Care for the caregiver: Benefits of expressive writing for nurses in the United States

Janel D. Sexton, James W. Pennebaker, Christine G. Holzmueller, Albert W. Wu, Sean M. Berenholtz, Sandra M. Swoboda, Peter J. Pronovost, J. Bryan Sexton

Research output: Contribution to journalReview articlepeer-review

19 Scopus citations


This paper introduces expressive writing as a new tool to build psychological resilience in nurses by helping themto reduce the negative impact of the primary sources of stress in their jobs.Delivering care to patients exposes nurses to intense stressors including staffing and workload problems, communication breakdowns, death, bereavement, and medical error. Not surprisingly, these conditions contribute to job dissatisfaction and burnout which are primary causes of nurse turnover. There is an acute need for low cost and simple interventions that enhance nurses' coping with problems leading up to burnout and turnover.We found almost 2 out of 3 RNs reported trouble sleeping, almost half reported feeling burned out, and 1 out of 4 were depressed.Expressive writing has been widely used and is well validated inmany non-nursing populations in helping people cope more effectively with job-related stress and traumatic events. Writing improves health in several ways. One way is through exposure, the process by which difficult emotions become less potent and more manageable. Second is cognitive restructuring, which brings about new ways of thinking about stress thatmakes painful events less upsetting.Third is improved self-regulation, which is the ability to cope with and regulate one's emotions. The well-being of nurses directly affects the quality of patient care.Expressive writing is a time-efficient and easy-to-use intervention to help nurses cope with job upheavals in an effort to reduce job distress, turnover and, ultimately, improve the work environment and patient outcomes.

Original languageEnglish (US)
Pages (from-to)307-312
Number of pages6
JournalProgress in Palliative Care
Issue number6
StatePublished - Dec 1 2009


  • Expressive writing
  • Job stress
  • Nurse resilience

ASJC Scopus subject areas

  • General Nursing


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