maslach’s three burnout dimensions are emotional exhaustion, depersonalization and personal accomplishment. SPS has yet to be expansively and exclusively studied within this particular context of nursing, or even nursing in general. The current research explored the most common nursing stressors as well as burnout levels in nurses that are considered highly sensitive by nature in comparison to their less sensitive peers. Distribution of Highly Sensitive People in Nursing: Stress Results252 registered nurses and licensed practical and vocational nurses were recruited from Allnurses, Facebook, Reddit and a Southern Texas hospital. Results revealed that nurses with SPS were significantly more prone to stress and burnout after controlling for potential covariates and other significant personality factors. Upon hierarchical regression, after age, gender, years of nursing experience and the FFM types were controlled for, SPS was significant at p<.01 with 3.3% of the variance for overall nursing stress. Inadequate preparation (pertaining to the inability to deal effectively with patients and their families) was significantly predicted by SPS, with p<.01 with 5.8% accounting for the variance of nursing stress. Workload was also predicted by SPS, with p<.01 with 5.3% accounting for the variance in nursing stress. Negatively emotionality was the only FFM personality type that significantly predicted nursing stress, representing 5% of the variance at p<.01. Gender was a non-significant predictor for both stress and burnout. Negative emotionality was significant at p<.01 with 11% of the variance for stress. Burnout ResultsFor burnout, SPS was significant at the p<.01 level with a variance of 9.2%. Emotional exhaustion was also significantly predicted by SPS, with p<.01 with 7.6% of the variance. The implications of these findings overall reveal that SPS is a unique construct which predicts stress and burnout separately and in addition to the commonly used FFM types. In general, this study shows that Highly Sensitive People (HSPs; those with the SPS trait) are more prone to increased stress and burnout as nurses, particularly emotional exhaustion. Due to this finding, people who happen to be highly sensitive in an already emotionally demanding profession such as nursing may also be able to better understand part of the reason for their current predicament with regards to chronic stress and burnout from emotional exhaustion. Knowing this should empower them to re-assess the level of stimulation that they can tolerate on a day-to-day as well as long-term basis. ImplicationsIn practical terms, this means that the HSP may have to figure out other ways to preserve their emotional energy during each shift, as most of it will be spent with people in general. For instance, the nurse may want to make an assessment of which people require the most expenditure of energy during interaction. The HSP could then better determine in a disciplined manner on appropriate time limits for spending with each person, including patients, and also how they choose to interact with those individuals or when they interact with them. In other terms of practicality, the HSP may also have to make an even more difficult decision on whether or not to stay in the current nursing setting or environment. HSPs take longer to recharge emotionally, and highly or chronically stressful work tends to bleed over into one’s personal life, affecting other areas of life not previously considered to be associated with a stressful work environment. Thus, for the HSP, it is highly important to be present in a work environment in which one does not feel constantly emotionally drained from. Lastly, the current study’s findings naturally implicate the organization. On this level, working to alleviate the most frequent and intense nursing stressors would be the most practical way to assist all nurses in addition to HSPs themselves. ConclusionIn conclusion, a better understanding of the trait of SPS would most likely provide valuable contributions to many stressful and helping occupations. Since SPS exists in roughly 20% of the world’s population, the societal impact of this construct could be significant. Furthermore, the field of Psychology recognizes the importance of individual differences. As more of these differences are discovered, the increased complexity of the human condition will be more fully represented by studying traits such as SPS. To the Allnurses community: Thank you for all of your help with my thesis research. I sincerely could not have done it without you. I have as of recent successfully defended my thesis at the university I currently attend.

Hi Crystal-Wings, thanks for sharing.

Thanks for sharing.

Thank you for your post.

HI Luchador, there is also a self-test at hsperson.com, if you are interested. Thank you for your reply.

Hi 37changes, thanks for writing. What a timely thing to do before you decide where to work! You should get great information out of that (by E. Aron)! There are great things about being highly sensitive too, I just couldn't include both in my study. Maybe one day. Congratulations on graduating, and good luck.

I'm an RN and am wondering if anyone would be willing to help me with my graduate thesis by taking my online survey. It is on stress and burnout in nursing, and I am researching some newer aspects of personality and cognition. I would really appreciate it! Everything will be kept anonymous and confidential. The survey takes about 15 minutes to complete, and you need to be a practicing RN, LVN or LPN within the U.S. The number of times allowed for survey participation is one. Thank you all for your help! I have included a more formal description of my study below, but if you would like to go ahead and take the survey, here is the link: https://angelo.az1.qualtrics.com/jfe/form/SV_3m9RwEJMiAcG5BX Highly Sensitive PeopleTo date, Highly Sensitive People (HSPs) have never been researched within the context of nursing stress and burnout, or even nursing in general. Although this is true, Sensory Processing Sensitivity (SPS), the temperamental trait that characterizes one as a Highly Sensitive Person, has only existed since 1997, and more widespread research on the construct did not begin until several years later. This refers to this particular construct, which is specifically defined within the literature. HSPs make up roughly 20% of any given population (Aron, 2012). This group can become more overwhelmed by internal and external stimuli, which stems from certain physiological processes within the brain. Examples of these stimuli are loud noises, too much social or emotional stimuli, or stimuli from the moods of others, strong smells, bright lights or new or changing situations (Aron & Aron, 1997; Acevedo et al., 2014). When overwhelmed, those with the trait of SPS can experience heightened levels of both stress and burnout at work. Stress in NursingIn addition, the nursing profession has been ranked by the US National Institute as one of the top 40 most stressful careers to have (Heim, 1991). Out of a study among physicians, pharmacists and nurses, Wolfgang (1988) found that nurses ranked the highest in stress levels by a significant degree. Also, research by the American Nurses Association (ANA) revealed that nurses ranked being overworked and the effects of stress as the most serious concerns in their profession, which has not changed in nearly a decade (Roberts & Grubb, 2013). Burnout in NursingAccording to one study, burnout accounted for the largest explanation in mental health as well as physical health disparities of nurses (Maria, 2012). Cooper, Dewe & O'Driscoll (2001) describe burnout as the result of being exposed to stressful working circumstances for a protracted period of time, reflecting a state of both emotional and physical exhaustion. Burnout is divided into three dimensions: emotional exhaustion, depersonalization and low personal accomplishment (Renzi et al., 2012). Lastly, knowing that both HSPs and nurses are affected by stress and burnout, I believe this research is vital. Although different forms of sensitivity have been measured in the past in different ways, these previous tools did not measure what we know it today to represent, which includes a more defined set of criteria. We are still lacking insight into things that lead to stress and burnout (other than work-related causes) in some of our most vulnerable populations, such as nursing. Therefore, my goal with this research is to find more answers concerning the backbone of the healthcare industry: nurses! Thank you for reading! When my thesis has been completed, I will post the conclusions of the study for you all to see, most likely under the same title. If you are interested in my thesis research survey, here is the link again: http://angelo.az1.qualtrics.com/jfe/form/SV_3m9RwEJMiAcG5BX

Apparently my girlfriend has witnessed the lime green scrubs before. I am still surprised anyone would have to wear this color, however!

I agree. This issue has an obvious political charge. I would hope that we could talk about other issues surrounding the target issue in this forum, but this only works if we can avoid personal attacks.

I think right now there is a little too much research that contradicts other research saying that pot is physically and mentally safe for various purposes. One study infers that smokers tend to suffer more from affective disorders such as bipolar disorder. Then there is another study suggesting that working memory and decision-making is mildly impaired in weed smokers as well. I also think the insurance industry would have to be regulated from above to provide some benefits that could be related to use, or, the research needs to be fleshed out significantly, which I think will take awhile. http://adai.uw.edu/pubs/pdf/2017mjbipolar.pdf COMORBID MOOD, PSYCHOSIS, AND MARIJUANA ABUSE DISORDERS: A THEORECTICAL REVIEW

Hi Ruby Vee, this is the first poll that I have ever created. Do you have any tips? Or, was anything confusing about the questioning? Thank you for responding anyways! I personally dislike royal blue because that was my nursing school's uniform color.

Hi Everyone, Besides white scrubs, I was wondering what you all thought the worst scrub color that you have ever had to wear as a nurse? And this can be for any reason... whether it makes you feel silly, reminds you of something gross, or makes you feel unattractive, reminds you of a past employer where a different occupation was assigned that color, etc.. Feel free to take the poll. Thanks!

I look forward to hopefully writing many more.

Hi Michellelove, Absolutely, I would totally apply again... but I also see two other ways to go about gaining progress on your goal. One is a possible front-end solution. If you have any friends who work in the department you seek that has a good relationship with the manager, you could ask them to inquire directly for you or simply put in a good word on your behalf prior to you submitting your application. This may help in avoiding any negative impressions from memory that she may have from the last time, assuming she has any at all that is. Also, your friend may also help to create a favorable initial impression on your behalf as well. The other is a back-end solution. If say you did apply and happened to interview again and then got denied the position again, then it is totally within your right to politely inquire as to the reason(s) why you were turned away for the position. If you are willing to move on anyways after the second attempt, then maybe it would be too late to take any feedback at this point for this job; but if you still want it, then its possible there could be something you can work on that is within your control to help your aim with any future attempts thereafter. And, feedback is just good to have as long as you are motivated to receive it and the feedback is truthful and accurate. I know this is reaching into the future here, but if you do get another interview, and the issue of job-hopping or "commitment" comes up, then that would be your chance to turn perception in your favor by 1) figuring out how to honestly explain the reasons behind your past frequent job switches in a way that sets you up to explain #2, which is: 2) think beforehand the most important, earnest and substantive reasons why you want to be a part of that department, and how (if this is true), once you have obtained the job you have wanted the entire time, your own motivation and commitment will not be an issue while at this new job because of those reasons. The key here is to not come off as desperate. The best way to do this is to really work on developing any good-willed or aspirational reasons for why you want to join and aid her team and really think about those reasons beforehand. And I have to say after this long response that all of this is pretty much my own opinion and I could totally be wrong on all of this stuff. With that being said, I hope you find something in this useful. Good luck!

Thank you sincerely, Nurse Beth!

A few years ago, my Chest Pain unit nominated me to represent them on our hospitals newly created Shared Governance Committee, or SGC. We began by talking about topics we would like to work together on with hospital leadership. I must have been more enthusiastic than most, because this committee nominated me to be its chairman. Yet, I quickly realized that I had been duped. Most of the 30 representatives in attendance did not want to help much to get the committee started, much less commit to a role that would require more than what they wanted to give. In other words, our shared governance committee had a motivation issue. I racked my brain about this for a while, thinking and hoping there were ways I could motivate members of the committee to give more than what they were currently. Now after chairing the SGC for a year, I can say that it has been an invaluable learning experience. I've learned some lessons that I will carry with me for the rest of my life. I started with a list of fifteen big tips and whittled them down to ten. These tips are for those who enter leadership roles within hospital shared governance committees and need to be able to deal with motivation issues while also executing the essential leadership tasks. I hope you find them useful. 1. Find out who the motivated people are as soon as possible.You will usually have a few more motivated people in the group than what you realize, so begin making these assessments immediately. These individuals may be quieter than the rest at first, or even hang around afterwards to chat about anything related to the SGC. After figuring this out, you will have a much easier time in delegation and task completion, without having to go to the same people for everything over and over. They will make your role two times easier and will happily help, so long as you show true appreciation in return. 2. Be willing to ask for help.Asking for help from committee members is not considered weakness, but it is if you fail to ask for it. The key to asking for help is to give everyone the reasons for why need their help. I found that more people will be much more cooperative if you are willing to meet them halfway with the realities of the situation, which is sometimes just a lack of hands on deck, time or resources. 3. Hold your fellow nurse officers accountable and meet with them regularly.Hold your Vice-President accountable. This can be difficult, especially if your relationship is not its finest with this person. The Vice-President should be ensuring that all the assigned subcommittees and projects are coming along in between each SGC session. If you do not have a scribe, request a volunteer from the group to keep up with the notes and speakers for each meeting. You will also need to review and approve with the committee in the beginning of each session a summary of the past session, and you will also need these summaries to reference in future meetings as well. Lastly, try to learn as much as you can about your fellow nurse officers, and use this knowledge to enrich your working relationships. 4. Meet with your leadership mentor.It is possible you will have anywhere from one to four members of hospital leadership present at each meeting to assist in guidance when requested or needed. They may be unit managers or directors. You will want to hitch yourself onto one of these people. Preferably, you will want to choose the one you deem that is knowledgeable about shared governance, accountable, that listens to you, and is a good people person or leader. Good leaders are typically good communicators as well. If you can find the person who best fits this description, you will find that generating each meeting's agenda will be much easier. 5. Keep track of time and plan ahead.You have the gavel. You must be steadfast in sticking to the projected time budget for each speaker and topic. You do not want any of the hospital leadership having to tell you that it is time to move on because you are falling behind on the agenda items within the set time frame. Also, it really stinks to not be able to complete your carefully planned agenda list! Also, schedule your guest speakers early and not late in the meetings. They will likely arrive late at times, and you should allow for some flexibility in your agenda to account for this. Make sure to give yourself enough time between meetings to plan, rather than two days beforehand. It takes time to line up speakers to come to these meetings. For example, if the SGC wants the hospital CMO to come to talk about an issue of concern to them, you will need to make sure they will be there for the day you are having your meeting. Also, it is a good idea to send future scheduled speakers a gentle reminder email, one or two days before the event as well. Be sure to get their contact information for this. 6. Be prepared to quell heated discussions.A caveat to this is to diffuse these only if they are escalating quickly or become non-substantive or personal. There can be utility to conflicts if they are devoid of the personal punches, and the rest of the committee may gain some insight into the problem from these exchanges. Be prepared, however, to get with leadership beforehand and let them know that you plan on being fully intentional with this caveat and what the limits would be, because the last thing you want to do is destroy any group cohesion that can be near impossible rebuild. 7. Establish the committee's most essential function.Each shared governance counsel will have a communication pathway that allows members to go back and spread the SGC's message to everyone on his or her respective unit while simultaneously collecting feedback from each staff member of that unit. Then, feedback from the floor's staff will funnel back up through the same pathway it came down from. This function is very important, because the SGC represents the nurses' voices. This should be running smoothly and dependably before the SGC begins taking up any major resolutions to pass through the counsel. 8. Keep your big agenda items small.This can be the biggest derailment of your leadership role on the committee, because it relates to momentum and motivation. Remember that we get pleasure out of attaining worthy, realistic goals. No madder what, you must always begin with small goals, and build your momentum slowly from there. Always keep your agenda realistic. For example, tackling the issue of unsatisfactory bedside reports occurring at shift change due to other contending peak unit demands may not be feasible when considering that it is tied to the much broader complex issue of hospital throughput. You may pass a resolution to present it to leadership, but you may lose any initial backing you had from your hospital's Chief Nursing Officer, thus losing your momentum. This is because the goal was too broad and complex. Instead, chose to work on things that the counsel can either influence directly or create and maintain. For example, if there is a nagging Pyxis or Med-Station issue that could be fixed on the floors, assign two or three people to a subcommittee to begin an inquiry about the problem, and go from there. Or, you could work on a simple and unique employee recognition initiative to point out special behaviors that the committee votes should be rewarded within the hospital. Last but not least, do not try to do too many agenda items at once. You will have to decide what is too much. If you can do these things and stay within some set boundaries, then you will have no problem scoring some early momentum from small victories, which are BIG motivators. 9. Build your political capital outside of SGC meetings.That's right. I said it. This may feel unnatural but try not to think of it as anything too crazy, because it's not. This is more about being social with those you are involved with inside the SGC meetings, including any leadership that are working with you to get certain items done. So, if you happen to see the lead pharmacist who made a stop by the meeting last month, say hello and something earnest about how much you appreciate their presence at the last meeting, or their initiative in the agenda that you are both working on. This will aid your committee's efforts in the future. 10. Promote group cohesion whenever possible.Promoting group cohesion will aid in the pursuit of motivating and unifying your members. What can you do to promote group cohesion? At the beginning of every meeting, ask everyone how they are doing. Try to make time for this in the beginning of each meeting or even before starting each meeting, when the feel is less formal. Try to get shy members to share by indulging them in something they might find interesting and try to get members who you have never seen talking to one another to engage in something that links them. This method of self-disclosure allows people to build confidence in one another by risk-taking in small ways, so that as time passes, these connections become more worthwhile if they are nurtured. Also, proposing and having all members agree to no personal attacks or judgment will help cohesion. If members know they will not be attacked for their personal views, then the bond will remain stronger and individuals will be more likely to contribute to the discussion in the room.

Hi passionfornursing77, I agree with brownbrook. Additionally, I also have worked at a small hospital before, and it actually did close down eventually. Some of the staff was absorbed into the nearby sister hospital, and some were not. I was not, and so I began travel nursing because of this. It was actually the boost I needed! So, even though I was concerned about losing my job due to the closure, everything worked out. I also think that some of these things might be out of your control and also hard to predict anyways. You will never know what the eventual factors will be that will go into an employer making a decision to hire an employee, and it truly comes down to the level of the individual making those decisions. Even then, I imagine they will be much more likely to choose based on assessed traits like conscientiousness and openness or perceived motivation to succeed at their organization. I really hope this was helpful and that everything turns out well for you!

Hi Lostsoul123, I'm sorry to hear about these difficulties. Stress, anxiety and/or burnout is far too common is much worse when you are also potentially dealing with issues of livelihood vs. no livelihood. Like Ruas61 was saying, counseling might be a really good option. I would also add that as much as it sucks, there is no "or is it eventually time to quit?". You are past that. It would not be unwise to switch to a much less stressful or less demanding job that has the characteristics you know would provide that for you and begin seeing someone to help you figure out what the heck is going on up there, no madder the source of the problem. No shame in it. Best.