Introduction
Correctional nurses working in a jail setting often feel stress due to a high workload, role conflicts, aggression, and other factors. Moreover, correctional nurses may suffer from stress because of staff shortages, overload and safety issues, and the high-risk behaviors of prisoners. Moral distress is another challenge experienced by correctional nurses working in jail. According to Lazzari et al. (2019), moral distress is a painful sensation accompanied by anger, guilt, frustration, headache, and other symptoms. They arise when a nurse cannot perform a morally appropriate action due to various external and internal factors (Lazarri et al., 2019, p. 41). A lack of access to medical equipment, lack of time, legal limits, and lack of managerial support – all these obstacles may lead to mental and physical stress. The Stress Theory of Adaptation and Resilience will be created further to understand how correctional nurses should cope with work-related stress. The purpose of this theory is to guide correctional nurses, improve their knowledge about stress, and help them manage stress with the help of adaptation, resilience, and inner strength.
The topic of stress is relevant for my practice as an advanced practice nurse because stress is unavoidable in my profession. Therefore, it is crucial to manage stress and recover oneself from it. High levels of stress may cause different mental health problems, threatening the health of advanced nurse practitioners and their patients. Moreover, moral distress may lead to medical errors and professional burnout, increasing the risks of collective dismissal. The biggest problem is that stress may be difficult to notice. If left untreated, it will cause various physical disorders, such as high blood pressure, insomnia, overeating, being overweight, anorexia nervosa, and other ailments. Mental health disorders, like despair or anxiety, are also inevitable when stress is unaddressed. One can see that the stress theory of adaptation and resilience may be helpful for correctional nurses since it will help them manage stress at work and prevent physical and mental disorders related to this problem.
Definitions and Descriptions
As evident from the title, the main concepts of the analyzed stress theory are adaptation and resilience. Adaptation is the capacity to adjust to changes, alter one’s habits and behaviors in accordance with new alterations, and an ability to learn quickly and adopt necessary alterations. This quality is essential for all correctional nurses, especially those who begin to work in a jail setting after working in a usual medical setting. Changes in healthcare practices may be significant, so nurses should be able to adjust to them.
Resilience is another important concept of the stress theory for correctional nurses. A nurse should develop resilience through positive thinking, strong and healthy relationships, social assistance, and a sense of meaning. If correctional nurses comprehend the value of their work, they will feel more confident and secure. A resilient nurse has a strong sense of self, faith, insight, and hope and always finds time to look after oneself (Ramalisa et al., 2018, p. 2). Strengthening resilience is essential for correctional nurses because this quality may help them cope with stress at work.
Research showed that adaptation is a fundamental instrument for building resilience in nursing. According to Lyng et al. (2021), the concepts of resilience and adaptation are interrelated and interconnected (p. 2). Adaptation may have positive and negative effects on nurses and may either increase or decrease resilience. At the same time, resilience is often associated with an ability to adapt to stressful situations and reorganize one’s work as a response to changes (Lyng et al., 2021, p. 3). One can see that the concepts of adaptation and resilience are crucial for correctional nurses since they can be used to manage stress and adapt to changes.
One more concept associated with the stress theory is inner strength. Inner strength in nursing is not only about the qualities of a leader. It is about being strong enough to be passionate toward the patients, even if they are criminals (Solbakken et al., 2018, p. 13). Inner strength can be defined as an internal capacity to move forward in a positive direction through challenging and stressful life events (Morgan, 2020, p. 1). Correctional nurses should be able to pull themselves together and persist even when they have no desire to continue their mission. However, some nurses may find it difficult to develop inner strength, and if they do not spend enough time on it, they will be more likely to burn out from stress.
This stress theory aims to explain how correctional nurses can deal with stress at work and in their daily lives. This theory will examine and describe the relationships between different concepts influencing stress. Thus, according to this theory, strengthening adaptation and resilience will help correctional nurses cope with stress at work. Moreover, the theory will demonstrate that professional training and education will increase personal strength and, consequently, decrease the sense of stress. It will also consider personal motivation and work on one’s self. According to it, higher motivation and lower anxiety in correctional nurses help them deal with stress. Finally, stress theory assumes that correctional nurses with higher inner strength are more likely to manage stress than those with lower inner strength.
The stress theory of adaptation and resilience will try to test the hypotheses mentioned above and either confirm or refute them. The purpose of this theory is to guide nursing practice, making it more effective and successful for nurses and patients. If correctional nurses are happy and satisfied with their work, their patients will be happier too, and their health outcomes will be positive. Stress theory will be useful for all advanced practice nurses because all nurses deal with stressful situations, especially during the period of a pandemic.
Role of Research
Research plays an imperative role in the development and use of my theory in practice. The use of credible scientific resources may help define the main concepts applied in theory and review previous research in the field of interest. Before creating a nursing theory, one should build an independent knowledge base in the field of interest. In my case, it is correctional nursing in a jail setting. The first step in the development of stress theory was the review of literature on this subject. The review showed that the topic of stress and the role of adaptation and resilience in correctional nursing is underdeveloped. Thus, it was necessary to examine each concept separately and connect them later.
One should take into account that research will not produce a theory. It will only help build a theory based on empirical knowledge. There is little chance of creating a viable theory without proper scientific research. Research helps interrelate different concepts and apply them to the development of a theory. For instance, the concepts of adaptation and resilience are often interconnected and interrelated. However, they are rarely viewed in relation to stress and stress-coping strategies. Thus, research helped unite these two concepts and interrelate them to one purpose – managing stress at work. Moreover, the concept of inner strength is often considered concerning patients with serious illnesses. However, research helped look at this concept from a novel perspective and apply it to correctional nurses who work in a jail setting. One can see that the role of research is to guide a researcher in the right direction and help them develop a new nursing theory with the help of empirical knowledge.
At the same time, it is not enough to develop a theory. After creating a theory, it should be tested and used in practice, and scholarly research would also be helpful here. Thus, research helps generate theoretical hypotheses and test them in the healthcare environment. In the given case, the reaction of correctional nurses who work in a jail setting to stress and the role of adaptation, resilience, and inner strength in coping with stress were tested with the help of research and practice.
One more important step in the development of a nursing theory is a recording of the nursing process. As a correctional nurse, I deal with inmates who have more health needs than the general population. Unfortunately, there is a lack of advice on working in a prison environment in the scientific literature (Choudhry et al., 2017). Therefore, the role of research is to find evidence that will help generate a working theory and educate nurses on stress-coping strategies through adaptation and resilience.
Research showed that the prisoner culture and environment might positively and negatively affect nurses. On the one hand, working in prison is stressful because prisoners often manipulate nurses, trying to receive medicines they do not need to sell to their inmates, or self-harming to arouse compassion and sympathy (Choudhry et al., 2017, p. 22). On the other hand, correctional nurses find a prison a good autonomous place for practice because they have some power and autonomy there (Choudhry et al., 2017, p. 22). For example, nurses may use their power to visit patients in their cells or manipulate them, using their knowledge about prisoners (Choudhry et al., 2017, p. 22). All these aspects play an imperative role in correctional nursing practice and should be used to develop and apply stress theory.
Case Example
Suppose a prisoner is stabbed in his chest while being outside in the courtyard. A correctional nurse is in a hurry to assist the inmate, but the correctional officer does not allow them to enter the courtyard. The patient is bleeding, something is happening around him, and the nurse cannot assess the situation from the outside. In ten-fifteen minutes, another officer manages to calm down the first officer, but still, he does not allow the nurse into the yard. The patient is bleeding and screaming from pain. It is only one example of stressful situations that may occur in a prison environment. An ability of a nurse to adapt to such situations and make quick and right decisions is crucial for managing stress for both a nurse and a patient.
A correctional nurse could use adaptation, resilience, and inner strength to cope with stress in this and similar cases. Stress theory suggests that strengthening adaptation and resilience will help correctional nurses manage stressful situations. To strengthen resilience, nurses could use the following strategies: receiving support from supervisors and managers, providing support to each other, and engaging in life-long training and learning (Ramalisa et al., 2018, p. 6). In addition, teamwork and improved security measures can also be helpful.
However, one can see that some of the issues mentioned above depend on other people, like supervisors, managers, or security guards, as in the case of correctional nursing. Thus, stress theory recommends that managers, supervisors, and other staff members provide constant psychological support to nurses and each other to preserve healthy relationships at work. Research showed that nurses strengthen resilience when receiving non-work-related support at work. For example, if the security guard did not want to allow the nurse into the courtyard, he could ask his colleagues to bring the patient to a safer place and admit the nurse immediately. Instead, he did nothing, contributing to a stressful situation and decreasing the nurse’s resilience.
Adaptability is an important part of resilience, and if nurses learn to be more adaptable, they will be able to respond to stressful events. Self-motivation and constant education are crucial for nurses, contributing to their well-being and knowledge. Inner strength is another factor influencing the development of adaptation and resilience and an ability to cope with stress. Thus, educational training should be designed to create awareness about different strategies for stress coping and increase nurses’ awareness about coping skills needed in a jail environment. Moreover, organizations should include such training programs in nurses’ working schedules to ensure that they have enough time to learn.
Barriers to Implementing Stress Theory of Adaptation and Resilience in Practice
Although the stress theory of adaptation and practice may seem easy to implement, there are some barriers to applying it in practice. The main barrier is time because correctional nurses often work longer and do not have time to attend educational programs unrelated to their professional growth. Strengthening resilience and adaptation can be achieved through self-education, working on one’s feelings and emotions, and support from colleagues. However, since work in a jail setting is usually more stressful and requires more time and effort from nurses, it may be difficult to find time and inner strength for self-improvement. Therefore, it is important to develop adaptability and resilience before becoming a correctional nurse or including educational programs in nurses’ working schedules.
Conclusion
Stress is an integral part of every prison nurse’s life, and it is essential to find proper strategies that will help nurses manage stressful situations. The stress theory of adaptation and resilience focuses on the importance of these two concepts in coping with stress. Adaptation and resilience are two interrelated and often interdependent concepts. If nurses develop and strengthen these qualities, they will be able to adjust to different complicated situations and deal with stress effectively. However, the main barrier to implementing stress theory in practice is a lack of time. Correctional nurses often have no time to learn about coping strategies and self-improvement. If their organizations included such educational programs in their working schedules, the results would benefit nurses, patients, and other staff members. Nurses who can easily adapt to any environment and respond to stressful events with resilience will manage stress and assist themselves and their patients without any negative consequences for each of them.
References
Choudhry, K., Armstrong, D., & Dregan, A. (2017). Prison nursing: Formation of a stable professional identity. Journal of Forensic Nursing, 13(1), 20-25.
Lazzari, T., Terzoni, S., Destrebecq, A., Meani, L., Bonetti, L., & Ferrara, P. (2019). Moral distress in correctional nurses: A national survey. Nursing Ethics, 27(1), 40-52.
Lyng, H. B., Macrae, C., Guise, V., Haraldseid-Driftland, C., Fagerdal, B., Schibevaag, L., Alsvik, J. G., & Wiig, S. (2021). Balancing adaptation and innovation for resilience in healthcare – a metasynthesis of narratives. BMC Health Services Research, 21(759), 1-13.
Morgan, B. E. (2020). A dimensional analysis of inner strength in people aging with serious illness. Nursing Inquiry, 27(4), 1-12.
Ramalisa, R. J., du Plessis, E., & Koen, M. P. (2018). Increasing coping and strengthening resilience in nurses providing mental health care: Empirical qualitative research. Health SA Gesondheit, 23(0), 1-9.
Solbakken, R., Bergdahl, E., Rudolfsson, G., & Bondas, T. (2018). International nursing. Nursing Administration Quarterly, 42(4), 1-19.