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GRIT IN NURSING 1
Grit in Nursing: Concept Analysis
Name
School Name
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Abstract
Grit in nurses has numerous positive outcomes that may have implications for nursing practice as
well as nurses themselves. But the concept is not well defined and often confused with other
constructs. The paper discusses available literature data. According to the literature review, five
attributes of nursing grit are identified: resilience, perseverance, passion, conscientiousness, and
compassion. Antecedents and consequences are defined. Based on the attributes, a model case is
constructed to illustrate the concept of grit in nursing.
Keywords: nursing, grit, concept analysis
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Grit in Nursing: Concept Analysis
Grit is a relatively new concept. Some researchers see it as similar to other constructs, but
it is unique. This paper explores the concept of grit in nursing. The concept analysis utilizes steps
from Wilson’s Concept Analysis. Purposes of the analysis are identified for nursing practice,
education, and research. Its uses, and definitions are outlined based on the available literature.
Based on the literature review, there are five defining attributes of grit in nursing: resilience,
perseverance, passion, conscientiousness, and compassion. Antecedents of nursing grit include
discovery of interest, setting the goal, and presence of adversity. Consequences of nursing grit
are excellence in practice, personal growth, and happiness. A model case is presented for a better
illustration of grit in nursing.
Purposes of the Grit Analysis
The purpose of this concept analysis is to explore the meaning of grit in the context of
nursing. The enhanced understanding will then contribute to its use in nursing education,
practice, and research. Improved awareness of the concept will enable nurses to exercise and
grow their grit to provide excellent care to their patients. It will help nursing educators to
incorporate methods to foster grit in nursing students. Researchers report that grit can be taught,
but there is lack of evidence about what interventions may be helpful. It addition, it may prompt
researchers to develop evidence-based recommendations about fostering grit. Nursing
administrators may seek grittier nurses to achieve better patients’ outcomes.
The Uses of Grit
A thorough data research using keywords grit, grit in nursing was performed. Major
databases CINAHL, ProQuest, and Google Scholar were utilized. According to Merriam-
Webster dictionary (2021), grit is a “sand, gravel”, “a hard sharp granule (as of sand), “any of
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several sandstones”, “the structure of a stone that adapts it to grinding”, “firmness of mind or
spirit: unyielding courage in the face of hardship or danger”.
Psychologist Duckworth has been studying grit. According to her definition, grit is a
“perseverance and passion for long-term goals” (Duckworth et al., 2007, para. 1). Sustained
interest gives motivation for achieving long-term goals. People with grit are consistent with their
goals, they do not give up and trade them in the face of difficulties and failure. Grit, not talent or
intellect, is a predictor of high achievements in different fields like education, military, sports or
any professional development. Grit predicts personal success. Conscientiousness implies self-
control in a given moment, grit represents pursuing long-term goals, persistency and consistency
of grit differ it from other similar constructs. To achieve their long-term goals, gritty people
choose more effective methods to practice over more enjoyable but less effective activities
(Duckworth et al., 2007).
Maddi et al. (2012) characterize grit as “a sustained pursuit of a given interest or goal”
(p.23). They measured grit by the grit scale developed by Duckworth and Quinn, which includes
assessment of two main factors of grit: consistency of interests and perseverance of effort.
Among other variables that were measured, grit had a more predictive value than other variables
on retention in difficult circumstances (Maddi et al., 2012).
Cosgrove et al. (2018) use the Duckworth definition of grit as well. Grit is viewed as a
measure of behavior and goal achievement that leads to outstanding behavioral outcomes. Grit is
a stable, but modifiable persistence toward long-term goals. Higher grit predicted better
academic scores, but it did not predict higher fitness testing (Cosgrove et al., 2018).
Stoffel and Cane (2018) also define grit as sustained commitment toward achieving long-
term objectives despite obstacles, failures and setbacks. Grit Scales by Duckworth are used to
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compare academic performance of students, the total grit score was a predictor for a higher grade
point average (Stoffel & Cane, 2018). Robinson uses the Grit Scale to evaluate the relationship
between grit and nursing student academic engagement and found association of higher grit and
stronger course engagement (Stoffel & Cane, 2018). Measuring grit is very challenging because
it is based on self-reporting and has social desirability bias (Stoffel & Cane, 2018).
Hellman and Gwinn (2017) also characterize grit as perseverance and passion for long-
term goals, which can be significantly increased along with other character strengths (zest, self-
control, optimism, gratitude, social intelligence, and curiosity) after brief hope intervention.
Bolton et al. (2016) associate grit with nine themes: frailty (ability to adapt to physical
impairments positively), determination (the will to survive and refusal to be defeated, refusal to
be helpless), perseverance, self-reliance, head-on approach to challenges, moving forward with
life, will to live, strengths that buffer the impact of well-being, and anticipating one’s future
losses. Crede et al. (2017) have conducted a meta-analysis of grit research and have found that
grit is strongly related to conscientiousness. Perseverance has a stronger effect on performance
than consistency of interests (Crede et al., 2017).
Vainio and Daukantait (2016) state that grit positively relates to well-being factors:
psychological well-being, satisfaction with life and harmony in life since people are naturally
motivated to realize their highest potential. Substance of grit is not a strict determination to
pursue goals no matter the costs, but to pursue the goals that are consistent with one’s inner
values relying on consistency of self (Vainio & Daukantait, 2016).
Jin and Kim (2017) have also explored how grit relates to the subjective side of life, such
as well-being. They state that “grit means dedication to long-term goals with enthusiasm, which
is closely related to success in objective terms” (para. 1). Grit increases satisfying the autonomy
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and competence needs, autonomy then reduces depression, and competence increases life
satisfaction, and both in turn lead to better well-being (Jin & Kim, 2017).
Payne (2017) suggests that grit in nursing is about looking forward, setting and achieving
goals, seeking excellence rather than perfection. Nurses express passion and love for their work
as they find joy in helping patients to recover or being there for them at their death or bringing a
new life into the world, being able to support patients and families in crisis. When nurses go
back to school, there is excitement about learning new things, becoming technically proficient,
reinforcing, and expanding skills. Gritty nurses have goals, courage (managing fear of failure),
they take risks every day, conscientious (meticulous attention to detail, counting on each other)
while moving from novice to expert. Nurses with grit are resilient in bouncing back from failures
or problems. Nursing ethics are about purpose as well as supporting good decisions, which also
promote resilience. Grit is a mindset or an attitude about striving for something good and
virtuous like nursing (Payne, 2017).
McCabe (2016) emphasizes that grit has a great benefit to nursing practice. Nurses with
grit practice with excellence, determination, and compassion. She suggests that grit in nurses
develops with more clinical experience and role modeling and that grit can be nurtured through
communication with experienced nurses and reflecting on own experiences. She believes that
characteristics of grit (conscientiousness, establishment of long-term goals, resiliency, and
excellence) can be developed in nursing students and new nurses (McCabe, 2016).
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Attributes, Antecedents, and Consequences
Attributes
Walker and Avant (2011) define attributes as the most frequent characteristics associated
with the concept. The attributes of grit in nursing are: resilience, perseverance, passion,
conscientiousness, and compassion.
Resilience is one’s ability to go on after negative experiences and adversity (Stoffel &
Cane, 2018). Traditional resilience is applied to severe psychological trauma and adversary
experience, but current society has used the term resilience in broader and less extreme context,
such as daily setbacks, negative experiences (Stoffel & Cane, 2018). Protective factors are
influences that change responses to negative experiences from maladaptive to adaptive outcomes
(Stoffel & Cane, 2018). Protective factors may include coping mechanisms, social and family
support, role modeling and mentorship, and intellectual stimulation (Stoffel & Cane, 2018).
Resilient nurses have an ability to withstand, adapt, and learn something positive from barriers
and adversity (Meyer & Shatto, 2018). Maturity and drive are factors for greater resilience
(Meyer & Shatto, 2018).
Perseverance is working hard, finishing what was started, or mastering skill despite
adversity or discouragement (Duckworth et al., 2007). Being passionate towards long-term goals
is when one is focused on projects that take years to finish without losing interest or being
distracted (Duckworth et al., 2007). Conscientiousness is a personality trait of being “self-
controlled, responsible to others, hardworking, orderly, and rule abiding” (Roberts et al., 2014,
para. 2).
Compassion is an attribute mentioned only in studies of nursing grit. Nursing is a
righteous endeavor, a profession of compassion. Nurses with grit strive to provide excellent care.
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Excellent nursing care is possible only with compassion. There is no true nursing without
compassion.
Antecedents
Antecedents are the events that must take place before the concept can occur and they
cannot also be the defining attribute for the concept (Walker & Avant, 2011). The first
antecedent of grit is discovery and development of consistent interests. Then, based on the
consistent interests, the second antecedent is understanding and setting the long-term vision or
goal. For development of grit, there must be some adverse circumstances or barriers present. It is
impossible to reach long-term goals that take years to accomplish without some barriers,
boredom, or negative circumstances. So, the third antecedent is setbacks, boredom, or barriers in
achieving the goal.
Consequences
Consequences are the events that happen as a result of the concept occurrence and also
cannot be defining attributes (Walker & Avant, 2011). The outcomes of grit in nursing are
excellence, personal growth, and happiness.
Nurses with high grit have a better potential to reach excellence. Excellence in nursing
practice is related to practical wisdom based on scientific knowledge (Flaming, 2002). The
grittier the nurse, the more motivated she/he is to be an excellent nurse, the more years of hard
work is invested into it, the more potential she/he would have to do it.
Personal growth is a reflection of a person’s development. Gritty nurses have positive
attitudes, higher expectations about themselves, their lives and the nursing profession. These
nurses view adversities and difficulties differently from those with low grit, which improves their
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subjective well-being. They lead a more meaningful and engaged life that makes them happier
people than those with lower grit. Grit improves life satisfaction (Vainio & Daukantait, 2016)
Model Case
A model case demonstrates how the concept is used with all the defining attributes at
display (Walker & Avant, 2011). Ann’s mom was diagnosed with breast cancer when Ann was
12 years old. What followed were two years of fighting, hope and desperation. By the age of 14
Ann was left without her mother. Somewhere along those two years Ann had decided that she
wanted to be a nurse, not just a nurse, but a nurse who makes a real difference in the lives of
people and families, who eases their pain, supports them in their decisions, and understands what
they are going through. After finishing high school Ann went to a community college for an
associate degree in nursing while working full time to help her father financially with bringing
up her two little sisters and her education. Nursing school was tough with full time work,
evening classes and clinicals. But it did not discourage her, she worked through it, meticulously
finishing all her homework and assignments, and looking forward to an ultimate goal to become
an excellent nurse. After graduation, she started working in a hospital on a medical-surgical unit.
It was an urban hospital, nursing staffing ratios were unfair, patient acuity was high, and supplies
were scarce. Ann was the only new graduate who did not quit during the first year of
employment on that unit. She found support and guidance in one of the experienced nurses who
was like a mentor to Ann. After a year she got involved in the hospital governance, she joined a
quality improvement committee and advocated for safe staffing and better working conditions to
be able to provide quality patient care. After several years of working as a nurse, she decided to
go back to school and earn her baccalaureate degree in nursing and get her certification in
oncology nursing. Over the years, her knowledge and expertise grew along with her curiosity to
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know more. Ann is still a compassionate nurse, she loves what she does, she cares about her
patients and families, and she has expertise from the years of nursing practice. In retrospective,
Ann realizes that she has been “fortunate” to discover her passion to nursing early on in life, it is
her calling. Her work has a purpose beyond herself.
Conclusion
Grit is relatively new and confusing concept. This paper about grit in nursing has a
purpose to improve understanding of the concept. Enhanced understanding may lead to wider
awareness and use of grit in nursing practice, education, and research. Literature review showed
that the concept is well defined in psychology, but not in nursing. Further research related to grit
in nursing and how to foster grit in nurses would be beneficial since consequences of grit include
excellence in practice, personal growth and happiness. There are five attributes of grit in nursing:
resilience, perseverance, passion, conscientiousness, and compassion. Compassion is a unique
attribute of nursing grit. In order for grit in nursing to happen, the following antecedents are
needed: discovery of the field of interest for future passion, understanding and setting the long-
term goal, and finally, some setbacks or barriers in the path to the goal. Nursing grit is
characterized by sustained interest and passion for nursing and working with perseverance
towards excellent and compassionate care throughout the years, which is reflected in the
constructed model case.
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References
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