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Resilience key to retention

Developing resilience is central in keeping nurses from leaving the profession.

Developing intimate and meaningful relationships with residents is central to enhancing the resilience of aged care nurses, new research shows. And developing resilience is central in keeping nurses from leaving the profession.

Experienced registered nurses are in short supply in the ageing workforce, and residential aged care facilities consistently fail to attract and retain younger nursing graduates, the study said.

“Improving the conditions of employment for aged care nurses and fostering a culture that focuses on strengthening nurses’ resilience to the physical, mental and emotional demands of their job will be necessary to attract and retain aged care nurses,” said the study to appear in the next edition of the Australasian Journal on Ageing.

“Aged care providers need to be aware that the sense of conflict and frustration that nurses express when there is not enough time to provide the care needed is correlated with emotional exhaustion and burnout.”

The qualitative study of nine nurses working in residential aged care facilities on the Queensland’s Sunshine Coast examined the most important contributors to resilience – defined as “an ability to rebound from adversity and overcome difficult circumstances in one’s life”.

Being able to offer person-centred care largely contributes to resilience, said the authors Fiona Cameron from the School of Health and Sport at Sunshine Coast Tafe and Sonya Brownie from Southern Cross University.

“Nurses in our study expressed a tension between having to manage increasing workplace demands and maintaining compassion and empathy towards residents and their families,” they said.

“Our participants clearly valued long-term, close and intimate relationships with residents and their families. They maintained that these ties helped to buffer them from some of the pressures of the job. They viewed these relationships as deeply satisfying and a key reason for remaining in aged care, and out of the hospital sector.”

When comparing aged care nursing to caring for older people in hospital, one nurse said “it was like drive-by medicine to me. You would see a patient for sometimes a matter of hours then they’re gone. You don’t know what happened to them before and you don’t know what happened after, while in an RACF there is continuity and there is a depth that comes from being able to provide holistic care”.

It was also found resilience could be fostered and learnt when opportunities such as further training, peer support, mentoring and self-reflection were present. Experienced nurse clinicians point to collegial support and opportunities to debrief with colleagues, the use of humour, and the ability to create and maintain a healthy work–life balance as buffers to work place stress.

In the study, the nurses said that, unlike acute care nurses, those working in the aged care sector have limited opportunities to network with professional colleagues. This negatively impacted on their level of job satisfaction and sense of value.

Providing opportunities for aged care nurses to debrief and network with other colleagues needs to be encouraged and facilitated, particularly when stressful situations arise, the authors said.

“Nurses should be encouraged, and supported through adjustments to their workload, to undertake post graduate training, which has been shown to foster professional resilience. Creating stronger professional links with universities and hospitals including mentoring programs will reduce the sense of isolation that many aged care nurses currently experience.”

“Ensuring a work–life balance through exercise, personal interests and social support networks also promotes well-being in aged care nurses. These measures are necessary in order to ensure this valuable workforce is retained, encouraged to expand and is appropriately supported to continue caring for older Australians.”

Key Points
• Resilience in gerontological nurses develops through clinical knowledge, skills and experience that enable nurses to be confident and flexible in their approach to prioritising tasks while maintaining compassion and empathy towards the residents and their families.
• The notion of making a positive difference in older peoples’ quality of life and the degree of satisfaction gained from providing holistic skilful care as well as the enduring long-term relationships with residents and their families fosters the phenomenon of resilience.
• Resilience is experienced when cohesive working teams, colleagues or mentors provide physical or psychological support including opportunities to self-reflect, debrief or validate as well as provide relief through humour and team camaraderie.
• Ensuring work–life balance is promoted through exercise, rest, strong social support networks and interests promote well-being and resilience.

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