The mental health of nursing students and professionals should be considered as important by school authorities or health services. This academic and work reality is even more difficult when nurses have to face contexts of stress and anxiety during their study and work days. The use of social-emotional competencies allows nurses to develop the necessary skills to manage their own emotions, establish healthy bonds with their colleagues, communicate their emotional needs and support each other; In this way, Nursing enriches its capabilities to face the health challenges of today's world.

Keywords: nursing, mental health, socio-emotional skills, care, quality of life

During recent years, and with special emphasis on the reality experienced during the covid 19 pandemic, characterized, in many cases, by the collapse of health services, constant health alerts and the detrimental consequences derived for the course of life of humanity, the work in contemporary Nursing has gained a special point of reference for the civil community in terms of health care and attention throughout all vital stages. Although Nursing has always been a fundamental anchor for health systems and for caring for the quality of life of people around the earth, it seems that today the challenge of the profession has reached significantly different levels in a positive sense, delimiting a turning point that makes visible on a large scale the work and professional scope required to honor the science of care in the world we inhabit today.

However, the intra-academic and intra-work reality in Nursing has not been benefited by the professional work carried out during the pandemic nor by the current academic and professional work; on the contrary, the pandemic and its consequences represent a showcase for contemplate the way in which educational and health systems continue to deprive nursing students and professionals through extensive workloads, insufficient economic remuneration, poor emotional quality during training and throughout the teaching-learning processes, academic demands and disproportionate labor conditions and lacking the humanitarian treatment that is so preached in the profession and that will then be required of students and professionals in their spaces of patient care in the various areas of career development,^1,2 omitting, by default, mental health and the socio-emotional component of human beings that exalt the name of Nursing; a showcase that, consequently, calls us to action.

From what has been described and through this work, the urgent role of the responsibility of providing optimal attention to the rights and needs of an intrapersonal, emotional and social nature of professional nurses and those in training around the world is expressed. In this regard, and with regard to the tools of Psychology, socio-emotional competencies constitute a path to achieving the states and affective and relational resources required for the study and exercise of the profession, since they complement cognitive training and executive taught in universities and other academic centers with skills that facilitate interrelation, individual and collective mental health and strengthen positive affective states, consolidating an enriched scenario for professional development, and above all, for life.³

Socio-emotional competencies represent a repertoire of human dispositions and capabilities aimed at optimizing the emotional and bonding areas of individuals, allowing the expansion of awareness of one's own emotions and those of others, self-recognition of affects, the ability to genuinely connect with the feelings of our peers, family members or patients and facilitate the adaptive management of these emotions, which constitutes a significant increase in prosocial behavior; All of this has a positive and direct impact on all areas of human development. In this way, the ability to maintain healthy relationships at work, at school and at home is consolidated, while the relationship with oneself is strengthened since it improves self-knowledge, decision making, emotional validation, self-control and general satisfaction with life.³

In this sense, socioemotional competencies represent a set of skills that optimize individual’s recognition, understanding and emotional expression, both at a personal and interpersonal level, thus laying the necessary foundations for the genesis of affective regulation and self-knowledge. The use of these skills is essential for managing self-esteem, improving academic, work and professional relationships and obtaining a work environment conducive to responsible and humanitarian action in the career. In any case, the use of socio-emotional competencies allows us to return to nurses the status of human beings that, so many times and in so many ways, both the educational and health systems show that they have lost their treatment of them. It is important to emphasize the relevance of socio-emotional competencies in relation to Nursing, given the working conditions that frequently lead to high levels of stress and the high prevalence of Burnout Syndrome in professionals, as well as the need to have psychological resources for the healthy management of emotions in the students of the career.⁴ In this regard, it is important to highlight some significant statistics related to the mental health problems experienced by nurses in their professional work. A Latin American study carried out in Chile found that 48.5% of nurses had high levels of stress, associated in 68.2% with observing the suffering of patients during their illness processes, while stress increased in 57.6% of cases in which nurses had to perform procedures that caused pain to users, and was also present in 53% of nurses who had to perform additional tasks due to lack of staff in the work area, which gave rise to Burnout Syndrome.

Along the same lines, the impossibility of expressing to other colleagues in the work unit the feelings experienced during work days, as well as the absence of spaces to share experiences lived in the workplace represented the expression of high levels of stress in 74.3% of cases.⁵ On the other hand, a study carried out in China showed that anxiety in nurses was equivalent to 26.88%, almost doubling the anxious symptoms found in doctors (14.29%), at the same time, anxious symptoms were more present in women (25.67%) than in men (11.63%).⁶

Finally, a study carried out in Ecuador reports the presence of anxiety states in 60% of nurses during work days that involve the care of patients infected with Covid-19, likewise, 45% of professionals experienced depressive symptoms, 63% reported difficulties associated with the presence of sleep disorders and 75% expressed cognitive difficulties such as decreased concentration, memory and attention due to high workloads. It is important to note that 73% of nurses indicated that they did not receive training aimed at caring for their mental health.⁷ Regardless of the health status present in the community or in the workplace, whether in a pandemic context or not, it is evident that nurses around the world must face a series of challenges on a daily basis that reinforce a state of physical and psychological vulnerability that can be better managed if socio-emotional competencies are used.

Research that has explored the association between work difficulties, the quality of patient care and the skills incorporated in socio-emotional competencies in the professional nursing population has shown that empathy, emotional regulation, emotional understanding and compassionate understanding are the main basis for the development of successful therapeutic approaches characterized by the ability to establish a relationship between the professional and the patient based on trust, communication and assertiveness, through the use of the aforementioned socio-emotional tools, which translates into a significant improvement in care.⁸ In this line, nurses make use of the intrinsic elements of socio-emotional competencies in order to optimize their decision-making in work environments, and in this way, this capacity gives rise to emotionally safe and planned professional interventions that go beyond approaches that exclusively emphasize the procedural care of cases, leaving aside the emotions of professionals and consultants, which represents a terrible limitation in services.⁹ The use of these resources takes on special relevance given the impact of such optimized emotional work on patient care in environments frequently defined by a high workload, where the knowledge and management of socio-emotional competencies is especially useful to structure the improvement in the quality of services.¹⁰ In all cases, research has shown that emotional management and the recognition of patients' emotions directly influences positively the processes of care and health recovery.^11,12 Similarly, research has been able to demonstrate that training in emotional regulation and empathy is associated with high effectiveness in reducing work stress in nurses, which implies a significant improvement in the well-being of professionals, both professionally and personally, and in their interventions with patients.¹¹ Likewise, it has been shown that training linked to the implementation of socio-emotional competencies in professional work scenarios generates an increase in positive emotional states such as joy, satisfaction and confidence, since nurses develop communication skills aimed at expressing and understanding the emotions of their colleagues and patients, skills that are cultivated by reinforcing respect and emotional validation; in this sense, they experience an increase in the feeling of autonomy and self-efficacy, greater clarity in thinking and decision-making, a decrease in stress levels and a significant increase in self-awareness, self-regulation and leadership, factors that provide space for the formation of a favorable work environment and the ability to provide successful holistic care.¹³ On the contrary, research that studies the consequences for nurses who do not receive training in the use of socio-emotional competencies in the work environment records that they have great difficulties in managing conflicts without feeling negatively impacted in relation to their emotions, while they showed a greater tendency to distance themselves from problems physically and psychologically, trying not to actively get involved in the resolution of conflictual circumstances that arise in health centres, which implies a strategy of denial and avoidance in the absence of personal coping resources, and reveals a major problem, both for the well-being of professionals in their daily work and for the quality of care in health services.^14,15

It is important to note that the presence of these difficulties and the general absence in the use of socio-emotional competencies in nurses is not something isolated from the training proposals given in Education; this is reflected in a study based on the Ranking of Universities of Mexico published by America Economia Intelligence; the study shows that universities prioritize nurses being able to work in a team (80%), also, they want them to have the ability to self-criticize (50%), and to solve problems (50%), however, they only emphasize socio-emotional skills such as empathy in 20%, assertive communication (20%), good self-concept (10%), assertiveness (10%) and the ability to work under stress (10%).¹⁶ These figures are alarming and constitute the basis of the problem, because if academic institutions do not devote their efforts to achieving the comprehensive development of their students and place their focus only on the acquisition of knowledge and the correct execution of procedures, it is very difficult for these students to have an optimized professional future to face work challenges, not only from the scientific information they have, but also from the use of essential socio-emotional resources for day-to-day life because they lack them, and educational priorities have not changed significantly to improve this reality. Based on what has been described, the incorporation of the use of socio-emotional competencies in Nursing is especially valuable since it is a profession that focuses its axis of action on the care of other people. However, who takes care of the caregiver? How can we expect the students and professionals provide optimal comprehensive care if their own emotions and social and professional ties are not protective factors for their own health? And while the profession requires the continuous use of capabilities such as emotional attention, empathy, emotional management and active listening, there are not enough strengthened systems in the use of socio-emotional competencies dedicated to the protagonists.¹⁷ Based on this, a schematic diagram of my authorship based on the 5 socioemotional competencies is presented below; subsequently, the descriptive content of each of them will be given (Figure 1).¹⁸

Figure 1 Socio emotional competencies.

a) Awareness of emotions

Represents the ability to identify our own emotional experience, recognizing its subjective nature and its cognitive and physiological condition. Based on this competence, nurses are able to relate to their own affections in a healthy way, both in educational centers and in health services, which allows them greater self-knowledge, better self-regulation, greater self-compassion and emotional validation. Likewise, this competence gives rise to the learning of emotional management techniques based on Psychology and that can be used in daily life.

b) Discernment and understanding of the emotions of others

Implies the ability to adequately interpret the emotions that our peers, colleagues, study or work colleagues and people in any sphere of life are experiencing, based on the analysis of the emotions of others, non-verbal expressions of others, such as facial expressions, body movements that accompany communication and some elements of language such as tone of voice, rhythm and the intention embedded in the message. This competence facilitates coexistence at an academic and work level, as it allows the adaptation and emotional validation of the affections of our peers, which positively feeds the performance climate and creates a context of empathy and mutual trust.

c) Use of emotion and expression vocabulary

Refers to the ability to learn to relate to our colleagues in the professional career through language based on our emotions and our subjective experiences. Academic or work stress frequently takes control and delimits a distance between what we feel and what we need to express to be able to regulate ourselves emotionally, however, this represents a gap in communication and makes it difficult for nurses to support each other emotionally and warm during study and work days. The use of a vocabulary based on the placement of the appropriate words for what we feel allows us to connect intimately with the affections of our colleagues, which consolidates support networks and optimizes our possibilities to overcome difficult or stressful circumstances.

d) Empathy and sympathy

These competencies imply the human capacity to give an appropriate response to the emotions of others, which represents a significant advance towards the understanding of others and coexistence in universities, academic centers, health services and in any place where there is a Nursing team. On the one hand, empathy represents the understanding and comprehension of the emotions of others, on the other hand, sympathy addresses the compassion we experience in the face of these emotions. The importance of these emotional competencies is based on their role in assertive communication, in social connection and interaction based on respect, solidarity and humanity, crucial elements for other capabilities such as emotional validation and emotional responsibility. From the competence of empathy and sympathy, the willingness to help others is developed, starting with our peers in academic and work environments, and being able to extend this competence to our personal life as well; Likewise, this prosocial behavior will be characterized by altruism and genuine emotional involvement, where the sum of all this represents a significant development at a socio-emotional level and a positive tendency towards productive behaviors for the community and the current world.

e) Ability to differentiate internal emotional experience from external emotional expression

Based on this competence, nurses are able to manage their emotions according to the context in which they find themselves, that is, emotions will not invade direct work scenarios with patients, however, they will not be repressed either since it is intended that nurses can find or create spaces to communicate their emotions, recognize them and deal with them, either on their own or with their colleagues. This competency reinforces emotional self-efficacy and revalues ​​the ability of groups of nurses around the world to stay together and provide mutual emotional support during academic and work days.

Students and nursing professionals coexist in academic and work environments characterized by a significant emotional burden, where humanized care is the axis of this science. In this sense, nurses go through different circumstances every day that move between the state of well-being and illness, and sometimes between life and death. Based on this, it is essential that nurses have emotional spaces to manage their emotions and support their colleagues in regulating their emotional states as well, which represents the construction of environments based on empathy, respect, trust and cooperation. Socioemotional competencies provide the necessary notions for the creation and optimization of these spaces by placing the importance of self-care at the center of professional work, as well as the need to have professional environments that prioritize the emotional stability and mental health of nurses who leave their homes every day to care for the world.

None.

The author declare that there is no conflicts of interest.

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