Emotions at work: what is the link to patient and staff safety? Implications for nurse managers in the NHS (original) (raw)

Emotional stability of nurses impact on patient safety

Title. Emotional stability of nurses: impact on patient safety. Aim. This paper is a report of a study conducted to examine the influence of the emotional stability of nurses on patient safety. Background. Individuals with greater emotional stability are less likely to exhibit strong emotional reactions to stressful situations, and tend to be more proactive and successful in problem-solving. Effectively managing patient safety is a priority concern in countries where nurses face high pressure. A heavy work load leads to burnout (a syndrome associated with negative emotions), reduced job satisfaction and increased turnover. While emotional stability influences job performance in various contexts, its influence on patient safety has not been addressed. Method. A cross-sectional design was adopted. The sample comprised 263 nurses working in two Taiwanese medical centres. The data were collected in 2007-2008, with a response rate of 92AE6%. All participants were nursing college graduates aged below 50 years. Participants provided information on both their emotional stability and patient safety. Staffing adequacy, hospital, and years of nursing experience served as control variables. Findings. Hierarchical regression analysis indicated that emotional stability predicted patient safety (b = 0AE18, P < 0AE01). The addition of emotional stability as a predictor of patient safety increased the associated explained variance (DR 2 = 0AE03, P < 0AE01). Conclusion. It is important for to managers create an organisational climate that promotes the emotional stability of nurses. This could help to improve global patient safety by reducing the frequency of adverse events.

New perspectives on psychosocial safety climate in healthcare: A mixed methods approach

Safety Science, 2018

The psychological safety of frontline healthcare workers receives less attention in policy and from management than either physical safety or productivity goals. In other industries, Psychosocial Safety Climate (PSC) has been used to better understand how management values shape job design and the health and wellbeing of workers. Our study looks at how PSC theory manifests in healthcare on a day-today basis, aiming to explore the factors shaping that climate from the perspective of the frontline worker. A grounded theory approach was used in content analysis of semi-structured interviews with staff from three government hospitals (N = 27), including nursing, medical, allied health, and administrative employees. Findings suggest that PSC theory might at a broad level be applicable to a wide range of industries, such as through key themes like 'Communication' and 'Group Expectations'. However it is important to acknowledge industry-specific factors in how PSC is manifested, such as the major role that PSC plays in the management of systemic risks in healthcare like balancing the 'Conflicting Pressures' of staff personal safety versus delivering quality patient care. In addition, practical implications of our study include three methods by which management and Australian policy makers can mitigate psychosocial risks, enacting a positive change in safety climates that better value frontline worker psychological health.

Mental health nurses' experiences of managing work-related emotions through supervision

Journal of Advanced Nursing, 2016

Aim To explore emotion cultures constructed in supervision and consider how supervision functions as an emotionally safe space promoting critical reflection. Background Research published between 1995-2015 suggests supervision has a positive impact on nurses' emotional wellbeing, but there is little understanding of the processes involved in this, and how styles of emotion interaction are established in supervision. Design A narrative approach was used to investigate mental health nurses' understandings and experiences of supervision. Methods 8 semi-structured interviews were conducted with community mental health nurses in the UK during 2011. Analysis of audio data used features of speech to identify narrative discourse and illuminate meanings. A topic-centred analysis of interview narratives explored discourses shared between the participants. This supported the identification of feeling rules within participants' narratives, and the exploration of the emotion context of supervision. Findings Effective supervision was associated with three feeling rules: Safety and reflexivity; Staying professional; Managing feelings. These feeling rules allowed the expression and exploration of emotions, promoting critical reflection. A contrast was identified between the emotion culture of supervision and the nurses' experience of their workplace cultures as requiring the suppression of difficult emotions. Despite this contrast supervision functioned as an emotion micro-culture with its own distinctive feeling rules. Conclusions The analytical construct of feeling rules allows us to connect individual emotional experiences to shared normative discourses, highlighting how these shape emotional processes taking place in supervision. This understanding supports an explanation of how supervision may positively influence nurses' emotion management and perhaps reduce burnout.

A qualitative thematic review: emotional labour in healthcare settings

Journal of advanced nursing, 2015

To identify the range of emotional labour employed by healthcare professionals in a healthcare setting and implications of this for staff and organisations. In a healthcare setting, emotional labour is the act or skill involved in the caring role, in recognizing the emotions of others and in managing our own. A thematic synthesis of qualitative studies which included emotion work theory in their design, employed qualitative methods and were situated in a healthcare setting. The reporting of the review was informed by the ENTREQ framework. 6 databases were searched between 1979-2014. Studies were included if they were qualitative, employed emotion work theory and were written in English. Papers were appraised and themes identified. Thirteen papers were included. The reviewed studies identified four key themes: (1) The professionalization of emotion and gendered aspects of emotional labour; (2) Intrapersonal aspects of emotional labour - how healthcare workers manage their own emotion...

Chapter 6 Emotional affects – developing understanding of healthcare organisation

Research on Emotion in Organizations, 2006

This paper looks at the current portrayal of emotion in healthcare as delivered within formal organisational settings, notably the UK National Health Service (NHS). Its purpose is to set out some examples of the problems and suggest new ways of conceptualising issues that will assist healthcare organisations in gaining a better understanding of the role of emotion and its impact, using appropriate examples. Developing understanding of the location of emotion and its differing constructions indicates that interdisciplinary and interpersonal boundaries differentiate interpretations of emotion, often for instrumental purpose as examples drawn particularly from the Public Inquiry into Paediatric Cardiology at Bristol Royal Infirmary (The Kennedy Report) demonstrate. The privileging of rationality over emotion as part of the dominant paradigm within the healthcare domain is shown to affect outcomes. However, the boundaries between organisations and individuals are changing, so are the location, access, technologies and timing of activities, and these are reconstructing healthcare organisation and the patient's experience of healthcare at both rational and emotional levels. It is suggested that in healthcare it is the patients' journey through their lives (the macro con-1 3 5 7

A Qualitative Study of the Impact of Emotional Labour on Health Managers

The Qualitative Report, 2016

The objective of the study was to examine how surface acting is used by middle managers to manage the emotional displays of executives in the health industry in Australia. The research was located within a social constructionist epistemology and the theoretical construct used to structure the study was surface acting. Data was generated through qualitative interviews with 49 middle managers. Analysis was undertaken using grounded theory and thematic analysis. The main finding was that unlike male managers, female managers took on the role of managing the emotional displays of senior staff and used surface acting as the means of doing this. They expressed optimism, calmness and empathy even when these were not the emotions that they were actually feeling. It is argued that the propensity for female managers to take on the role of managing the emotional displays of powerful others demonstrates the extent to which gender stereotypes still persist in the health system. The long-term imp...

Emotional Influences in Patient Safety

Journal of Patient Safety, 2010

The way that healthcare providers feel, both within themselves and towards their patients, may influence their clinical performance and impact patient safety, yet this aspect of provider behavior has received relatively little attention. How providers feel--their emotional state --may be influenced by a variety of factors including characteristics of the patient, ambient conditions in the healthcare setting, diurnal, circadian, infradian and seasonal variables, as well as endogenous disorders of the individual provider. Analogous to cognitive errors, the provider's emotional state may also contribute to errors, which can be referred to as 'emotional errors'. Clinical reasoning and judgment may be particularly susceptible to emotional influence, especially those processes that rely on intuitive judgments. However, emotional influences on decision making and patient safety have attracted little attention to date. To reduce emotional errors, the level of awareness of these factors should be raised. Emotional skills training should be incorporated into undergraduate and postgraduate education. Specifically, clinical teaching should promote more openness and discussion about provider's feelings towards patients. Strategies should be developed to help providers identify and de-bias themselves against untoward emotional influences that may impact care, particularly in the emotionally evocative patient. Psychiatric conditions within the provider that may compromise patient safety need to be promptly detected, diagnosed and managed.

Thinking about the emotional labour of nursing – supporting nurses to care

Journal of Health Organization and Management, 2013

Purpose -The aim of this article is to report some of the work undertaken by a nursing "think tank", focussed on examining the causes of poor nursing care in hospitals, and potential solutions. Design/methodology/approach -A "think tank" was convened which incorporated widespread discussion with national, regional and local stakeholders, a critical literature review, and a focus group of senior nurses. Findings -It was found that there are no widespread systems of staff support that help nurses working in hospitals to cope with the emotional component of their work. This is one element that contributes to nurses providing poor care. A number of approaches to staff support have been developed that warrant further study. Practical implications -If episodes of poor care are to be prevented it is necessary for hospital boards to recognise the importance of supporting nurses in managing the emotional labour of caring. The introduction of routine systems of staff support should be considered. Originality/value -In addition to highlighting and condemning poor care, it is important to seek solutions. This article offers a new perspective on an enduring problem and identifies approaches that can be part of the solution.

You Can't Take It Personally': Emotion Management as Part of the Professional Nurse's Role

Czech Sociological Review, 2014

This study looks into the culture of nursing professionals in the present-day Czech health-care system at a time of personal, generational, and educational transitions (reforms), which have driven a change of organisational-cultural means in the relationship between two key professions: doctors and nurses. The article presents the results of a biographical study of nurses, paying detailed attention to their emotional labour in cooperation with doctors in accident and emergency ward settings. The study draws on the concept of organisational culture in practice/action, on a Goffmanian and Garfi nkelian ethnomethodology of scripts of interaction (rules, norms) in order to reconstruct the feeling rules that govern a nurse's emotional display and her role in cooperating with doctors. The article stresses the importance of emotion management as a substantial part of the gendered professional identities of health-care workers and discusses the situations when nurses' subordinate status requires a kind of stressful emotion management to keep the doctor-nurse professional relationship intact, which is not required from doctors. The study also presents a variety of coping strategies or practices normalising these morally questionable feeling rules and norms, which guide action as an integral part of the ordinary practices of the social organisation of the nurse's occupation in hospital settings.