Helping nurses cope when patients bring them down


Nurses work for the good of society, and a new study from the University of Iowa finds they are more likely to feel better about their jobs when hospitals remind them of that.

The finding is important at a time when nurses are under mounting pressure from patients and others who increasingly treat them with disdain, in particular through the COVID-19 pandemic. The study finds negative interactions with patients are associated with lower self-worth among nurses, but with help, they are also able to re-frame those experiences as acts of self-sacrifice and that they’re doing their job for a common good.

“If people can re-frame a bad experience as self-sacrifice, they can remind themselves of the purpose of their work,” said Amy Colbert, professor of management and entrepreneurship in the Tippie College of Business and study co-author.

But the study also found that re-framing those experiences is difficult without a broad support network of peers. Without that support, Colbert says reframing may do more harm.

“They start to think that maybe I’m not making the difference I thought I was, and they become less satisfied with their job and it starts to affect their performance,” she said.

Together with Jordan Nielsen of Purdue University, Colbert surveyed hundreds of nurses and asked how they cope with uncivil behavior from the patients who benefit from their work. She said the study did not attempt to identify what the breaking point might be, as that depends on individual nurses and their coping skills.

But she said the findings generally suggest hospitals and clinics can help nurses stay engaged by facilitating connections that help build a broad network of peers that helps them cope with negative interactions. For instance, they can encourage informal peer support networks among nurses, or more frequent one-on-one meetings with managers.

However, she said those initiatives need to be seen as building real and authentic connections that respond to the nurses’ stress with empathy and honesty. She said nurses will be able to see through initiatives that are little more than cheerleading sessions or break room posters, which are likely to spur the opposite reaction.

Ultimately, she says hospitals and clinics are responsible for taking actions that discourage uncivil behaviors from patients in the first place, as well as providing nurses with the support they need to cope with these interactions.

The researchers also surveyed people working in other professions, such as retail and accounting, and found those employees had similar reactions to encounters with uncivil clients or customers. Colbert said that suggests the findings could be extended to other professions where practitioners face significant public backlash, such as public school teachers.

The study was published in the Academy of Management Journal.

More information:
Jordan D. Nielsen et al, It’s Not Always Sunny in Relationally Rich Jobs: The Influence of Negative Beneficiary Contact, Academy of Management Journal (2022). DOI: 10.5465/amj.2019.1288

Journal information:
Academy of Management Journal

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