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Education Plan for Nurse Burnout at North Mountain Medical
The current issue at North Mountain Medical is nursing burnout, which is caused by various factors including inadequate staffing, increased workload, long working hours, poor working environment, and inadequate time to complete a task effectively. The proposed change project to address this issue is an educational plan that targets nursing burnout, particularly workplace stress management. In this regard, the practicum education project focuses on training nurses at North Mountain Medical on nursing burnout, particularly workplace stress management. Through the insights obtained from this course, nurses in this facility will be able to implement evidence-based strategies on workplace stress management and preventing/dealing with nursing burnout.
Learning Objectives or Outcomes
As shown in the educational plan in Appendix A, this practicum education project seeks to accomplish three major objectives. Each of these learning objectives or learning outcomes was developed using Bloom’s Taxonomy, which…
Although both methodologies of quantitative and qualitative studies are present in the fields of medicine and nursing, the two approaches are occasionally pitted against one another. Quantitative studies are data-driven and numerical. They usually make use of an experimental or quasi-experimental study design and include both a control and an experimental group in terms of how they are structured. Qualitative studies, in contrast, usually are focused on small populations. Unlike quantitative studies which make use of the deductive method (generalized principles based upon a larger population which can then be applied to individual cases) qualitative studies make use of the inductive method, using a small population to create a theory which may then be generalized to others (or not, given that some qualitative studies are so focused on tiny subpopulations they may only have relevance to a very narrow subgroup). "Whereas quantitative research counts occurrences (eg, estimates prevalence,…
Curry, L., Nembhard, I., Bradley, E. (2009). Qualitative and mixed methods provide unique contributions to outcomes research. Circulation. 119: 1442-1452.
Deary, I., Watson, E., & Hogston, R. (2003). A longitudinal cohort study of burnout and attrition in nursing students. Journal of Advanced Nursing (Impact Factor: 1.69). 08/2003;
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…
Polikandrioti M.( 2009). Burnout Syndrome. etrieved March 24, from 2014 http://www.hsj.gr/volume3/issue4/340.pdf
This article is on burnout syndrome which is described as a complex phenomena on the rise associated with a stressful work environment.it was described by Freudenberger in the mid-1970s and ever since it has been a subject of discussion. According to the article, the burnout syndrome is characterized using three dimensions; emotional exhaustion which refers to the depletion of emotional resources when it comes to contact wit other people. The second dimension is depersonalization which includes negative feelings and a cynical attitude towards someone who is receiving care. The third dimension is reduced personal accomplishment which involves the tendency of evaluating one self in a negative way especially when it comes to work. The article sites a pronounced impact of the burnout syndrome as the reduction in the performance of an employee and their quality of service…
Polikandrioti M., ( 2009). Burnout Syndrome. Retrieved March 24, from 2014 http://www.hsj.gr/volume3/issue4/340.pdf
ScienceDaily, LLC., (2012). Long shifts lead to nurse burnout and dissatisfied patients. Retrieved March 24, from http://www.sciencedaily.com/releases/2012/11/121106114046.htm
Helpguide.org, (2010). Preventing Burnout. Retrieved March 24, from 2014 http://www.helpguide.org/mental/burnout_signs_symptoms.htm
739, p=0.009, e?=0.727). This study clearly highlighted that sleep shortage and work fatigue poses a threat to patient safety and that nurse self-care is warranted.[Dorrian et.al, (2006)]
Nurse Support Services
An earlier Australian study by Moore KA (2001) which observed 201 nurses working in three different hospitals had concluded that organizational restructuring policies and the consequent work overload was a high stressor for nurses and this was made worse by the poor communication style (top -- down approach instead of consultative style) that only contributed more to nurse burnout. [Moore KA, (2001)]. Given the high levels of occupational stress and burnout among nurses, it is important that nurse self-care interventions are prioritized. A recent literature review on the subject of work stress and coping methods among Australian nurses revealed that 'work load ', 'role conflict' and 'expression of aggression' were the three main stressors. The literature study also revealed 'seeking…
1) Linda H. Aiken, 'Image of Nursing Global Trends', retrieved Sep 4th 2010, from, http://www.fpnl.co.za/downloads/Presentations/Presentations/Prof%20Linda%20Aiken%20-%20Image%20of%20Nursing%20-%20Global%20Trends.pdf
2) Jillian Dorrian, Nicole Lamond & Cameron Van del Heuvel et.al (Oct 2006), 'A Pilot study of the Safety Implications of Australian Nurses' Sleep and Working Hours', Chronobiology International, Vol 23, Issue 6, pg 1149-1163
3) Lim J, BOGOSSIAN F. & AHERN K. (2010), ' Stress and coping in Australian nurses: a systematic review. International Nursing Review 57, 22-31
4) Moore KA, (2001), 'Hospital restructuring: impact on nurses mediated by social
Nurse Study eview
Vahey et al. (2004) research indicated the importance of investigating the role of environment and clinical situation for both nurse performance and patient satisfaction. This study is a quantitative approach to investigating these topics as it sought to find correlations between these variables.
The article is premised on the idea that nurses employed in hospitals are experiencing greater workloads resulting in career fatigue and burnout. The article incorporated past research on these topics and suggested that "Indeed, more than 40% of hospital staff nurses score in the high range for job-related burnout, and more than 1 in 5 hospital staff nurses say they intend to leave their hospital jobs within 1 year. The understaffing of nurses and the overwork of health professionals in hospitals are ranked by consumers as major threats to patient safety, and more patients are bringing their own caregivers to the hospital with them."…
Vahey, D.C., Aiken, L.H., Sloane, D.M., Clarke, S.P., & Vargas, D. (2004). Nurse burnout and patient satisfaction. Medical care, 42(2 Suppl), II57.
Nursing Staff Levels Affect Patient Mortality
Managing unnecessary variability in patient demand to reduce nursing stress and improve patient safety.
Litvak, E., Buerhaus, P.I., Davidoff, F., Long, M.C., McManus, M.L. & Berwick, D.M.
Date of publication: June 2005
Examination of the operational issues affecting health care delivery, including patient driven peaks in demand and effects of nursing shortages or inadequate staffing on clinical outcomes for patients.
esearch question and/or hypothesis:
In this study the researchers propose that increases in adverse clinical outcomes occur when hospital nurse staffing is inadequate. Further the researchers suggest that increases in census rates increase the potential for serious stresses for patients and nurses working in the field. Lastly the researchers suggest that if hospitals reduce unnecessary variability of staff levels in a hospital, the hospital can reduce the probability of negative patient outcomes, improve safety for patients and improve the overall quality of care.
Aikan, L.H., Clarke, S.P., Sloane, D.M, Sochalski, J. & Silber, J.H. (2002 -- Oct).
"Hospital nurse staffing and patient mortality, nurse burnout and job dissatisfaction." JAMA, 288(16): 1987-93.
Halm, M., Peterson, M., Kandels, M., Sabo, J., Blalock, M., Braden, R., Gryczman, A.,
Krisko-Hagel, K., Larson, D., Lemay, D., Sisler, B., Strom, L., Topham, D. (2005 -- Sept). "Hospital nurse staffing and patient mortality, emotional exhaustion and job dissatisfaction." Clin Nurse Spec, 19(5): 241-5.
Paediatric, pediatric, infant
How would you describe your Participant, Patient, or Population group?
Female hospital worker age 20 to 45
What characteristics of your Patient/s are important? Age, gender, condition, etc. can all be significant.
What Intervention are you interested in?
Work shift 8 hours long
Defining the Intervention is often the central part of PICO.
What alternative or different option do you want to Compare your intervention to?
Work shift 12 hours long
You might want to Compare the chosen intervention to usual care, to another intervention or to no intervention.
What measurable Outcome/s are you interested in?
Outcome is the final aspect of PICO. Some examples include: symptoms of asthma, accuracy of diagnosis or mortality.
2. eformatted (PICO) Clinical Question
In healthcare providers working in a hospital (nurses) (P…
Classen, J., Davis, S., Sutter, E. (2016). The impact of an 8-hour versus 12-hour shift for registered nurses: An integrative review. Cedarville University Symposium. Retrieved from http://digitalcommons.cedarville.edu/research_scholarship_symposium/2016/poster_presentations/12/
Dall'Ora, C., Griffiths, P., Ball, J. (2016). 12-hour shifts: burnout or job satisfaction? Nursing Times, 112(12/13): 1-2.
Dall'Ora, C., Griffiths, P., Ball, J., Simon, M., Aiken, L. (2015). Association of 12 h shifts and nurses' job satisfaction, burnout and intention to leave: findings from a cross-sectional study of 12 European countries. BMJ Open, 5(9): e008331 doi:10.1136/bmjopen-2015-008331.
Han, K., Trinkoff, A., Geiger-Brown, J. (2014). Factors associated with work-related fatigue and recovery in hospital nurses working 12-hour shifts. Workplace Health & Safety, 62(10): 409-414.
ecause this is true, it is critically clear that the nursing leadership manager's role is one of a vital nature and that support for nurses in their role is the primary component that must necessarily be integral to leadership in nursing in dialysis units if the turnover of nurses is reduced to the lowest possible level. The nursing leadership manager's role is one that must proactively deal with burnout of these dialysis unit nurses instead of attempting to address these as they occur. Prevention is 'key' toward this end. As the demands grow for quality and competent nursing staff so does the need grow for competency in leadership nursing manager roles. ecause the dialysis unit nurse is very closely involved in their patient's care and because these patients are required to report for treatment several days a week for several hours a day the nurse's mental, physical and emotional state…
Aiken, L.H., & Patrician, P. (2000). Measuring organizational traits of hospitals: The Revised Nursing Work Index. Nursing Research, 49, 146-153.
Aiken, L.H., & Sloane, D.M. (1997). Effects of organization innovation in AIDS care on burnout among urban hospital nurses. Work Occupation, 42, 453-477.
Aiken, L.H., Clarke, S.P., Sloane, D.M., Sochalski, J., & Silber, J.H. (2002). Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction [Electronic version]. JAMA, 288, 1987-1993.
Aiken, L.H., Clarke, S.P., Sloane, D.M., Sochalski, J.A., Busse, R.A., Clarke, H., Giovanetti, P., Hunt, J., Rafferty, a.M., & Shamian, J. (2001). Nurses' reports on hospital care in five countries [Electronic version]. Health Affairs, 20, 43-53.
Importance of the Issue
Nurse need to keep the records and specific information about their patients. The services in the hospitals require that every detail of the patients be kept in the records. For patients whose conditions recur, record helps the medical practitioners understand the health history of the patient. Proper records in the hospital are helpful in patient transfers (Voyer et al. 2014). Often, patient referrals are common in hospitals and thus records help the doctors in the new hospital to attend to the needs of the patient. The family members of the patients require the health records of their patients to arrange for better treatments. The law requires the nurses to keep records of the nature of services they offer to the patients. Often, the records of each patient are permanents in the hospital where they are kept physically or electronically. Records are essential because they…
Communication is one of the most important aspects of nursing, as the case study of the student and the instructor indicates. The student nurse failed to communicate to the instructor the patient's abnormal oxygen saturation reading -- a reading that could have had very serious consequences for the patient. An entire week going by before this information is relayed to another nurse is highly unacceptable, considering how much emphasis is placed upon preventing medical errors from occurring (Cimiotti, Aiken, Sloane, Wu, 2012). Thus, it is imperative that student nurses appreciate the ramifications of failures in communication -- ramifications that could be potentially fatal for patients and, by extension, legally adverse for the health care facility. Stressing the crucial importance of nurse to nurse communication is vital to the well-being both of the health care organization and the well-being of the patient.
Importance of Nurse to Nurse Communication
Cimiotti, J., Aiken, L., Sloane, D., Wu, E. (2012). Nurse staffing, burnout, and health care -- associated infection. American Journal of Infection Control, 40(6): 486-490.
Dall'Ora, C., Griffiths, P., Ball, J. (2016). 12-hour shifts: burnout or job satisfaction?
Nursing Times, 112(12/13): 1-2.
Dall'Ora, C., Griffiths, P., Ball, J., Simon, M., Aiken, L. (2015). Association of 12 h shifts and nurses' job satisfaction, burnout and intention to leave: findings from a cross-sectional study of 12 European countries. BMJ Open, 5(9): e008331.
eview On Nurses Shortage
The supply of professional nurses relative to the increase in demand for their services has been on a general decline over the years. As a career choice, nursing has been facing perennial shortage of professionals. Most healthcare organizations will affirm that their daunting tasks were recruiting fresh nurses and retaining the ones already in practice. The 2008 projections from the Bureau of Labor Statistics showed that the demand for professional nurses would increase from the then two million to three million, which represents sixty percent increment. In ideal situations, the number of those who have enrolled in nursing will be sufficient to supply the rise in their number. Nevertheless, this would not be the case if nothing were done to salvage the worrying trend of most students not graduating or resorting to other careers. According to Benjamin Isgur of PWHC Health and esearch Institute,…
American Association of Colleges of Nursing. (2009, September, 28). Nursing Shortage Fact Sheet. USA: AACN.
Buerhaus, P.I., Staiger, D., & Auerbach, D.I. (2009). The future of the nursing workforce in the United States: Data, trends, and implications. Boston: Jones and Bartlett Publishers.
Blakeley, J., & Ribeiro, V. (2008). Early Retirement among Registered Nurses: Contributing Factors. Journal of Nursing Management, 16(1), 29 -- 37
Cummings, G., et al. (2008). The Relationship between Nursing Leadership and Nurses' Job Satisfaction in Canadian Oncology Work Environments. Journal of Nursing Management, 16(5), 508 -- 518.
In interacting, factors may also modify each other:
nurse who might return to work for a higher salary might decide to do so only later when her children are older. The incentive of salary is therefore modified by the factor of young children.
The table is significantly complicated by the inclusion of more than two factors:
Any combination of the factors could result in the majority of nurses returning to work. Individually, each nurse has his or her own motivations for doing so.
The iterative proportional fitting procedure can be used to calculate expected frequencies.
Note: pecifically, the indication of this study is that nurses would return to work were certain factors in the work situation to change. pecifically, the highest frequencies are assigned to work load and hours. These are also the two most common factors in causing burnout and stress in the profession. Concomitantly, if inactive nurses were…
StatSoft, Inc. (2008). Log-Linear Analysis of Frequency Tables. http://www.statsoft.com/textbook/stloglin.html
Williams, Kimberly a., Stotts, R., Jacob, Susan R., Stebauer, Cheryl C.; Roussel, Linda, & Carter, Donna (2006, April). Inactive Nurses: A source for alleviating the nursing shortage? In Journal of Nursing Administration, Vol. 36(4).
Autonomy in the nursing profession states the importance of the client's role in making decisions that reflect advocacy for the client (Wade, 1999, p.310). Ultimately, this includes taking care of the patient physically as well as mentally and emotionally, developing a relationship with the patient that is beneficial to his care and actively advocating for the patient's rights and care. This type of autonomy, it is important to note, is not the same as individual or work autonomy, yet it must be considered that empowerment in nursing autonomy will inevitably lead to better professional and personal autonomy and should also lead to increased job satisfaction (Wade, 1999, p.310).
Typical definitions of autonomy would include the idea of complete independence for the person making the decisions. However, in the case of the nursing profession, the client's needs and desires must be heavily weighed and, in fact, become central…
Wade, G.H. (1999). Professional nurse autonomy: Concept analysis and application to nursing education. Journal of Advanced Nursing, 30(2), 310-8.
Gaylord, N. & Grace, P. (1995). Nursing advocacy: An ethic of practice. Nursing Ethics, 2(1),
White, L. (2004). Foundations of nursing: Second edition. Clifton Park, NY: Delmar Learning.
It is thus possible for the institution to retain nurses by strengthening the interpersonal leadership and management skills that lead to empowerment within the healthcare environment. This is especially supported by studies that found that despite the fact that a nurses' pay is important, it is not as critical in enhancing retention as a positive work place or an empowered environment that promotes teamwork and encourages ongoing learning, trust, and respect. (Chan, 2001).
It must always be remembered that nursing retention is the result of a combination of factors. There is no easy solution, and managers and leaders need to choose the combination of approaches that will be effective in their specific organization, since there is no one range or combination of strategies that will fit all.
Buerhaus, P., Staiger, D.O. & Auerbach, D.I. (2003) Is the Current Shortage of Hospital Nurses Ending? Health Affairs 22: 191-198.
Buerhaus, P., Staiger, D.O. & Auerbach, D.I. (2003) Is the Current Shortage of Hospital Nurses Ending? Health Affairs 22: 191-198.
Chan, C.C.A. (2001). Implications of organizational learning for nursing managers from the cultural, interpersonal and systems thinking perspectives. Nursing Inquiry, 8(3), 196-199.
Faulkner, J., & Laschinger, H. (2008). The effects of structural and psychological empowerment on perceived respect in acute care nurses. Journal of Nursing Management. 16(2): 214-221.
Kanter, R.M. (1979). Power failure in management circuits. Harvard Business Review, 65-75.
The survey population included hospital administrators and physicians as well as registered and practicing nurses, and as such it provides a comprehensive view of this issue. The research was also able to not certain key differences in perception amongst these groups as to thee likely effects of an ongoing nursing shortage, including some major differences in perception between nurses and hospital administrators, and it is suggested that this will serve as a barrier to implementing necessary changes; working to bring expectations of all stakeholders more in line would be ideal, and this research can accomplish this and ground perceptions in empirical evidence.
Buerhaus, P. (2011). Nurses Assess the Impact of the Shortage of RNs on Hospitals,
Nurses, and Quality of Patient Care. Sigma Theta Tau Biennial Convention
In this research, also a survey study that aimed to obtain qualitative results regarding nurse stress and reactions to the nursing…
In any organization, leadership is a key element of success. The leader is the person who defines not only the organization's mission, but its tone and cultural, and determines how the organization's resources will be deployed to achieve these goals. This paper will examine the role of nursing leadership, in particular how leadership can change a nursing unit.
Leadership study has developed over the course of the 20th and 21st centuries to move from the basic principles of scientific management to modern conceptions of the transformative leader who emphasizes organizational culture and personal development. Where the leader as manager was intended to be replaceable, modern leaders are individualistic and as such they can have a significant influence over the organization.
One of the unique facets of contemporary nursing leadership is that it has both an internal and an external focus. Internally, the leader must guide the unit, but…
Antrobus, S. & Kitson, A. (1999). Nursing leadership: influencing and shaping health policy and nursing practice. Journal of Advanced Nursing. Vol. 29 (2) 746-753.
Laschinger, H. & Leitner, M. (2006). The impact of nursing work environments on patient safety outcomes. The Journal of Nursing Administration. Vol. 36 (5) 259-267.
Richardson, A. & Storr, J. (2010). Patient safety: A literative review on the impact of nursing empowerment, leadership and collaboration. International Nursing Review. Retrieved April 25, 2016 from http://u.osu.edu/electives/files/2014/05/Patient-Safety-Why-Teamwork-Matters-Week-3-124bq6a.pdf
Nursing Problem: Shortage of Nurses in Healthcare
The researcher works at Phoebe Memorial Hospital, where there is an extreme nursing shortage. Without an adequate amount of nurses, patient care and safety may turn out to be compromised, while nurses themselves may be stunned, upset, and dissatisfied. At the researcher's workplace, high patient-to-nurse ratios has been displaying that there is a lot of frustration and job burnout, which is linked to higher yield. At Phoebe, there is an inadequately staffed nursing force which has been discovered to play a negative part in patient results. In difference, studies have confirmed that hospitals like Phoebe Memorial Hospital with low nurse turnover are the ones that have the lowest rates of risk-adjusted death and severity-adjusted span of stay.
There is no very exact way of describing the concept of nursing shortage at the Phoebe Memorial Hospital Phoebe, but a report of this…
NURSING PROBLEM: SHORTAGE OF NURSES
The assumption here is that ounselor burnout may be heightened as a result of the diversity of students who attend post seondary eduational institutions, and the variety of servies the 2-year postseondary ounselors must provide to these students. This assumption is ongruent with the findings of a study by Wilkerson and Bellini (2006) who advise, "Professional shool ounselors are asked to perform multiple duties as part of their daily work. Some of these duties math the desriptions set forth by national standards for shool ounseling programs, whereas others do not" (p. 440).
Consequently, shool ounselors are required to formulate deisions on a daily basis onerning the best way to perform their jobs (Wilkerson & Bellini). Not surprisingly, many shool ounselors are overwhelmed by these onstantly hanging working onditions and requirements, and a number of ounselors experiene high levels of stress as a result. Beause the onnetion between high levels of…
cited in Angerer, 2003). Unfortunately, it would seem that most helping professionals, including counselors, possess characteristics which predisposed them to this construct. For example, Lambie notes that, "Counselors may have increased susceptibility to burnout because of their training to be empathic which is essential to the formation of a therapeutic relationship. In fact, research has found counselor empathy to account for two thirds of the variance in supporting clients' positive behavioral change" (p. 32). The ability to remain empathic to the plights and challenges typically being experienced by students in community colleges is complicated by the enormous diversity that is increasingly characterizing these institutions, of course, but all helping professionals run the risk of becoming burned out while performing their responsibilities by virtue of their empathic sharing. In this regard, Lambie emphasizes that, "Empathy helps counselors understand the client's experience, but at the same time, a counselor may experience the emotional pain of multiple traumatized clients. Empathy is a double-edged sword; it is simultaneously your greatest asset and a point of real vulnerability; therefore, a fundamental skill of effective counselors, being empathic, may place counselors at high risk for burnout" (p. 33).
Citing the alarming results of a national survey of counselors that indicated that incidence may be almost 40%, Lambie also emphasizes that although all professions involve some degree of stress, counselors and other human service providers are at higher risk of burnout compared to other professionals. For example, this author notes that, "Counseling professionals are often in close contact with people who are in pain and distress. This continuous exposure to others' despair, combined with rare opportunities to share the benefits of clients' successes, heightens counselors' risk for burnout" (Lambie, p. 34). Other authorities confirm the incidence of burnout among educators, and cite even higher rates than the foregoing estimate. For instance, Cheek, Bradley and Lan (2003) report that, "Based on several international studies, approximately 60% to 70% of all teachers repeatedly show symptoms of stress, and a minimum of 30% of all educators show distinct symptoms of burnout" (p. 204). Indeed, a study by Lumsden (1998) determined that overall teacher morale was sufficiently severe that fully 40% of the educators who were surveyed indicated they would not choose teaching again as a career, and far more than half (57%) remained undecided at the time concerning ending their teaching career, were actively making plans to leave teaching, or would opt to leave the teaching field in the event a superior opportunity presented itself.
There are some other qualities that typify school counselors that may predispose them to becoming burned out over the course of time (some quicker than others, of course), but which may reasonably be expected to adversely effect the ability of school counselors to maintain their effectiveness in the workplace. For instance, Lambie concludes that, "Common counselor qualities of being selfless (i.e., putting others first), working long hours, and doing whatever it takes to help a client place them at higher susceptibility to burnout. As a result, counselors may themselves need assistance in dealing with the emotional pressures of their work" (p. 34).
Counselors and Characteristics of Burnout
Nursing Home esident Agitation: Predictors and Interventions
To critically review selected articles investigating and discussing predictors of nursing home resident agitation, and recommended interventions.
Burgio et al., (2007, p. 642) provides a working definition of nursing home resident agitation "… as verbal, vocal, and motor activities that are repetitive, outside of social standards, and considered inappropriate by staff." Agitation can often involve physical and/or verbal aggression, which can increase the risk of harm to residents and staff, disrupt activities, divert precious resources, and lead to staff burnout and high turnover.
Critical literature review.
Medical literature databases were searched using the keywords 'agitation, nursing home, and demetia' and a limited number of articles published within the last 10 years were selected for review.
Inclusion Criteria. Articles investigating and/or reviewing the etiology of agitation in geriatric nursing home residents suffering from dementia were selected, as were articles recommending interventions.
Exclusion Criteria. Only…
The two cohort studies reviewed here used computer assisted behavioral observation systems (CABOS) to identify predictors of agitation in geriatric nursing home residents suffering from dementia. One study monitored 78 nursing home residents (Burgio, Park, Hardin, and Sun, 2007, mean age = 82.2) and the other 123 (Vance, Burgio, Roth, Stevens, Fairchild, and Yurick, 2003, mean age = 82.3), but neither study used a normal control population. The experimental strategy involved assessing various physical and mental criteria periodically to determine if they predicted agitation behaviors within this population. Both studies found a statistically significant correlation between cognitive functioning and agitation (p < 0.01). Burgio et al., (2007) was unable to find a significant correlation between agitation and gender, age, and daily activities, but the earlier study (Vance et al., 2003) reported significant, but weak correlations between agitation and gender (r = 0.21), visual impairment (r = -0.21), and hearing impairment (r = 0.42). The inverse relationship between visual impairment was attributed to residents being unable to notice staff walking by, which can otherwise trigger outbursts. Only in the latter study was retrospective nursing staff reports able to predict agitation behavior based on assessments of cognitive functioning, suggesting variability in the ability of nursing home staff to correctly assess resident cognitive status. The authors of both studies recommend the use of CABOS-like systems of measurement to determine activity levels for future studies, because staff reports aren't a reliable predictor of agitation behavior.
For more than 60 years it has been recognized that agitation worsens in Alzheimer's patients in late afternoon and early evening, a phenomenon accordingly termed Sundowning Syndrome (reviewed by Bachman & Rabins, 2006). Volicer et al. (2001) used body temperature to track circadian rhythms in inpatient Alzheimer patients with a mean age of 71 and suffering from different levels of dementia. It was discovered that individuals within the
Nursing Fiscal Plan
The author of report is asked to assess a budget framework and compare what has happened to what is set to happen through the rest of the year and ascertain how best to close out the year. The author is asked to assess budget line item requests for the duration of the year as well as what expenses can and should be deferred until the new fiscal year. The budget projections that were accurate are to be labeled as well as what factors have caused the inaccuracies. As to the latter, it is asked if those inaccuracies were controllable or predictable.
The author is asked to do a bit of research on patient acuity symptoms and to ascertain the best approach for that process vis-a-vis quality patient care. The author is asked what strategies pertaining to motivation, communication, care delivery and so forth need to be implemented…
Brennan, CW, and BJ Daly. "Patient Acuity: A Concept Analysis." Journal of Advanced
Nursing 65.5 (2009): 1114-1126. CINAHL with Full Text. Web. 29 Apr. 2013.
Ekwall, A, M Gerdtz, and E. Manias. "The Influence of Patient Acuity on Satisfaction
With Emergency Care: Perspectives of Family, Friends and Careers." Journal Of
cute care facilities try to maintain low costs and employ quality nurses. Within this statement is a double standard. How can we have quality nurses and cut costs at the same time? This is where the skill mix comes into play. In the skill mix, there are Registered Nurses (RNs), Licensed Practical Nurses (LPNs), and unlicensed staff. If the lesser skilled staff free RNs they can be better able to perform their nursing duties and assessments. If acute care facilities can agree on an appropriate number of each type of staff member within the facility, they might be better able to accomplish safe patient outcomes while keeping costs down.
Determining nurse-to-patient ratios is a complex issue where one solution is not sufficient to cover all circumstances. The merican Nurses ssociation assembled a panel of nursing and health professionals to research appropriate staffing levels. The panel developed the following Matrix for…
Aiken and colleagues have been pioneers in studying nurse patient ratios and their relationship to patient outcomes.
Aiken, Sochalski, and Lake (1997) demonstrated that nursing presence, whether measured as RN ratios or as RN hours relative to other nursing personnel hours, is significantly correlated to mortality. When studying patient outcomes in specialized AIDS units,
Aiken, Sloan, Lake, Sochalski, and Weber (1999) found that at 30 days post admission, mortality rates were 60% lower in magnet hospitals, and 40% lower in dedicated AIDS units than in conventional scattered bed units. The researchers concluded that higher nurse patient ratios were a major factor in these lower
The prescriptions include wisdom, honesty, and courage, as well as human dignity, integrity, respect, health, and independence.
Part 3: Formulate possible evidence-based practices and an action plan that could work towards achieving improvement outcomes.
Provide insight into the diagnostic processes (e.g., root cause analysis) used to determine the primary causes of the problem. Consider both qualitative (cause-effect diagram, barrier analysis), and quantitative (theory testing or drill down analysis) methods.
Analyze the cost-effectiveness of your initiative and how your initiative mitigates risk and improves health care outcomes.
Countless interventions have been used for fall prevention amongst the elderly population. These include risk-assessment and management programs, I.e. Designed to screen those who are most at risk and to design interventions that will reduce their risk of falling; exercise programs slanted dot enhancing flexibility, endurance, and strength; education programs (including one-to -one counseling on methods to prevent falls); environmental modification in homes or…
ANA Nursing-Sensitive Indicators. http://www.nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursing/PatientSafetyQuality/Research-Measurement/the-National-Database/Nursing-Sensitive-Indicators_1
Butts, JB Ethics in professional Nursing Practice
Broe, K et al. (2007) a Higher Dose of Vitamin D Reduces the Risk of Falls in Nursing
1). This is a problem that needs to be addressed by adding more training to the budget. The problem is, most hospitals' budgets are already spread too thin. Therefore, hospital administrators need to work harder to find sources to help fund their activities.
Nurses have more power and responsibility than ever before to ensure that they are making honest reports about their patients. They may be in a rush to get home and not feel like entering all of the proper data into the computer. Or, they may take shortcuts in the use of other technologies. It is a nurse's ethical responsibility, however, to ensure honesty in all that she does. This includes 'blowing the whistle' when she sees that other nurses are not being honest or are misusing technology.
This can be extremely difficult, however, considering that nurses often suffer negative repercussions for 'whistleblowing'. A study conducted…
Birdi, K., Clegg, C.W., Patterson, M.A., Robinson, A., Stride, C.B., Wall, T.D., & Wood, S.J. (2008). The impact of human resource and operational management practices on company productivity: A longitudinal study. Personnel Psychology, 61, 467-501.
Bodenheimer, T., MacGregor, K., and Stothart, N. (2005). Nurses as leaders in chronic care. British Medical Journal, 330(7492), 612-613.
Carver, L. & Candela, L. (2008) Attaining organizational commitment across different generations of nurses. Journal of Nursing Management, 16 (8), 984-991.
Charette, R. (2006, June) EHRs: Electronic Health Records or Exceptional Hidden Risks? Communications of the ACM, 49(6),120.
University Doctor of Nursing Practice Program?
The Doctor of Nursing Practice is a unique degree in that it prepares nurses with the research skills to work more effectively in clinical settings. Unlike a purely academic degree, it is designed to prepare nurses to become leaders in the field, rather than work primarily in a university. But it still demands a rigorous understanding of evidence-based practice. The DNP reflects the fact that research can be critical in improving the quality of medicine while still ensuring that the research has a practical focus and can be used in a meaningful way to better the lives of patients and providers alike.
The increased complexity of healthcare regulation, the sophistication of medical technology, and the growing diversity of the patient population all reflect the need for leaders in the nursing field to pursue advanced degrees. To have the necessary background to act as an…
Leadership and Management
In the medical field, the recent topic of debate relates to Nurse Staffing atios where many argue that governments need to intervene in setting minimum staffing laws. Currently, the only state that has enacted a law is California and nurse unions in other states are fighting for the implementation of the same in their workplaces. However, most of the attempts made by other states to implement California's strategy have failed since hospitals fail to participate (Schultz, 2013). The argument of many hospitals is that the laws do not give them the opportunity or ability to make decisions regarding staffing and at the same time be a financial burden (Schultz, 2013, par. 3). As seen from many nursing unions, hospitals have abused the system to the point of employing few nurses and yet the patients are ever increasing. Inappropriate staffing ratios influence the safety of patients, the satisfaction…
Aiken L., Clarke S., Sloane D., Sochalski J., Silber, J. (2002). Hospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job Dissatisfaction. Journal of the American Medical Association, 288: 1987-1993.
AONE. Mandated staffing ratios. Retrieved from http://www.aone.org/resources/leadership%20tools/staffingratios.shtml
Curtis, E., Vries, J. & Sheerin, F. (2011). Developing Leadership in Nursing: Exploring Core factors. British Journal of Nursing, 20(5): 306-309.
Hughes, R., Ginnett, R. & Curphy, G. (2006). Leadership: Enhancing the lessons of Experience, (5th Eds.). McGraw-Hill, Boston.
This is a legislator information sheet on nurse-patient ratios (as adapted from Aikan et al. 2010) for a busy legislator who will only have time to read bullet points:
The ratio of nurse patient is lower in California than in other states with nurses in CA having at least one patient less than nurses have in other states (as for instance in New Jersey and in Pennsylvania as mentioned in Aikman et al. (2010))
California nurses had lower nurse-patient ratio on medical and surgical units when compared to other states. The average amongst CA nurses was 2 patients less than those in other states.
The lower the nurse-patient ration, the lower the level of mortality amongst patients
When nurses' workloads paralleled those of workloads of Californian nurses, the following results occurred:
a. nurses' burnout decreased
b. nurses' job dissatisfaction decreased
c. nurses reported consistently better quality of care…
Abood, S. (2007). Influencing health care in the legislative arena. Online Journal of Issues in Nursing, 12(1), 12 pp.
Aikan, L.H., Sloane, D.M., Cimiotti, J.P., Clarke, S.P., Flynn, L., Seago, J.A., Spetz, J., & Smith, H. (2010, April 9). Implications of the California nurse staffing mandate for other states. Health Services Research. Retrieved from http://www.nursing.upenn.edu/chopr/Documents/Aiken.2010.CaliforniaStaffingRatios.pdf
According to the Commission on Collegiate Nursing Education (CCNE), "accreditation is a nongovernmental process conducted by representatives of postsecondary institutions and professional groups. As conducted in the United States, accreditation focuses on the quality of institutions of higher and professional education and on the quality of educational programs within institutions" (Standards of accreditation for post-baccalaureate nurse residency programs, 2008, CCNE). Accreditation is a source of objective evidence from an outside entity that a program meets certain quality and content standards. This is essential for both students and patients. Students make a considerable financial and time investment in their education and need to expect that they can emerge with real skills as well as a diploma upon graduation. They do not have to tools to vet a program before they are accepted. Patients have a right to expect that the nurses who oversee them graduated from high-quality programs. Accreditation serves…
Maslow's hierarchy of needs. (2014). R.N. Retrieved from:
Q4. "The strongest predictor of nurse job dissatisfaction and intent to leave a job is stress in the practice environment" (Paris & Tehaar 2011). Not only is Maslow's hierarchy of needs extremely useful for nurses to better understand their patients: it is also useful for nurses to better understand themselves. Burnout is very common in the nursing profession because nurses do not attend to their own, personal needs. The nurse must recognize that she has physiological and safety needs that must be addressed before accessing the higher needs of social and personal fulfillment on the hierarchy. It is vital that nurses engage in appropriate self-care, ensuring that they get adequate enough healthy food and sleep to be able to treat their patients in a compassionate manner. It is also important that healthcare organizations address the human needs of nurses and do not ignore the need for nurses to take care of their mental and physical health.
The shortage of nursing staff remains a major challenge in the U.S. According to the American Association of Colleges of Nursing (AACN) (2014), the shortage is expected to be even greater in the next one decade or so. The shortage has been fuelled by factors such as reduced enrolment into nursing schools, increased retirement of the nursing workforce, as well as higher demand for healthcare due to population ageing and greater incidence of lifestyle diseases (AACN, 2014).
The shortage of nursing staff has severe implications for the nursing workforce. A high number of patients relative to nursing staff often translate to increased workload for nurses. Indeed, nurses continue to grapple with unhealthily lengthy work shifts, often stretching up to 12-13 hours. It is an issue that has sparked a great deal of debate given the connection between excessive workload and nurse outcomes. Literature extensively demonstrates that excessive workload as a…
1997, the average pass rate for first time test takers on the NCLEX-RN was 93%. Since 1997, the national average pass rate on the NCLEX-RN has declined to 83.8% (National Organization for Associate Degree Nursing, 2002). The pass rate for the state of North Carolina and many other states has also declined in recent years.
Community colleges are the prime educators of new registered nurses in the United States. In 1997, 701 community colleges awarded 41,258 associate degrees in nursing (National Center for Education Statistics 1997). The combined ADN graduate pool constituted 60% of the U.S. graduates who took the NCLEX-RN exam in 2000,and these graduates represent the largest group of nurses entering the profession (National Council of State oards of Nursing 2001). On the other hand, baccalaureate programs graduated 37% of the total; and diploma or hospital-based educational programs, graduated 3%.(Teich, et al.)
In addition to educating the majority…
Adams, Carolyn, Valiaga, Theresa, Murdock, Jane. McGinnis, Susan & Wolfertz, Joanne (2002). Trends in Registered Nurse Education Programs: A Comparison Across Three Points in Time. In National League for Nursing (Ed.), pp. 1-10).:.
American Association of Colleges of Nursing (1999). Temporary Nurses Called A Serious Risk Threat At Hospitals. In (Ed.), p.).: American Association of Colleges of Nursing.
American Health Care Association.(1999).Facts and Trends, The Nursing Facility Sourcebook.Washington, D.C.:American Health Care Association.
American Hospital Association.1999.Trendwatch:RN Shortages in Hospitals. Washington, D.C.: American Hospital Association.
autobiography of the author of this report. The remainder of the report will mostly focus on the four meta-paradigms of nursing. Of course, those meta-paradigms are patient, nurse, health and environment. The author will also offer two practice-specific concepts from the scholarly literature that can be applied to the career and environment of the author of this report. Next up will be a list of propositions that will number five in total. As suggested and required by the assignment, the paper will integrate these discrete elements and in a way that connects to the concepts described. While analysis of the nursing professional can get a little silly and/or delve too much into a bit of navel-gazing, the profession is indeed noble and deep and is thus worthy of the proper full analysis.
The author of this report started as an electrocardiogram (EKG) technician and nursing assistant while the author…
Lee, R.C., & Fawcett, J. (2013). The Influence of the Metaparadigm of Nursing on Professional Identity Development Among RN-BSN Students. Nursing Science
Quarterly, 26(1), 96-98. doi:10.1177/0894318412466734
Schim, S.M., Benkert, R., Bell, S.E., Walker, D.S., & Danford, C.A. (2007). Social
Justice: Added Metaparadigm Concept for Urban Health Nursing. Public Health
As noted above, one of the most prominent leadership theories that has been applied to the nursing profession is transformational leadership. Properly applied and managed, transformation leadership can also be used to facilitate creativity in the workplace. For instance, according to Vesterinen, Isola and Paasivaara (2009, p. 504), transformational leadership can create changes and, by definition, is capable of transformed individuals and the organization in which they work. By providing the leadership needed to motivate employees to bigger and better aspirations, transformational leaders can therefore encourage the creative spark among their followers in ways that might not otherwise be possible (Vesterinen et al. 2009). Indeed, Vesterinen et al. (2009, p. 504) specifically state that, "A transformational leader motivates inspirationally, stimulates intellectually and considers employees individually." Taken together, these positive outcomes are valuable in any organizational setting, but they can be particularly important in health care settings.
Why understanding organisational culture…
Fourie, WJ & Keogh, JJ 2011, October, 'The Need for Continuous Education in the Prevention
of Needlestick Injuries,' Contemporary Nurse: a Journal for the Australian Nursing
Profession, vol. 39, no. 2, pp. 194-201.
Hutin, Y, Hauri, A, Chiarello, L, Catlin, M, Stilwell, B, Ghebrehiwet, T & Garner, J 2003, July,
Performance scorecards provide a straightforward means of integrating metrics into a healthcare organization’s strategic planning. Scorecards are most effective when they have a clear purpose, identifying specific patient populations and outcome measures. According to Baker (2015), “savvy organizations select the best metrics to track that are appropriate to what the organizational staff members wish to measure,” which could include specific issues like patient vital signs or patient satisfaction survey outcomes (p. 224). Moreover, performance scorecards need to be simple, kept on a manageable scale so that the data gleaned can be readily communicated to inform organizational practices, policies, and procedures (Hansel, n.d.). The following performance scorecard includes three core categories including performance, quality, patient safety, and employee engagement, all while focusing on addressing the needs of a specific patient population: adults over the age of 65 who have been diagnosed with Type II Diabetes.
Globally, a nursing shortage is impeding the advancement of healthcare systems around the world. The nursing shortage refers to any situation in which the labor market cannot keep up with patient demands. Causes of the nursing shortage include poor working conditions leading to high turnover rates, insufficient nursing education programs, and lack of incentives for nurses to work in areas of critical concern. Effects of the nursing shortage include further staff shortages due to high stress environments and poor patient care—including higher rates of mortality and morbidity. Nursing shortages have affected almost every region of the world, and may become worse unless concerted efforts are made to remedy the problem.
Even the most advanced healthcare systems in the world are short on nursing staff. As a result, existing nurses are working longer hours under high duress, and are more prone to making errors or experiencing workplace violence and…
Nursing Time Management Strategies
By its very nature, the profession of nursing requires effective time management. Nurses are constantly asked to balance the needs of patients and also the demands of administrators as they care for patients and attend to the bureaucratic aspects of their duties. The nursing shortage has made the need for time management particularly acute. Nurses are often overburdened with the care of many patients, whom they must attend to all at the same time while working long shifts. They must budget their time but still dispense high-quality care. With this in mind, the article by Nelson (2010) entitled "Helping new nurses set priorities" argues that time management skills must be a component of the training of all new nurses. During the first critical years of practice, the nurse develops the habits and assumptions for how she will govern her time.
In general, "orientees' time-management skills improve…
Jones, T. (2010). A holistic framework for nursing time: Implications for theory, practice, and research. Nursing Forum, 45 (30): 185-196. Retrieved from:
Nelson, J. (2010). Helping new nurses set priorities. American Nurse Today, 5.5.
Retrieved from: http://www.americannursetoday.com/article.aspx?id=6620&fid=6592
Nursing Theory -- oy Adaptation Model
The oy Adaptation Model is one of the most commonly cited and used options when it comes to nursing theories. It has been in existence since 1976, and has had a number of years to be adjusted and changed to work with the adjustments that have occurred in the field of nursing over time (Alligood, 2011). Being able to adapt and change is a very important part of nursing, because all patients are different. Additionally, treatments and medications change rapidly, and that can be difficult to keep up with if a nurse is not focused on adapting his or her style and beliefs to the changing nature of medicine. Here, the importance of nursing theory will be explored, along with the key points that are used in the oy Adaptation Model. The views and ideas that the model provides when it comes to nursing…
Alligood, M.R. (2011). The power of theoretical knowledge. Nursing science quarterly, 24(4), 304-305.
Polit, D.F., & Beck, C.T. (2013). Essentials of nursing research. Lippincott Williams & Wilkins.
Roy, C. (2011). Extending the Roy adaptation model to meet changing global needs. Nursing science quarterly, 24(4), 345-351.
Roy, C. (2011). Research based on the Roy Adaptation Model last 25 years. Nursing science quarterly, 24(4), 312-320.
Nursing Proposal -- Evidence-Based
The utilization of call lights particularly in hospital settings has recently been put under study as a function of various aspects of nursing including shortages, rounds and analyses of patient outcomes. The proper scheduling of nursing rounds may be essential to enhance the capability of nurses to tackle common or ordinary patient issues relative to more dire needs that have to be regarded as the primary/main target for the use of call lights by patients. Besides patients' general well-being and safety while hospitalized, nursing employees are also concerned with how satisfied the patients are. On a rather fundamental level, hospital settings that enable patients to experience peace of mind allow them to heal quicker than those that do not; these patients are highly likely to relay less stressful communications to those around them, and have a higher possibility of clearer perspectives that allow them to distinguish…
American Nurses Association (ANA). (2006). Assuring patient safety: The employer's role in promoting healthy nursing work hours for registered nurses in all roles and settings. Retrieved from http://nursingworld.org/MainMenuCategories/ThePracticeofNursing/workplaceNurse
(AACN). The American Association of Critical-Care Nurses (2001, March 3). Mandatory Overtime. Retrieved from http://www.aacn.org/WD/Practice/Content/PublicPolicy/mandatoryovertime.pcms?menu=Practie
Bae, S. (2010).Mandatory overtime regulations and nurse overtime. Policy, Politics, & Nursing Practice, 11(2), 99-107.
Bae, S-H. (2013). Presence of nurse mandatory overtime regulations and nurse and patient outcomes. Nursing Economics, 31(2), 59-68. Retrieved from http://www.medscape.com/viewarticle/806796
Nursing: Theory and Nursing Practice Issues
Theory and Nursing Practice Issues: Nursing
The modern-day staff nurse faces a variety of challenges in the work environment. These include inadequate staffing, the authority gradient, and issues related to changing models of care. The nurse leader has a duty to aid staff nurses working under him in addressing the challenges posed by these, and other issues facing the nursing profession. Leadership theories provide effective guidelines by which nurse leaders can address issues inherent in the nursing profession. In so doing, they accord staff nurses adequate opportunities to make meaning out of their lives. Leadership theories such as the situational leadership theory, the transformational leadership theory, role theory, and path-goal theory provides crucial insights from which nurse leaders could draw reference when seeking solutions for problems facing subordinate staff nurses. This text explores how leadership theory can be applied to nursing practice issues, and…
Barker, A. (1992). Transformational Nursing Leadership: A Vision for the Future. New York NY: Jones & Bartlett Company.
Department of Health and Human Services. (2010). Addressing New Challenges Facing Nursing Education. The Department of Health and Human Services. Retrieved from http://www.hrsa.gov/advisorycommittees/bhpradvisory/nacnep/reports/eighthreport.pdf
Early, G. (2005). Leadership Expectations: How Executive Expectations are Created and Used in a Non-Profit Setting. London, UK: OCMS Publishers.
Edmonson, C. (2010). Moral Courage and the Nurse Leader. The Online Journal of Issues in Nursing, 15(3), Manuscript 5.
The author of this report is offering a brief treatise on the broader subject of magnetism when it comes to nursing, learning, leadership and evidence-based practice. The five components of magnetism, as described by Debisette, will be named and described one-by-one. In the appendix of this report there is a concept mind map of the broader subject of magnetism as covered and broken down in this report. Finally, there will be the showing of a strong relationship between the qualities specified for magnet designation and the associated benchmarking strategies and evidence-based practice models. While the magnet designation is not an entirely simple thing to describe, the facets that make up nurse magnetism are fairly easy to fathom when identified and described.
As noted in the introduction, there will be a description of the five elements of nursing magnetism as described by Debisette. Those five components are transformational…
ANCC. (2015). Announcing a New Model for ANCC's Magnet Recognition Program. Nursecredentialing.org. Retrieved 20 October 2015, from http://www.nursecredentialing.org/MagnetModel
Debisette, A., & Vessey, J. (2011). Annual review of nursing research. New York: Springer.
Lowell General. (2015). What it means to be a Magnet® hospital / / Lowell General Hospital. Lowellgeneral.org. Retrieved 20 October 2015, from http://www.lowellgeneral.org/about-lgh/a-magnet-hospital/what-it-means-to-be-a-magnet-hospital
UC Davis. (2015). What is Magnet Designation?. Ucdmc.ucdavis.edu. Retrieved 20 October 2015, from http://www.ucdmc.ucdavis.edu/nurse/magnet/designation.html
In the heatlh care profession, any nurse or other professional would be guided by certain values and ethics. These are vitally important in terms of promoting the profession as one worthy of its purpose; to care for the health and well-being of others. Hence, the S.P.I.R.I.T. values I have been particularly focused on lately include "Integrity," "Innovation," and "Teamwork."
Integrity refers to the ability to communicate openly and honestly. Such communication creates a basis of trust and the conduct of the self to adhere to the highest ethical standards. In my work, this component is part of my daily work with colleagues and patients. I remember one case in which a minor patient begged me not to let her parents know about her drug problem. I was, however, obliged to let her care takers know, since she was placing herself in mortal danger. I therefore informed her that my…
Instrument Measures Nurse Practice
In a hospital or any medical care setting, nurses make up the majority of the environment, and are the backbone of facilitating patient care between physicians. However, between meeting the demands of the patients and following through doctors' orders, the roles nurses play are a high-stressed one, which influences on his or her overall well-being. The purpose of this paper is to display the findings from a study led by Pisanti (2008) regarding the relationship between nurses and their abilities to cope with environmental demands with the use of the Occupational Coping Self-Efficacy for Nurses (OCSE-N) Scale.
In order to gain a better understanding about the investigation, it is significant to comprehend about the foundation on which the study was based on, which is the Lazarus cognitive-medication theory of stress and Bandura's social cognitive theory. The former is about certain cognitive appraisals regarding one's work provokes…
Role as a Nurse/Life Helper in a Long-Term Care Facility
Nursing in a long-term care facility would be the prescription for burnout and depression for many people. And yet, it is an essential activity in the current society. There are ways to approach the profession, however, that help explain its purpose and also allow the nurse to place his or her activities into a context at once useful and conceptual. There are traditions from almost every philosophy and religion that point to the same things; the value of service, humility, compassion, and transcendence all arising out of the desire to do good works (nursing) and the will to create the skills necessary to do those works.
A knowledge of some of these is essential to place the activities of nursing into a scheme that will give the best result possible for all concerned, the nurse, the patient, the patient's family…
Bajunid, Ibrahim Ahmad. 2004. "The meaning of active citizenship." New Straits Times, 14 March 2004.
Barber, Benjamin. 1994. "Theory and practice: democracy and the philosophers. (2,500 Years of Democracy)" History Today, 1 August 1994.
Hegevary, Sue Thomas. 2002. "How nursing matters."
Journal of Nursing Scholarship, 22 December 2002. Database online accessed 19 March 2004.
To the degree that nurses match their skills with patient's needs, thus is qualified nursing met (AACN, 2006).
From my experience, most surgeons, specifically in the cardiac ward focus on the minutiae of their skill and on saving the patient's life mo matter what. A failed surgery seems to them to cast aspersions on their skills. Dr. Agnihotri is, however, unique in that he places the patients needs first and foremost and ascertains that his assistants and interns do the same.
A case, at one time, for instance, that made ripples around the ward and impressed me intensely involved patient x who, at a great deal of pain and an advanced age with a surgery that seemed to promise only complications, just wanted to expire. Her family, however, endeavored to keep her alive, despite cost, level of pain, frequency, extension, and complications of surgery involved. Dr. Agnihotri focused on the…
American Association of Critical-Care Nurses (AACN). (2006). The AACN Synergy Model for Patient Care. Retrieved April 3, 2011, from http://www.certcorp.org/certcorp/certcorp.nsf/vwdoc/SynModel ? opendocument
Hardin, S. (2005). Introduction to the AACN Synergy Model for Patient Care. In S.R. Hardin & R. Kaplow (Eds.), Synergy for clinical excellence: The AACN Synergy Model for Patient Care (pp. 3-10). Sudbury, MA: Jones and Bartlett Publishers.
Salmon, M. (2008). Cardiac Care Unit. Heart health Center. Retrieved April 3, 2011, from http://heartdisease.about.com/lw/Health-Medicine/Conditions-and-diseases/Cardiac-Care-Unit.htm
Advance Practice oles in Nursing
The Main oles Within Advanced Practice Nursing
They are charged with the responsibility to provide primary health care for clinics, hospitals and similar settings. They diagnose and treat common illnesses and immunize, examine the patients and deal with high blood pressure cases among others (Macdonald, Schreiber & Davis, 2005).
Certified Nurse-Midwives: They are the ones that give gynecological care and prenatal attention to the normal women with little or no health complications. They assist the women deliver in a range of places including hospitals, homes, clinics and health centers. They also give postpartum care (Macdonald et al., 2005).
Clinical Nurse Specialists: They are the ones involved in specialty areas such as neonatal, oncology, cardiac, pediatric, gynecological nursing or obstetric service (Macdonald et al., 2005).
Certified egistered Nurse Anesthetists: They provide and administer over 65% of all anesthesia administered to patients every year. They…
Federal Register, (n.d.). The Constitutional Amendment Process, National Archives. Retrieved from https://www.archives.gov/federal-register/constitution/ on August 30, 2016
Graduatenursingedu.org, (n.d.). Family Nurse Practitioner (FNP). Retrieved from http://www.graduatenursingedu.org/family-nurse-practitioner/ on August 30, 2016
Huston C. (2008) Preparing nurse leaders for 2020. Journal of Nursing Management 16, 905 -- 911
Jennings, B.M. (2008). "Work Stress and Burnout Among Nurses: Role of the Work Environment and Working Conditions." In: Hughes, R.G. (editor). Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (U.S.).
e., males and females per nurse specialty).
Variables & Measures
Variables for the study are as follows: workload management, work environment, burnout rate, and job satisfaction. In addition to these variables, instruments gauging the level of burnout experienced will be used, particularly the Maslach Burnout Inventory (MBI). An index of attitudes and perceptions on workload management, work environment, and job satisfaction will also be formulated, and will be tested for internal and construct validity.
FGD Guide / Survey Instrument
The FGD Guide will have four (4) sections, focusing on the following broad themes/topics: workload management as experienced by the discussants, work environment, burnout (concepts and experiences), and job satisfaction (as related to burnout). The survey instrument or questionnaire will also have the sections used in the FGD guide, with an additional section allotted for the Maslach Burnout Inventory (MBI).
Data analysis will make use of both bivariate and…
Ablett, J. And R. Jones. (2007). "Resilience and well-being in palliative care staff: a qualitative study of hospice nurses' experience of work." Psycho-Oncology, Vol.16.
Browning, L., C. Ryan, S. Thomas, M. Greenberg, and S. Rolniak. (2007). "Nursing specialty and burnout." Psychology, Health & Medicine, Vol. 12, No. 2.
Gawel, J. (1999). "Herzberg's Theory of Motivation and Maslow's Hierarchy of Needs." ERIC Digests Website. Available at http://www.ericdigests.org/1999-1/needs.html .
Gustafsson, G., a. Norberg, and G. Strandberg. (2008). "Meanings of becoming and being burnout -- phenomenological-hermeneutic interpretation of female healthcare personnel's narratives." Scandinavian Journal of Caring Science, Vol. 22.
This makes retention essential, as new nurses must stay with the hospital and become nurse specialists for CMC to continue to maintain its reputation. Nursing education is also essential.
Unfortunately, a stressed and pressured environment that is understaffed can create tension rather than foster cooperation between nurses, particularly old and young nurses. Older nurses may believe that their younger colleagues must 'pay their dues' before they are fully accepted as part of the staff. Younger nurses may find themselves given more onerous tasks and denied learning opportunities, as they assume the 'grunt work' of the nursing staff.
Sadly, no one benefits from such an adversarial culture. Younger nurses leave in greater numbers, out of frustration, further compounding the nursing shortage at CMC. Little hands-on instruction and education means that new graduates lack confidence and autonomy in their decision-making and are more prone to error and relying upon more skilled…
AACN Fact sheet. (2009, September). AACN website. Retrieved April 10, 2010 at http://www.aacn.nche.edu/Media/FactSheets/NursingShortage.htm
Addressing the nursing shortage: Background brief. (2010). Kaiser Permanente. Retrieved April
10, 2010 at http://www.kaiseredu.org/topics_im.asp?imID=1&parentID=61&id=138
Buerhaus, Peter I. (2010). Trends in the experiences of hospital-employed registered nurses:
Staffing shortages in nursing are a consequence of poor nurse retention and nurse satisfaction. Being a nurse requires a lot of dedication, patience, and ability to keep updated in a constantly evolving world. When hospitals and other medical facilities have staffing shortages or shortages in qualified nurses, the healthcare delivery of that particular place dwindles. Nurses are the backbone of any healthcare facility.
Especially in recent times, nurses provide prescriptions, treatment protocols, and diagnosis when doctors are away or busy. This literature review is meant to explain such a phenomena and how it relates directly to nurse satisfaction and nursing retention. From here, the connection crosses over to nursing care and healthcare delivery as standards of practice. Things like arrhythmias will be viewed to understand how nursing shortages attribute to lower quality of care. Utilizing Polk's theory of esilience, this review will allow a look into performance improvement concerns and…
Bosch, R., Kirch, W., Theuer, J., Pittrow, D., Kohlhaussen, A., Willich, S., & Bonnemeier, H. (2013). Atrial fibrillation management, outcomes and predictors of stable disease in daily practice: Prospective non-interventional study. International Journal Of Cardiology, 167(3), 750-756. doi:10.1016/j.ijcard.2012.03.053
GIANFERMI, R., & BUCHHOLZ, S. (2011). Exploring the relationship between job satisfaction and nursing group outcome attainment capability in nurse administrators. Journal Of Nursing Management, 19(8), 1012-1019. doi:10.1111/j.1365-2834.2011.01328.x
Hudgins, T. (2015). Resilience, job satisfaction and anticipated turnover in nurse leaders. Journal Of Nursing Management, n/a-n/a. doi:10.1111/jonm.12289
Minhas, R., Vogelaar, G., Wang, D., Almansoori, W., Lang, E., & Blanchard, I. et al. (2015). A prehospital treat-and-release protocol for supraventricular tachycardia. CJEM, 1-8. doi:10.1017/cem.2014.53
medical professionals, nurses as a group come closest to te ideal of treating te wole patient, addressing pysical, emotional, psycological and even social concerns. Tis is especially true of psyciatric nurses wo work to elp patients address bot te pysical and cognitive symptoms of teir conditions as well as to come to terms wit te stigma attaced to aving a mental illness - a stigma tat often is applied as muc by te patients to temselves as by oters.
Tis paper examines te paradigm of psyciatric nursing troug te lens of Betty Neuman's Systems Model. Neuman believes tat te demands and opportunities of nursing as unique because te nurse is te only medical professional wo truly does care for te wole person, elping to alleviate all of te stresses tat affect eac individual. Because nurses see teir patients as "wole" people, by extension Neuman sees te profession of nursing as…
Leon, 2002, interview.
Selleck, 2002, interview.
The conceptual framework that I feel best helps to explain ethics, morals and laws is that found in the Aristotelian framework, which stipulates that ethics describe the theoretical beliefs and standards that are held individually or in a society, morality describes the behavior or activity of an individual or society, and laws refer to what is prohibited or what one has the right to do in society according to the government (Kristjansson, 2014; Chowdhury, 2016). Building on this framework in the modern era is the utilitarian framework which holds that a community should pursue the common good—i.e., the greatest good for the greatest amount of people. In the nursing environment, this type of conceptual framework can help nurses to better understand their roles in the health care organization and how to ensure that the greatest level of quality care is being achieved.
The utilitarian ethical framework can be…
This really helped me to remember why it was I became a nurse, and demonstrates the true needs of patients that I was helping to care for and not simply trying to cure. These moments also made the more mundane and laborious elements of the job seem more worthwhile, and I was definitely feeling less stress and more satisfaction upon the completion of my shift than I had the previous day, when such patient connections has not seemed possible.
Though falls from hospital beds are more common than might be expected, a fall that occurred in the medical-surgical unit was deemed worthy of calling a meeting of available nursing staff to review fall prevention procedures and stress the importance of maintaining regular and frequent rounds as well as sitting with fall-prone patients whenever possible, even in short and frequently rotating shifts, to ensure that movement can be facilitated…
Furukawa, M., Raghu, T. & Shao, B. (2010). Electronic Medical Records, Nurse Staffing, and Nurse-Sensitive Patient Outcomes: Evidence From the National Database of Nursing Quality Indicators. Medical Care Research and Review 67(11):77-89.
Heaven, C. & Maguire, P. (2008). Communications Issues. In Psychological Issues in Palliative Care, Lloyd-Williams, M, ed. New York: Oxford University Press.
Shever, L., Titler, M., Mackin, M. & Kueny, a. (2010). Fall Prevention Practices in Adult Medical-Surgical Nursing Units Described by Nurse Managers. Western Journal of Nursing Research 32(9): 17-24.
Simonazzi, a. (2009). Care regimes and national employment models. Cambridge Journal of Economics 33(2): 211-32.
ffective mentoring entails regular meetings to actively discuss roles, revisit issues and cultivate role modeling. The mentor typically supports and enhances a mentee's personal and career development. He or she must also be consistently available, have faith that the protege is on the right track, and have awareness of the larger issues relevant in the health care environment. This combination of skill, confidence and communicative ability is not common among nurses, which is part of the reason that healthy mentoring relationships do not always flower in the health care environment. However, the robust desire to help fellow nurses is the most important variable, and the primary reason most mentor relationships develop and prosper.
Four questions worth exploring in conjunction with a literature review include the following. How do administrators develop effective mentorship programs in health care institutions? How does the presence of mentors correlate to job burnout? What are the…
Escobio, M. (2005). Giving Back: Nurses and Mentoring. Retrieved from https://www.nnsdo.org/dmdocuments/NurseMentoring.pdf
Kuhl, L. (2005). Closing the Revolving Door: A Look at Mentoring. Journal of Illinois
Nursing, vol 102 (2), 9.
Nurse burnout is a common occurrence. This can exacerbate an ongoing problem that is seen in hospitals, nosocomial infections. Nosocomial infections remain prevalent for patients with extended hospital stays like those in intensive care units. An infection that starts roughly 48 hours after admission, those in intensive care units (ICUs) experience a continued rate of infection leading to increase length of stay, mortality, and morbidity. The number of patients that develop a nosocomial infection are from 7 to 10% internationally (Dasgupta, Das, Hazra, & Chawan, 2015). As such, hospitals have decided to classify nosocomial infection sites based on clinical and biological criteria.
esearch has led to the discovery of several bacterial strains that involve the formation of nosocomial or hospital acquired infections. "The agents that are usually involved in hospital-acquired infections include Streptococcus spp., Acinetobacter spp., enterococci, Pseudomonas aeruginosa, coagulase-negative staphylococci, Staphylococcus aureus, Bacillus cereus, Legionella and Enterobacteriaceae family members,…
CDC. (n.d.). HAI Data and Statistics. Retrieved from https://www.cdc.gov/hai/surveillance/
Cheng, C., Bartram, T., Karimi, L., & Leggat, S. (2016). Transformational leadership and social identity as predictors of team climate, perceived quality of care, burnout and turnover intention among nurses. Personnel Review, 45(6), 1200-1216. doi:10.1108/pr-05-2015-0118
Cimiotti, J. P., Aiken, L. H., Sloane, D. M., & Wu, E. S. (2012). Nurse staffing, burnout, and health care -- associated infection. American Journal of Infection Control, 40(6), 486-490. doi:10.1016/j.ajic.2012.02.029
Dasgupta, S., Das, S., Hazra, A., & Chawan, N. (2015). Nosocomial infections in the intensive care unit: Incidence, risk factors, outcome and associated pathogens in a public tertiary teaching hospital of Eastern India. Indian Journal of Critical Care Medicine, 19(1), 14. doi:10.4103/0972-5229.148633
Quality of Work Life of Health Care Providers in Saudi Arabia
In iyadh, the quality of work life of health care providers is not as high as it should or could be, according to researchers (Alhousaini, 2006; Almalki, FitzGerald, Clark, 2012). Almalki et al. (2012) have shown that "30.3% of nurses in iyadh were not offered any training courses or continuing education programs and 65.9% were offered very short courses (1 to 5 days per year)" (p. 30). Overall, health care providers have expressed dissatisfaction with their work life (Almalki et al., 2012). Likewise, Abu-Zinadah (2006) has indicated that work life in conditions in iyadh are sub-par for health care providers and could be improved considerably through attention to work hours and other variables. In iyadh as well as in other regions throughout the Kingdom, a lack of clinical experience can negatively impact a health care providers' quality of work…
Abu-Zinadah, S. (2006). Nursing situation in Saudi Arabia. Riyadh: Saudi Nursing
Board, Saudi Commission for Health Specialties.
Al-Ahmadi, H., Roland, M. (2005). Quality of primary health care in Saudi Arabia: a comprehensive review.
Alhusaini, H. A. (2006). Obstacles to the efficiency and performance of Saudi nurses at the Ministry of Health, Riyadh Region: analytical field study. Riyadh, Saudi Arabia, Ministry of Health.
The two surveys taken for this assignment both hone in on what can lead to a "running out" of compassion as well as burnout in general. Indeed, people's emotional and compassion reservoirs can only hold so much. Further, if those reservoirs are tapped too much for too long, they become exhausted and this leads to emotional exhaustion and burnout. When it comes to the quizzes themselves, the spiritual and emotional maturity quiz was indeed the more fascinating and intricate, at least in the perception of the author of this response. The six principles identified as part of the wider model as well as the level of maturity that can be had for each part of the model are very well-designed and crafted. Indeed, all facets of our maturity are on a sliding scale that ranges from infant to adolescence and it should be the goal of every person,…
The broad definition of the term 'theory' is development and elucidation of any aspect or field of cognition. Theory then is a collection of interrelated propositions that must forecast, describe, influence, or explain events. Theories of learning have attempted to offer explanations about learning as well as its application. In the last century, educational researchers and psychologists have postulated a number of theories to account for how people attain, organize and apply knowledge and skills. Rather than offering a specific theory, educational psychology provides multiple approaches and theories about the process of learning and the motivation for change and learning in individuals. Understanding theories of learning, (essentially educational psychology), is central to the field of education, for enabling nursing educators to offer an atmosphere conducive to learning, enhancing the educational system's efficiency and education harmonization. In the previous century, learning theory formulation and assessment has greatly facilitated the…
Ahmed, S. (n.d.) Theories and models of nursing practice. College of nursing/university of Baghdad. Retrieved from: http://www.conursing.uobaghdad.edu.iq/uploads/others/conursing/leacture/theory.pdf
Aliakbari, F., Parvin, N., Heidari, M., & Haghani, F. (2015). Learning theories application in nursing education. J Educ Health Promot. Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4355834/
Azimian, J., Negarandeh, R., & Movahedi, A. F. (2014). Factors Affecting Nurses' Coping With Transition: An Exploratory Qualitative Study . Global Journal of Health Science, 1916-9744.
Duchscher (2015). Transition Theory. Nursing the Future. Retrieved from: http://nursingthefuture.ca/transition_theory
Coping With the Nursing Shortage
Like many healthcare institutions, Nightingale Home Care Inc., in La Mesa, CA is suffering from a severe staffing shortage. The nursing shortage has been a persistent problem within the profession for many years due to what has been called a perfect storm of circumstances. First, the aging of the population as a whole has increased the demand and need for more nurses. People are living longer yet require more assistance from the healthcare profession to navigate the problems of aging. Chronic diseases such as heart disease, diabetes, and osteoarthritis are likewise on the rise in the elderly population and this requires continued monitoring and support. Secondly, the current population of Ns is itself aging and leaving the profession for retirement. A third, concurrent problem is that nursing schools lack sufficient faculty to admit and teach even all qualified candidates who do wish to…
Robeznieks, A. (2015). Looming nursing shortage fueled by faculty shortfall. Modern Healthcare. Retrieved from: http://www.modernhealthcare.com/article/20150124/MAGAZINE/301249971
Rosseter, R. (2014). Nursing shortage. AACN. Retrieved from:
Wood, D. (2008). Hospitals offer big incentives to attract nurses. Nursing News. Retrieved from:
Ethical and moral distress may result in feelings of irritation and helplessness. Such distress transpires when nursing professionals are required to behave in a way that contradicts their ideals. Nurses' integrity may be undermined by such a disregard for professional and personal ideals. Nurses are caught in a quandary between their duty to offer comfort in death and their duty to abide by the orders of the physician (Davies, et al., 1996). Obstacles might emerge when personnel in the healthcare sector cannot act in accordance with professional norms and personal ideals. The obstacles can be both internal and external. The former emerge due to ineffective communication and job-based skills and knowledge in the nursing staff, from providing adequate palliative care, while the latter occur when the opinion of the nursing staff isn't asked for or given value at the workplace. Such obstacles should be resolved for ensuring both proper…
Dalmolin, G. d., Lunardi, V. L., Barlem, E. L., & Silveira, R. S. (2012). Implications of moral distress on nurses and its similarities with Burnout. Texto contexto - enferm, 21(1).
Davies, B., Clarke, D., Connaughty, S., Cook, K., MacKenzie, B., & McCormick, J. (1996). Caring for dying children: Nurses' experiences. Pediatric Nursing, 22(6), 500-507.
Gallagher, A. (2010). Moral Distress and Moral Courage in Everyday Nursing Practice. OJIN: The Online Journal of Issues in Nursing, 16(2).
Morgan, D. (2009). Caring for Dying Children: Assessing the Needs of the Pediatric Palliative Care Nurse. Pediatr Nurs, 35(2), 86-91.
Improving Nursing Practice by educing Burnout Levels
Nursing may be the most stressful of all professions, and it is not surprising that many nurses abandon their careers after experiencing the rigors of their workplace. A growing body of research clearly shows that nurses in general and those working in emergency department settings in particular are at the highest risk of any profession for experiencing professional burnout syndrome (Hamaideh & Ammouri, 2011). For instance, Hamaideh and Ammouri (2011) emphasize that, "Many nursing tasks by normal standards are distasteful, giving strong evidence to support the belief that nursing is a stressful profession and that some causes of stressors are found in different areas of work, especially in areas where multiple and complex skills are required such as emergency rooms or departments" (p. 174).
Because there is already a critical shortage of professional nurses in many Western nations, identifying opportunities to reduce burnout…
Hamaideh, S. H. & Ammouri, A. (2011, February). Comparing Jordanian nurses' job stressors in stressful and non-stressful clinical areas. Contemporary Nurse: a Journal for the Australian Nursing Profession, 37(2), 173-179.
Karwowski, W. (2006). International encyclopedia of ergonomics and human factors. Boston: CRC Press.
Nikolaos, A. (2012, June). An examination of a burnout model in bsasketball coaches. Journal of Physical Education and Sport, 12(2), 171-175.
The decade-old system that specifies least standards for staffing in nursing homes need to be restructured, the report says. The U.S. Department of Health and Human Services must call for nursing homes to have at least one N within the facility during all times. Based on the departments' 2001 report to Congress on minimum staff-to-patient ratios for nursing homes, the HHS should mention the staffing levels that increased with the number of patients. Central and state report cards on nursing homes should give information on levels of nursing staff, and measuring of staffing levels should be developed for hospital report cards. The healthcare facilities should avoid using nurses from temporary agencies to fill the vacancy. (Substantial Changes equired in Nurses Work Environment to Protect Patients from Health Care Errors)
Working for long hours on the part of the nurse's makes them fatigue since it decreases their energy and reduces their…
ANA Commends IOM Report Outlining Critical Role of Nursing Work Environment in Patient Safety" (November 5, 2003) Retrieved at http://www.nursingworld.org/pressrel/2003/pr1105.htm . Accessed on 11 February 2005
Hallmarks of the Professional Nursing Practice Environment" (January, 2002) AACN White Paper. Retrieved at http://www.aacn.nche.edu/Publications/positions/hallmarks.htm . Accessed on 11 February 2005
Statement of the American Nurses Association for the Institute of Medicine's Committee on Work Environment for Nurses and Patient Safety" (September 24, 2002) Retrieved at http://www.nursingworld.org/pressrel/2002/iom924.htm . Accessed on 11 February 2005
Substantial Changes Required in Nurses Work Environment
Another 1997 study suggested that the increasing intensity of work and the regular exposure to potentially violent patients is another significant stressor that accounts for job burnout among CMHNs.
A much earlier study from 1987 was also cited by the authors because it specifically identified two factors as unique sources of stress for psychiatric nurses: patient contact and administrative and organizational factors. In that regard, the authors reported the collective findings of a series of studies from 1985 to 1996 that further detailed the roles of exposure to violent and disruptive patients, staff shortages, and conflicts with fellow staff members and patients' families as significant sources of vocational stress related to job burnout in the mental health nursing field. wo separate studies in that series from 1989 and 1995 both determined that scarce resources (including staff shortages) greatly exacerbated the negative effects of all of those stressors.
The article concluded that on the basis of the comprehensive literature review, the main sources of vocational stress capable of leading to job burnout among CMHNs are: (1) stressors considered intrinsic to the job; (2) role-based stressors such troubled relationships among coworkers; (3) career development-related stressors in the nature of insufficient time or flexibility to pursue advanced career goals; and (4) organizational structure and operational changes necessitated by legislative and institutional policy reforms.
Edwards D, Burnard P, Coyle D, Fothergill a, and Hannigan B. "Stress and burnout in community mental health nursing: a review of the literature" Journal of Psychiatric and Mental Health Nursing; 2000 Vol. 7: 7-14.