This chapter included three parts, which are conclusion, implications, and limitations and suggestions for future research. Conclusion of this study was provided at first.
Implications were presented for ICU nurses and health care institutions. Finally, limitations were discussed and suggestions for future research were also presented.
Conclusion
The purposes of this study were to identify ICU nurses’ experience of using emotion management strategies, the incident outcome after using the strategies as well as the influence of incident outcome on the involved ICU nurses. Through social learning perspective, this study also aimed to understand ICU nurses’ social learning for emotion management. This study adopted qualitative approach and collected data through in-depth interview and document review. The data was analyzed through open coding and axial coding and finally categorized into three dimensions, which are emotion management strategies, incident outcome and influence, and social learning of EM strategies.
To respond to the first research purpose, the study found four most widely applied emotion management strategies belonging to three categories in Gross’s emotion regulation model, which are situation modification (“search for other’s help,” “reassure patients or relatives”), cognitive change (“put oneself in other’s shoes”), and response modulation (“to hide emotions”). In second research purpose, the main finding of this study was that among all strategies, “reassure patients or relatives” was found to result in more significantly satisfactory incident outcome, while “to hide emotions” always made nurses to finish their work with bad mood. Another main finding corresponded to the last research purpose was that through observing the interaction between coworkers and patients and relatives and the
situation to avoid more argument. They were also found to learn cognitive change and situation modification from personal experience and observing others performing tasks.
Implications Implications for ICU Nurses
The study found that to reassure patients and relatives when they were angry or sad could lead to many satisfactory outcome but sometimes it could also result in unsatisfactory outcome. From the interaction observation and personal experience, the nurses implied two things they learned to reassure patients and relatives properly. First, the nurses should think more from the patients’ and relatives’ perspective while communicating with them, so that the nurses could turn their anger into empathy and most patients and relatives could accept the reassurance when the nurses tried to understand how they felt. Second, if the nurses could not control the situation with angry relatives, they could search for head nurses’ or doctors’
help to avoid argument with relatives because most of them thought doctors were more reliable. Here were two things the nurses could benefit from searching other’s help. One was that the nurses could learn how head nurses or doctors dealt with the situation; the other was the relatives could have some time to calm their emotions when the nurses left a while for searching for help.
Implications for Health Care Institutions
In addition to negative emotional experience with patients and relatives, disagreeable senior nurses were also found to be one of reasons that ICU nurses felt stressful, especially when they were new nurses. As indicated in the literature review, the learning situation during new nurses’ orientation training was found to have significant influence on their intention to leave, so a supportive learning environment could help nurses adapt to the work condition and enhance their retention intention (Liu, 2010). However, most ICU nurses felt
stressful because some senior nurses often spited them or blame them for making some mistakes. To new nurses, the senior nurses may become their role model and lead them to different experience for them (Henderson et al., 2010). Therefore, the health care institutions should establish and maintain the relationship of mentor and mentee to benefit from positive social learning condition. The two-way evaluation could be conducted and included in individual performance evaluation to ensure the mentor leads the mentee properly and the mentee learns well.
Limitations & Suggestions for Future Research
This study conducted face-to-face interviews to explore ICU nurses’ emotional experience, social learning, and emotion management strategies. However, this study included four limitations. First, participants’ retrospective reports may have been biased by memory problems or affected by current situation. To manage this potential problem, the researcher sent the interview outline for the participants to prepare beforehand in case that they could not recall the memory in the short time. Second limitation for interviews was that the participants may not truly respond their own experience. To manage this problem, the participants were told that the interview participants would be anonymous and the researcher asked many probing questions about the detailed incident and the subject feeling of the participants under the situation, instead of asking some objective judgments. Therefore, the quality and accuracy of responses were reasonable. Third, this study only focused on ICU nurses’ interpersonal emotional incidents without taking non-interpersonal factors into consideration. However, as mentioned in literature review, the primary source of ICU nurses’
work stress was interpersonal factors, and actually emotional labor exists in all social relations in organizational context (Gibson, 1997); therefore, this study focused on ICU nurses’ emotional experience with patients, patients’ relatives, coworkers, and doctors. Lastly,
the incidents may be considered different from patients’, relatives’, other nurses’, or doctors’
perspective. For instance, the nurses may already get used to experiencing patients’ death, however, from relatives’ perspective, it would be very unacceptable and sorrowful.
This study proposed three suggestions for future researches. First, because some non-interpersonal factors may also result in nurses’ work stress, such as workload, work environment, and their personal problems (Diefendorff et al., 2008), future researches were also encouraged to take non-interpersonal factors into consideration when exploring emotion management strategies. Second, this study identified more detailed strategies from Gross’s emotion regulation model (2002) and it was found that some strategies were most often used than others, future researches were suggested to assess the effectiveness of the specific strategies which were found to be most frequently and widely used emotion management strategies. Third, research researches were suggested to investigate the emotional incidents from different people’s perspective. For example, the nurses were angry with patients who did not trust them, however, if future research could investigate the incident from patients’
perspective to understand their thoughts, it would be more helpful for understanding the problem.
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APPENDIX A: INTERVIEW QUESTIONS
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本人為國立臺灣師範大學國際人力資源發展所研究生，目前正在進行論文研究，研究之內 容主要想要了解加護病房護理師的情緒管理與其學習過程。
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國立臺灣師範大學 國際人力發展研究所 研究生 姚莞羚 指導教授 張媁雯 敬上
姚莞羚 Wan-Ling Yao Mobile: 0910-040563 Email:[email protected]
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Consent Form
Dear Sir/Madam,
You are being asked to participate in a research. The researcher is a student at Graduate Institute of International Human Resource Development of the National Taiwan Normal University. The research title is “Emotion Management Strategies and Social Learning Process of ICU Nurses in Taiwan”. This research aims to understand ICU nurses’ experience of using emotion management strategies and ICU nurses’ social learning for emotion management..
This form provides you with general information about the research. The researcher will also introduce the study and will answer all your questions related to it. Please read through the following information and if you have any question please do not hesitate to ask the researcher before signing.
You will be asked to participate in an interview lasting about 60 minutes long.
General topics of discussion will include emotion management strategies in emotional
General topics of discussion will include emotion management strategies in emotional