At times, our own light goes out and is rekindled by a spark from another person. Each of us has to think with deep gratitude of those things that have lighted the flame within us. - Albert Schweitzer
As we look forward to the possibilities of a new year, it is natural to reflect and be thankful for those people who are most important to us including family, friends, and coworkers and to acknowledge the facets that make our lives meaningful and bring us happiness. As nurses, we should be aware that the act of conveying gratitude is more powerful than we may realize.
An attitude of gratitude is the foundation for regular appreciation for both major and minor life events. The effort of focusing on what we are grateful for diminishes pessimism and jump-starts optimism. Showing gratitude is not merely about soft skills that create good feelings. There is science behind the power of gratitude, emanating from the emerging field of positive psychology. As a defense mechanism, humans are wired for sensitivity and action to address negative situations. Neurons that fire together wire together. Brain research demonstrates that enabling neurons to fire and wire together around gratitude can be accomplished with merely six periods of 30-second gratitude practice performed daily (Comaford, 2017).
Positive thoughts, centered on thankfulness, activate the release of dopamine and serotonin. These neurotransmitters spark optimism and generate intrinsic motivation. This is referred to as "the gratitude circuit." When the gratitude circuit is triggered, it prompts one to be more aware of positive events, rather than automatically being drawn to negative details (Burton, 2016). Brain imaging observations have elucidated this. A pay-it-forward exercise conducted at UC Berkeley illustrated that people who gave a charitable contribution, as an act of gratitude, showed greater neural sensitivity in the medial prefrontal cortex. This neural activity is associated with learning and decision making. The studies also concluded that people who experienced more gratitude are also more aware of how they show gratitude to others. This brain activity was manifestly different from subjects who acted out of guilt or the need to support a particular cause, rather than purely related to being grateful (Wong & Brown, 2017).
Gratitude is a healthy practice. Prominent researcher in the science of gratitude, Robert A. Emmons, at UC Davis, reports that individuals who consistently practice gratitude also take steps toward a healthy lifestyle, with nutrition, exercise habits, lower rates of smoking, and limited alcohol use. The cardiovascular wellness markers of improved cholesterol levels, lower systolic blood pressure at rest and during stress, lower levels of C-reactive protein, and better heart rate variability response are associated with individuals who regularly demonstrate gratitude (UC Davis Health, 2015). A significant finding of research on gratitude indicates that of all character strengths, gratitude is the highest predictor of well-being. Psychological studies indicate that people who regularly express thanks experience less depression, are more positive and optimistic, and exhibit better self-esteem (Cox, 2018).
Considering the daily stresses that face nurses, it is understandable that negativity in the work environment can result in a toxic culture, centered on faultfinding and cynicism. A recent survey conducted by http://Nursing.org asked nurses who were in the profession for less than 1 year what they wished they had known before starting their first positions. The top five items were understanding and acceptance that no one has all the answers, realization of the independent nature of the work, recognition that slow deliberate action is better than rushing, the need to keep the best interests of the patient in the forefront, and the insight that small degrees of gratitude can make a considerable difference (Becker's Hospital Review, 2018).
This survey has important implications for nursing leaders. The act of practicing gratitude is a component of emotional intelligence and is essential for effective leadership. Gratitude affects the way nursing leaders are perceived by others and is a conduit for collaboration. When people feel valued, they have higher job satisfaction, engage positively with coworkers, and are more eager to work toward organizational goals.
Showing gratitude need not be complicated. However, it does need to be genuine and it does need to be hardwired. This comes with practice. Following are a few ways that nurse leaders can exercise gratitude:
* Use huddles to convey gratitude. State three things you are glad about in beginning shift huddle. Articulate the contributions others have made, especially when meeting to debrief a troublesome event such as a fall or critical occurrence.
* Start a gratitude journal. In this fast-paced environment, this may seem unnecessary; yet, the simple act of writing down what we are thankful for forces us to be intentional. Remember that we are wired to be negative and we need all the help we can get to work against that reality.
* Regularly recognize a colleague from another discipline or area in staff meetings. Gratitude is contagious and appreciated on an interdisciplinary level.
* Show appreciation for the good things that happen at the moment you realize it, rather than waiting for the annual appraisal.
Gratitude is contagious and so are the good feelings that follow. On the Joint Replacement Unit at my organization, the Medical University of South Carolina, a monthly ritual was started several years ago. This consists of bestowing "The Golden Bone Award" to a unit care team member during the monthly unit staff meeting. This is a small gesture, yet it is highly coveted. Recipients are nominated by coworkers as an act of gratitude for qualifying attributes such as exemplifying excellence in care of a difficult patient, solving a problem that makes work-life easier, helping a care team member through a particularly rough shift, or going above and beyond what is expected. Notes of thanks directed at all nominees are read aloud by the nurse manager. The winning care team member is announced and his or her photograph with The Golden Bone trophy-a gold spray-painted pelvis or femur-is featured in a prominent hallway. On our 10 East Joint Replacement Unit, the photographs are put on display adjacent to the Center of Excellence and Joint Commission Advanced Hip and Knee and Shoulder Certification plaques. Without these golden bones, those accolades of excellence would never be achievable. As noted, gratitude is contagious. The act of being grateful for a golden bone among the nursing care team has spread through the entire musculoskeletal department. Golden Bone nominations to recognize physicians, orthopaedic residents, clinic staff, and others on the interdisciplinary team have been adopted by the orthopaedic surgical leadership. There is something special about this small token of appreciation and gratitude that makes us a winning team!
In a world where we seem to be increasingly accosted with negativity and doubt, practicing gratitude allows us to celebrate our interconnectedness and purpose. Neurons that fire together wire together. Take a few pauses every day to focus on what you are thankful for and use that gratitude circuit to help keep the spark alive.
I would like to voice my appreciation for all that NAON accomplishes and for all who are part of the NAON family. Thank you for everything you do in support of orthopaedic nursing practice. Best wishes for a bright 2019!
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