Thursday, May 21, 2020
Work related stress in healthcare - Free Essay Example
Sample details Pages: 10 Words: 2944 Downloads: 10 Date added: 2017/06/26 Category Medicine Essay Type Essay any type Level High school Did you like this example? Stress may be defined as the physical and emotional response to excessive levels of mental or emotional pressure, which may arise from issues in both the working and personal life. Stress may cause emotional symptoms such as anxiety, depression, irritability or low self-esteem, or even manifest as physical symptoms including insomnia, headaches, loss of appetite and difficulties concentrating. Individuals experiencing high levels of stress may experience difficulty in controlling emotions such as anger, and may be more likely to experience illness or consume increased quantities of alcohol (NHS Choices, 2015). Donââ¬â¢t waste time! Our writers will create an original "Work related stress in healthcare" essay for you Create order In the UK a survey undertaken by the Health and Safety Executive (HSE) has estimated that in the year 2013-2014, 487,000 of work related illnesses (39%) could be attributed to work-related stress, anxiety or depression (HSE, 2014). Additionally the survey found that as many as 11.3 million working days were lost in the year 2013-2014 as the direct result of work-related stress (HSE, 2014). Studies have shown that healthcare professionals, particularly nurses and paramedics, are at an increased risk of work-related stress compared with other professionals (Sharma et al., 2014). This is likely to be due to the innate long hours and high pressure of maintaining quality care standards in the job, as well as pressures caused by staff shortages, high levels of patient demand, a lack of adequate managerial support as well as the risk of aggression or violence towards nurses from patients, relatives or even other staff (Royal College of Nursing (RCN), 2009). Indeed, a 2014 survey of nursi ng staff by the RCN showed that up to 71% of staff surveyed worked up to 4 hours more than their contracted hours a week, 80% felt that work-related stress lowered morale, and that 72% reported that understaffing occurred frequently in their workplace. As a result of these issues, 66% of respondents in the survey considered leaving the NHS or the nursing profession altogether (RCN, 2014b). A separate report by the RCN suggested that over 30% of absence due to illness was due to stress, which was estimated to cost the NHS up to Ãâà £400 million every year (RCN, 2014a). In addition to the physical and emotional symptoms of stress previously discussed, studies in this area have shown that nurses experiencing high levels of work-related stress were more likely to be obese and have low levels of physical exercise, factors which increased the likelihood of non-communicable diseases and co-morbidities such as hypertension and type 2 diabetes (Phiri et al., 2014). Stress and staff absence Chronic stress has been linked to burnout(Khamisa et al., 2015; Dalmolin et al., 2014), or a state of emotional exhaustion under extreme stress related to reduced professional fulfilment (Dalmolin et al., 2014) and compassion fatigue, where staff have experienced so many upsetting situations that they find it difficult to continue empathising with their patients (Wilkinson, 2014). As previously discussed, reducing staffing levels contribute to stress in nursing staff, and in this way chronic stress within the workplace launches a self-perpetuating cycle of understaffing; increased stress leads to increased illness, more staff absence and increased understaffing. In turn, these negative emotions also reduce job satisfaction and prompt many staff to consider leaving the nursing profession, further reducing staffing availability for services (Fitzpatrick and Wallace, 2011). Reasons for work-related stress amongst healthcare professionals Studies amongst nursing staff have also reported stress occurring as the result of poor and unsupportive management, poor communication skills amongst team members, institutional and organisational issues (e.g. outdated or restrictive hospital policies) or bullying and harassment (RCN, 2009). Even seemingly minor issues have been reported as exacerbating stress amongst nursing staff, for example a lack of common areas to take breaks in, changing shift patterns, and even difficulty and expense of car parking (Happell et al., 2013). Work related stress can particularly affect student or newly qualified nurses, who often report higher expectations of job satisfaction from working in the profession, they have worked hard and aspired to join, and are therefore particularly prone to experiencing disappointment on discovering that they do not experience the job satisfaction that they presumed they would do whilst training. Student and newly qualified nurses may also have clear ideas fr om their recent training on how healthcare organisations should be run and how teams should be managed, and may then be disillusioned when they discover that the reality is that many departments could in fact benefit from improvements and further training for more experienced staff in these areas (Wojtowicz et al., 2014; Stanley and Matchett, 2014). Nursing staff are also likely to, on occasion, find themselves in a clinical situation that they feel unprepared for, or do not have the necessary knowledge to provide the best possible care for patients, and this may cause stress and anxiety (RCN, 2009). They may also be exposed to upsetting and traumatic situations, particularly in fields such as emergency or intensive care medicine (Wilkinson, 2014). Moral distress can also cause strong feelings of stress amongst healthcare professionals. This psychological state occurs when a discrepancy occurs between the action that an individual takes, and the action that an individual feels th ey should have taken (Fitzpatrick and Wallace, 2011). This may occur if a nurse feels that a patient should receive an intervention in order to experience best possible care, but is unable to deliver it, for example due to organisational policy constraints, or a lack of support from other members of staff (Wojtowicz et al., 2014). For example, a nurse may be providing end of life care to a patient who has recently had an unplanned admission onto a general ward but is expected to die shortly. The nurse may feel that this patient would benefit from having a member of staff sitting with them until they died. However, due to a lack of available staffing this does not happen as the nurse must attend to other patients in urgent need of care. If the patient dies without someone with them, the nurse may experiences stress, anger, guilt and unhappiness over the situation as they made the moral judgement that the dying patient should have had a member of staff with them, but were unable to pr ovide this without risking compromising the safety of other patients on the ward (Stanley and Matchett, 2014). One large scale questionnaire based study in the USA on moral distress amongst healthcare professionals has shown that moral distress is more common amongst nurses than other staff such as physicians or healthcare assistants. The authors suggested that this may be due to a discrepancy between the level of autonomy that a nurse has in making care decisions, (especially following disagreement with a doctor, who has a high level of autonomy), while experiencing a higher sense of responsibility for patient wellbeing than healthcare assistants, who were more likely to consider themselves to be following the instructions of the nurses than personally responsible for patient outcomes (Whitehead et al., 2015). Recommendations for policies to address work related stress It is acknowledged that many individuals find that being asked to perform tasks that they have not been adequately trained or prepared for can be very stressful. As such management teams should also try to ensure as far as possible that individuals are only assigned roles for which they have adequate training and abilities, and support employees with training to improve skills where necessary (RCN, 2009). Surveys have frequently reported that organisational issues such as a lack of intuitive work patterns, overloading of workloads and an unpleasant working environment can all contribute to work related stress. Organisations can reduce the impact of these by developing programmes of working hours with working staff and adhering to them, making any necessary improvements to the environment (e.g. ensuring that malfunctioning air conditioning is fixed), and that incidents of understaffing are reduced as much as possible (RCN, 2009). Issues such as insomnia and difficulty in adapting to changing shift patterns can also be assisted by occupational health, for example by encouraging healthy eating and exercise (Blau, 2011; RCN, 2005). For example, in 2005 the RCN published an information booklet for nursing staff explaining the symptoms of stress, ways in which it can be managed e.g. relaxation through exercise or alternative therapies, and when help for dealing with stress should be sought (RCN, 2005). More recently, internet based resources are available from the NHS to help staff identify if they need assistance, and how and why it is important to access it (NHS Employers, 2015). Witnessing or experiencing traumatic or upsetting events is an unavoidable aspect of nursing, and can even result in post-traumatic stress disorder (PTSD). However, there are ways in which staff can be encouraged by their management teams and organisations to deal with the emotions that these circumstances produce, limiting the negative and stressful consequences of these events. T his may include measures such as counselling or even peer support programmes through the occupational health departments (Wilkinson, 2014). Staff should also be encouraged to use personal support networks e.g. family, as this can be an important and effective source of support, however studies have shown that support within the work place is most beneficial, particularly if this can be combined with a culture where healthcare professionals are encouraged to express their feelings (Lowery and Stokes, 2005). One commonly cited reason for work related stress amongst nurses is the incompetence or unethical behaviours of colleagues, and a lack of opportunity to report dangerous or unethical practice without fear of reprisal. Therefore it is important that institutions and management teams ensure that there is an adequate care quality monitoring programme in place, and a culture where concerns can be reported for further investigation without fear of reprisal, particularly with respect to senior staff or doctors (Stanley and Matchett, 2014). It has been reported that in the year 2012-2013, 1,458 assaults were reported against NHS staff (NHS Business Service Authority, 2013). Violence and abusive behaviour towards nursing staff is an acknowledged cause of stress and even PTSD, and staff have a right to provide care without fear (Nursing Standard News, 2015; Itzhaki et al., 2015). Institutions therefore have a responsibility towards their staff to provide security measures such as security staff, workplace design (e.g. locations of automatically locking doors) and policies for the treatment of potentially violent patients e.g. those with a history of violence or substance abuse issues (Gillespie et al., 2013). As previously discussed, nurses are more likely than other healthcare professionals to experience moral distress as the result of a discrepancy between the actions they believe are correct and the actions they are able to perform (Whitehead et al., 2015 ). However there are policies that can be introduced into healthcare organisations to reduce its occurrence, and the severity with which it can affect nursing staff. Studies have shown that nurses who were encouraged to acknowledge and explore feelings of moral distress were able to process and overcome these in a less damaging manner than those who did not (Matzo and Sherman, 2009; Deady and McCarthy, 2010). Additionally, it is thought that moral distress is less frequent in institutions and teams that encourage staff to discuss ethical issues with a positive attitude (Whitehead et al., 2015). For example, institutions could employ a designated contact person for staff to discuss stressful ethical issues with, or set up the facility for informal and anonymous group discussion, for example on a restricted access internet-based discussion board (Matzo and Sherman, 2009) Conclusion Work related stress is responsible for significant costs to the NHS in terms of staffing availability and financial loss from staff absence from stress itself or co-morbidities that can be exacerbated by stress (RCN, 2009), for example hypertension and diabetes (Phiri et al., 2014; RCN, 2009, 2014a). The loss of valuable and qualified staff from the profession is also a significant cost to health services, and of course exacerbates the situation by increasing understaffing further, which in turn increases stress for the remaining staff (Hyrkas and Morton, 2013). It can also exert a significant cost to healthcare professionals who experience it, in terms of their ability to work, their personal health, effects on personal relationships (Augusto Landa et al., 2008) and job satisfaction (Fitzpatrick and Wallace, 2011). However, organisations can implement recommendations to reduce work related stress, for example by encouraging a positive and supportive culture for staff by offering i nterventions such as counselling (Wilkinson, 2014; RCN, 2005). Furthermore, interventions such as encouraging the reporting of unsafe or unethical practice a commonly cited source of stress amongst nurses (RCN, 2009; Stanley and Matchett, 2014) may also contribute to improving the quality of patient care. References Augusto Landa, J. M., LÃÆ'à ³pez-Zafra, E., Berrios Martos, M. P. and Aguilar-LuzÃÆ'à ³n, M. D. C. (2008). The relationship between emotional intelligence, occupational stress and health in nurses: a questionnaire survey. International Journal of Nursing Studies, 45 (6), p.888à ¢Ã¢â ¬Ã¢â¬Å"901. [Online]. Available at: https://www.ncbi.nlm.nih.gov/pubmed/17509597 Blau, G. (2011). Exploring the impact of sleepà ¢Ã¢â ¬Ã related impairments on the perceived general health and retention intent of an Emergency Medical Services (EMS) sample. Career Development International, 16 (3), p.238à ¢Ã¢â ¬Ã¢â¬Å"253. [Online]. Available at: https://www.emeraldinsight.com/doi/abs/10.1108/13620431111140147 Dalmolin, G. de L., Lunardi, V. L., Lunardi, G. L., Barlem, E. L. D. and da Silveira, R. S. (2014). Moral distress and Burnout syndrome: are there relationships between these phenomena in nursing workers? Revista Latino-Americana de Enfermagem, 22 (1), p.35à ¢Ã¢â ¬Ã¢â¬Å"42 . [Online]. Available at: https://www.scielo.br/scielo.php?script=sci_arttextpid=S0104-11692014000100035 Deady, R. and McCarthy, J. (2010). A Study of the Situations, Features, and Coping Mechanisms Experienced by Irish Psychiatric Nurses Experiencing Moral Distress. Perspectives in Psychiatric Care, 46 (3), p.209à ¢Ã¢â ¬Ã¢â¬Å"220. [Online]. Available at: https://www.ncbi.nlm.nih.gov/pubmed/20591128 Fitzpatrick, J. J. and Wallace, M. (2011). Encyclopedia of Nursing Research. 3rd ed. New York: Springer Publishing Company. Gillespie, G., Gates, D. M. and Berry, P. (2013). Stressful Incidents of Physical Violence Against Emergency Nurses. OJIN: The Online Journal of Issues in Nursing, 18 (1). [Online]. Available at: https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-18-2013/No1-Jan-2013/Stressful-Incidents-of-Physical-Violence-against-Emergency-Nurses.html Happell, B., Dwyer, T., Reid-Searl, K., Burke, K. J., Caperch ione, C. M. and Gaskin, C. J. (2013). Nurses and stress: recognizing causes and seeking solutions. Journal of Nursing Management, 21 (4), p.638à ¢Ã¢â ¬Ã¢â¬Å"647. [Online]. Available at: https://www.ncbi.nlm.nih.gov/pubmed/23700980 HSE. (2014). Statistics Stress-related and psychological disorders in Great Britain. Health and Safety Executive. [Online]. Available at: https://www.hse.gov.uk/statistics/causdis/stress/index.htm Hyrkas, K. and Morton, J. L. (2013). International perspectives on retention, stress and burnout. Journal of Nursing Management, 21 (4), p.603à ¢Ã¢â ¬Ã¢â¬Å"604. [Online]. Available at: Itzhaki, M., Peles-Bortz, A., Kostistky, H., Barnoy, D., Filshtinsky, V. and Bluvstein, I. (2015). Exposure of mental health nurses to violence associated with job stress, life satisfaction, staff resilience, and post-traumatic growth. International Journal of Mental Health Nursing, 24 (5), p.403à ¢Ã¢â ¬Ã¢â¬Å"412. [Online]. Available at: https://www.ncbi.nlm.n ih.gov/pubmed/26257307 Khamisa, N., Oldenburg, B., Peltzer, K. and Ilic, D. (2015). Work Related Stress, Burnout, Job Satisfaction and General Health of Nurses. International Journal of Environmental Research and Public Health, 12 (1), p.652à ¢Ã¢â ¬Ã¢â¬Å"666. [Online]. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4306884/ Lowery, K. and Stokes, M. A. (2005). Role of peer support and emotional expression on posttraumatic stress disorder in student paramedics. Journal of Traumatic Stress, 18 (2), p.171à ¢Ã¢â ¬Ã¢â¬Å"179. [Online]. Available at: doi:10.1002/jts.20016 Matzo, M. L. and Sherman, D. W. (2009). Palliative Care Nursing: Quality Care to the End of Life. 3rd ed. New York: Springer Publishing Company. NHS Business Service Authority. (2013). 2012-13 figures released for reported physical assaults against NHS staff. NHS Business Service Authority. [Online]. Available at: https://www.nhsbsa.nhs.uk/4380.aspx NHS Choices. (2015). Stress, anxiety a nd depression. NHS Choices. [Online]. Available at:à https://www.nhs.uk/conditions/stress-anxiety-depression/understanding-stress/ NHS Employers. (2015). Health work and wellbeing. NHS Employers. Available at: https://www.nhsemployers.org/your-workforce/retain-and-improve/staff-experience/health-work-and-wellbeing Nursing Standard News. (2015). Stress at work affecting nurses health, survey finds. Nursing Standard, 29 (27), p.8à ¢Ã¢â ¬Ã¢â¬Å"8. [Online]. Available at: https://journals.rcni.com/doi/10.7748/ns.29.27.8.s6 Phiri, L. P., Draper, C. E., Lambert, E. V. and Kolbe-Alexander, T. L. (2014). Nurses lifestyle behaviours, health priorities and barriers to living a healthy lifestyle: a qualitative descriptive study. BMC Nursing, 13. [Online]. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4264254/ RCN. (2005). Working well initiative: Managing your stress. A guide for nurses. Royal College of Nursing. [Online]. Available at: https://www.rcn.org.uk/__da ta/assets/pdf_file/0008/78515/001484.pdf RCN. (2009). Work-related stress. Royal College of Nursing. [Online]. Available at: https://www.rcn.org.uk/__data/assets/pdf_file/0009/274473/003531.pdf RCN. (2014a). Importance of stress awareness. [Online]. Available at: https://www.rcn.org.uk/newsevents/news/article/uk/importance_of_stress_awareness RCN. (2014b). Two thirds of staff have considered leaving the NHS. [Online]. Available at: https://www.rcn.org.uk/newsevents/news/article/uk/two_thirds_of_staff_have_considered_leaving_the_nhs Sharma, P., Davey, A., Davey, S., Shukla, A., Shrivastava, K. and Bansal, R. (2014). Occupational stress among staff nurses: Controlling the risk to health. Indian Journal of Occupational and Environmental Medicine, 18 (2), p.52à ¢Ã¢â ¬Ã¢â¬Å"56. [Online]. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4280777/ Stanley, M. J. C. and Matchett, N. J. (2014). Understanding how student nurses experience morally distressing situat ions: Caring for patients with different values and beliefs in the clinical environment. Journal of Nursing Education and Practice, 4 (10), p.p133. [Online]. Available at: doi:10.5430/jnep.v4n10p133 Whitehead, P. B., Herbertson, R. K., Hamric, A. B., Epstein, E. G. and Fisher, J. M. (2015). Moral Distress Among Healthcare Professionals: Report of an Institution-Wide Survey. Journal of Nursing Scholarship, 47 (2), p.117à ¢Ã¢â ¬Ã¢â¬Å"125. [Online]. Available at: https://www.ncbi.nlm.nih.gov/pubmed/25440758 Wilkinson, S. (2014). How nurses can cope with stress and avoid burnout: Stephanie Wilkinson offers a literature review on the workplace stressors experienced by emergency and trauma nurses. Emergency Nurse, 22 (7), p.27à ¢Ã¢â ¬Ã¢â¬Å"31. [Online]. Available at: https://rcnpublishing.com/doi/abs/10.7748/en.22.7.27.e1354 Wojtowicz, B., Hagen, B. and Van Daalen-Smith, C. (2014). No place to turn: Nursing students experiences of moral distress in mental health settings. International Journal of Mental Health Nursing, 23 (3), p.257à ¢Ã¢â ¬Ã¢â¬Å"264. [Online]. Available at: https://www.ncbi.nlm.nih.gov/pubmed/23980930
Wednesday, May 6, 2020
Philanthropy Essay - 864 Words
Philanthropy, or the act of private and voluntary giving, has been a familiar term since it first entered the English language in the seventeenth century. Translated from the Latin term ââ¬Å"philanthropiaâ⬠or ââ¬Å"love of mankind,â⬠philanthropy permeates many social spheres and serves several social purposes including charity, humanitarianism, religious morality and even manipulation for social control. Peter Kropotkin, a nineteenth century evolutionary theorist, proposed that philanthropic behaviors aided development of civilization and survival of the human race. However, it seems the idea of unselfish giving was a conflicted concept in early East Asian religious thought. For instance, Confucius said altruism was an important personal virtue.â⬠¦show more contentâ⬠¦For example, Deuteronomy 14:22 states: ââ¬Å"For the poor shall never cease out of the land; therefore I command thee, saying, Thou shalt open thine hand wide unto thy brother, to thy poor, and to thy needy, in thy land.â⬠During the oppression of the Jews in Russia around 1885, the Baron de Hirsch Fund assisted emigration as a philanthropic act to reduce acts of persecution. As the Jews considered themselves children of God, being charitable to each other was a primary principal in daily life as well as in the synagogue. Jews also faced many persecutions throughout history, so the practice of philanthropy created cohesion within the group. The Hebrew forms of philanthropy influenced Christianityââ¬â¢s concepts of the practice. Christians believed that fulfilling charitable demands in this life would bring rewards in the afterlife and that giving in this life also brought one spiritually closer to God. Expressing Christian love included committing oneââ¬â¢s goods and services to those in need, as exemplified by Jesus Christ. As Christianity expanded and divided, philanthropic efforts changed due to the combination of traditional values with new social, economic, political and religious attitudes. One fundamental change was the Protestant rejection of the idea that charity led to salvation and that instead salvation could be achieved through faith. However, the Catholic Church continued to practiceShow MoreRelatedCulture of Philanthropy Essay1093 Words à |à 5 Pages In todayââ¬â¢s society, we are blessed with various forms of philanthropy and different ways to achieve this philanthropic culture. 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American Lit Unit 8 Free Essays
S. Q. 8 Nathanil Hawthorne 433, ââ¬Å"The Ministerââ¬â¢s Black Veilâ⬠457, ââ¬Å"The Birthmarkâ⬠465, Herman Melville 504, ââ¬Å"Bartleby the Scrivenerâ⬠507 1. We will write a custom essay sample on American Lit Unit 8 or any similar topic only for you Order Now What is the attractive legend about Hawthorne? He was believed to be a shy recluse, always brooding in solitude. 2. How do the authors describe Hawthorne? He is described as a public figure, capable of a certain urbanity. He is absorbed by the evils of enigma and of moral responsibility. 3. Briefly describe Hawthorneââ¬â¢s background. He was born in Salem and moved to Maine with his mother to live with an uncle as a child. He returned to Salem to attend college. He secretly go married, he enjoyed reading and the first novel he wrote was recalled and almost completely destroyed. He continued writing and his first big break was The Scarlet Letter. 4. What is the principle appeal of Hawthorneââ¬â¢s work? It is in the quality of its allegory, always richly ambivalent, providing enigmas which each reader solves in his or her own terms. ? 5. How does the preaching of Mr.. Hooper change as he puts on the black veil? He still had the same characteristics of style and manner, but it was tinged rather more dark than usual, with the gentle gloom of his temperament. 6. How does Elizabeth respond to the veil? At first she defends him saying questioning why everyone thought it to be such a big deal. Then she asks him why he is wearing it and seems to take offense of his reasoning and that he will not remove it. ? 7. What did Aylmer think of his wifeââ¬â¢s birthmark? He despised it, he wanted her to have it removed. He felt it was the one thing that kept her from being perfect. 8. What word best describes Aylmerââ¬â¢s treatment of Aminadab? He treats him like he is insignificant and doesnââ¬â¢t matter. He doesnââ¬â¢t understand the science behind Aylmerââ¬â¢s work and doesnââ¬â¢t agree with him trying to remove the birthmark. Aylmer doesnââ¬â¢t care what he thinks nor his own wife. He treats Aminadab as a servant. ? 9. How does the narrator of ââ¬Å"Bartleby the Scrivenerâ⬠characterize himself as a lawyer? He says he is an eminently safe man, he doesnââ¬â¢t address juries, rather he works with rich menââ¬â¢s bonds, mortgages and title-deeds. 10. What concerns the narrator most about Bartlebyââ¬â¢s behavior? He is concerned about him ruining his reputation and his business. He tried to get him to work or leave and he refused to do either. 11. Where does Bartleby die? He dies in the prison yard. ? 12. How does the narrator fail Bartleby? He is unable to save him. He moved his office and when he did the next tenant causes him to be sent to prison because he still refuses to leave. 3. ââ¬Å"At the end of the story, Bartlebyââ¬â¢s significance expands, and he becomes not only a double for the narrator but also a kind of double for all of humanity. â⬠Explain this statement. We learn that Bartleby lost his job at the Dead Letter Office because of an administration change. The Dead Letter Office would be a place of gloom, where one would deal with human mortality on a daily basis. Also, the narrator had lost his previous job due to bureaucratic changes. The narrator was able to adapt to life but Bartleby, he was unable to save. How to cite American Lit Unit 8, Essay examples
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