AIM: This study was designed to determine: a) if a provided toolkit of resiliency building activities would increase resiliency over a 6 week period b) which activities were most often utilized by nurses; c) if nurses would continue using the activities once the study ended. IRB approval was obtained by the hospital system and the university affiliated with the nurse researchers. The hospital system funded this study.
SAMPLE: Nurse participants were recruited from four hospital campuses within one governing hospital system in an urban metropolitan area in one southern state in the last quarter of 2017. Two to four hospital nursing units were chosen from each hospital campus. The nurses were employed by the facility on a full or part time basis and practiced at the bedside, caring for similar medical/surgical patient populations with a 1:5 nurse to patient ratio.
INTERVENTION: Participants received a toolkit including a) guided meditation smartphone app, b) deep breathing smartphone app, c) gaming smartphone apps, d) Sudoku and mind game book, e) lavender aromatherapy, and f) adult coloring book with pencils.
DATA COLLECTION: Data were collected between November 2017 and February 2018 using Qualtrics. In Qualtrics, each participant had a unique link by which to access their data collection surveys. An initial assessment was completed prior to beginning that included demographic data and a baseline Connor-Davidson Resiliency Scale (CDRISC)(Connor & Davidson, 2003). Once an intervention was used,participants completed an investigator created online checklist over the course of 10 worked shifts within a 6-week period. After 10 shift checklists were completed, the participants completed a CDRISC post-test.
DESIGN: The design was a multi-site quasi-experimental pre- and post- test interventional study using within subjects design due to the absence of a control group.
RESULTS: Initially, 142 subjects completed the demographics, and 90 completed all 10 shift checklists, with 70 completing the post-test. The majority of participants worked during the day shift (60.4%), and were BSN graduates (55%). A paired t-test on the pre/post resiliency scores showed a significant difference after the use of the tools (p<0.02, df = 72, t = -2.37). Outside stressors and demographics/variables were not related to the CDRISC scores. Subjects used the interventions more frequently and spent more time using them as the study progressed. Further, 97.1% reported a desire to continue using the interventions. The top four activities were: deep breathing 83.1%, lavender aromatherapy 57.7%, guided meditation 29.6% and gaming (Bejeweled) 28.2%.
DISCUSSION: This study looked at how nurses can modulate stress while on-shift in the hospital using activities provided by administration. The two most accessible and expeditious interventions were also the most popular (breathing exercises and a lavender inhaler). Having resiliency building activities readily available during work hours was shown to increase resiliency scores in a six week period. Stress has been shown to cause loss of nursing staff (Adriaenssens, De Gucht, & Maes, 2015; Delgado et. al, 2017). Offering a means of addressing stress during work hours appears to lead to increased resiliency. Making a culture change in hospitals to not only acknowledge but address work place stress may result in higher retention rates and a healthier workplace environment.