Loma Linda study highlights coping resources in a challenging environment.
A team of faculty and a Ph.D. student at Loma Linda University School of Nursing discovered how nurses working in Haiti manage to sustain resilience and display exemplary dedication toward patient care amid difficult working conditions.
Haitian nurses see nursing as more than a job, as a “divine calling” that yields a deeply ingrained sense of purpose, according to a study published by the Journal of Christian Nursing titled, “Dedication in a Difficult Context: Faith-Based Nursing in Haiti,” in early April 2021.
“They see themselves as missionaries to their fellow citizens and community,” said lead author Lisa Roberts, a professor and research director for LLU School of Nursing. “My feeling is that it is the basis of their resilience.”
The study noted the nurses’ hope, positive attitudes, and mutual supportiveness as resilience characteristics and coping aids when facing daily persistent stressors. Many expressed desire for personal growth, career ambitions, and the value of patient-centered care.
And yet, nearly every contributing factor to burnout exists in these nurses’ working environments. Haiti is the poorest country in the Western hemisphere, and, because of its geographic location in the Caribbean Sea, is the country fifth most prone in the world to a range of natural disasters — storms, floods, earthquakes — and the devastating aftermath, including infectious disease outbreaks and wound infections.
Such challenges, unique to Haiti, are compounded by the more common struggles experienced in institutions and countries, including socio-economic and health-care disparity, low wages, and the challenges of caring for high-needs patients, along with nursing shortages and maldistribution.
Interested in describing the outlook of Haitian nurses and their responses to such challenges, LLU researchers conducted a series of interviews with 17 nurses working across two faith-based hospitals. The interviewees acknowledged stressors such as long shifts, exhaustion, lengthy commutes, working extra jobs, irregular schedules, food insecurity, emotional pain, lack of autonomy, and lack of respect from other health-care providers.
“The circumstances they are working in are tremendously difficult, and the nurses are acutely aware of these challenges,” Roberts said. “We observed that the nurses had an alignment of personal purpose with the mission focus and values of the faith-based organizations they work in, making it possible to rise above the difficulties as much as possible.”
In other words, the nurses persevered, linking their faith inextricably to their profession. They infused their responses with expressions of professional pride and of nursing as an ethical duty or divine calling:
- “Well, since you made a vow, you need to respect the vow and always do your duty.”
- “Care with love, and all that you have learned, do it well.”
- “When we give a service, we don’t do it for ourselves, but we do it directly for God.”
- “It is a work which is noble because we can help save someone’s life.”
Analyzing the interviews with Haitian nurses gave LLU researchers a better understanding of how nurses working in a difficult context demonstrate coping and resilience. Roberts said she hopes the findings will guide future recommendations and interventions that may be applied for nurses in other countries and organizations experiencing similar challenges.
“Many of the difficulties they face serve as a basis for commonality between sites and nurses in different parts of the world,” she said. “I hope that highlighting the dedication of these nurses will be an inspiration to others who are in difficult circumstances too.”