Work Place Stress of Nurses While Giving Care to Critically Ill Patients - Coursework Example

Nursing Leadership and Management Work place stress of nurses while giving care to critically ill patients The This paper will address theissue of workplace stress of nurses who take care of critically ill patients. The awareness of how nursing staff is stressed has increased in the United States since 1970s with the commencement of hospice movement. There are several issues which deal with health care system which can increase the tension of health care staff, especially, nurses who take care of critically ill patients. For example, death of a patient simply increases nurses’ consciousness of their own losses and intensify their fear of demise, thus raising nervousness and stress level. Studies have shown that burnout and stress may differ among nursing specialties. For example, nurses working in palliative care may experience less stress compared to nurses who work in areas such as oncology. However, the reasons which cause undue stress in all specialties should be addressed and it is proved that alcohol, drug use, depression and suicidal tendency are serious concern among health care professionals. (Chochinov, H., & Breitbart, W. 2000. p. 303–19). The ideal It is very important to recognize and control the causes and symptoms of stress among nurses because then only they can provide the care which is required for critically ill patients. Moreover, there is a possibility that the care provided may be compromised if the nurses fail to care for themselves due to grief and loss. (Ellis, S. 1997. 3(4):197–202). Now several nurses experience stress while taking care of critically ill patients. Lack of hospital resources and the reduction in nursing staffs have made things become worse, and several nurses find themselves avoiding patients and their families; at home, they feel exhausted and irritable. They even question their ability to provide good care because of job stress they experience. Though it is not possible to eliminate all the factors which create stress, it can be reduced by self- care .There is a general tendency among health care professionals to look for external solution to problems .But they should give more attention to their inner life i.e., their feelings , thoughts and actions . They should also develop self confidence i.e., trusting intuition and instinct. They also must try to develop healthy professional and personal relationships The Actual The European Agency for Safety and Health at work says, “There is increasing consensus around defining work- related stress in terms of the ‘interactions’ between and (exposures to hazards in) their work environment within this model stress can said to be experienced when the demands from the work environment exceed the employee’s ability to cope with (or control) them.” (Our Apologies. 2005). When health care professionals such as nurses experience invariable stress it may have an effect on their well-being and leads to poor judgment, distress , detachment and burnout. (Meier DE, et al. 2001. 286(23):3007–14). Some nurses suffer from compassion fatigue which is a form of burnout due to poor quality of care and inspired care giving. According to Yancik, burnout is “the social and psychological dysfunction of nurses who are repeatedly exposed to suffering, death and the demand for compassion and understanding.” (Yancik, R. 1984. 2(2):19–35). Causes of the problem The causes which give stress to nurses could be related to inter-personal, personal and health care system. Personal variables play crucial role in creating stress among health care professionals .For example, over involvement and perfectionism may lead to burnout or compassion fatigue. Purpose in life, sense of mastery and self-esteem also lead to stress connected with caring for critically ill patients. As critically ill patients die, nurses may feel personally susceptible to sickness or struggle psychologically with grief. Van Staa and his colleagues believe that some of risk factors, such as psychiatric illness may accelerate the process of burnout and there is possibility of younger nurses with few years experience account higher level of suffering. (Van, Staa, A. et al. 2000. 4(1):93–105). Moreover, some of the nurses are very committed which might lead to over involvement with the patient and they start wondering why God permits people to suffer and feel helpless to alleviate their emotional, physical, and spiritual suffering. Interpersonal variables that lead to burnout are related to patient and his families. For example, the extent to which the patient or members of his family accepts his sickness and his imminent death. Sometimes, nurses develop strong attachment with patient who reminds them of somebody important in their lives. Moreover, in some cases, some nurses identify themselves with critically ill patient who are alike in appearance, age or background. This identification can heighten personal pain and increase feelings of guilt. Studies have shown that Nurses often mourn the death of the patient and this grieving may not be over before the death of the next patient. This situation might lead to guilt, anger, frustration, irritability, and inadequacy, feelings of helplessness, depression and sleeplessness. Moreover, taking care of famous, awfully angry, depressed patient might also increase healthcare professional’s emotional suffering. Insufficient support from coworkers and not getting sufficient time off, assigning different duties will also lead to emotional and social isolation and ultimate desires to leave work setting. (Marino, P. A. 1998. 21(2):101–4). Shortage of staff or partial participation of staff on other areas can result in uncontrollable work loads and stress. Moreover, there is a possibility of interpersonal clash which can also happen as a nurse’s role overlie with other staff. Work stress increases further if there are differences among members of the interdisciplinary team regarding the objectives of the care. Nurses’ relationship with their managers, supervisors and fellow nurses can either decrease or increase work stress. (Isenalumhe, A. E. 2000. 30(2):52). Further, the lack of collaborative and supportive work places relationship reduces nurses’ self esteem and professional effectiveness. (Vachon, M. L. 1998. 14(2):152–7). Treatment errors and undesirable effect of treatment are also sources of mental agony for nurses. A fear of legal action and a consciousness of professional liability many worsen stress. Result and Symptoms of Burnout After finding out the sources of work place stress and factors which increases them, the nurses should have awareness about their stress level. They should be able to recognize the symptoms of stress as soon as they appear. Some of the physical symptoms are gastrointestinal disturbances, change in appetite, somatic complaint such as fatigue, headache, clammy hands, exhaustion, changes in sleep and increased motor activity. Some of the psychological problems are anger, memory disturbances, self doubt, hopelessness, increased isolation, low self esteem, impaired judgment and reasoning. Burnout and stress may have important consequences for both patients and nurses. For example, nurses are prone to express strong emotional reaction to patient’s distress which may lead to her detachment from or avoiding of the patient and members of his family. This may also lead to constant discontent with work. Finally stress and burnout result poor care as well as failure to recognize family values and objectives of care which lead to patient distrust. Some other consequences of stress and burnout include lack of clarity about one’s professional role, a loss of meaning and purpose, a sense of professional loneliness and cynicism. It is possible that constant work related stress may produce substance abuse, illness, suicide and family conflict. Proposed solutions Self- Care Though it is impossible to eliminate stress completely, it can be managed easily. It is important that nurses shouldn’t view death as failure. It should be seen as a chance to face hardships in life and to embrace life more completely; self care is a self initiated behavior that is useful to promote general well-being and good health. Nurses must be familiar with their stress level and try to employ self-care strategies to refill themselves in emotional, mental, physical and spiritual ways to overcome various sources of stress. Physical Health To increase physical health, nurses should take care of their bodies by taking nutritious food .They should also do proper exercise such as walking, yoga, aerobics etc. They are also encouraged to do relaxing activities such as taking warm bath, napping and massage therapy; acupuncture and bio feed back are useful to balance physical energy. Emotional health can be promoted by focusing on peaceful thoughts and developing a calm mind. Interacting with cheerful people, enjoying play and fantasy, reading a daily journal, letting go of negative emotion and speaking with colleagues or friends about concerns are some of the methods to overtake negative feelings with positive ones. Nurses should ask themselves, what makes me sad, and what makes me happy? A good number of nurses still find that anxiety is getting the best of them and they feel out of control. Then they should focus on good feelings which they have about nursing and try to write it about in a magazine or journals. They should take time off to watch a movie, or read a good book to improve their state of mind. They should not allow their professional role to dominate their life; mental health could be strengthened by making purposeful choices in response to stress. Letting go of conflict, setting priorities, and keeping the mind open to new ideas are some of the methods to keep off stress. In addition to this, nurses should try to be gentle and forgiving. They should also do meditation and use relaxation techniques which increase their sense of inner peace, wholeness and harmony. Health care professionals working with critically ill patients in particular must consider ways at promoting inner harmony in their daily life. Finally, when they think about self care to reduce stress and burnout, they should listen to their mind ant trust their intuition. Interpersonal stressors and self-care When things get difficult, nurses should reflect on the moments in which they made huge difference to patients and their families. Such incidents can strengthen the nurses’ commitment to their work. In order to cope with grief and loss, arranging memorial services and discussion of patients during team rounds are helpful. They may write in a journal or magazine about their experience while giving care to the patients. Professional stressors in health care system and self –care Nurses should speak to the hospital administration about the need for proper resources, staffing and ways to decrease workloads. Hospital administrators should provide support on both unit and institutional level. For example, nurses should be give further training and tuition which would increase their confidence. Works Cited Chochinov, H., & Breitbart, W. (2000). Handbook of psychiatry in palliative medicine. New York: Oxford. p.303–19. Ellis, S. (1997). Research and development. Patient and professional centered care in the hospice. Int J Palliat Nurs; 3(4):197–202. Our apologies. (2005). European Agency for Safety and Health at Work. Retrieved April 5, 2007, from http://agency.osha.eu.int/publications/factsheets/8/en/facts8_en.pdf. Meier, DE, et al. (2001). The inner life of physicians and care of the seriously ill. JAMA 2001; 286(23):3007–14. Yancik, R. (1984). Coping with hospice work stress. J Psychsoc Oncol; 2(2):19–35. Van Staa A, et al. (2000). Caring for caregivers: experiences and evaluation of interventions for a palliative care team. Patient Educ and Couns. 4(1):93–105. Marino, P. A. (1998). The effects of cumulative grief in the nurse. J Intraven Nurs; 21(2):101–4. Isenalumhe, A. E. (2000). Nurses are not their sisters’ keepers. J Nurs Adm; 30(2):52. Vachon, M. L. (1998). Caring for the caregiver in oncology and palliative care. Semin Oncol Nurs; 14(2):152–7. Read More