In my opinion the nursing education is not simply to raise awareness of rules and procedures, but to help learning how to get in touch with the cognitive and emotional processes present in places of care and that are started by caring of the patient.

We teachers should think of a training of health professionals that recognized the ethical and epistemological roots of nursing, putting at the center of caring enhancement of human relationship between nurse and patient.

The evolution of scientific knowledge takes place within different contexts of practice in relation to life stories, so nursing student has the need to deepen the emotional dimension of the experience of fragility and pain.

Hi Nuno, despite nurses play an emotional management work in the vast majority of client interactions are still little aware of that fact as a therapeutic instrument. Emotional management is intrinsically present in nursing practice and has been studied as emotional labour in nursing. Researchs on the concept is expanding.

Pam Smith (1992, 2012) is a research reference.

Thank you for your answer, Prof. Paula Diogo.

Since very few nurses are still aware of the fact emotion management is a therapeutic instrument, how can research on its outcomes be performed and how can it be systematized in clinical practice, particularly in critical care?

I think that different strategies may be mobilized in a logic of reflective practice. Regular meetings to review the practices can be performed to reflect on concrete situations mostly related to grief, loss and death. These moments of analysis should be supported by scientific evidence. And they need to be addressed by a more experienced nurse and with specific knowledge in emotional management.

I hope I have clarified ...

There's a considerable amount of literature concerning specific strategies and their efficacy for promoting emotional regulation and emotional competence in psychotherapy. It would be beneficial for all health professionals to create a common platform of contact, development and discussion, in which knowledge is shared and translated into evidence based practices. For example, emotional coaching as advanced by Professor Leslie Greenberg could be adapted and translated into nursing. In order to accomplish such project, it would be necessary to fully develop an understanding of the common aspects between the specific procedures involved in nursing and the intricate theory and practice concerning emotional coaching. I think such dialogue between researchers and practitioners would result in high degree gains for each field.

References:

http://www.sciencedirect.com/science/article/pii/S0277953612005114

http://www.sciencedirect.com/science/article/pii/S0277953612000172

Thanks for your reply, João.

I agree with you when you say that all healthcare practitioners could benefit from a common platform of discussion and practice-sharing. I'm currently involved in a project that aims at doing so, concerning emotions in healthcare.

Going to take at look at the links you provided as soon as I can.

Emotional competence in nursing and emotional care is a subject little studied in nursing, but certainly it is an area that needs to be used to improve the user satisfaction, health and welfare, and no doubt, in satisfaction of nurses themselves.

Possibly would be investigated in order to realize the emotional competence as a practical nurse.

You also need to present in the most modern theoretical framework in nursing and highlight the necessary attention and emotions, such as Dra.Jean Watson.

Guadalupe, thank you for you answer.

You state some interesting aspects regarding the importance of emotional competence in quality of care.

Research is, indeed, one of the best ways to systematize nursing interventions that reveal emotional competence in practical nurses and that subject is part of what we study at "Emotions & Health" research line at ui&de, coordinated by Prof. Paula Diogo.

Dr. Jean Watson is one my personal references when studying nursing care in general and particularly emotional competence.

Hello Nuno - I agree Pam, Smith's work is very important here and draws on the work of Arlie Hochschild who first studied Air hostesses and then nurses..... Also Steven Fineman has written books and papers about Emotion in Organizations and my own work has shown a link between nurses’ emotions and patient care experiences. Finally check out the Point of Care Foundation http://www.pointofcarefoundation.org.uk/Home/ where you can find out more about Schwartz Rounds – which have been brought to the UK from Boston, USA. These ‘Rounds’ are multidisciplinary forum where staff can come together to discuss their emotional responses to difficult or upsetting patient care experiences for example – find out more here: http://www.pointofcarefoundation.org.uk/Downloads/Schwartz-Center-Rounds-FAQs.pdf

Hello Jill, very interesting website you have indicated and exemplary intervention in a hospital in order to facilitate the emotional management of health professionals. It is a very useful sharing with translation into practice of scientific evidence!

As the pioneering studies on emotional labour Arlie Hochschild totally agree. But the concept when applied to nursing by Pam Smith (initially students) took into account the specificities of the nurse-patient interaction, and so the concept was expanded or even developed. Smith (1992, 2011) argues that nurses deal with many disturbing emotions, but we must take account of their vocation, the mission of the profession, his satisfaction with the selflessness that generates feelings of contentment and gratification. Thus, nurses consciously use emotions to promote and improve care, and do work with the emotions centrality in patients and centrality in itself. In fact, the pioneering perspective associated with stressful work and emotional dissonance is enlarged in nursing practice, the three other prospects that a whole contribute to the explanation of emotional labour in nursing today. The four perspectives of emotional labour in nursing: a result of the care process, competence of nurses, regulation of own emotions in nurses, stressful work.

Thanks Paula- glad you found the Point of care website useful. Another author who has written in this area is Sharon Bolton:

http://onlinelibrary.wiley.com/doi/10.1111/1467-9566.00242/pdf

Is emotional management valued by nurses in clinical practice? Assuming they have some idea and consensus as to what it is then we could ask them. Should they value it if they don't is probably yes they should. But how it is to be done is enormously complex as neuro-sciences, psychology and philosophy are all showing us. I wonder if you can 'consciously use' emotions. They seem to be more of a reaction to things managed by or informed by reason. If you have to consciously use them perhaps you have (moral) continence and are on your way to something like phronesis I guess. But what would count as 'emotional competence'? When and for whom? So being trained to use it as a therapeutic instrument seems to me to miss the whole point. And we must not forget that patients and others within the scope of nursing practice are all moral agents and ought to think of how they react to others.

I would like to share an article about nursing therapeutic tools.

The concept of therapeutic nursing (MacMahon & Pearson, 1998) emphasizes the intentionality of nursing interventions as having a dynamic force in helping people to achieve health. Within the care the existence of space and opportunity to express emotions, recognize them and manage them in a healthy way process is a means to promote the emotional well-being, which influences the gobal person's health.

In my opinion the nursing education is not simply to raise awareness of rules and procedures, but to help learning how to get in touch with the cognitive and emotional processes present in places of care and that are started by caring of the patient.

We teachers should think of a training of health professionals that recognized the ethical and epistemological roots of nursing, putting at the center of caring enhancement of human relationship between nurse and patient.

The evolution of scientific knowledge takes place within different contexts of practice in relation to life stories, so nursing student has the need to deepen the emotional dimension of the experience of fragility and pain.

In general all nursing schools curriculum pay great attention to this point; however, I don't think this is enough. Although preparing the student to be nurses include preparing them to provide emotional care, this is not always the case.

Therefore, schools should incorporate emotional care in specific courses, in order to really have nurses who provide care to body and mind!!!!!

In general all nursing schools curriculum pay great attention to this point; however, I don't think this is enough. Although preparing the student to be nurses include preparing them to provide emotional care, this is not always the case.

Therefore, schools should incorporate emotional care in specific courses, in order to really have nurses who provide care to body and mind!!!!!

In fact many nursing schools already include in their curriculum lessons on managing emotions, the emotional dimension and emotional labour of nurses. I have been doing some work at this level in the initial and advanced training. I teach one course only on the emotional labour in pediatric nursing and do mentoring graduate students.

But I think it is essential to invest in research on emotions in nursing and make the publication and dissemination through teaching and practice of care.

There is an arduous way to go it is nonetheless an interesting challenge!

I agree with the idea of ​​developing a research on the integration of the theme of emotions in different curricula in nursing schools, in different countries. An international project.

At university I was much taken by Hildagard Peplau's notion of the theraputic relationship between nurse and patient. Although this approach had its roots in mental health nursing i find, on a personal level, being mindful in my acute geriatric nursing practise, of the impact that my way of being has on a delerious, demented and or afraid patient.

At this point I reflect on the call for nursing practise to be scientific and quantifiable juxtaposed against the eternal human condition of coming to terms with suffering and the question of how should one be in the face of it. The whole of the book of Job for instance could be seen as an examination of this issue.

The question for nurses following on from this can be looked at as " how can one be with one who is suffering such that my presence/interventions have a positive impact on the patient's [and here we can insert so many terms but for example] dignity, sense of worth , peace, acceptance, satisfaction with care.

Such questions are informed and examined in great literature- how exciting for us nurses that applying them in everyday practise is our job!