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A Systemic Review of the Impact of Essential Oil Aromatherapy on Nurse Work-Related Stress Taylor Brogan, BSN, RN, CCRN; Sandra Hubbard, BSN, RN; Kalyn O’Conner, BSN, RN - 9M NTICU *Editors note: This EBP Analysis was completed through an EBP Concentration with the Office of Nursing EBP & Research. Mentor - Kim Carter, PhD, RN, NEA-BC Stress occurs when the physical and psychological borders of an organism are threatened 1. Intermittent stress poses little threat to the body; however, when stress is experienced for long periods of time with moderate to severe intensity, anxiety can follow. Nurses who experience high levels of stress for long periods of time are at increased risk of psychological issues such as depression and low self-esteem, as well as physical symptoms such as increased blood pressure and cardiovascular disease2. They are also more likely to leave their current position or leave the nursing profession all together2. Nurses report that factors that increase job-related stress are moral distress, increased workloads, increasingly higher patient acuity, physician communication struggles, and poor leadership3. The result of this cumulative stress can be increased job dissatisfaction, symptoms of moral burnout, and high turnover rates4. Research indicates that nurses who have higher resilience and a larger arsenal of coping mechanisms are better able to cope with work-related stress and are less likely to experience symptoms of moral distress and burnout. One alternative coping mechanism that may be helpful is aromatherapy. Aromatherapy is defined as the "safe and professional use of essential oils, which are extracted and processed from a plant's bark, flower, root, peel or leaf" 5, p. 95. In addition, clinical aromatherapy is the practice of using essential oils for specific quantifiable effects on the human mind, body and spirit. Holistic approaches to managing stress in the healthcare setting, such as the use of aromatherapy, are supported by the American Holistic Nurses Association 6 because of the impact on positive health behaviors, resilience, and improved nurse-patient communication, care and satisfaction5. The purpose of this work was to identify current knowledge related to the use of aromatherapy to decrease stress for nurses. The Neuro-Trauma Intensive Care Unit (NTICU) experienced a 26% staff turnover percentage in the 2018 fiscal year. The unit based shared governance initiative for 2019 focused on improving staff wellbeing by identifying and reducing the symptoms and causes of stress and burnout. The emphasis on wellness practices to promote resilience and coping led to the development of this study. PICOT question: In ICU nurses, what is the effect of essential oil aromatherapy with peppermint, lavender, lemon and bergamot on work-related stress? Search Strategy and Screening Summary The study focused on four commonly used essential oils: peppermint, lavender, lemon and bergamot. CINAHL, HERO and TRIP were searched to find peer reviewed, evidence-based articles written in English using the terms, “nurs*, essential oil, peppermint, lavender, lemon, bergamot.” Clinically based, nursing specific studies were chosen for review. Organizational websites such as the American Association of Critical Care Nurses (AACN) and the American Holistic Nurses Association (AHNA) were also consulted. In addition, current Carilion policies were reviewed. The findings were analyzed using a matrix.
