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Improving resilience in OR nursing

Nurse researcher and former OR nurse Dr Brigid Gil
Photo: Nurse researcher and former OR nurse Dr Brigid Gil
Resilience. It’s often described as the power within. But what forges resilience and how do you improve resilience in the demanding clinical environment of OR nursing? According to one researcher, the answer may lie in five main qualities, writes Karen Keast.

Dr Brigid Gillespie worked as a theatre nurse for 16 years.

She loved working in the operating room – with its unique set of factors that set it apart from every other field of nursing.

“I just loved the challenge - every day was different in the OR,” she says.

“There was a lot of routine but there were also a lot of challenges, you have got to think on your feet particularly when you have got trauma.

“That’s probably why there’s a certain type of nurse who likes that environment.”
 
 In her time in the OR, Dr Gillespie watched nurses come and go, and was particularly intrigued by the nurses who “stuck it out”.

“I wanted to figure out what it was about the nurses who did stick it out that I worked with,” she says.

“They worked there for 30 or 40 years and would never work anywhere else.”

Dr Gillespie eventually followed her curiosity into nursing research, and she is now a Senior Research Fellow at Griffith University’s NHMRC Centre for Research Excellence in Nursing (NCREN).

In her research, Dr Gillespie has studied resilience; which is recognised as a vital attribute for nurses in demanding and volatile clinical environments such as ORs.

“If nurses are not resilient themselves, it is hard for them to care for their patients,” she says.

“In the worst case scenario, it can impact on the patient outcome. Nurses have to look after themselves.”

Economic rationalism, increased workloads, changes in nursing education and the ageing of the nursing workforce have all contributed to greater levels of nursing stress.

Dr Gillespie says those stress factors have also impacted on the OR specialty, where nurses are continually challenged on a daily basis to provide safe and competent patient care.

And if nurses are unable to manage the contextual stressors associated with the OR, she says they are at greater risk of being unable to cope and as a result may leave the profession.

Dr Gillespie studied a range of qualities and also how personal characteristics, including age, nursing experience and education contribute to resilience in OR nursing.

More than 700 nurses were surveyed, who worked across public and private sector OR departments in rural and urban regions across all Australian states and territories, who were also members of the Australian College of Operating Room Nurses.

Dr Gillespie’s research identified five qualities that contribute to resilience in OR nurses – hope, self-efficacy, coping, control and competence.

And it found age, nursing experience, education and years of employment did not influence resilience in OR nurses.

Dr Gillespie says while there are likely to be other contributing qualities that remain unexplained, she says hope and self-efficacy were found to be the main contributors to resilience – affecting how nurses perform in the OR environment.

“For OR nurses, it’s building up their competence and building your self-efficacy, building your clinical skills, that way you are able to move across more specialties – orthopaedics, vascular, eyes, ENT, cardiac – you are going to feel more confident in your ability to do your job.”

Dr Gillespie wants to see strategies implemented that promote the five behaviours in a bid to retain nurses in the OR specialty, from educational programs that improve knowledge and skills to stress management programs centred on teaching coping strategies.

Importantly, Dr Gillespie says nurses can also improve their resilience in the OR through self-care and reflective practice.

“I think, if we know from experience that there are certain situations at work that make you feel inadequate and uneasy and you know you don’t cope as well…it’s about reflecting on your practice and being aware of your own limitations,” she says.

“I think it’s being in touch and knowing the things that trigger anxiety in an individual in a work situation – and it’s about finding a mentor.

“Whether you are a newly graduated nurse or a seasoned nurse, even having someone to talk to and to debrief - what you did, what you can improve on, it helps to build self-efficacy, the way you cope and your competence.”

Dr Gillespie says nurses should also tap into employee assistance programs, from counselling services to exercise programs.

“Look after yourself first and have some insight into the things that make you feel stressed in the workplace and how can you deal with that,” she says.

“Know what works for you - it’s different for everyone.”

Dr Gillespie says while more research is needed in the field the findings are a good starting point for improving nursing retention in the OR specialty.

“One of the main things is nursing retention,” she says.

“We are churning young graduates out now from universities all around Australia and we hope they will be able to get a job.

“Jobs are getting scarce, even in nursing. For those that do get jobs, we want them to stay in nursing, we don’t want them to burn out.”

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Karen Keast

Karen Keast is a freelance health journalist who writes news and feature articles for HealthTimes.

Karen regularly writes for some of Australia’s leading health news websites and magazines.  In a media career spanning 20 years, Karen has worked as a senior journalist in newspapers and television. She has covered the grind of daily news and worked as a politics reporter at countless state and federal elections.

Since venturing into freelance writing five years ago, Karen has found her niche in writing about the health sector for editors, businesses and corporations.

Karen has interviewed the heads of peak health organisations in Australia and overseas, and written hundreds of news and feature articles covering the dedicated work of health professionals who tread the corridors of hospitals and health services, universities, aged care facilities and practices, day in and day out.

Follow Karen Keast on Twitter @stylemywords