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Management and prevention of stress
Management and prevention of stress
Stress in the workplace
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Understanding Role Stress in Relation to Nurse Burnout A Concept Analysis Recent literature reports that there is a nursing shortage and it is continually increasing. Data released by the American Association of Colleges of Nursing (2011) projects that the shortage, would increase to 260,000 by the year 2025. AACN (2011) also reported that 13% of newly registered nurses changed jobs and 37% were ready to change within a year. A study conducted reports that there is a correlation between higher nursing workloads and nurse burnout, retention rates, job dissatisfaction and adverse patient outcomes (Vahey & Aiken, 2004). Among the nurses surveyed in the study, over 40% stated that they were suffering from burnout while 1 in 5 nurses intended Typically this type of concept analysis, consist of an eight-step approach. The steps included in this method are defined as first selecting a concept, determine the purpose of analysis, identify the uses of the concept, define and determine the attributes, identify a model case, identify related cases, identify the consequences and antecedents and finally define the empirical referents (McEwen & Willis, 2011). To complete this concept analysis, the concept was defined and a literature search was performed. For the purposes of the paper, role stress was the concept and it was defined as “any physical or psychological strain experienced by an individual, who needs greater abilities or resources than available, in order to perform the role which has revealed disparity to the expected role currently being practiced, through an appraisal” (Riahi, 2011, pg. As stated previously, some of the effects of role stress and burnout, are low retention rates, high staff turnover, decreased quality of care and decreased job satisfaction. According to data, stress has been shown to cause 40% of turnover and half of absenteeism in the workplace. Empirical referent By definition, the empirical referent, are classes of actual events that demonstrate the presence of the occurrence or the actual concept. The tool designed to assess the occurrence is the Nurse Stress Scale, (NSS) which is a questionnaire that assesses situations that could potentially be stressful. These tools are only designed to detect symptoms already experienced related to stress. These tools are not great for primary prevent needs (Riahi, 2011). Model
In the recent years, organizations have paid extra attention to employee stress and its effect on job performance. Burnout, an outcome of stress is known to cause individual, family and organizational problems and health conditions such as insomnia and hypertension. The question many ask is where does it originate from? And, how supported are the employees by the organization? Researchers have attempted to link stress and burnout and its effect on job performance. This research analysis includes different scholarly studies done and that found many contributing factors such as job satisfaction, work and family demands, work environment, and culture.
Working in long-term care can be overwhelming. Imagine you are a new graduate nurse putting your new found knowledge and skills to practice for the first time. Your orientation lasted three days which is standard for nurse home orientation compared to hospital orientation that last approximately six to eight weeks for new grads. The shift has just begun and already you have a new admit, new found pressure ulcer to assess, a possible medication reaction, several new orders to take off and eight patients to document on for varying reasons. Feelings of frustration and confusion take over as you are the only nurse on the unit along with a Certified Medication Technician (CMT) and three Certified Nursing Assistants (CNAs) taking care of 47 patients. Ideal nurse-to-patient ratio continues to be a national issue in both the hospital and long-term care setting (LTC). In the LTC setting there is no official nurse-to-patient ratio; there is a suggested staff-to-patient ratio. This issue not only affects the new licensed nurses but the seasoned nurse as well. Recently, there has been controversial debates as to whether heavy workloads are detrimental to patients. The federal, state, and local government regulates many aspects of healthcare. However, it is the physicians, nurses and other healthcare professional that provide care directly to patients. Consequently, does insufficient staffing, heavy workloads, and unsupportive work environment directly contribute to poor patient satisfaction, nurse burnout, high turnover and job dissatisfaction?
Many negative results stem from nurse burnout. The greatest of these negative results can be seen in patient mortality rates. There is a correlation between poorly staffed nursing shifts and nursing burnout. A study which examined “197,961 admissions and 176,696 nursing shifts of 8 hours each in 43 hospital units to examine the association between mortality and patient exposure to nursing shifts during which staffing by RNs was 8 hours or more below target” (Needleman et al., 2011, p. 1037). The researchers found a strong connection “between increased mortality and unit shifts during which staffing by RNs was 8 hours or more below the target level (hazard ratio per shift 8 hours or more below target, 1.02; 95% confidence interval > 1.01 to 1.03; P <0.001)” (Needleman et al., 2011, p. 1037). The “risk of death increased by 2% for each below target shift and 4% for each high turnover shift to which a patient was exposed” (Needleman et al., 2011, p. 1043).
One of the most serious issues in nursing, that can affect a nurses career is nursing burn- out. According to the article “Where have all the nurses gone”, current nurses that are practicing, report high rates of job dissatisfaction (which is part of burn out) and 1 of 5 nurses may quit nursing in the next 5 years (Dworkin, 2002). Burnout is associated with nurses not coming in to work, not feeling satisfied when doing their job, high turnover rates and a lack of commitment to the work (Katisfaraki, 2013). If a nurse becomes burned- out, they may not take care of their patients as well and could make mistakes with medication administration. A study performed in the United States by Dr. Jeannie Cimiottti, shows that hospitals with high burn-out rates among nurses have higher levels UTI’s, and surgical infections (World, 2012). Nursing burnout not only affects the nurse, but it also affects the patient, the nurses’ colleagues, and the nurses’ family; nursing burn out often leads to emotional exhaustion and depression, that can effect relations and communication between the nurse effected and the person they are communicating with. This paper will cover what burn-out is, who is susceptible to burn out, and treatment and prevent nursing burn out.
However, upon securing a job, they find that things on the ground are not as they had expected them to be and this results in some of them deciding to leave the profession early. Research shows that turnovers within the nursing fraternity target person below the age of 30 (Erickson & Grove, 2011). The high turnover within the nursing fraternity results in a massive nurse shortage. This means that the nurses who decide to stay have to work for many hours resulting in exhaustion. A significant percent of nurses quitting their job sites exhaustion and discouragement as the reason that contributed to their decision. In one of the studies conducted on the issue of nurse turnover, 50% of the nurses leaving the profession argued that they felt saddened and discouraged by what they were unable to do for their patients (Erickson & Grove, 2011). When a nurse witness his/her patients suffering but cannot do anything because of the prevailing conditions he/she feels as if he/she is not realizing the reason that prompted him/her to join the nursing profession. The higher rate of nursing turnover is also affecting the quality of care nurses provide to
The nursing profession is one of the most physically, emotionally, and mentally taxing career fields. Working long shifts, placing other’s needs before your own, dealing with sickness and death on a regular basis, and working in a high stress environment are all precursors to developing occupational burnout in the nursing profession. Burnout refers to physical, emotional and mental exhaustion, which can lead to an emotionally detached nurse, who feels hopeless, apathetic, and unmotivated. Burnout extends beyond the affected nurse and begins to affect the care patients receive. Researchers have found that hospitals with high burnout rates have lower patient satisfaction scores (Aiken et al 2013). There are various measures that nurses can take
“This literature review explores the effect that nurse staffing patterns have on the frequency of medical errors, fatigue, and nurse burnout (Garrett, 2008, p.1191)”. A concept that is relevant to this study would include nurse sensitive concepts. Houser stated that nurse sensitive concepts include but are not limited to burnout, medication errors as well as patient falls (Houser, 2015). All these concepts are relevant in this one article which discusses studies that have been done to provide evidence based research. “Variables included total staff member work hours and nurse-sensitive outcome rates for CLIs, pressure ulcers, medication errors, falls and restraint application duration rates (ie, duration for use of mechanical restraints)(Garrett, 2008, p.1197).” The technique that was used in this research was the quantitative method. The text book defines quantitative research as “a traditional approach to research in which variables are identified and measured in a reliable and valid way” (Houser, 2015). This study that was conducted identified variables as stated above as well as collected data from diverse units of hospitals to analyze separately to measure the outcomes. The participants of this study included ninety five patient care units from ten adult acute care hospitals for this sample. The instrument used by the researcher was from an observational form that
Cathryn, you bring up an excellent point. Physician burnout is real and I am glad to hear that the AMA is doing something to help the physicians. I believe burnout is a major problem among all health care workers. I remember being in nursing school and learning about the nursing shortage. Then we would go to the hospital for clinical training and the nurses would be tired and burned out. I remember thinking that I did not want to be like them, but here I am 23 years later and I, too, am fighting burnout. I don’t believe enough is being done to address this issue, it is hard work to care for other people and with rising expectations and budget cuts it is getting more difficult to provide compassionate care.
Burnout in critical care nursing has been a longstanding, serious yet under recognized issue that has recently been magnified due to the nursing shortage. The key components of burnout include emotional exhaustion, depersonalization or detachment, and lack of personal accomplishment. These factors are closely interwoven and create a snowball effect which results in burnout. Emotional exhaustion stems from the stress placed on critical care nurses. Stress from patient acuity, heavy workload and responsibility, limited autonomy, ethical dilemmas, inadequate staffing ratios, and caring for patient’s families all contribute to emotional exhaustion (Epp, 2012, p. 26). In turn, emotional exhaustion triggers depersonalization which is a way for critical care nurses to cope. Finally, lack of personal accomplishment is achieved when the nurse cannot meet their inherent high standards and are unsupported by their colleagues and superiors (Epp, 2012, p. 28). To prevent and remedy burnout, Epp’s (2012) article suggests that nurse managers play an integral role by regulating staffing levels and encouraging interdisciplinary collaboration. In addition, they can foster a supportive work environment by participating in daily reports, establishing relationships with staff nurses to identify individual signs of stress, and instituting educational workshops. Critical care nurses are also encouraged to play an active role in combatting burnout by advocating for themselves and for their colleagues to institute personal measures such as rest, delegation, and stress management (Epp, 2012, p.
Analyst Lars Tummers has taken an interest in this phenomenon, and has been able to deduce three primary points as to why the burnout rate is so high for this field, the first being the increasing life expectancy of many people in first world countries has lead to an increased need of people to take care of them. Since more and more people are requiring aid as they live longer and longer, nurses are required to provide more for these people on top of their already filled work schedule often times with no increase in pay or aid; people are asking of more output from them, without any compensation. To add to this, the second factor Tummers identified was the demand many consumers wanted for the highest quality treatment all the time, which has lead to many nurses becoming overly stressed from overbearing coworkers and over-entitled consumers alike as they demand 110% all the time from employees who are only human and already in low supply. The final reason as to why the burnout rate of nurses is drastically high compared to other professions is, as pointed out by Tummers, that the average age of nurses
It is likely that most people have heard about the nursing shortage for years now, and perhaps they believe it’s been fixed. However, the nursing profession is experiencing a reoccurring deficiency. According to Brian Hansen, (2002), there was a nation wide shortage in 2001 of 126,000 full-time registered nurses, but the shortage will surge to 808,000 by 2020 if something isn't done. This pattern is a persisting cycle of high vacancies followed by layoffs and a high over supply of registered nurses. Various factors contribute to the lack of nurses within the health care facilities, but today’s shortages are a little different. Many feel that this scarcity is severe and long-drawn-out. The four major issues contributing to the nursing shortage include demand, supply, educational preparedness, and job satisfaction.
Burnouts have become a big problem among nurses. Burnout is the frustration, loss of interest, decreased productivity, and fatigue caused by overwork and prolonged stress. As a nurse, you have an overload of things to do, patients to see and there need; no including person life. Burnout has also become a negative outcome towards the patient. The problem with burnouts is that it can easily seek up on you. Many nurses not knowing or not being aware of the warning signs of burnout have caused them to lead to a full-fledged, career-ending case of burnout. I have researched many articles about finding the cure for burnout and came across many tips, warning sign, and ideas to stop burnout in its tracks.
In a research by Admi and Moshe-Eilon (2010) the results explained that stressors explained in Friberg and Creasia (2016) are always the focus of nursing stressor. There are many other work stressors that are unique to each nurse based on the situation. Role overload was what I had deal with when I worked in a skilled nursing facility/ memory unite. I had about 17-20 patients a shift. Some had stable and some were critical condition. I had to learn how manage my time between my patients, and to delegate the task to my nurse assistant. Some stressors had no strategy to solve, the only solution is look for the job that won’t become a
Happell, Martin, and Pinikahana (2007) also argue in their research that “despite the strength of discourse and debate in relation to stress and burnout in psychiatric nursing, limited research has been conducted in this area” (p. 40). Although a handful of studies (Cañadas et al., 2013, Dickinson and Wright, 2008; Happell, Martin, and Pinikahana, 2007, Ewers et al., 2001) agree that burnout reduces employee effectiveness which can compromise quality of care provided for the patient, there is still little research and support in this
The individual personality traits also effect the stress equation because what may be overloading to one person may be terrifying to another. In organizations the Job stress among employees leads to several behavioral, psychological and physiological complications and as a result it directly affects the employee's health. There is a growing understanding that job related stress negatively affects the health of workers. In previous studies the effects of job stress has been extensively examined on employees' job satisfaction, performance, motivation, and turnover (Sheraz et al. 2014; Kazmi, Amjad, S., and Khan, 2008). The employees' Job stress is very much within the area of industrial and organizational psychology. However, the association of job stress to the physical and mental health of employees has not been studied extensively by many industrial and organizational psychologists. As most of the employees spend most of their time to work related activities, it seems likely that in addition to physical factors on the job the social and psychological factors may have important influence on their health and job (Tucker et al. 2010). So, it is not surprising to discover that most of the information regarding the effects of job stress on health is in non-industrial and organizational psychology journals (Quick et al.