Critical Factors in Managing Relationally Demanding Jobs, in Care for Very Ill and/or Dying Patients: A Phenomenological Study among Public Hospital Nurses

Abstract

Background: Workload, interpersonal relationships, professional conflict and the emotional cost of providing care are potential sources of stress and burnout among nurses. Based on experiences of hospital nurses, this paper aims to identify critical factors for nurses in managing relationally demanding situations in care for very ill and/or dying patients. Methods: In-depth interviews were carried out with six nurses, working in a medium-sized hospital in Norway. The interviews were analysed using an interpretative phenomenological analysis. Results: The lack of identification with the core aspect of the job, relational contact with patients and relatives, and external motivation were found as potential barriers for managing relationally demanding jobs. The results also indicate that the nurses' experiences of symptoms of burnout can be a result of demands that exceeded the nurses' resources. A match between personal capacity and demands, mutual support among colleagues and leadership support, and contextual factors are critical to prevent the negative process of burnout. Conclusion: The results underscore the importance of an early response to employees who are beginning to struggle at work and the relevance of a true match between personal capacity and job demands. Moreover support among colleagues and leadership seems critical to prevent a negative process of burnout and help to manage relationally demanding jobs.

Experiences of Staying Healthy in Relationally Demanding Jobs: An Interpretative Phenomenological Study of Work-Engaged Nurses in the Hospital

“…The dominating approach towards authenticity is to understand autonomous acts as being authentic acts; that is, the action springs from values, wishes or motivations which the persons identify with [32]. Several studies have shown that the consequence of not identifying with an activity, or not feeling competent to perform it, may have contributed to the symptoms of burnout and problems in maintaining their health over time [34]- [36]. When the nurses act in accordance with their own values and interests, they can avoid feeling the stress that is often connected with acts of inauthenticity and thus gain positive health benefits.…”