The Nurse and the Patient: Influence of Context in Knowing the Patient

Pearson fixates her memoir on several different instances of medical mishaps that have happened in her career. For instance, she talks about the tragic death of her patient Mr. Rose. This patient provides Dr. Pearson with a life lesson that it is important to cherish the things you have then the things you wish you had. In this case, Dr. Pearson regrets cherishing the remaining time she had with Mr. Rose before he passes away. Another instance she learns a life lesson would be with her patient Elias, a young boy diagnosed with brain cancer. Even though Elias was slowly dying, his parents continued surgical procedures and heavily depended on the hospital staff to create a miracle. Dr. Pearson knew that Elias would not be able to recover, but she continued to assist through the surgeries as her “hands were tied”. Nevertheless, Dr. Pearson reflects that she could have put down her surgical tools and said no; instead, she participated in the surgeries. Later, Dr. Pearson realizes that her role and her identity as a doctor is to help her patients with their problems and to try to solve them as much as she can in a humane and respectable

She talks about how Paul, a medical student who spent the night at the hospital struggling to collect information from his patient, and by the end of the night was left frustrated and “dehumanized by the process of caring for the patient.” She makes an important point when she mentions that Paul feels “incompetent” because he felt he wasn’t able to perform well in his interview with the patient.

Nursing is an arduous profession and it has many rewards and hardships. After devoting five years into nursing, I always ask my fellow, elderly nurses that how they manage to work at the bedside this long. The answer is usually, "nursing has changed over the years". The nursing value has shifted from patient centered care to patient and family centered care. Therefore, the focus is geared more towards patient satisfaction and healthcare costs. This in return has built enormous amount of stress among nurses, causing mental and physical burnout. The physical burnout is from lifiting and turning patients without a proper staffing and equipments provided. Budhrani-Sahni & Collegues (2016) stated that nursing is the fifth largest

Inconsistent nurse-patient ratios are a concern in hospitals across the nation because they limit nurse’s ability to provide safe patient care. Healthcare professionals such as nurses and physicians agree that current nurse staffing systems are inadequate and unreliable and not only affect patient health outcomes, but also create job dissatisfaction among medical staff (Avalere Health, 2015). A 2002 study led by RN and PhD Linda Aiken suggests that "forty percent of hospitals nurses have burnout levels that exceed the norms for healthcare workers" (Aiken, Clarke, Sloane, Sochalski & Silber, 2002). These data represents the constant struggle of nurses when trying to provide high quality care in a hospital setting.

Additionally, the study found that a high patient to nurse ratio resulted in greater emotional exhaustion and greater job dissatisfaction amongst nurses. Each additional patient per nurse was associated with a 23% increase in the likelihood of nurse burnout, and a 15% increase in the likelihood of job dissatisfaction. Moreover, 40% of hospital nurses have burnout levels exceeding the normal level for healthcare workers, and job dissatisfaction among hospital nurses is four times greater than the average for all US workers. 43% of nurses involved in this study that reported job dissatisfaction intended to leave their job within the upcoming year. (Aiken et al.)

The issue of healthcare personnel scarcity continues to be an ongoing challenge across the globe. Invariably, nurses are at the pinnacle in the delivery of quality care in any healthcare setting. The ever-increasing demands for care stem from a patient populace that is emergent, growing older and needing more care due to the escalating shift in their disease process. Hence, nurses are torn between balancing an overloaded schedule, working extra hours and maintaining astuteness and professionalism. This transcends to compromised patient care, nursing burnout makes it difficult for them to experience the rewards of caring for patients in the way they had expected; thereby, adding to the shortage of

Nurses work long hours and deal with high levels of stress during the workday which leads to nurse burnout. Nurse burnout is classified as physical and mental fatigue, which strongly affects the nurses emotions and motivation. (“Nursing Burnout”). Burnout is caused by various factors within the workplace, such as dealing with a hectic, fast-paced environment, caring for too many patients at one time, and working odd hours. When nurses deal with multiple patients per shift, high levels of responsibility, and their own personal problems, they can become exhausted and overwhelmed. Stress due to burnout can also affect the nurse’s mood in a negative way, causing the nurse to become impatient or irritable, which can oftentimes results in verbal or emotional abuse towards the

A nurse’s typical day isn’t without stress; it is usually a lot of complex planning, critical thinking, time management, an abundance of communications with all departments of the hospital, and documenting events that have happened throughout the day on their entire patient assignment. “Nurses who are mandated following the completion of their regular shift are often ill-equipped to continue working. They have not planned for that situation with: proper advanced rest, arrangements for

The term burnout, according to Catalano, is a continuing depletion of energy and strength combined with a loss of motivation and commitment after prolonged exposure to high occupational stress (2015). When a unit or facility is understaffed, not only do the nursing staff get burnt out, the patients also don’t receive the quality of care they deserve. Due to the increase in workload, nursing staff are more prone to making mistakes and medical errors and sometime times do not fellow facility policies. The nurse-patient ratio aspect sometimes gets overlooked at and that could lead to possible medication errors, lack of communication, falls, neglect, abuse and/or death may occur. Sometimes, it become so overwhelming people turn to leave the workforce all together. When nurses and CNA workload increase, they become frustrated and unhappy, and the desire to leave

Workload was described to be heavy, stressful, increase in intensity and overtime hours. As a result 25.8% consider resigning, 20.2% consider retiring and 25.6% consider leaving profession. Another problem that was observed at individual level was poor commitment to care. One of the factors that often limited nurses to provide therapeutic care was the change in nurse to patient ratio. As nurses assignments increase with the increase in the number of patients (i.e. 1 nurse to 6-8 patients) the quality of care provided decreases. Nurses’ ability to maintain safe environment became challenging. As part of caring, nurses also showed decreased amount of time spent with their patient. This eventually led to nurses being less satisfied with their current job. Self – efficacy was often low. Nurses felt that they did not have enough knowledge and skills required for professional practice (Newhouse, Hoffman, & Hairston, 2007). This often led into stressful transition and the ability to care for a patient even harder. New graduate nurses often had difficulty maintaining leadership role. They often felt that they did not have the ability to self advocate and raise their voice to be heard by others. They often feared that they would be over heard and that no one would listen to them (Mooney, 2007).

Those of us who graduated from nursing school and started their first job were full of dreams, aspirations, and had every intention of making a difference. Now fast forward five years; these same nurses have been on their feet for 16 hours and have not had time to eat or use the bathroom since leaving their homes this morning. The call lights will not stop going off long enough for them to give report to the oncoming nurses and once again they are late for their children’s dance recitals or soccer games. They can forget about trying to squeeze a yoga class in this week. I understand what it is like to rush to your car feeling as if some important task was forgotten; was Mr. Smith’s tube feed restarted, did room 8 receive their pain medication? Nurses all over the world are experiencing “burnout”. To avoid burnout, nurses must properly care for themselves by separating work from personal life, knowing when to say no, and making time for enjoyable activities to manage stress, because we cannot provide quality patient care if we are neglecting ourselves.

Nurses are especially vulnerable to several related effects of stress, such as burnout, job dissatisfaction, increased interpersonal problems, increased health complaints, disturbances in sleep patterns, as well as clinical depression and anxiety (Villani, Grassi, Cognetta, Toniolo, Cipresso, & Riva, 2013). The potential for stress can be reduced by resolving difficulties in the workplace promptly, addressing staff shortages, turnover and absenteeism, and developing clear objectives and plans (McIntosh, & Sheppy, 2013). Learning to manage and reduce stress by developing insight and coping strategies will help to maintain and promote nursing integrity and consistent patient care (McIntosh, & Sheppy, 2013).

Nurses, always involved in patient care, sometimes experience detrimental effects with prolonged stress or “burnout” during their career throughout the years. Burnout is defined as an extended response to physical or emotional stressors. Some examples of these stressors are; memories of witnessing death, patient and family suffering, emotional stress of losing patients, feeling emotionally and physically drained, or emotional disconnect from staff which can all contribute to burnout. As a result, nurses can experience; exhaustion, anxiety, dissatisfaction and low capacity. Overall, burnout can have negative effects not just on the emotional and physical health of nurses but also on; patient satisfaction, outcomes and mortality of nurses and patients. Although, there are ways to reduce or prevent these negative effects of burnout from manifesting. For example, nurses can apply interventions to reduce these risks including; staff support, onsite counselors and psychiatrists for nurses and salary increases and reimbursement opportunities for nurses through clinical ladder programs. Nurses can also start by just saying no to certain requests, being aware of their tolerance level, by taking care of themselves and having fun outside of work. On the other hand, others do not think nursing burnout is fatal and nurses just need a break from their job to initiate change. Although, the issue of burnout is prevalent in nurse’s careers which need to be addressed more in society in

“Burnout has been widely studied in the health service profession, and nursing is recognized as one of the occupations with the highest burnout prevalence rates” (Harkin & Melby, 2014, p. 152). Nursing burnout affects many nurses in the profession in one way or another. In the nursing world, a typical shift length is now twelve hours or longer. This shift length has changed from the past in which nurses worked a normal shift of eight hours. While there are benefits and disadvantages to each of these shifts, there has to be a regulation of total hours worked in a week. Nurses who work at the bedside of critically ill patients witness marked human suffering (Sacco, Ciurzynski, Harvey, &

As educators, caretakers and lifelines, nurses take on several roles as they routinely care for patients day in and day out. Fidelman and Charlie published an article on‘‘Young nurse 's 'dream job ' turned into nightmare; She suffered burnout at 26 after staff cuts in hospital 's intensive care unit in Montreal Gazette on 25 Oct 2014. The article was about Ariane Bouchard, who worked for six years as a night nurse in the intensive care unit of a Montreal hospital who chosen nursing out of her passion and suffered a burnout after staff cuts due to the Montreal Health Departments rules faced new challenges night after night.The reluctant effects of staff burnout are many. ‘‘ Patients who are sent to the ICU might die without close monitoring and observation’’(Bouchard 1).Even though ,Bouchard is a dedicated nurse she have to take a leave of absence due to burnout at the age of 26. Nurses have to work continuously even without a break during night times. Another menace is the organization’s threat..The limitation of resources also is another burden for nurses.Due to the busy schedules disinfection and transport of laboratory samples got delayed.‘’Rooms weren 't fully cleaned, only areas that came in contact with the patient got wiped down’’( Bouchard ) .