...for the hard work that they are doing. People want to work in a place where there are not a lot of opposing personalities and egos. “Two studies of occupational stress and its relation with antecedent variables and job performance were completed by Stephan J. Motowidlo, John S. Packard, and Michael R. Manning. The first study, in which 104 nurses participated in group discussions and 96 nurses completed a questionnaire, identified 45 stressful events for nurses. In the second study, 171 nurses who completed another questionnaire were also rated by a supervisor and/or a co-worker. Ratings of interpersonal aspects of job performance (such as sensitivity, warmth, consideration, and tolerance) and cognitive/motivational aspects (such as concentration, composure, perseverance, and adaptability) correlated significantly with self-reported perceptions of stressful events, subjective stress, depression, and hostility. Models developed through path analysis suggest that the frequency and subjective intensity of the 45 events identified in Study 1 cause feelings of stress, which lead to depression, which, in turn, causes decrements in interpersonal and cognitive/motivational aspects of job performance (Motowidlo, Manning, & Packard, 1986, p. 1).”The tests resulted in several causes of stress with the top two being stress events such as case overload and individual characteristics such as people hostility. “Stress...
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...Nurse Burnout and Its Impact on Patient Safety Georgetown University Foundations of Health Systems and Policy NURO-624 September 12, 2013 Nurse Burnout and Its Impact on Patient Safety Patient safety encompasses the application of best practices that are geared towards achieving positive outcomes and promoting safety, and can serve as an indicator of quality in healthcare institutions; sustainable nursing workloads improve the quality of health care by reducing unsafe conditions, as well as reducing mortality and morbidity. Several literature reviews have clearly identified the consequences for patients when nurses are overtaxed or over utilized to bridge the gap of nursing shortages. According to Mckee et al, each patient added to nurses’ workloads (beyond four patients) is associated with a seven percent increase in mortality following common surgical procedures (McKee, M. 1999). Recent health reform legislation has further stimulated increased awareness and focuses on patient centered care, and emphasizes on the importance of the patients’ experience. Moreover, patients’ expectations of their caregivers to be positively engaged in their work and performing efficiently and effectively in a supportive environment are prudent. However, several challenges are being encountered by nurses, as they strive to meet the mandates of the aforementioned health care reform. Challenges resulting from unfavorable working conditions that are not conducive to the provision of patient...
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...department, the Emergency medical services (EMS) workers are primary providers of pre-hospital emergency medical care and integral components of disaster response. The potentially hazardous job duties of EMS workers include lifting patients and equipment, treating acute injuries or life-threatening illnesses, handling hazardous chemical and body substances, and participating in the emergency transport of patients in ground and air vehicles. These duties create an inherent risk for EMS worker occupational injuries and illnesses. Healthcare workers in the Emergency medicine has evolved to treat conditions that pose a threat to life and have a significant risk of morbidity. Work-related stressors in which Emergency Department nurses encounter are numerous as a result of the hectic and chaotic environment in which they work. The main work stressors included the large number and continuous influx of patients, the increased patient acuity, and the lack of skilled nursing staff. Emergency physicians are tasked with seeing a large number of patients, treating their illnesses and arranging for disposition—either admitting them to the hospital or releasing them...
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...Patient Services/Intensive Care Nurses/Compassion Fatigue Intervention/BESt 173 Best Evidence Statement (BESt) Date: July 17, 2013 Title: Decreasing Compassion Fatigue* among Pediatric Intensive Care Nurses Using Self-Care Skills* and Compassion Fatigue Training* Clinical Question: P (Population/Problem) I (Intervention) C (Comparison) O (Outcome) Among pediatric intensive care nurses does functional knowledge of compassion fatigue and the practice of self-care skills, compared to not, demonstrate less compassion fatigue? Definitions for terms marked with * may be found in the Supporting Information section. Target Population for the Recommendation: Nurses working in pediatric intensive care settings who provide direct patient care Recommendation: It is recommended that nurses working in pediatric intensive care settings receive training that includes compassion fatigue awareness, coping strategies, stress management, relaxation techniques and self-care interventions to decrease the level of compassion fatigue experienced in the work environment (Marine, Ruotsalainen, Serra, & Verbeek (2009) [1a]; Gunusen, & Ustun (2010) [2a]; Kravits, McAllister-Black, Grant, & Kirk (2010) [4a]; Meadors & Lamson (2008) [4a]). Discussion/Synthesis of Evidence related to the recommendation: The evidence referred to a variety of concepts related to the manifestation of compassion fatigue, including burnout, emotional exhaustion, and workplace stress. The concepts...
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...Combating Compassion Fatigue Compassion is defined as a feeling of wanting to help someone who is sick, hungry, or in trouble, according to Merriam-Webster dictionary. Compassion is a fundamental characteristic needed by health care providers. Compassion is what makes patient care enjoyable; without compassion, patients would begin to feel neglected. There are many different types of health care providers, but the ones who have the most contact with the patients are the nurses. Nurses provide such selfless and devoted service, compassion, and dedication to their patients and to their job. Many nurses work long twelve hour shifts, but not all. This can be very tiring though, and it may not leave a lot of room for a personal life. Sometimes nurses are so consumed with work, that they often neglect their personal needs. In doing that, it makes them susceptible to a disorder called compassion fatigue or burnout. Compassion fatigue is exactly what it sounds like; it is an indifference to charitable appeals on behalf of those who are suffering (Google dictionary). It is characterized by a gradual lessoning of compassion over time. Often times, compassion fatigue occurs due to the demands of the stressful situations health care providers are forced to encounter everyday. There are five major concepts of compassion fatigue. There is the cognitive, emotional, behavioral, spiritual, and the somatic. Each of these concepts has warning signs to be aware of. The first concept is cognitive...
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...DR. HAROLD RAY GRIFFIN HEALTH CARE POLICY, LAW AND ETHICS-HSA515002VA016-1114-001 In this paper, the writer is taking on the role of manager of a cancer center in a small, suburban hospital. The manager is dealing with a lot: The nursing staff has expressed burnout because of an increase of terminal cancer patients. In one extreme case, Nurse Nancy, feeling empathy for a rapid decline in one of the patient’s health (a 30-year-old single mother), wants to give an extra dose of narcotic that could potentially end the patient’s life – and what Nurse Nancy perceives as her suffering. Needless to say, concepts including end-of-life rights, death with dignity and right to life apply to this particular case. In examining this particular case, we’ll find that the nurse is trying to act with the purest of motives. However, what she is doing could skirt ethical decision-making, while being blatantly against the law. Additionally, it could provide a negative view of the cancer center. Though many people might support the idea of dying with dignity, others might take a dim view of a nurse who, in her zeal to prevent a patient’s suffering, would deprive children of their mother. Patient Bill of Rights The Patient Bill of Rights, sponsored by Senators John McCain, John Edwards and Ted Kennedy (S.1052), guarantees patients the right to access to health care specialists when necessary and requires continuity of care protections to patients so they don’t have to change health care providers...
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...IMPACT OF NURSE SHORTAGE ON HOSPITAL‐BASED PATIENT CARE AND NURSES 1 Literature Review Nursing shortage is acknowledged nationwide as a problem in the health care sector that has generated a body of research by various scholars. A review of the existing literature was done using EBSCO Host and Cochrane data bases with the goal of exploring the nature of nursing shortages in hospitals and other health care facilities. The search keywords include nursing shortage, stress, work environment, job satisfaction, economic crisis and hospitals, and quality of patient care. The body of literature reviewed indicated that nursing shortage impacts on the quality of patients’ care, as well as the nurses who feel the direct impact of these shortages. A major research gap in the body of literature was found to be the failure to examine the role of the poor economic conditions that all sectors are being faced with, including the health care sector, in exacerbating the nursing shortages since 2008, which is worsening by the day. Framework This review of literature on nursing shortage was done within the frame work of the general theory of nursing, which explains the purpose of nursing as that of assisting patients to achieve their highest possible level of physical, mental/emotional and spiritual well being. Simply put, the nursing theory is about facilitating healing. But the reality is that some nurses, in no small percentage, are working in conditions that do not lend credence to this...
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...Can Adequate Nurse Staffing Improve Patient Outcomes? Nursing is more than caring for the sick and injured. It is a twenty-four hour inpatient monitoring system. It is well known that nurses spend significantly more time caring for and looking after patients than any other profession. They routinely monitor and report changing patient conditions around the clock that aid physicians in modifying and updating treatment plans to improve health and prevent complications. The level of safety of hospitalized patients and the degree of quality care that they receive has more to do than fixed nurse-to-patient ratios. It has been well established in the literature that when nursing workload increase to unmanageable levels; weather it be from the addition of patients, increases in acuity and/or care complexity, or from high levels of fluctuation in patient turnover, that nurses ability to perform patient surveillance is disordered, putting patients in undue risk (Needleman, et. al, 2011). Furthermore, excessive workloads contribute to burnout and dissatisfaction leading to nurse attrition that further compounds to the staffing problem. Hospitals need to be held accountable for providing safer nurse staffing levels. Payers and purchasers of care should demand compliance, but should also stimulate better quality and patient safety by providing financial incentives. In addition, a more comprehensive, proactive team approach to nurse staffing can help keep patients safer...
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...ample exposure to varying degrees of job satisfaction. What makes some so happy with their chosen profession, and others so unhappy? Aside from a change of career, is there a solution? With the current employee’s shortage, and the anticipation of worsening conditions, the researcher of this study set out to investigate the sources of dissatisfaction in the hotel and restaurant settings. Most medium-sized enterprises realize that their effectiveness depend on the utilization of their human resources. Employees’ levels of burnout, job satisfaction and job performance give an indication of the effectiveness of an enterprise. The objective of this study was to determine the relationship between a dispositional variable (sense of coherence), burnout, job satisfaction and job performance. A once-off cross-sectional survey design was used.. The Orientation to Life Questionnaire, Maslach Burnout Inventory, Minnesota Job Satisfaction Questionnaire and Performance Appraisal Questionnaire were used as measuring instruments. Sense of coherence was related to the three subscales of burnout. Job satisfaction was found to be negatively related to burnout. The results showed that one component of burnout, namely low personal...
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...Lowering Nurse Staffing Ratios The growing need of more nurses in hospitals is becoming an issue in hospitals all over America. The patient’s safety is being put at risk due to the number of nurse to patient ratios (Welton 1). A low nurse to patient ratio will cause a lack of care for the patients. Nurses will have to take on more patients then they are capable of which will affect the health of the patient and the nurse. John M. Welton, an RN (Registered Nurse), said that “the safety of patients is directly related to the size and experience of the nursing staff” (Welton 1). A high nurse to patient ratio can be on the costly side for the hospitals. “Hospitals will not receive any additional revenue for providing more patient care”...
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...------------------------------------------------- BROCHURE ON CALIFORNIA STATE MANDATED NURSE PATIENT RATIO. Does mandating Nurse-Patient ratio improve care? Information for nurses and patients. BY SHINY EDWARD RN UNIVERSITY OF PHOENIX JULY 8, 2012. ------------------------------------------------- BROCHURE ON CALIFORNIA STATE MANDATED NURSE PATIENT RATIO. Does mandating Nurse-Patient ratio improve care? Information for nurses and patients. BY SHINY EDWARD RN UNIVERSITY OF PHOENIX JULY 8, 2012. Explanation of the facts, history, legislative regulations, controversial aspects and opinions Explanation of the facts, history, legislative regulations, controversial aspects and opinions MANDATED NURSE PATIENT RATIO How does it affect you and your loved ones? Nurse patient ratio for safe care means when the staffing between the nurses and the patients are safe to provide the care patients need to get well in the hospital or nursing homes. Why is this important? Several studies have shown that patients get well faster and safer when they receive more nursing care. Even more importantly according to Linda Aiken study (2003), mortality rates and staffing ratios are closely tied. Each additional patient per RN after four patients, chances of dying in the hospital is increased by 7%.Patient on a surgical unit with patient –RN ratio of 8:1 were 31% more likely to die within 30days than those on surgical units with ratios of 4:1.Studies have shown that more infections like UTI, pneumonia...
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...January 2016 Leadership and Management Executive Summary Nursing burnout is serious and in order to ensure that nurses are taken care of, the administration must implement incentives and policies that will provide nurses with the resources to maintain a healthy work life balance. Burnout accounts for many of the medication errors and patient injuries in healthcare facilities. Most nurses are overwhelmed because of the caseload and longer workdays necessary to complete charting. Many nurses are also disgruntled because of denied vacation requests that cannot be approved because of non-coverage. Research has shown that when employees are happy then there are less errors and injuries in the workplace. It’s ironic that nurses care for patients but they don’t feel as though the healthcare facility cares for them. Many things can be done to boost employee morale which in turn will increase the quality of care that the patients receive. Adequate coverage needs to be address and using temporary staffing is a way to fill chronic vacant positions so that float RN’s are available for PTO requests. Insurance credits and consumer discounts can be used as incentives for those employees that practice healthy living activities. Staff meetings held during work hours, discussion boxes, timeout rooms, and partnerships with massage clinics are all changes that can provide stress relief for nurses. These changes are not too costly for the facility, and in the end, will result...
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...population means more work for health care workers, and nurses bear the brunt of this reality. There is some legislation in place to restrict mandatory overtime, but research suggests that overtime hours have not decreased since those policies were created. Furthermore, voluntary overtime is unregulated, with many nurses exceeding the recommended 40-hour workweek. Studies have shown that exceeding recommended hours results in workplace injuries to nurses, increased burnout and lower retention of nurses, and poorer outcomes for patients, including early readmission, medication errors, falls and nosocomial infections. More regulation may be necessary to reduce the hours worked by nurses. Advanced practice registered nurses are in a position to advocate for stricter policies in their facilities, and to implement strategies that would reduce overtime hours worked in their facilities, for example by increasing staffing. Nurse managers can ensure that their nurses doing overtime take the recommended breaks and do not exceed the recommended number of hours worked per week. Nursing Overtime and Adverse Effects Mandatory overtime is defined as employer-imposed work time in excess of one’s assigned schedule. Voluntary overtime is time worked at the employee’s discretion over and above that specified for a full-time employee. Both of these are utilized frequently by the health care sector, primarily in light of the nursing shortage. A study by Berney, Needleman and Kovner (2005) demonstrated...
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...Why is it Important to Articulate Your Personal Philosophy of Nursing? Nurses often feel a conflict between the ideals of the profession and the reality of the job. Deheny (2001) writes “demands and expectations of the role are greater than the resources or number of hours in the day to accomplish what nurses would define as quality nursing care” (para. 1). Also, the use of advanced technology can create emotional withdrawal from the patient as the nurse focuses more on the machines than the person. These factors increase job dissatisfaction and emotional burnout. To articulate one’s personal philosophy requires examining the values and beliefs that define a person. Masters (2014) writes, “the overall purpose of personal philosophy is to define how one finds truth” (pg. 100). With a knowledge of personal values and beliefs, the nurse can examine why they entered the nursing field. With this introspective activity, the nurse can find balance and meaning in the workplace (Deheny, 2001). What is the Relationship Between Your Personal Philosophy of Nursing and Your Professional Practice? My personal philosophy of nursing is based on caring and compassion. With these core beliefs, I strive to provide the best patient-centered care that I am capable of. Like many of my colleagues, the demands of nursing tire me emotionally and physically. The reduction in staff to patient ratio creates a tense environment. Our staff is under constant pressure to perform more work and to...
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...benefits the clients and the employer since the facility enjoys uninterrupted services. The situation in Ashford General Hospital is now getting out of hand and slowly undermining the status and the hard earned reputation. This hospital has a capacity of 263 beds, 24 hour emergency department and an extended hour’s urgent clinic. This hospital despite being in practice for 50 years has its nurse retention rate below that of the nation by 4%, meaning that its staff turnover is very high. We must remember that 68% of nurses in this hospital are almost retiring. This is a hospital is understaffed in the first place, has overworked nurses who are fatigued an aspect that has caused the hospital many problems including; patient dissatisfaction, huge losses in terms of clients and money for as we speak cases of patient suing the hospital due to neglect are increasing. Working with poorly motivated and inadequate staff is only detrimental to this facility and has led to outsourcing replacement of nurses and this is proving to be very expensive (Tillott, Walsh, & Moxham, 2013). The outsourced nurses are so green and occasionally unreliable, since they don’t understand the operations of the hospital. They also show a degree of neglect to our patients since they are only around for a short duration and their contracts are usually more expensive. The situation is so bad that if it continues...
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