The power of gratitude : Nursing Management

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Department: Leadership Q&A

The power of gratitude

Cox, Sharon MSN, BSN

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Nursing Management (Springhouse) 49(4):p 56, April 2018. | DOI: 10.1097/01.NUMA.0000531176.85470.42
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Q Although my unit is getting the work done, staff engagement scores aren't great, absenteeism is up, and my own sense of job satisfaction is dwindling after 5 years in this role. How do we raise morale and make a much needed attitude adjustment?

Catching this deterioration before it impacts patient care is a key and you're right on target to focus on an attitude adjustment. With insights from the emerging field of positive psychology, as well as improved imaging techniques to better understand how our brains work, we're just beginning to understand the attitude of gratitude and the impact that grateful leadership can have.1

Writing in the Wharton Healthcare Quarterly, Linda Roszak Burton highlights the need to include the practice of gratitude as part of emotional intelligence and an essential skill set for leaders. She reports on the neuroscience connected to gratitude, calling gratitude the “secret sauce” to enhance employee engagement. When we're expressing gratitude or reflecting on positives, our brains release dopamine and serotonin, which trigger positive emotions such as optimism and intrinsic motivation. The more we activate these “gratitude circuits,” the stronger the neural pathways become and the more likely we are to notice what's going right rather than habitually being drawn to the negative. As the saying goes, “neurons that fire together, wire together.” Burton references a study on the psychological well-being of nurses, indicating that gratitude is a consistent predictor of less exhaustion and cynicism, fewer absences, higher job satisfaction, and more proactive behaviors.2

Cultivating the practice of gratitude can also change the way others see you. The positivity that you create allows others to perceive you as being friendlier and more willing to help and they, in turn, want to help you. Expressing gratitude “builds a bridge to other people and invites them to cross it.”3 Studies show that people who practice gratitude have less depression, better impulse control, greater optimism, and higher self-esteem. They also have lower BP, lower levels of cortisol, and a stronger immune system. It's interesting to note that, of all the character strengths, gratitude has been found to be the greatest predictor of well-being.3,4

If gratitude does a body good and can be the secret to improving engagement, what can managers do to better practice the attitude of gratitude? How do we tap into the power of acknowledgment? Consider the following ideas to spur your thinking:

  • Keep a gratitude journal—we're wired to hold on to the negative, so be intentional.
  • At the end of the day and first thing in the morning, think of three things for which you're grateful.
  • Write an e-mail of appreciation to start your day and connect it to an organizational value.
  • End meetings, including staff meetings, with each person mentioning one thing for which he or she is grateful.
  • Share your appreciation in the moment (make it timely) rather than just a generic word of thanks in staff meetings.
  • Set a target to have recognition moments each day.5
  • Find something positive about someone who ordinarily frustrates you and thank him or her.
  • During staff meetings, routinely recognize a colleague from another department nominated by your staff members.
  • Collect stories of employees living organizational values and share them in group meetings.

Expressing appreciation helps us identify the right behaviors, provide feedback, break down silos, and create trust.5 It's also worth noting that grateful people pay it forward, achieve more, and create a positive feedback loop.5 As Mark Twain said, “I can live for 2 months on a good compliment.” Gratitude is the gift that keeps on giving.

When your appreciation is sincere, fair, and deserved, you're drawing on the power inherent in the attitude of gratitude. It's the perfect place to begin your turnaround efforts and, by the way, thanks for your question!


1. Umlas J. Grateful Leadership: Using the Power of Acknowledgement to Engage All Your People and Achieve Superior Results. New York, NY: McGraw-Hill; 2013.
2. Burton LR. The neuroscience of gratitude.
3. Felps P. Discover the hidden power of “thank you.”
4. Steindl-Rast D. Want to be happy? Be grateful.
5. Mosely E, Irvine D. The Power of Thanks: How Social Recognition Empowers Employees and Creates A Best Place to Work. New York, NY: McGraw-Hill; 2014.
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