...COMPASSION FATIGUE AMONG HEALTHCARE WORKERS A PROPOSAL PRESENTED TO THE FACULTY OF THE GRADUATE SCHOOL OF UNIVERSITY OF THE VISAYAS CEBU CITY, PHILIPPINES IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF ARTS IN NURSING MAJOR IN NURSING MANAGEMENT BY: CONCHITA BRANZUELA BERGADO CHAPTER I THE PROBLEM INTRODUCTION: Quality of life among healthcare providers will matter on the quality and safety of patient care. Today the proportion of acute patients entering the health care system through emergency departments continues to grow and the number of patients in the Intensive care unit also increasing. In emergency room 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...
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...Research of Literature for Case Study #5 Primary Hyperparathyroidism Carrie Virgil Gillette College Case Study #5 Primary Hyperparathyroidism Introduction Hyperparathyroidism is an endocrine disorder involving the parathyroid glands. According to Timby and Smith (2010), Hyperparathyroidism occurs when the parathyroid gland dysfunctions. Primary hyperparathyroidism and secondary hyperparathyroidism are two disorders that occur when the parathyroid gland dysfunctions (Timby and Smith, 2010). This case study will focus on primary hyperparathyroidism. Timby and Smith (2010) report that primary hyperparathyroidism occurs when excess parathormone is secreted from an enlarged parathyroid gland. Mayo Clinic (2011) notes the excess hormone results in increased phosphorus released in the urine and an excessive loss of calcium from the bones. According to Mayo Clinic (2010), the excess calcium in the blood stream causes hypercalcemia, which can cause a variety of health problems. Timby and Smith (2010) confirm that hypercalcemia can depress the responsiveness of the peripheral nerves, which can result in fatigue and muscle weakness. Fuleihan and Silverberg (2012) report severe bone loss and kidney stones are major clinical manifestations of hyperparathyroidism. Primary hyperparathyroidism is diagnosed by an elevated PTH concentration or by a normal PTH concentration with an elevated serum calcium concentration (Fuleihan and Silverburg, 2012). Timby and Smith (2010) state a 24 hour urine...
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...Nursing Overtime and Adverse Effects Blima Marcus Hunter College Abstract This paper will explore the topic of nursing overtime and its effect on adverse events and errors in the workplace. The prevalence of mandatory and voluntary overtime is high. Nursing shortages combined with the aging baby boomer 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...
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...Evidence-Based Nursing Care for Multiple Myeloma Patients Evidence-Based Nursing Care for Multiple Myeloma Patients Comprised of the blood cells, blood, lymph, and other organs involved in the formation or storage of blood, the hematologic system allows the human body to maintain adequate oxygenation and tissue perfusion (Ignatavicius & Workman, 2010, p. 876). Because every cell, tissue, organ, and system is dependent on blood circulation for survival, hematologic problems involving impaired production, impaired function, or abnormal destruction of blood cells are likely to have wide-reaching effects on the patient's health and wellness (Ignatavicius & Workman, 2010, p. 876). This is especially clear when examining cancers of the hematologic system, including multiple myeloma. A cancer of certain white blood cells in the bone marrow known as plasma cells, “myeloma” refers to a tumor of the bone marrow, and “multiple” refers to more than one area of the bone marrow being affected (Mangan, 2006, p. 64hn1). Because the disease is incurable, and because only 30 percent of patients survive longer than five years after diagnosis, living with multiple myeloma can be difficult for patients and their families (Mangan, 2006, p. 64hn1). As health care providers on the front lines of patient care, nurses must be aware of the multi-system manifestations of multiple myeloma, be able to make the assessments needed to identify and prevent complications...
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...part of the team who deliver the care need to understand how important it is to understand this concept. Delivering compassion care can be something as small as holding somebody’s hand when they are in the later stages of their life, if they feel scared or another thing is as simple as listening to the patient and to hear their problems. The patient will feel better and the nurse should feel good about themselves too knowing that something as small as holding somebody’s hand or listening has benefited that patient. The nursing standard had a report on how student nurses are eager to deliver good and professional compassionate care to their patients when out on practice however lack of time and paperwork are factors on how much time they can actually spend with their patients. It has been said that a high amount of nurses in the NHS are set to retire over the next few years and this article reports why this may be. Watson, R et al (2003) if this is the case then why is it when they become professionals then they struggle to still have...
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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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...Alarm Fatigue Alarm fatigue is a growing national problem within the health care industry that links medical technology as a serious hazard that poses a significant threat to patient safety within hospitals across the country. Alarm fatigue occurs when nurses encounter an overwhelming amount of alarms thus becoming desensitized to the firing alarms. Alarm desensitization is a multifaceted issue that is related to the number of alarming medical devices, a high false alarm rate, and the lack of alarm standardization in hospitals today (Cvach, 2012). Desensitization can lead to delayed response times, alarms silenced or turned off, or alarms adjusted to unsafe limits, which can create a dangerous situation for the patient. Alarm fatigue has been identified as having negative effects on patients as well as healthcare professionals. Many hospitals have reported that alarm-related injuries have occurred due to the overwhelming amount of constant sounding alarms. Critical alarms cause nurses to tune out sounds, which in turn triggers the brain to adjust to stimulation, thus causing a healthcare professional to disregard the alarms. Hospital alarms can come from an array of devices including blood pressure machines, oxygen saturation devices, sleep apnea devices, fall prevention alarms, intravenous pumps, patient-controlled analgesia pumps, patient call systems, ventilators, telephones, anti-embolism pumps, and heart monitors. The purpose of this paper is to analyze the problem...
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...Clinical Case Study Assignment 2014 Jennifer Ahonen Cambrian College a00050951 BSN 2144: Nursing Practice Frances Carvalho & Jillian Smythe March 21, 2014 Clinical Case Study Assignment 2014 The purpose of this paper is to utilize the data collected in the Gordon’s Functional Health Patterns Assessment Tool (Appendix A). After data collection, it will be analyzed and a priority nursing diagnosis will be used to make a care plan (Appendix B). Patient X is an 82 year old male, who presented to the emergency department from his home at Extendicare York with a fever of 38.9 degrees Celsius, a blood pressure of 75/40 mm Hg, blood glucose level of 3.7, diaphoretic and a three day history of diarrhea, nausea and generalized weakness. The admitting diagnosis for this 82 year old male was Pneumonia. Pneumonia is an acute inflammation of the lower respiratory tract due to an infectious agent that impairs gas exchange due to alveolar edema and congestion (Thiem, Heppner, & Pientka, 2011). There are many factors that predispose individuals to pneumonia; however, in the case of this patient the predisposing factors are age and the presence of chronic diseases. The patient’s complete history and demographics can be found in Appendix A. The classic clinical manifestations of pneumonia consist of a temperature above 38 degrees Celsius, diaphoresis, cough, and shortness of breath, chest pain, tachycardia, purulent sputum, fatigue, nausea, vomiting, and diarrhea (Thiem, Heppner...
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...TREATING A PATIENT WITH CANCER: MAINTAINING PATIENT QUALITY OF LIFE Introduction Cancer is one of the most prevalent diseases in the U.S. Case (2011) noted that the 2010 report of the American Cancer Society (ACS) indicated that more than a million an d a half new cases of cancer are diagnosed every year. Along with physical disease, cancer also brings a significant impact on the patient’s overall quality of life (QOL). This paper asserts that for optimal patient outcome, healthcare workers, particularly nurses, need to attend to the cancer patient’s overall QOL rather than simply focusing on the physical disease of cancer. This essay will first address the issue of understanding what constitutes the patient’s QOL. Then key factors that directly affect the QOL are reviewed in the context of current best evidence. That will be followed by a section that addresses the nursing implications of this subject. The paper concludes with a brief summary and conclusion about the importance of maintaining patient QOL in cancer patients. The first element, is thus to define what is meant by “quality of life.” The next section of this paper addresses that specific issue. Defining Patient Quality of Life Before patient QOL can be addressed in a nursing practice, it is essential to understand what is meant by QOL. Bahrami (2011) has noted that no specific, well accepted definition of patient QOL exists. One reason for this lack of consensus on QOL is that life quality is a highly...
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...patients see the same nurses over many shifts. What they may not realize is how many hours RNs work in a given 24-hour period to provide continuous patient care. According to Bae (2012a), a 2004 research study found that “43% of U.S. RNs worked more than 40 hours per week and about 9% worked more than 60 hours per week” (p. 205). In most instances RNs work overtime to alleviate staff shortages in their units. According to Bae (2012b), staff shortage in hospitals is not a new phenomenon and many researchers in health care system contend that such chronic shortage of nurses has a direct and negative impact on patient care (Bae, 2010; Bae, 2012b, Bae, Brewer, & Faan, 2012). For example, in several of her research articles, Bae (2010, 2012a, & 2012b) cited several research articles where researchers have found that the long hours worked by RNs are at the root of many adverse patient outcomes. Anecdotal evidence should suggest that anyone working long hours over an extended period of time will experience fatigue and decreased working performance. However, the health care system, as a whole, has not adopted the recommended standards from the Institute of Medicine (IOM) of “no more than 12 hours in a 24-hour period and no more than 60 hours in a 7-day period to avoid error-producing fatigue” (Bae, 2012a, p.60). The logical question is why not? Additionally, it...
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...Advanced Pathophysiology Case Study 6 Case Study 6 Scenario: John is a 4 year-old boy who was admitted for chemotherapy following diagnosis of acute lymphoblastic leukemia (ALL). He had a white blood cell count of 250,000. Clinical presentation included loss of appetite, easily bruised, gum bleeding, and fatigue. Physical examination revealed marked splenomegaly, pale skin color, temperature of 102°F, and upper abdomen tenderness along with nonspecific arthralgia. Pathophysiology signs and symptoms The primary pathophysiological etiology for signs, symptoms and laboratory findings in 4 year-old John’s case study are secondary splenomegaly as a result of primary Acute Lymphoblastic Leukemia (ALL). Because of its proximity to the diaphragm, splenomegaly results in pain or fullness in the left upper abdomen (subsequent tenderness and loss of appetite) that may spread to the left shoulder (non-specific arthralgia). Splenomegaly may result in anemia (bruising, bleeding gums, decrease in pallor) fatigue and frequent infections (4 year old John’s WBC 250, 000 count and fever 102°F). However, in John’s case, some of the symptoms related to splenomegaly can also overlap with those of his diagnosis of ALL such as fever and abdominal distention. Additionally, anorexia, headache, seizures, lethargy, arthralgia, infection, and bruising are also potential side effects (Ghazi et al., 2010). Pathophysiology of acute lymphoblastic leukemia-AML comparison According to Gedaly...
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...lupus. A big portion of information in the paper comes from a patient Anna. The areas of her life that are affected by the disease , and the motivators for lifestyle change are discussed. The education of Anna regarding the disease and learning model theory will be examined. What is Lupus? Lupus is a chronic autoimmune disease. The immune system fights off invaders in the body. The body develops antibodies to protect from invaders. The immune system affected by lupus cannot tell the difference between good and bad tissue. This process causes the immune system to attack itself. There are many different types of lupus. The type Anna has is cutaneous and systemic. Cutaneous affects the skin. Systemic lupus in her case affects the joints. Cutaneous lupus causes skin rashes/lesions. The most familiar rash is the butterfly rash. The rash occurs on the bridge of the nose and across upper cheeks. Systemic lupus cause the joints become painful and inflamed. Anna The interview with Anna was held over a couple of days. Anna was diagnosed a year and a half ago with lupus. Anna believes that she has had the disease for longer than a year and a half. The rashes that she experienced had been occurring since she was 19. Anna is now 41 years old. Anna is married and has two children. She practices as a nurse in orange county, CA. Her children are two boys five and 10. Anna resides with her family in Long Beach, Ca. Her husband travels quite a bit with his...
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...Compassion Fatigue . . Lewin (1996) described compassion as a complex emotion that enables health care providers to sustain themselves in emotional balance while holding their patients’ despair in one hand and their hopefulness in the other hand. (Bush, 2009) Compassion fatigue is caused by empathy. It is a natural consequence from stress resulting from caring for and helping traumatized or suffering people. All health care providers are at major risk for compassion fatigue, and registered nurses are especially at risk because nurses are at the forefront of patient care. Nurses are compassionate and empathetic, it’s the nature of the job description. Nurses are experts at multitasking and putting the needs of others above and beyond their own needs each and every day. It is of the utmost importance that registered nurses understand compassion fatigue and familiarize themselves with the signs and symptoms for themselves and their coworkers so that they can take necessary steps to combat compassion fatigue at the first sign. The core of nursing and being a nurse is compassion. Nurses pride themselves on the extraordinary gift of being compassionate and caring for patients. Nurses see people at their worst and most vulnerable times and assist their patients back to optimal health. Nurses pick you up when you are down and clean you up when you cannot do it for yourself. Nurses provide a caring touch, a smile, and hope where hope is lost. It is not difficult to see that...
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...Infective Endocarditis Case Study 1. The overall nursing goals for Infective Endocarditis include normal or baseline cardiac function, performance of activities of daily living (ADLs) without fatigue, and the knowledge of the therapeutic regimen to prevent recurrence of endocarditis. 2. Once the patient has been diagnosed with infective endocarditis, important patient teaching should include understanding of and adherence to the planned treatment regimen. The patient should understand the need to avoid persons with infection, especially upper respiratory tract infection, and to report cold, flu, and cough symptoms. The importance of avoiding excessive fatigue and the need to plan rest periods before and after activity should be carefully explained to the patient. Good oral hygiene, including daily care and regular dental visits, is also important. The patient must also inform all health care providers performing dental, medical, or surgical procedures of the history of IE. The patient should also be taught the significance of the prescribed prophylactic antibiotics therapy before any invasive procedure. 3. A patient with IE has many problems that require nursing management. IE generally requires treatment with antibiotics for 4 to 6 weeks. After initial treatment in the hospital, the patient may continue treatment at home. Patients who receive outpatient IV antibiotics will require vigilant home nursing care. The patient and or the family also need instruction by...
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...Increasing changes in diversity puts a demand on healthcare professionals. Changes in healthcare have popularized empirical and evidence-based research in the field of nursing research (Hung, Chang,Chen, 2010) New roles that are emerging are tele-conferencing, providing nursing care over the phone triage style nurses need to be effective leaders and managers to meet the new challenges, advocate for policies that contribute to the health of populations, to sustainable development, and to the security and just treatment of nurses and health care professionals (NSNA,2011). Health care evolving at a fast rate and as provider’s nurses will need to adapt by meeting the needs and demands of individuals. The elderly are increasing and have been at a steady rate, and we need the professionals to be available to take care of the elder generation. The acuity on my floor are seeing more and more elderly’s coming in with stroke and fractures. Hung, H., Wang, H., Chang, Y., & Chen, C. (2010). [Nursing knowledge: the evolution of scientific philosophies and paradigm trends]. Hu Li Za Zhi The Journal Of Nursing, 57(1), 64-70. Retrieved from EBSCOhost. NSNA (2011) Meeting Today’s Global Health Care Challenges retrieved from http://www.nsna.org/Portals/0/Skins/NSNA/pdf/Imprint_Feb04_Hancock.pdf patterns of health events in populations characterizes health outcomes in terms of what, who, where, when, and why: What is the outcome? Who is affected? Where are they? When do events occur...
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