加護病房護理師之情緒管理與學習歷程

Abstract

護理工作是需要很多情緒勞務的工作，許多研究以醫院各個單位的護理師作為研究對象，調查他們的情緒管理策略，然而，每個單位的工作條件和工作壓力都不一樣，加護病房的護理師主要的工作壓力就是來自於密集的人際互動，所以，這個研究旨在了解加護病房護理師使用情緒管理策略的經驗。另一個研究目的為了解使用某個策略後對情緒事件和對護理師的影響，加護病房裡密集的人際互動也讓護士經歷不同的學習歷程，所以，這個研究也想要調查加護病房護理師對於情緒管理的學習歷程。這個研究採用質性研究並透過訪談和文件審查來蒐集研究資料，訪談對象來自不同醫院的加護病房護理師，基本年資都有一年以上。研究發現指出現況改變、認知改變和反應調節是最常用的情緒管理策略，且當護理師安撫病患或病患家屬，通常會讓情緒事情有滿意的結尾，反之，若護理師傾向於隱藏當下的情緒，通常會讓自己帶著不愉快的心情下班。研究也發現大部分的護理師會經由觀察同事和病人、家屬間的互動學習到反應調節，經由個人的經驗和對於他人做事的觀察可學習到認知改變和現況改變。Nursing job is considered as high level of emotional labor. Many research studies have examined the emotion management strategies by randomly choosing participants from all sections of the hospital. However, the work condition and work stress are different in every hospital section. Intensive Care Units involve highly intensive social interaction that is the primary source of ICU nurses’ work stress. Thus, this study focused on ICU nurses to understand their experience of using emotion management strategies in emotional incidents. This study also aimed to explore the incident outcome after using the strategy and discuss what influence the outcome brings to the involved ICU nurses. The highly intensive social interaction in ICU also made nurses go through different learning process at work. Therefore, another purpose of this study was to understand ICU nurses’ social learning process for emotion management. This study adopted the qualitative approach and collected data through interview and document review. The research participants were ICU nurses who came from different hospitals and had at least one year ICU work experience. Snowball sampling was utilized to enlist qualified ICU nurses through nurses’ networks. The techniques of triangulation and member check were applied to enhance the credibility of the study. The main findings indicated that situation modification, cognitive change, and response modulation were most widely applied emotion management strategies. Among all strategies identified in this study, “reassure patients or relatives” was found to result in more significantly satisfactory incident outcome, while “to hide emotions” often made nurses to finish their work with bad mood. The study also found that most nurses learned to use response modulation through observing the interaction between coworkers and patients and relatives. They were also found to learn cognitive change and situation modification from personal experience and observing others performing tasks. Moreover, this study connected social learning’s literature review with ICU nurses and discussed their social learning situation. The findings of the most used strategies were also compared with previous research studies and discussed. Finally, the study concluded with implications for ICU nurses and health care institutions and suggestions for future researches.