Simple Strategies to Increase Positive Emotion Skills

Jul 21, 2020

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Symposium in AACN Advanced Critical Care focuses on promoting well-being and resilience in critical care nursing

ALISO VIEJO, Calif. – July 21, 2020 – Making a concerted effort to increase positive emotion shows promise as a way to improve wellness and address burnout in nurses, according to an article in AACN Advanced Critical Care.

Many wellness programs and burnout prevention interventions focus on reducing negative states, such as stress, depression and anxiety. A growing body of evidence highlights the unique and independent role of positive emotion in coping with stress, making it a promising avenue for interventions that aim to reduce burnout and promote well-being among nurses and other healthcare professionals.

Positive Emotion Skills Intervention to Address Burnout in Critical Care Nurses” offers quick, convenient and relatively inexpensive strategies that can be easily integrated into the busy lives of critical care nurses, with both individual and team applications.

Co-author Elaine Cheung, PhD, is research assistant professor in the Department of Medical Social Sciences at Northwestern University Feinberg School of Medicine and Osher Center for Integrative Medicine at Northwestern Medicine, both in Chicago.

“To fully address burnout in nursing, organizational change is necessary,” she said. “However, such change takes time, resources and effort to implement. In the meantime, individual-level interventions such as ours can help address burnout and compassion fatigue.”

The intervention teaches several skills for increasing the frequency of positive emotion in daily life:

  • Noticing Positive Events: Take time to savor everyday positive moments, such as celebrating a patient reaching a milestone toward recovery or appreciating meaningful interactions.
  • Capitalizing: Amplify and extend the impact of positive events to strengthen the connection between the event and the emotions. This skill could include telling a friend about the event, sharing it on social media or writing about it in a journal.
  • Gratitude: Nurture a sense of thankfulness and express gratitude to others.
  • Positive Reappraisal: Reframe the significance of negative or stressful events in a more positive way.
  • Mindfulness: Pay attention, focus on the present moment, in a nonjudgmental fashion, such as through formal meditation or informal activities that incorporate mindfulness into everyday workplace activities.
  • Personal Strengths: Recognize and appreciate one’s unique set of strengths, skills and talents, and acknowledge those of colleagues.
  • Attainable Goals: Establish and pursue personal and team goals for a greater sense of control in a sometimes hectic and often unpredictable work environment.
  • Self-Compassion: Be kind and understanding toward oneself and help create a workplace culture where personal experiences with errors and feelings of inadequacy are openly shared and addressed.
  • Compassion Toward Others: Help colleagues with seemingly small gestures that provide emotional support and build an overall culture of collaboration and teamwork.

These elements were originally developed and tested in populations coping with health-related stress. Recently, the authors conducted an extensive modification process to develop a customized pilot program for medical students. The tailored program included four hour long sessions integrated into the mandatory medical school curriculum and access to specific online practice exercises and resources.

The authors suggested adapting the learnings from those interventions to help critical care nurses cope more effectively with workplace stress and sustain a sense of meaning and engagement in their work.

In recognition of nurses’ busy schedules, the article includes several examples of brief and practical applications that require a minimal time commitment, are simple and enjoyable to do, and can be easily integrated into everyday workplace activities. In addition, it includes exercises that can be practiced in a team setting to build collegial support and stronger relationships across the healthcare team.

The article is part of a five-article symposium published in the summer 2020 issue of the journal, with a focus on promoting well-being and resilience in critical care nursing. The series includes a timely examination of the recent consensus report, “Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being,” from The National Academy of Sciences, Engineering, and Medicine (NASEM).

Meredith Mealer, PhD, served as editor for the symposium. She is associate professor in the Department of Physical Medicine and Rehabilitation at the University of Colorado Anschutz Medical Campus in Aurora.

“The NASEM report is an encouraging step as we try to develop interventions to mitigate symptoms of distress, improve well-being, build resilience, and improve overall clinician and patient satisfaction with the healthcare environment,” she said. “We must continue to seek solutions and make caregiver well-being a priority.”

AACN Advanced Critical Care is a quarterly, peer-reviewed publication with in-depth articles intended for experienced critical care and acute care clinicians at the bedside, advanced practice nurses, and clinical and academic educators. Each issue includes a topic-based symposium, feature articles and columns of interest to critical and progressive care clinicians. The American Association of Critical-Care Nurses (AACN) publishes the journal.

Access the issue by visiting the AACN Advanced Critical Care website at

About AACN Advanced Critical Care: AACN Advanced Critical Care, is a quarterly, peer-reviewed publication with in-depth articles intended for experienced critical care and acute care clinicians at the bedside, advanced practice nurses, and clinical and academic educators. An official publication of the American Association of Critical-Care Nurses, the journal has a circulation of 4,845 and can be accessed at

About the American Association of Critical-Care Nurses: For more than 50 years, the American Association of Critical-Care Nurses (AACN) has been dedicated to acute and critical care nursing excellence. The organization’s vision is to create a healthcare system driven by the needs of patients and their families in which acute and critical care nurses make their optimal contribution. AACN is the world's largest specialty nursing organization, with more than 120,000 members and over 200 chapters in the United States.

American Association of Critical-Care Nurses, 27071 Aliso Creek Road, Aliso Viejo, CA 92656; 949-362-2000;;;