The relationship between emotions and stress among mental health nurses

This paper presents findings from an exploratory correlational study that examined the relationships between Emotional Competency, Trait Affectivity, Stress and Experienced Emotions among 43 mental health nurses in Australian regional hospitals. A significant relationship was found between Emotional Competency and Personal Self‐doubt in male nurses only; however, no association was found between Emotional Competency and Experienced Emotions. Trait Affectivity was found to be associated with Experienced Emotions but not Stress. Gender differences were found in Trait Affectivity and Experienced Emotions. The results of the study have implications for the retention of mental health nurses in their profession.     

Emotional labour in mental health nursing: An integrative systematic review

Emotional labour is the effort consumed by suppressing one's own emotions to care for others effectively while also caring for oneself. Mental health nurses are required to engage in effective therapeutic interactions in emotionally‐intense situations. The aim of the present integrative systematic review was to investigate the emotional labour of mental health work and how this manifested, the impacts, and the ways to mitigate these impacts. In June 2016, using Preferred Reporting Items for Systematic Reviews and Meta‐Analyses methodology, a systematic search of the bibliographic databases was undertaken to identify relevant literature. Screening, data extraction, and synthesis were performed by three reviewers. The inclusion criteria included any original research that investigated the emotional work of mental health nurses. We identified a total of 20 papers to be included in this review. Thematic synthesis of the findings revealed three emergent themes: emotional labour and caring, emotional exhaustion, and self‐protection (expressed as emotional intelligence). Emotional labour, emotional exhaustion, and emotional intelligence were considered to be intrinsically linked, where they were both the influencing factor for burnout and a contributor to attrition. The results highlighted that emotional labour could inspire the development and personal growth of emotional intelligence in mental health nurses. In light of these findings, recommendations for clinical practice were considered; they included supportive work environments, involving nurses in shared decision‐making, and the provision of ongoing professional development opportunities that facilitate the development of emotional intelligence and resilience.     

Caring as a resilient practice in mental health nursing

This paper will develop a discussion about caring as a modern mental health nurse. We argue that the demands of mental health nursing today extend beyond the more traditional skills of care and caring. We believe that in order to meet mental health needs in the 21st century that caring should be extended to encompass the additional expertise of emotional intelligence and resilience. Emotional intelligence, resilience, and resilient behaviours have the potential to assist individuals to transcend negative experiences and transform these experiences into positive self-enhancing ones. This has implications for improved consumer outcomes through role-modelling and educational processes, but also may hold implications in supporting a strong workforce in mental health.     

The work and values of mental health nurses observed

While there is agreement among stakeholders that change is required in mental healthcare, yet the precise nature of this change and how it should be brought about are relatively under-explored. Research has looked at developments taking place in primary mental health services, but relatively little has examined the work of community mental health nurses (CMHNs), especially those working at the interface between primary and secondary care. This study used a 39-item questionnaire to explore how CMHNs perceive their role and the degree to which they are able to carry it out. The findings suggests that while CMHNs are enthusiastic about their work and are keen to see mental health services develop in primary care, many are concerned about how they are perceived by other health personnel, deficiencies in their therapeutic skills and the level of support they currently receive. The study concludes by suggesting areas that managers, commissioners and educators should target to enable CMHNs to continue to play their part in a service that relies heavily upon them.     

Exploring the relationship between perceived emotional intelligence, coping, social support and mental health in nursing students

Studies conducted with nurses or nursing students have shown that emotional intelligence is a skill that minimizes the negative stress consequences. The present work examines the role of perceived emotional intelligence (PEI) measured by the Trait Meta-Mood Scale, in the use of stress-coping strategies, in the quantity and quality of social support and in the mental health of nursing students. The results indicated positive correlations between clarity and social support, social support and repair, and social support and mental health. Hierarchy regression analysis pointed out that clarity and emotional repair are predictors of social support, and emotional repair is the main predictor of mental health. These results show the importance of PEI in stress coping within the nursing framework.     

A hermeneutic approach to the characteristics of mental health nursing practice

Mental health nursing (MHN) takes a non-reductionist view of the human being, based on a hermeneutic and interdisciplinary perspective. MHN is dependent on the development of hermeneutic knowledge for understanding the deeper meaning of, for example, encountering a patient with emotional pain. The aim of this study was to provide a philosophical discussion about the characteristics of MHN practice. The hermeneutic approach was used to expand the philosophical discussion of MHN. In order to explore the consequences for MHN practice, previous relevant research within the discipline of MHN was used, exemplified by patients suffering from emotional pain. Two themes emerged: A reflective way of being and working and Relationships as a foundation for change and improvements. Four themes emerged related to the practice of the nurse: Desire for confirmation and trust, The vulnerable human being, The difficulties involved in responsibility and The power of self-development, authenticity and freedom. MHN must be open to changing some of the negative images of past interdisciplinary discussions in order to provide high quality care and support to the suffering patient. The hermeneutic approach is one way to help nurses who work in the context of mental health to understand and use their intuition and empathy to empower patients, thus providing hope and future possibilities.     

Clinical supervision for mental health nurses in Northern Ireland: formulating best practice guidelines

Nurses work in a constantly challenging and changing environment. Within this context, there is a continuing need for support. Such support will help increase morale, decrease strain and burnout, and encourage self-awareness and self-expression. Clinical supervision address all these issues and enhances the quality of care for patients. While clinical supervision is a policy imperative in Northern Ireland, it was clear that there were problems in its implementation in mental health nursing. The aim of this project was to explore ways to make clinical supervision available to all mental health nurses and to improve and evaluate their contribution to patient care. The research team undertook a comprehensive literature review and a baseline survey of relevant stakeholders. Results represent the outcome of the group work. They will assist healthcare providers to develop local policies and procedures on clinical supervision for practising mental health nurses.     

护士组织公平感现状及其与情绪耗竭和心理健康的关系

目的：了解护士组织公平感现状及其与情绪耗竭和心理健康的关系。方法：分层方便抽取辽宁省4所三级医院、7所二级医院共813名护士进行问卷调查,采用LISREL8．7软件进行路径分析,探讨护士组织公平感现状及其与情绪耗竭和心理健康的关系。结果：护士的分配公平感较差;组织不公平感对护士情绪耗竭产生直接影响,对心理健康通过情绪耗竭的中介作用产生间接影响;领导不公平感对护士心理健康产生直接和间接影响。结论：组织不公平感对护士的情绪耗竭和心理健康均有负性影响,通过调整结果分配和提高领导公平感可以降低护士的情绪耗竭,提高其心理健康水平。     

A review of the literature considering the role of mental health nurses in assertive outreach

A review of the literature considering the role of mental health nurses in assertive outreach Assertive outreach teams are a central component of the UK government vision for Mental Health. The general aim of such services is to engage with clients who for one reason or another lose contact with traditional services and require a more flexible approach to care. Researchers and the Government recognize that nurses who work within Assertive Outreach need specialist skills, knowledge and personal attributes to carry out their work. A comprehensive review of the literature was carried out via computer search engines, an Internet search and a hand search of pertinent references. Two screens were applied to the literature to make sure only the highest quality information was evaluated. The results of the literature search were presented in tabular format and three key themes were identified as being important for mental health nurses working in assertive outreach services. These themes were clinical knowledge and skills, successful outcomes for assertive outreach services and personal attributes of practitioners. Multidisciplinary working within assertive outreach services allows for some of the ethical dilemmas to be resolved. However, the competing demands placed on nurses, including risk assessment verses engagement, may lead to high stress levels and burnout. Research studies highlight that without experienced and knowledgeable staff the provision of an assertive outreach model is in jeopardy. The Government and service providers need to ensure that practitioners within assertive outreach services receive sufficient training, managerial and clinical supervision, in order to do the best for a very challenging and chaotic client group.     

门诊护士执业环境及身心健康的现况分析

目的 调查门诊护士执业环境及身心健康现状,为改善护士执业环境,提高护士身心健康提供依据。方法 采用《护士执业环境测评量表》、《症状自评量表SCL-90》,对上海4家三级甲等综合医院168名门诊护士进行问卷调查。结果 回收有效问卷168份,4家医院执业环境得分较高的维度优质护理服务的基础、护理管理者的能力、领导力及支持、医护合作。得分较低的维度护士参与医院事务。有一家医院各维度得分均低于其它3家医院。4家医院门诊护士SCL-90得分,各因子分和阳性项目数显著高于国内常模(P <0．05或P<0．O1)。结论 改善护士执业环境及身心健康重点在于护理管理者给予门诊护士更多参与医院行政管理的机会,采取更多有效措施,缓解工作压力,提高身心健康,营造健康的护理工作环境。     

Emotional intelligence as a mechanism to build resilience and non‐technical skills in undergraduate nurses undertaking clinical placement

The environments in which nursing work is undertaken can be highly stressful and complex with resultant harmful outcomes for the health of both nurses and patients reported. Undergraduate nursing students are particularly challenged when on clinical placement through having only partially developed work capabilities, with wide claims that these nurses remain underprepared for work even upon graduation. Over time undergraduate nursing education has arguably not prioritized developing resilience and other non‐technical skills required to respond effectively to these challenges. This paper reports findings from a qualitative study of student nurses who received training and coaching in emotional intelligence, a well‐established correlate of resilience, just prior to undertaking a mental health or medical/surgical clinical placement. Of that cohort, 12 agreed to qualitative semi‐structured interviews that sought to better understand how these students used the knowledge and capabilities from the training within clinical placement contexts. Four themes emerged from the thematic analysis of the interviews: (1) greater experiences of resilience; (2) responding positively to mental health consumers; (3) experiences of greater empathy and compassion; and (4) experiences of improved non‐technical work skills. Implications from these findings suggest that student and patient experiences of nursing placement, and mental health nursing placements in particular, would be enhanced by pre‐placement emotional intelligence training and coaching. Such training will support nursing graduates to be work‐ready upon entering the workforce.     

护士职业应激与精神卫生状况分析

[目的 ]了解护士职业应激与精神卫生状况及其相关性。 [方法 ]应用抑郁自评量表(SDS)和焦虑自评量表 (SAS)及护士职业压力源量表对 779名在岗护士进行调查。 [结果 ]护士抑郁和焦虑发生率分别为3 6.3 %和 14 .2 % ,两者并存者占 11.6% ,SDS和SAS标准分均值与国内常模比较有统计学意义 (P <0 .0 1) ;护士职业应激总分 1.97分± 0 .460分 ;精神卫生与职业应激呈高度正相关 (P <0 .0 0 1)。 [结论 ]护士群体精神卫生状况低下 ,与其职业应激密切相关。管理者应在引导护士正确认识和舒缓职业应激的同时 ,考虑到女性的社会脆弱因素及其独特的生理特征     

精神科护士情绪智力及影响因素分析

目的了解精神科护士情绪智力现状及其影响因素。方法使用一般资料调查表和情绪智力量表对山东省6所精神病专科医院的813名临床护士进行调查。结果精神科护士情绪智力总均分为(3.85±0.46)分,得分最高的为理解情绪(4.07±0.55)分,得分最低的为情绪知觉(3.68±0.48)分。工作年限、性别、学历为精神科护士情绪智力的影响因素。结论精神科护士的情绪智力处于中等水平,护理管理者应进一步重视护士情绪智力的培养,开展相关干预课程,提高精神科护士的情绪智力和心理健康水平。     

Clinical supervision and burnout: the influence of clinical supervision for community mental health nurses

Aims. The aim of this study was to establish the degree to which clinical supervision might influence levels of reported burnout in community mental health nurses in Wales, UK. Methods. The research instruments used were the Maslach Burnout Inventory and the Manchester Clinical Supervision Scale. At the time of the survey 817 community mental health nurses were reported to work within Wales. Two hundred and sixty (32%) community mental heath nurses working in 11 NHS Trusts responded to the survey. Results. One hundred and eighty‐nine (73%) community mental heath nurses had experience of clinical supervision in their present posts and 105 (40%) in their previous posts. The findings from the Maslach Burnout Inventory indicated high levels of emotional exhaustion for 36%, high levels of depersonalization for 12% and low levels of personal accomplishment for 10% of the community mental heath nurses surveyed. Univariate analysis showed that those community mental heath nurses who were younger, male and who had not experienced six or more sessions of clinical supervision were more likely to report cold negative attitudes towards their clients as indicated by higher scores on the depersonalization subscale of the Maslach Burnout Inventory. One hundred and sixty‐six community mental heath nurses had experienced six or more sessions of clinical supervision and had completed the Maslach Burnout Inventory. Higher scores on the Manchester Clinical Supervision Scale were also associated with lower levels of measured burnout, with significant negative correlations between the total Manchester Clinical Supervision Scale score and the emotional exhaustion subscale (r = ?0·148, P = 0·050) and the depersonalization subscale (r = ?0·220, P = 0·003) of the Maslach Burnout Inventory. These findings suggest that if clinical supervision is effective then community mental heath nurses are likely to report lower levels of emotional exhaustion and depersonalization. Conclusions. The findings from this study suggest that if clinical supervision is effective then community mental heath nurses report lower levels of burnout. Further research is required to determine the long‐term benefits of implementing clinical supervision and to determine which other factors have an influence on levels of burnout for this group of nurses. Relevance to clinical practice. Health service organizations have a responsibility for ensuring that all individual practitioners have access to effective clinical supervision and the Nursing and Midwifery Council could extend the registered nurses personal accountability to include – to seek clinical supervision as and when necessary.     

A comparison of the work and values of community mental health nurses in two mental health NHS Trusts

With the reconfiguration of health services in both the primary and secondary sectors, the role of community mental health nurses (CMHNs) has become a highly contested one within mental health care. There would be great variability in the skills that CMHNs possess, the contexts in which they work and the nature of the work they do. This study sought to explore aspects of the work of those nurses who provide services at the interface between policy and practice. Two groups of CMHNs were compared, one working in an urban setting (Trust A) and the other in a rural (Trust B), focusing particularly on caseloads and client mix, the values held by CMHNs, the models of care they utilize and what they consider would improve care in the future. A specially designed 39-item questionnaire was employed, with a mix of open and closed questions, and statements to which participants were asked to respond on a three-point Likert scale. The findings raised interesting issues around collaborative working, whether CMHNs are happy to take on clients previously on their caseload, bureaucratization, autonomy, role definition within a culture of working with primary care, lack of specific models utilized by CMHNs, and the demand for greater training and educational support. The implications of the study are discussed with the aim of assisting mental health nurses determine their future roles.     

Smoking and mental health nurses: a survey of clinical staff in a psychiatric hospital

There is a lack of evidence on the prevalence of smoking among mental health nurses, and the beliefs and attitudes they hold about smoking at work. This paper describes results from a cross-sectional survey of clinical staff working in a UK specialist charitable-status psychiatric hospital and focuses on the responses of registered mental health nurses. Questionnaires specifically developed for this study were sent to all 1371 clinical employees. Completed questionnaires were returned by 167 of 429 (38.9%) registered nurses (RNs), 300 of 842 (35.6%) nursing assistants (NAs), and 123 of 200 (61.5%) other health professionals (OHPs). Twenty-nine (17.4%) RNs, 93 (31%) NAs and eight (6.5%) OHPs reported themselves as current smokers. Differences in response to attitudinal questions between groups could not be attributed to age. RN smokers were significantly more likely than RN non-smokers to state that staff should be allowed to smoke with patients, and to report therapeutic value for patients in this activity. RN smokers were less likely than RN non-smokers to report that patients should be encouraged to stop smoking. RNs were significantly more likely than OHPs to report therapeutic value for patients in smoking with staff, even after controlling for the possible confounding effect of smoking status. Implications of the survey are discussed in the context of the international literature, including the disproportionately high smoking prevalence among patients living in psychiatric institutions and current guidelines to move towards no 'smoking allowed' areas for staff working in them.     

A comparative study of work characteristics and reactions between general and mental health nurses: a multi-sample analysis

AIM OF THE STUDY: The first aim of this study was to examine differences in work characteristics (autonomy, social support and workload) and work reactions (emotional exhaustion and job involvement) between general and mental health nurses. The second aim was to validate whether a specific pattern of relationships between work characteristics and reactions was the same for mental health and general nurses. BACKGROUND: Nurses are generally being considered as an above risk group regarding work stress. However, health care is a diverse sector and literature suggests important differences regarding the work of different categories of nursing, such as general and mental health nurses. In addition, little empirical evidence exists about these differences. In order to improve their work situation, more insight is needed regarding differences and similarities in the work of general and mental health nurses. The demand-control-support (DCS) model was used as a research framework. We hypothesized that autonomy, job involvement, and emotional exhaustion are higher in mental health nursing, whereas social support is expected to be lower. Next, in line with the propositions of this model and several recent studies, we hypothesized that emotional exhaustion is primarily predicted by workload and social support, whereas job involvement is primarily predicted by autonomy. In addition, we investigated whether this pattern of relationships was similar in both groups. DESIGN/METHODS: Questionnaires were distributed to nurses working in a general and a psychiatric hospital in the Netherlands. We used MANOVA and MSA (by means of LISREL) to analyse the data. RESULTS AND CONCLUSIONS: Regarding the differences in work characteristics and work reactions between mental health and general nurses, our hypotheses were confirmed, except for social support and job involvement. Autonomy and emotional exhaustion were higher among mental health nurses, whereas their job involvement proved to be significantly lower. Emotional exhaustion was primarily predicted by workload and lack of social support. Contrary to our expectations, the relationship between autonomy and job involvement was not significant in both samples. Finally, we found that the proposed pattern of relationships appeared to be invariant across the two samples.     

Self-esteem in community mental health nurses: findings from the all-Wales stress study

The authors conducted an all-Wales survey of community mental health nurses (CMHNs) to determine their levels of stress, coping and burnout. A total of 301 CMHNs were surveyed in 10 NHS Trusts in Wales. A range of measures were used. These included the General Health Questionnaire (GHQ-12), Maslach Burnout Inventory (MBI), Rosenberg Self-Esteem Scale (SES), Community Psychiatric Nursing (CPN) Stress Questionnaire, and PsychNurse Methods of Coping Questionnaire. The findings from the Rosenberg SES are reported here. Community mental health nurses in Wales scored as having average self-esteem. When the data were divided into high and low self-esteem, a large group of CMHNs (40%) were found to have low self-esteem. Factors that are associated with low and high self-esteem were identified. Alcohol consumption and being on lower nursing grades (D, E, F) were associated with low self-esteem, whilst amount of experience working as a CMHN was associated with high self-esteem.