Our Purpose

All of our group members continuously face similar ethical dilemmas resulting in the inability to provide competent and safe care that patients are entitled to. We as a group, have decided to come together to develop a plan on how we, as nurses, can affect change. It is vital for nurses to empower one another and provide support during stressful situations in the workplace. Equality in the work environment reduces power imbalances. Lastly, it is imperative that nurses unite to have stronger voices in creating policies and rules that ensure the best outcomes for the patients are achieved.

Ethical Situation

A situation arose where a nurse could not live out the value in providing safe, compassionate, competent and ethical care occurred on a busy evening shift on a sub-acute floor. On this particular evening, the nurse had 7 total-care heavy patients, and was expected to administer numerous medications, and provide evening care. During that evening, two of this nurses’ patients fell, and she also had to attend to her partner’s patient, who also had a fall. After ensuring all patients were uninjured, administration of medications, and completion of all assessments, the nurse barely had time to provide evening care. Two of the patients went to bed without being washed. The nurse was unable to do hourly safety checks on her patients, and she felt as if she had gone all evening without seeing some of her patients. She had to stay after her shift to complete two incident reports.

This experience affected the nurse deeply, and she did not feel in the least that she was safely providing care to these patients. The speed at which this nurse had to complete her tasks put her and her patients at risk, and the whole shift felt chaotic. This incident occurred approximately three years ago, and she still has not accepted another shift on the sub acute floor.

The barrier the nurse faced in being able to live this ethical value occurred at an organizational level, and is brought back to budget cuts. This heavy workload occurred because of the cost associated with hiring more nurses, or care aids, to reduce the workload. Another issue may have been staffing issues for this floor; turnover may be high, as other nurses may have similar experiences.

TIPS ON HOW TO AVOID NURSING BURNOUT



TIPS ON HOW TO AVOID NURSING BURNOUT


(NURSE TURNOVER: THE MEDIATING ROLE OF BURNOUT, Leiter, M., & Maslack, C. 2009).

What is Nursing Burnout?
·       Burnout is a psychological syndrome that involves a prolonged response to chronic interpersonal stressors on the job. 
·       Three key dimensions of this response are an overwhelming exhaustion, feelings of cynicism and detachment from the job, and a sense of ineffectiveness and lack of accomplishment (Maslach 1993).

(NURSE TIPS WEBSITE, Nursing General Information, n.d.)

Symptoms of Nursing Burnout
·       The symptoms of burnout are as varied as the sufferers. Some people become angry, blowing up or growling at anyone who crosses their path.
·       Some resort to blaming any annoyance, large or small, on external factors. Some become quiet, introverted and isolated, which can indicate the start of a serious depression.
·       Others manifest burnout by under or overeating or abusing alcohol or other mood-altering substances.
·       Still others may experience a range of physical symptoms, including chronic illness, high blood pressure and frequent headaches.
·       Some people on the verge of burnout actually become obsessive workaholics. Others become chronically late or psychologically absent.

Nursing Shortage Update
·       The nation's nursing shortage has had significant consequences during the past five years, even contributing to patient injuries and deaths. Inadequate nurse staffing has been a factor in 24 percent of the 1,609 cases involving death, injury or permanent loss of function reported since 1997 to the Joint Commission on Accreditation of Healthcare Organizations.
·       The report says there are 126,000 nursing positions unfilled in hospitals nationwide. Ninety percent of long-term care organizations lack sufficient nurses "to provide even the most basic care" and some home-health care agencies are being forced to refuse new patients.
·       With the aging of the nation's baby boomers and nurses themselves, it has been estimated that by 2020 there will be at least 400,000 fewer nurses available to provide care than will be needed.

(ETHICAL CHALLENGE IN COMMUNITY HEALTH NURSING Duncan, S. 1992)

Strategies to Alleviate Stress and Burnout
·       Continual communication and collaboration with all health care disciplines.
·       Understand and advocate for nursing rights, as well as patient rights.  Act according to personal values, and utilize support networks.
·       Nurses need to uphold professional standards in the face of difficult choices involving some degree of vulnerability.
·       Maintain fitness to practice – ensure a balance of adequate nutrition, exercise, laughter, support groups, etc. to assist in reducing stress levels in the workplace.

(WORK ENVIRONMENTS, LESS BURNOUT=SAFER PATIENTS, 2006).

Less Burnout = Safer Patients
·       Patient safety is related to the quality of a facility’s work environment for nurses, new research suggests.
·       In a study, about 8,600 Canadian nurses related their nursing work life and levels of burnout and reported the frequency of adverse patient events.
·       Results indicate that nursing leadership plays an important part in preventing nurse burnout through its influence on facility policies, staffing levels, support for a nursing model of care rather than a medical model, and nurse/physician collaboration.
·       Researchers found that adverse patient events were strongly correlated with understaffing, emotional exhaustion, and depersonalization.
·       Study results are consistent with the notion that patient-safety outcomes are associated with the quality of the nursing practice work environment and that the burnout/engagement process plays an important mediating role.
·       Nurses who feel their work environment supports professional practice are more engaged in their work, leading to safe, high-quality patient care.


WEBSITES

Article:  Teaching to Prevent Burnout in the Helping Professions
http://www.viterbo.edu/analytic/vol.24%20no.1/teaching%20to%20prevent%20burnout.pdf

CRNBC – Fitness to Practice
https://www.crnbc.ca/downloads/329.pdf

Stressed Out Nurses.com – “Avoid Burnout By Caring For Yourself.”
http://www.stressedoutnurses.com/2009/02/avoid-burnout-by-caring-for-yourself/

Allnurses.com – “How to Avoid Burnout.”
http://allnurses.com/health-stress-management/how-avoid-burnout-200205.html

For all Nurses – How to Avoid Burnout (Nurse Uncut: NSWNA)
http://www.nurseuncut.com.au/for-all-nurses-how-to-avoid-burn-out/

Soliant Health – 7 Tips to Improve Employee Engagement and Reduce Burnout
http://adeccousa.com/adeccogroup/insights-and-ideas/Documents/7%20Tips%20to%20Improve%20v2.pdf

Ten Tips for Stress Management (YouTube)
http://www.youtube.com/watch?v=xOpZU320v5E

Stressed? (YouTube)
http://www.youtube.com/watch?v=IgmaJC-Km5U
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