Realization of Cognitive Dissonance as a Nursing Leader

The impetus for this letter to the editor was after I read 3 of articles in August 2021 edition Nurse Leader, first with intense interest, then a realization cognitive dissonance as nursing leader. am writing trepidation assuming that some my leadership colleagues will be uncomfortable intentional action allowing behaviors past, would have resulted timely stronger discussion expected improvement. As pointed out Prestia’s “Nurse Executive Mental Health” article,1Prestia A.S. executive mental health.Nurse Leader. 2021; 19: 378-382Abstract Full Text PDF Scopus (2) Google Scholar she noted nurse executives experience moral distress on continual basis. especially focused description “disequilibrium resulting from inability react ethically situation.”1Prestia Scholar(p.379) former senior role same hospital where currently work, since returned position director clinical documentation improvement (CDI) team, now reporting chief financial officer—not officer. When doing daily rounding new role, find myself observing presumed maladaptive our bedside culture “tolerate” because perceived stress induced by pandemic. Sherman2Sherman R.O. Using trauma-informed approach.Nurse 321-322Abstract (1) page 321 issue, “recognizes and honors emotional scars people have” empathizing employees understanding turmoil. My reading article might not understand witness accept—without real-time dialogue—behaviors staff nurses “allowed” during time years before many profound consequences pandemic profession experiences occasionally lack adherence dress code, use profanity, loud voices night shift, drinks at nurse’s station all violation policies procedures. observe these distress, yet empathy coping mechanisms team need utilize adapt emotional, psychological, physical strain result treading very lightly address any conduct may negative effect interaction them, possibly lose their trust. In CDI accountable partnering physicians other members health care ensure electronic record reflects severity illness risk mortality, start day units interacting assess overall acuity: did we code blues, rapid responses; are cases operating room schedule due day; or patients scheduled tracheostomy (an unfortunately common conversation pandemic), name few entities needs know chart reviews. During conversations, utilized Sherman’s2Sherman emphasis allow unfiltered free themselves they express anxiety about stressors face when caring patient SARs-CoV-2 virus. one enlightening conversation, re-named “P” post-traumatic disorder (PTSD) known 70’s, “CTSD”—the “post” changed “current”: current-traumatic disorder. thought current state perfect description. From CTSD perspective, admit although attempt overt policy, full transparency, also note there times let way works level, sadly, often feel expressing. prepare submit this, reflect had an RN sending into Leader consideration. She sadly answered me inquired her saying “I just want it go back COVID. can’t take anymore.” said us knowing own—a shift who recently delivered healthy baby boy—is intubated ventilator COVID-19 pneumonia. realized goal intervene 1 time, try make difference feelings point avoid “closing door traumatic experience”2Sherman Scholar(p.322) Sherman advised work. uptick vaccinations local area, decrease number diagnosis hospital, how work together focus positives. We talked can build resilience focusing encouraging signs change. leave conversations like hoping reached them made difference, but walk away being sure did. proud what has offer well-being team—from mindfulness sessions, healing garden, employee assistance programs, monetary incentives, extra off, few; strongly is trying best responsive team. response discussions offerings, tell do campus done aim distance physically emotionally evidence A difficult leader sure. leaders provide support needed, Coicou3Coicou R.A. Our responsibility S.T.R.O.N.G.E.R.: (standing together: outreach navigating gracefully & effectively recharge).Nurse 348-351Abstract notes “Our Responsibility Be S.T.R.O.N.G.E.R.,” further research which interventions create outcome development resilience. become reconciled includes interactions tread cautiously hope get nonexhausted selves. must conflict empathy, recognizing own “CTSD.” reach each other, put foot front continually seek opportunities team—and ourselves. Marlene Goodwin-Esola, MSN, RNC, NE-BC, Director Clinical Documentation Improvement Jupiter Medical Center Jupiter, FL. [email protected] .