JoAnn Grif Alspach

The idea that individuals who help others incur health benefits themselves suggests a novel approach to improving health while simultaneously promoting greater civic orientation in our society.

—Schreier et al1 

One of the endearing attributes of the annual holiday season is its bestowal of a multitude of opportunities to live the adage that “It’s better to give than to receive.” There are many forms of giving, including donations of time, physical work, money, and expertise. One of the more common forms of giving is by volunteering, the offering or provision of helpful service without pay to others who are usually outside one’s immediate family.2  Those recipients might be individuals (eg, homeless persons), small groups (eg, 2 families displaced by a hurricane) or organizations (eg, the Salvation Army), or a broader swath of society (eg, populations fleeing their homeland to escape war or famine).

Volunteering is a familiar activity to many AACN members who contribute countless hours every year toward meeting the mission and goals of our professional specialty nursing organization. For these critical care nurses, volunteering with AACN may be motivated by an interest in contributing to an organization that needs their expertise for one of its programs, to pay back an organization that has been pivotal to their career, or to support colleagues who need assistance in completing or publishing a report on their first quality improvement project. As we traditionally view the value of volunteering, all of these altruistic engagements focus on their benefit to the recipient.

If AACN members are already familiar with volunteering and may practice it with other professional, social service, religious, educational, or environmental entities, why should critical care nurses take any additional note of this particular form of giving? One rationale could be from the accumulating evidence, gathered informally and formally, that suggests that volunteering is not just associated with paying it forward to the intended recipient, but likewise extends to paying it backward to the volunteer. Another intriguing finding from this literature is that among the benefits associated with volunteering is a substantial number of health benefits, suggesting that the affirmation “It makes me feel good” represents a considerable understatement of the actual physiologic beneficence accrued. Rather than repeating a description of the beneficial outcomes of volunteering from the point of view of the recipients, we can note where those have already been ably addressed38  and focus this editorial on benefits to the volunteer.

Although the state of the science related to the beneficial outcomes of volunteering to volunteers is barely inceptual in its development, there is sufficient evidence to warrant at least one group of researchers to study whether those findings suffice for health care professionals to consider volunteering as a public health intervention.9  Before we can address the feasibility of that proposal, let’s take a brief scan of the existing literature on that aspect.

From the volunteer’s point of view, the reported benefits of volunteering range across career, social, and health dimensions. Of these, the career and social gains are more familiar because many of these may also represent an individual’s personal motivations for serving as a volunteer. For example, Table 1 lists a number of the reported career-related benefits that volunteers may enjoy. Some of these, such as obtaining work experience and acquiring new skills, may influence a person’s decision to volunteer for a particular organization or program. Similarly, Table 2 lists some of the social benefits that volunteers receive. Outcomes such as meeting new people and expanding one’s social network may also reflect a person’s impetus for engaging in a particular volunteer activity.

Table 1

Career benefits of volunteering

Career benefits of volunteering
Career benefits of volunteering
Table 2

Social benefits of volunteering

Social benefits of volunteering
Social benefits of volunteering

The beneficial outcomes of volunteering that may be less frequently acknowledged are those related to enhancing the volunteer’s mental or physical health. As the summary of study findings in Table 3 indicates, a substantial volume of literature suggests that there is a positive and, in some cases, enduring association between serving as a volunteer and health benefits. It would also be useful to note that some of these findings reflect significant rather than slim health gains. For example, a dozen separate studies have reported that volunteering is associated with a statistically significant lower mortality risk for those who volunteer compared to those who do not volunteer (Table 3). A meta-analysis of 5 of those studies6165  completed by Jenkinson9  revealed a 22% lower mortality among volunteers compared to nonvolunteers. Mortality differences of that magnitude warrant our attention and further investigation for practice implications.

Table 3

Health benefits of volunteering

Health benefits of volunteering
Health benefits of volunteering

Even from this brief overview of evidence related to the therapeutic effects that volunteers experience, we can begin to appreciate how a team of health care professionals could start pondering how nurses could assist patients and families in harnessing the potential power of volunteering for obtaining these health effects and where volunteering could be located in the plan of patient care. With more of the Baby boomer generation entering retirement and advanced age, research groups have started considering how volunteering could be used to minimize functional limitations and risk for dementia,66  so we may already be overdue to apply comparable brainstorming for envisioning how nursing can use volunteering in our practice priorities. Would that be possible only for home health care nurses or could nurses in other settings start considering inclusion of “volunteering” in the plan of care? Nurses regularly provide pharmacologic and non-pharmacologic interventions aimed at managing a patient’s depression, minimizing patient or family stress, enhancing their sense of well-being, improving their self-esteem, strengthening their social support network, and carrying out their full independent range of activities of daily living. Similarly, critical care and progressive care nurses regularly administer pharmacologic and nonpharmacologic therapies to help patients improve pain management, lower blood pressure, diminish cardiovascular risk factors, adopt a healthy lifestyle, maximize longevity, reduce readmissions, and optimize coping with traumatic events. With evidence that volunteering activities can produce those desired outcomes, how can we use that strategy for our patients and families? Supporting patients and families to use volunteering as a primary or adjunctive strategy for any of these purposes would not only expand the practical potential of this evidence-based activity beyond the customary plan of care boundaries, but represent a fresh approach to care that would complement more familiar interventions of therapeutic support.

Although using volunteering as a health care plan intervention may not be fully ready for prime time, critical care nurses might cast a glance at these findings to see whether they are sufficiently intrigued to pilot test selected outcomes at their facility to determine whether they represent verifiable and viable patient care interventions that could benefit their patients, patient family members, or even themselves. What suggestions would you propose to test these ideas or to implement a pilot program at your facility? Contact Critical Care Nurse at [email protected] and let us know what you think.

In addition to our patients and patient family members who may benefit from using volunteering as a therapeutic tool, critical care nurses themselves could peer into this same looking glass to see whether volunteering activities might afford them some timely mental or physical health enrichment. Do take the opportunity to see if volunteering works for a better you.

1
Schreier
HMC
,
Schonert-Reichl
KA
,
Chen
E
.
Effect of volunteering on risk factors for cardiovascular disease in adolescents
.
JAMA Pediatrics
.
2013
;
167
(
4
):
327
332
.
2
The American Heritage Dictionary of the English Language
. 4th ed.
Houghton Mifflin Co
;
2000
. Updated in 2009. . Accessed October 6, 2014.
3
Bureau of Labor Statistics
.
Volunteering in the United States-2013
.
Washington, DC
:
US Department of Labor, Bureau of Labor Statistics
;
2014
.
4
Casiday
R
,
Kinsman
E
,
Fisher
C
,
Bambra
C
.
Volunteering and Health: What Impact Does It Really Have? Final report to Volunteering England
.
London, United Kingdom
:
Volunteering England
;
2008
.
5
Corporation for National and Community Service, Office of Research and Policy Development
.
The Health Benefits of Volunteering: A Review of Recent Research
.
Washington, DC
:
Corporation for National and Community Service
;
2007
.
6
Department of Health
.
Opportunities for Volunteering. Legacy Report: 30 Years of Funding Volunteering in Health and Social Care
.
London, United Kingdom
:
Department of Health
;
2011
.
7
Haldane
AG
.
In giving, how much do we receive? The social value of volunteering. Speech delivered to the Society of Business Economists
.
London
,
September
9
,
2014
. . Accessed October 6, 2014.
8
United Way
.
Benefits of Volunteering
. . Accessed October 6, 2014.
9
Jenkinson
CE
,
Dickens
AP
,
Jones
K
, et al
.
Is volunteering a public health intervention? A systematic review and meta-analysis of the health and survival of volunteers
.
BMC Public Health
.
2013
;
13
:
773
783
. . Accessed October 6, 2014.
10
HelpGuide.org
.
Volunteering and its Surprising Benefits: Helping Others While Helping Yourself
. . Accessed October 3, 2014.
11
World Volunteers Web
.
Benefits of Volunteering
. . Accessed October 1, 2014.
12
Spera
C
,
Ghertner
R
,
Nerino
A
,
DiTommaso
A
.
Volunteering as a Pathway to Employment: Does Volunteering Increase Odds of Finding a Job for the Out of Work?
Washington, DC
:
Corporation for National and Community Service, Office of Research and Evaluation
;
2013
. . Accessed October 6, 2014.
13
Brodie
E
,
Hughes
T
,
Jochum
V
,
Miller
C
,
Ockenden
N
,
Warburton
D
.
Pathways Through Participation: What Creates and Sustains Active Citizenship? Summary Report
.
London, United Kingdom
:
Pathways Through Participation
;
2011
.
14
Farrell
C
,
Bryant
W
.
Voluntary work for adults with mental health problems: a route to inclusion? A review of the literature
.
Brit J Occup Ther
.
2009
;
72
(
4
):
163
113
.
15
Son
J
,
Wilson
J
.
Volunteer Work and Hedonic, Eudemonic, and Social Well-Being
.
Sociological Forum
.
2012
;
27
(
3
):
658
681
.
16
Greenfield
EA
,
Marks
NF
.
Formal volunteering as a protective factor for older adults’ psychological well-being
.
J Geront B Psych Sci Soc Sci
.
2004
;
59
(
5
):
S258
264
.
17
McMunn
A
,
Nazroo
J
,
Wahrendorf
M
,
Breeze
E
,
Zaninotto
P
.
Participation in socially-productive activities, reciprocity and wellbeing in later life: baseline results in England
.
Ageing Soc
.
2009
;
29
(
5
):
765
782
.
18
Morrow-Howell
N
.
Volunteering in later life: research frontiers
.
J Gerontol B Psychol Sci Soc Sci
.
2010
;
65
(
4
):
461
469
.
19
Morrow-Howell
N
,
Hong
S
,
Tang
F
.
Who benefits from volunteering? Variations in perceived benefits
.
Gerontologist
.
2009
;
49
(
1
):
91
102
.
20
Nazroo
J
,
Matthews
K
.
The Impact of Volunteering on Wellbeing in Later Life: A Report to WRVS
.
London, United Kingdom
:
Royal Voluntary Service
,
2012
.
21
Schwingel
A
,
Niti
M
,
Tang
C
,
Ng
T
.
Continued work employment and volunteerism and mental wellbeing of older adults: Singapore longitudinal ageing studies
.
Age Ageing
.
2009
;
38
(
5
):
531
537
.
22
Thoits
P
,
Hewitt
LN
.
Volunteer work and well-being
.
J Health Soc Behav
.
2001
;
42
(
2
):
115
132
.
23
Van Willigen
M
.
Differential benefits of volunteering across the life course
.
J Gerontol B Psychol Sci Soc Sci
.
2000
;
55
(
5
):
S308
S318
.
24
von Bonsdorff
MB
,
Rantanen
T
.
Benefits of formal voluntary work among older people. A review
.
Aging Clin Exp Res
.
2011
;
23
(
3
):
162
169
.
25
Black
W
,
Living
R
.
Volunteerism as an occupation and its relationship to health and wellbeing
.
Brit J Occup Ther
.
2004
;
67
(
12
):
526
532
.
26
Coppa
K
,
Boyle
FM
.
The role of self-help groups in chronic illness management: a qualitative study
.
Aust J Prim Health
.
2003
;
9
(
2–3
):
68
74
.
27
O’Shea
E
.
An economic and social evaluation of the Senior Help Line in Ireland
.
Ageing Soc
.
2006
;
26
(
2
):
267
284
.
28
Wu
AM
,
Tang
CSK
,
Yan
EC
.
Post-retirement voluntary work and psychological functioning among older Chinese in Hong Kong
.
J Cross-Cult Geront
.
2005
;
20
(
1
):
27
45
.
29
Yuen
HK
,
Burik
JK
,
Krause
JS
, et al
.
Physical and psychosocial well-being among adults with spinal cord injury: the role of volunteer activities
.
Topics Spinal Cord Inj Rehab
.
2004
;
9
(
4
):
19
25
.
30
Li
Y
.
Recovering from spousal bereavement in later life: does volunteer participation play a role?
J Gerontol B Psych Sci Soc Sci
.
2007
;
62
(
4
):
S257
S266
.
31
Li
Y
,
Ferraro
KF
.
Volunteering and depression in later life: social benefit or selection processes?
J Health Soc Behav
.
2005
;
46
(
1
):
68
84
.
32
Li
Y
,
Ferraro
KF
.
Volunteering in middle and later life: is health a benefit, barrier or both?
Social Forces
.
2006
;
85
(
1
):
497
520
.
33
Lum
TY
,
Lightfoot
E
.
The effects of volunteering on the physical and mental health of older people
.
Res Aging
.
2005
;
27
(
1
):
31
55
.
34
Morrow-Howell
N
,
Hinterlong
J
,
Rozario
PA
,
Tang
F
.
Effects of volunteering on the wellbeing of older adults
.
J Gerontol B-Psychol Sci Soc Sci
.
2003
;
58
(
3
):
S137
S145
.
35
Musick
MA
,
Herzog
AR
,
House
JS
.
Volunteering and mortality among older adults: findings from a national sample
.
J Geront B Psych Sci Soc Sci
.
1999
;
54
(
3
):
S173
S180
.
36
Musick
MA
,
Wilson
J
.
Volunteering and depression: the role of psychological and social resources in different age groups
.
Soc Sci Med
.
2003
;
56
(
2
):
259
269
.
37
Field
TM
,
Hernandez-Reif
M
,
Quintino
O
,
Schanberg
S
,
Kuhn
C
.
Elder retired volunteers benefit from giving massage therapy to infants
.
J Appl Geront
.
1998
;
17
(
2
):
229
239
.
38
Hulbert
NJ
,
Morrison
VL
.
A preliminary study into stress in palliative care: optimism, self-efficacy and social support
.
Psychol Health Med
.
2006
;
11
(
2
):
246
254
.
39
Shannon
CS
,
Bourque
D
.
Overlooked and underutilized: the critical role of leisure interventions in facilitating social support throughout breast cancer treatment and recovery
.
Soc Work Health Care
.
2005
;
42
(
1
):
73
92
.
40
Clark
S
.
Voluntary work benefits mental health
.
A Life in the Day
.
2003
;
7
(
1
):
10
14
.
41
Leung
J
,
Arthur
DG
.
Clients and facilitators’ experiences of participating in a Hong Kong self-help group for people recovering from mental illness
.
Intern J Mental Health Nurs
.
2004
;
13
(
4
):
232
241
.
42
Messias
DKH
,
De Jong
MK
,
McLoughlin
K
.
Being involved and making a difference: empowerment and well-being among women living in poverty
.
J Holistic Nurs
.
2005
;
23
(
1
):
70
88
.
43
Raine
P
.
Promoting breast-feeding in a deprived area: the influence of a peer support initiative
.
Health Soc Care Comm
.
2003
;
11
(
6
):
463
469
.
44
Ramirez-Valles
J
,
Brown
AU
.
Latinos’ community involvement in HIV/AIDS: organizational and individual perspectives on volunteering
.
AIDS Educ Prevent
.
2003
;
15
(
1 suppl A
):
90
104
.
45
Richards
DA
,
Bradshaw
TJ
.
Can community volunteers work to trace patients defaulting from scheduled psychiatric clinic appointments?
So African Med J
.
2007
;
97
(
10 I
):
946
947
.
46
Arnstein
P
,
Vidal
M
,
Wells-Federman
C
,
Morgan
B
,
Caudill
M
.
From chronic pain patient to peer: benefits and risks of volunteering
.
Pain Manage Nurs
.
2002
;
3
(
3
):
94
103
.
47
Hainsworth
J
,
Barlow
J
.
Volunteers’ experiences of becoming arthritis self-management lay leaders: It’s almost as if I’ve stopped aging and started to get younger!
Arthritis Rheum
.
2001
;
45
(
4
):
378
383
.
48
Burger
CM
,
Teets
JM
.
Can volunteer mentors help chronically ill clients remain at home?
Home Healthcare Nurse
.
2004
;
22
(
11
):
779
783
.
49
Fitzpatrick
TR
,
Gitelson
RJ
,
Andereck
KL
,
Mesbur
ES
.
Social support factors and health among a senior center population in southern Ontario, Canada
.
Soc Work Health Care
.
2005
;
40
(
3
):
15
17
.
50
Jirovec
RL
.
Differences in family functioning and health between older adult volunteers and non-volunteers
.
J Geront Soc Work
.
2005
;
46
(
2
):
23
35
.
51
Davis
C
,
Leveille
S
,
Favaro
S
,
LoGerfo
M
.
Benefits to volunteers in a community-based health promotion and chronic illness self-management program for the elderly
.
J Geront Nurs
.
1998
;
24
(
10
):
16
23
.
52
Luoh
MC
,
Herzog
AR
.
Individual consequences of volunteer and paid work in old age: health and mortality
.
J Health Soc Behav
.
2002
;
43
(
4
):
490
509
.
53
Piliavin
JA
,
Siegl
E
.
Health benefits of volunteering in the Wisconsin longitudinal study
.
J Health Soc Behav
.
2007
;
48
(
4
):
450
464
.
54
Brown
WM
,
Consedine
NS
,
Magai
C
.
Altruism relates to health in an ethnically diverse sample of older adults
.
J Geront B: Psych Sci Soc Sci
.
2005
;
60B
(
3
):
P143
152
.
55
Rogers
R
.
The effects of family composition, health, and social support linkages on mortality
.
J Health Soc Behav
.
1996
;
37
(
4
):
328
329
.
56
Sabin
EP
.
Social relationships and mortality among the elderly
.
J Appl Geront
.
1993
;
12
(
1
):
44
60
.
57
Sneed
RS
,
Cohen
S
.
A prospective study of volunteerism and hypertension risk in older adults
.
Psychol Aging
.
2013
;
28
(
2
):
578
586
.
58
Librett
J
,
Yore
M
,
Buchner
DM
,
Schmid
TL
.
Take pride in America’s health: volunteering as a gateway to physical activity
.
Am J Health Educ
.
2005
;
36
(
1
):
8
13
.
59
Weitzman
ER
,
Kawachi
I
.
Giving means receiving: the protective effect of social capital on binge drinking on college campuses
.
Am J Pub Health
.
2000
;
90
(
12
):
1936
1939
.
60
Jung
Y
,
Gruenewald
T
,
Seeman
T
,
Sarkisian
C
.
Productive activities and development of frailty in older adults
.
J Geront B Psych Sci Soc Sci
.
2010
;
65B
(
2
):
256
261
.
61
Ayalon
L
.
Volunteering as a predictor of all-cause mortality: what aspects of volunteering really matter?
Int Psychogeriatr
.
2008
;
20
:
1000
1013
.
62
Harris
AHS
,
Thoresen
CE
.
Volunteering is associated with delayed mortality in older people: analysis of the longitudinal study of aging
.
J Health Psychol
.
2005
;
10
:
739
752
.
63
Konrath
S
,
Fuhrel-Forbis
A
,
Lou
A
,
Brown
S
.
Motives for volunteering are associated with mortality risk in older adults
.
Health Psychol
.
2012
;
31
(
1
):
87
96
.
64
Okun
MA
,
August
KJ
,
Rook
KS
,
Newsom
JT
.
Does volunteering moderate the relation between functional limitations and mortality?
Soc Sci Med
.
2010
;
71
:
1662
1668
.
65
Oman
D
,
Thoresen
CE
,
McMahon
K
.
Volunteerism and mortality among the community-dwelling elderly
.
J Health Psychol
.
1999
;
4
(
3
):
301
316
.
66
Anderson
ND
,
Damianakis
T
,
Kroger
E
, et al
.
The benefits associated with volunteering among seniors: a critical review and recommendations for future research
.
Psychol Bull
.
2014
;
August
25
. Epub ahead of print.

Footnotes

PS. Critical Care Nurse wishes you and yours the warmth of family, safe travels, the joy of time together, and the best of health throughout the holiday season and new year.