August 3, 2008
Response by Lisa Kennedy Sheldon to: "Why Emotions Matter: Age, Agitation, and Burnout Among Registered Nurses," by Erickson and Grove (October 29, 2007)
Reply by author Rebecca Erickson
Thank you for your informative articles in OJIN. Recently, I read the article, "Why Emotions Matter: Age, Agitation, and Burnout Among Registered Nurses," by Erickson and Grove. The authors address an important topic that requires further exposure: the emotional work of nursing. Not only do emotions play a part in occupational stress and burnout, they also affect the ability of nurses to authentically engage in conversations with patients. These interactions are necessary to explore patient concerns such as the need for more information or to identify more serious conditions such as anxiety and depression.
For the purposes of their study, emotion management was considered emotional labor and related to burnout. Drs. Erickson and Grove described "surface-acting" as "managing outward expression of emotions in the hope that authentic emotion will follow" and "covering up." The researchers concluded that younger nurses (less than 30 years) experienced more work stress and higher burnout but less surface acting/emotional work. Conversely, older nurses (over age 30) had less work stress and burnout but more surface acting. In conclusion, the authors stated that emotional labor did not explain the higher rates of burnout in younger nurses or why older nurses had lower burnout rates but felt less positive emotions.
Older nurses have usually developed different levels of emotional engagement to address patient concerns while maintaining a sense of personal integrity and the ability to fully engage in their other social roles. If they employ more surface acting and feel less of the negative emotions such as anger, irritation and frustration, they are also feeling less joy, hope and connectedness with their patients. There are dangers in maintaining emotional distance that may not be beneficial for nurses or patients. Younger nurses may feel more empathy but also are more likely to experience negative emotions. The authors concluded wisely that less experienced nurses require more support from experienced nurse mentors. The development of emotional management techniques in younger nurses may prevent the development of emotional detachment as nurses are employed longer in nursing. The pairing of experienced nurse mentors with newer nurses may also benefit the older nurse by reawakening the possibilities of joy and empathy during experiences with patients.
I am grateful that the authors have provided us with new insights into the emotional work of nursing and the need for more support mechanisms for newer and experienced nurses.
Lisa Kennedy Sheldon PhD ARNP
Oncology Nurse Practitioner
St. Joseph Hospital
Nashua, New Hampshire