Sensory Processing Sensitivity: Is Being Highly Sensitive Associated with Stress and Burnout in Nursing?

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 Sensitivity

Indeed, 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 Results

252 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 Results

For 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.

Implications

In 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.

Conclusion

In 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.