Nursing Burnout Issue at a Facility

North Mountain Medical is a super sniff facility as they specialized in high acuity level patient. The patient structure is respiratory, with staff trained in tracheostomy care and ventilator management. In house hemodialysis, in house physical therapy. This facility has been in operation since 2004. Patients in this facility do not self-diagnose. Patient diagnoses are from Medical doctors and Nurse Practitioners that work on site. Patient in the facility are cared for by interdisciplinary team.

Certified nursing assistants that care for patient will normally report a Change in patient’s condition to the nurse. Nurse completes an assessment and report changes immediately to the doctor. In the event of an emergency patients are send to emergency room for further evaluation and treatment. Health is a right in this facility. Yes, most of the patient’s life style has impacted the health of the patient. Noncompliance with medication regimen and diet changes.

Patients in this facility do not believe that health or illness is divinely sent. Most Hispanic and Native American patients tend to be hesitant to sign advance directives and DNR due to their spiritual beliefs. The patient that are diabetic are place on diabetic diet to manage their diabetes. Patient with cardiac issue are place on cardiac diet and patient on dialysis and also have congestive heart failure are on fluid restriction. These are all health promotion methods to improve health of patient.

This facility is not a male dominance facility. They have both male and female patients. The mission and values of this facility is reflected in their core values CAPLICO. It stands for celebration, accountability, passion for learning, love one another, intelligent risk taking, customer second and ownership. Employees are encouraged daily to always smile and greet everyone, have a great attitude and work hard. Be polite using please and thank you, do the right thing even when no one is looking. The facility does not have a religious foundation.

The facility operations do reflect the culture of the community. The facility implements a spirit of inquiry and use of evidence based practice in patient care in the following ways. This facility’s patient population is mostly patients that have trach and are ventilator dependent. Research studies have shown that about 10-20% acquires ventilator associated pneumonia and eventually die. This facility follows the guide lines of the institute for healthcare improvement. This measures includes elevation of head of bed 30 to 45 degrees to prevent aspiration.

Provision of daily oral care with chlorhexidine and this eliminate the risk of aspirating infectious oral secretions. They also use peptic ulcer disease prophylaxis medication that helps prevent stress ulcers from forming in patients that are critically ill. This facility also uses evidence base practice to prevent central line associated bloodstream infections, they use the following guide lines on patients with central lines.

All Nurses have received an education on how to care and maintain the catheter and this can be found on Point Click Care as standing orders that nurse sign off during their shift. Hubs are disinfected before a Nurse can access the port. Assessment completed daily to ensure that patient still need the central line.    Discontinue immediately when patient no longer in need to reduce the risk of infection.

The facility also uses the CDCs guidelines to prevent catheter associated UTIs by assessing daily the need for continuous use of catheter. Hygiene provided to the patient Q Shift and as needed. Measure and empty the urinary drainage bag Q shift and as needed. Hand washing and use of gloves during catheter Care.   Drainage bag kept below the bladder level.   Another use of evidence base practice is early mobilization of patients to reduce pressure injury, muscle atrophy and other complications due to prolonged bed rest.

This patient is seen by therapist within the first 48 hours for evaluation (Nurse.com, 2019).   An overview of the issue. The healthcare field in the 21st century is getting bigger and complex. Even though nurses make an effort daily to provide safe patient care, it is often noted that they encounter very stressful situations. This is usually as a result of increased work load, inadequate staff, new technology and the time factor, long shift, mandatory overtime.

All of this combined can result in emotional, physical and mental exhaustion to the nurse. If the nurse does not find a way to effectively managed this issue it can lead to nurse burnout (Nurse.org, 2018). Nurses at North Mountain Medical are suffering from burnout that is attributable to various factors in their workplace. Some of the major contributors to nurse burnout at this facility include inadequate staffing, increased workload for nurses, and the adoption of new technology that nurse may have a hard time learning.

The other factors include time constraints since nurses have very limited time to complete a task in an efficient manner, long work hours, and poor working environment. These factors contribute to poor judgment by nurses, which usually leads to poor patient outcomes (Nurse .org, 2018) The patient population is affected the most. Nurses are equally affected and families are affected. The entire healthcare team is affected. When nurses are not happy with their work environment, they quit.

This can be very expensive for the health care organization as they have to hire and train new ones. Programs that are currently related to this issue. How has this issue been dealt with in the past? Based on reports from my preceptor who happens to be the director of nursing, the facility has in the past attempted to address nurse burnout by providing adequate staff. Unfortunately, most of the new nurses get overwhelmed and quit.

This is thought to be an issue because nurses and certified nursing assistants work for long hours. While nurses are scheduled to work 7am-7pm, most of them end up leaving the facility at 11 or 12 midnight. This is 4 or 5 hours from the time their shift ended. The funding comes from the administrator. There is available funding to hire more staff. There are incentives for employees who refer a new hire. They each get $2000. There is currently a tuition reimbursement program.

Nurses that want to further their education at different levels ranging from an LPN studying to become a registered nurse, or a registered nurse pursuing their BSN get reimbursed. However, such nurses need to sign a contract to work for the facility for two years. These are attempts to retain nurses and reduce burnout. Even though North Mountain Medical has been working to address this problem, most of its efforts have remained unsuccessful.

The strength of this facility regarding nursing burnout is that they have an ongoing strategy in place to address the problem. When a nurse is called in to work on their day off, they give that nurse $200 for covering that shift. When nurses feel that they are appreciated for the services they provide, they are motivated to provide quality care to the patient. Thus the saying happy nurse, happy patients.

When called upon, staff from management like unit managers come to the floor to assist in medication pass, accrue checks, start tube feedings, and shower some patients. This prevents the nurses from being overwhelmed with work and allow them to efficiently provide safe client care and no longer experience burn out. Briefly discuss research-supported recommendations to implement a change process related to this issue. There are very simple and effective strategies nurses can use daily to reduce nurse burnout.

For example, when a nurse starts to feel stress, stop and breath. Put your thoughts to gather how this situation can be handled. Think and think, take a deep breath and relax and this can prevent the problem from spiraling out of control. Nurses can effectively reduce burnout by just writing down the things causing stress during work. Once those stressors are identified, they can request assistance from charge nurse and nurse manager on how to eliminate this stressor (Consult QD, 2017).

Also do not be the super nurse that wants to do it all. That can quickly lead to burn out. Please make sure to delegate appropriately if necessary. this will reduce the feeling of being overwhelmed. Make sure to practice healthy habits such as enough sleep, eat healthy foods and exercise. If you are unable to walk for 30 minutes at lunch, then walk to a bathroom or refill your water bottle on another floor. If the taco bar is tempting, fix a taco salad rather than a loaded burrito.

These efforts are small but significant and go a long way to reduce stress. Download and use free apps such as stress free now. They have relaxation techniques, daily stress assessment, and a healer’s version that is available and specific for nurses and caregivers (Consult QD,2017) Proposed solution.

Would you want to do an education session and measure knowledge levels on burn out? Do you think the facility needs to have a better system of identifying burn out? Do you have support from management? ???????????????????????????????????????????????Will this cost money? If so where would the money come from?  Narrow your focus and be specific on what you think the facility needs and what you would change.

The first step toward identification of a suitable approach or solution to the nursing burnout problem at North Mountain Medical entailed conducting a survey on this issue. The survey entailed the use of a questionnaire to measure nurses’ knowledge of burnout as they carry out their various roles and responsibilities in the facility. A group of ten nurses comprising experienced and new nurses at the facility was identified.

Given the difficulties in getting all the targeted ten nurses in one room, a questionnaire was administered as shown in the Appendix. The questionnaire comprised open-ended questions that would help determine nurses’ knowledge on burnout and how the avoid/cope with it. 7 of the 10 nurses i.e. 70% indicated that they did not understand what burnout was or did not know its signs and symptoms. The remaining nurses indicated that they understood what nursing burnout is and know how to recognize its signs and symptoms.

These results demonstrate that a significant percentage of nurses at North Mountain Medical do not know or understand what is nursing burnout and its signs. Therefore, these nurses are not adequately equipped to detect signs of this problem and develop measures for avoiding burnout or coping with it. Despite learning about nursing burnout in school, a significant portion of nurses at the facility do not understand this issue, which is an indicator of gaps in knowledge.

The gaps in knowledge on nurse burnout levels by the facility’s workforce indicate the need to establish a related health policy regarding awareness. Additionally, these gaps indicate the need to implement a regular training program to upgrade and refresh nurses’ knowledge and recognition of signs of burnout. The proposed solution for addressing the issue of nurse burnout at North Mountain Medical is conducting an educational program for the nurses.

Nabadda (2012) states that nurses should have the right perception of burnout through being adequately equipped with knowledge on this issue. Knowledge of issues relating to burnout improves the ability of nurses to identify, avoid and cope well with signs of burnout. While nursing burnout is a topic that is taught nursing schools, nurses still face issues relating to it. This implies that most nurses do not have adequate knowledge and the right perception, which in turn increases their burnout levels.

The lack of adequate knowledge and right perception on burnout is attributable to individual and organizational factors affecting nurses. From an individual perspective, the nursing environment is increasingly complex as nurses deal with patients and colleagues, which is a process that can generate chronic emotional demands and stress. The nature of the working environment can also be a source of nursing burnout. As previously indicated, the current working environment at North Mountain Medical is characterized by various stressors that contribute to nurse burnout.

Some of these stressors include inadequate staffing, increased workload for nurses, long work hours, and poor working environment. These factors in the working environment complicate the ability of nurses to experience job satisfaction as they result in high levels of burnout. Given these factors, leaders at North Mountain Medical should help establish suitable measures for addressing nursing burnout in the workplace. The proposed solution that will enable these leaders to provide assistance to nurses at the facility is an educational program that seeks to enhance nurses’ knowledge on burnout.

An educational program should be adopted to help provide sufficient training to the organization’s workforce, particularly new nurses with regards to identifying, avoiding, and coping with burnout. Through the program, nurses in the facility will be able to recognize the triggers of burnout and avoid them while those currently suffering from burnout will learn appropriate coping measures. The educational program should focus on different individual and organizational aspects that contribute to burnout. As.