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Author:
Publisher:
ISBN:
Category : COVID-19 Pandemic, 2020-
Languages : en
Pages : 0
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Book Description
The COVID-19 pandemic has brought rapid changes, increased stress, and ethical challenges to nurses across the globe. These factors may place nurses at increased risk for developing moral distress and substance use disorder. This stress can also increase nurse vulnerability to substance use. Previously there was little evidence about the rates of moral distress and substance use disorder among nurses during the COVID-19 pandemic. The primary objective of this evidence-based project was to describe levels of moral distress and substance use among nurses in a community hospital during the COVID-19 pandemic and to make recommendations for interventions to improve nurse wellbeing and patient safety based on findings. An online survey, consisting of demographic questions, the Measure of Moral Distress in Healthcare Professional Tool, the Alcohol Use Disorder Identification Tool, the Drug Use Screening Tool-10 items 1 and 2, and a single item asking about amount of time caring for COVID-19 patients was sent to inpatient and emergency department nurses working at a rural, community hospital. Frequency statistics and measures of central tendency are used to describe the rates of moral distress, substance use disorder risk for alcohol and drugs, and time spent caring for patients with COVID-19. A total of 57 nurses completed the survey. Nurses were found to be experiencing various levels of moral distress, with the collective group experiencing scores in the middle of the moral distress range. One-third of the nurses reported an intention to leave their position due to moral distress. In addition, a third of nurses who participated in the survey reported risky alcohol use, while 5.3% reported harmful alcohol use. Fully 21.1% of nurses reported using illicit substances, while 5.3% reported using illicit substances daily or nearly daily. Given the literature on the crescendo effect of moral distress and the nature of substance use disorder, the lasting effects to nurses during the COVID-19 pandemic will be important to the profession for years to come. Nursing leadership must commit to implementing resources to help prevent and care for nurses who experience moral distress and substance use disorder.Keywords: Moral distress, substance use disorder, substance misuse, COVID-19
Author:
Publisher:
ISBN:
Category : COVID-19 Pandemic, 2020-
Languages : en
Pages : 0
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Book Description
The COVID-19 pandemic has brought rapid changes, increased stress, and ethical challenges to nurses across the globe. These factors may place nurses at increased risk for developing moral distress and substance use disorder. This stress can also increase nurse vulnerability to substance use. Previously there was little evidence about the rates of moral distress and substance use disorder among nurses during the COVID-19 pandemic. The primary objective of this evidence-based project was to describe levels of moral distress and substance use among nurses in a community hospital during the COVID-19 pandemic and to make recommendations for interventions to improve nurse wellbeing and patient safety based on findings. An online survey, consisting of demographic questions, the Measure of Moral Distress in Healthcare Professional Tool, the Alcohol Use Disorder Identification Tool, the Drug Use Screening Tool-10 items 1 and 2, and a single item asking about amount of time caring for COVID-19 patients was sent to inpatient and emergency department nurses working at a rural, community hospital. Frequency statistics and measures of central tendency are used to describe the rates of moral distress, substance use disorder risk for alcohol and drugs, and time spent caring for patients with COVID-19. A total of 57 nurses completed the survey. Nurses were found to be experiencing various levels of moral distress, with the collective group experiencing scores in the middle of the moral distress range. One-third of the nurses reported an intention to leave their position due to moral distress. In addition, a third of nurses who participated in the survey reported risky alcohol use, while 5.3% reported harmful alcohol use. Fully 21.1% of nurses reported using illicit substances, while 5.3% reported using illicit substances daily or nearly daily. Given the literature on the crescendo effect of moral distress and the nature of substance use disorder, the lasting effects to nurses during the COVID-19 pandemic will be important to the profession for years to come. Nursing leadership must commit to implementing resources to help prevent and care for nurses who experience moral distress and substance use disorder.Keywords: Moral distress, substance use disorder, substance misuse, COVID-19
Author: Cynda Hylton Rushton
Publisher: Oxford University Press
ISBN: 0190619295
Category : Medical
Languages : en
Pages : 321
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Book Description
Suffering is an unavoidable reality in health care. Not only are patients and families suffering but also the clinicians who care for them. Commonly the suffering experienced by clinicians is moral in nature, in part a reflection of the increasing complexity of health care, their roles within it, and the expanding range of available interventions. Moral suffering is the anguish that occurs when the burdens of treatment appear to outweigh the benefits; scarce human and material resources must be allocated; informed consent is incomplete or inadequate; or there are disagreements about goals of treatment among patients, families or clinicians. Each is a source of moral adversity that challenges clinicians' integrity: the inner harmony that arises when their essential values and commitments are aligned with their choices and actions. If moral suffering is unrelieved it can lead to disengagement, burnout, and undermine the quality of clinical care. The most studied response to moral adversity is moral distress. The sources and sequelae of moral distress, one type of moral suffering, have been documented among clinicians across specialties. It is vital to shift the focus to solutions and to expanded individual and system strategies that mitigate the detrimental effects of moral suffering. Moral resilience, the capacity of an individual to restore or sustain integrity in response to moral adversity, offers a path forward. It encompasses capacities aimed at developing self-regulation and self-awareness, buoyancy, moral efficacy, self-stewardship and ultimately personal and relational integrity. Clinicians and healthcare organizations must work together to transform moral suffering by cultivating the individual capacities for moral resilience and designing a new architecture to support ethical practice. Used worldwide for scalable and sustainable change, the Conscious Full Spectrum approach, offers a method to solve problems to support integrity, shift patterns that undermine moral resilience and ethical practice, and source the inner potential of clinicians and leaders to produce meaningful and sustainable results that benefit all.
Author: Stephanie McClellan
Publisher:
ISBN:
Category : COVID-19 (Disease)
Languages : en
Pages : 0
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Book Description
Abstract: Background: Moral Distress has been studied in different healthcare environments and across disciplines. Most of the research and systematic reviews have evaluated the clinician at the bedside. While this information is valuable, a gap exists between what is known about leadership and the direct care provider and the effects of moral distress on one's ability to achieve moral resilience. The Coronavirus pandemic, also known as COVID-19, brought challenges to the nursing workforce that have proven difficult to overcome. Due to the complexity of what nurse leaders experienced, minimal research had been conducted on the impact of COVID-19 and moral distress. Purpose: The purpose of this EBP project was to determine if the webinar "Preventing and Managing Secondary Stress in the time of COVID-19" had an impact on the Nurse Leader's self-assessed Moral Resilience score. Methods: This project used a quasi-experimental design which consisted of a pre-intervention survey, the intervention, and a post-intervention survey. The nurse leaders were surveyed to understand their confidence with decisions during times of high stress. After completing the intervention, the Nurse Leaders completed a post-intervention survey. Results: Of the Nurse Leaders surveyed, a two-tailed Mann Whitney U test was used to evaluate findings. There was a statistical difference in the overall result of the pre and post intervention scale with a p score of 0.013 using and alpha of 0.05. The median for group 0 was 2.59 and the median for group 1 was 2.88. The results indicate an increase in the overall resilience score. Keywords: moral distress, leadership, healthcare, nurses, work engagement, moral sensitivity, COVID-19, nurse leaders.
Author: Leslie Neal-Boylan
Publisher: Springer Publishing Company
ISBN: 082611010X
Category : Medical
Languages : en
Pages : 226
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Book Description
" This is the first research-based book to confront workplace issues facing nurses who have disabilities. It not only examines in depth their experiences, roadblocks to successful employment, and misperceptions surrounding them, but also provides viable solutions for creating positive attitudes towards them and a welcoming work environment that fosters hiring and retention. From the perspectives and actual voices of nurses with disabilities, nurse leaders, nurse administrators, and patients, the book identifies nurses with disabilities (including sensory, musculoskeletal, emotional, and mental health issues), discusses why they choose to leave nursing or hide their disabilities, and analyzes how their disabilities may influence career choices. "
Author: National Academies of Sciences Engineering and Medicine
Publisher:
ISBN: 9780309685061
Category :
Languages : en
Pages :
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Book Description
The decade ahead will test the nation's nearly 4 million nurses in new and complex ways. Nurses live and work at the intersection of health, education, and communities. Nurses work in a wide array of settings and practice at a range of professional levels. They are often the first and most frequent line of contact with people of all backgrounds and experiences seeking care and they represent the largest of the health care professions. A nation cannot fully thrive until everyone - no matter who they are, where they live, or how much money they make - can live their healthiest possible life, and helping people live their healthiest life is and has always been the essential role of nurses. Nurses have a critical role to play in achieving the goal of health equity, but they need robust education, supportive work environments, and autonomy. Accordingly, at the request of the Robert Wood Johnson Foundation, on behalf of the National Academy of Medicine, an ad hoc committee under the auspices of the National Academies of Sciences, Engineering, and Medicine conducted a study aimed at envisioning and charting a path forward for the nursing profession to help reduce inequities in people's ability to achieve their full health potential. The ultimate goal is the achievement of health equity in the United States built on strengthened nursing capacity and expertise. By leveraging these attributes, nursing will help to create and contribute comprehensively to equitable public health and health care systems that are designed to work for everyone. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity explores how nurses can work to reduce health disparities and promote equity, while keeping costs at bay, utilizing technology, and maintaining patient and family-focused care into 2030. This work builds on the foundation set out by The Future of Nursing: Leading Change, Advancing Health (2011) report.
Author: Nancy Bevan
Publisher:
ISBN:
Category : Burn out (Psychology)
Languages : en
Pages : 277
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Book Description
Nurses act as moral agents for patients and use their moral sensitivity to build trusting relationships to act in patients’ best interests. However, nurses also lack power in their place of employment due to inequality in power relations. When this lack of power interferes with being a moral agent, moral distress occurs. Moral distress can lead to burnout and leaving the profession. In this dissertation, I sought to learn whether an intervention, guided by the principles of conscientization developed by the Brazilian philosopher and educational theorist Paulo Freire in his classic work, Pedagogy of the Oppressed, would be acceptable and feasible with nurses who had previously been exposed to moral distress. An interactive small-group intervention in three sessions was developed and piloted with 13 nurses within four different types of critical care units from three different hospitals. Pre-and post-intervention surveys were administered to measure change in psychological empowerment, structural empowerment and moral distress levels. Open-ended interviews were conducted at two weeks post-intervention to assess acceptability and feasibility, as well as the nurse’s sense of personal empowerment post-intervention. The pilot study demonstrated that the conscientization intervention is feasible and acceptable to participants. Narrative analysis of the moral distress stories revealed themes of powerlessness experienced by nurses in interactions with families, organizations, and physicians. Evaluation of goal attainment from each session revealed increased empowerment during the movement through the sessions of critical reflection, critical motivation, and critical action. Post intervention interviews indicated that nurses perceived that they gained an increased understanding of moral distress and a sense of personal and group empowerment after the intervention. Survey results showed a significant decrease in moral distress mean and frequency, a significant increase in moral distress intensity, and no significant change in mean levels of psychological or structural empowerment post intervention. The pilot study demonstrated that a conscientization intervention formulated around critical reflection, motivation, and action and delivered in a small-group format with nurses is a feasible and acceptable way to reduce moral distress levels and develop personal empowerment. Reducing moral distress among nurses is crucial for reducing burnout, improving retention, and improving patient care.
Author: American Nurses Association
Publisher: Nursesbooks.org
ISBN: 1558101764
Category : Business & Economics
Languages : en
Pages : 42
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Book Description
Pamphlet is a succinct statement of the ethical obligations and duties of individuals who enter the nursing profession, the profession's nonnegotiable ethical standard, and an expression of nursing's own understanding of its commitment to society. Provides a framework for nurses to use in ethical analysis and decision-making.
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
ISBN: 0309459575
Category : Medical
Languages : en
Pages : 483
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Book Description
Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.
Author: Charles Vincent
Publisher: Springer
ISBN: 3319255592
Category : Medical
Languages : en
Pages : 170
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Book Description
The authors of this book set out a system of safety strategies and interventions for managing patient safety on a day-to-day basis and improving safety over the long term. These strategies are applicable at all levels of the healthcare system from the frontline to the regulation and governance of the system. There have been many advances in patient safety, but we now need a new and broader vision that encompasses care throughout the patient’s journey. The authors argue that we need to see safety through the patient’s eyes, to consider how safety is managed in different contexts and to develop a wider strategic and practical vision in which patient safety is recast as the management of risk over time. Most safety improvement strategies aim to improve reliability and move closer toward optimal care. However, healthcare will always be under pressure and we also require ways of managing safety when conditions are difficult. We need to make more use of strategies concerned with detecting, controlling, managing and responding to risk. Strategies for managing safety in highly standardised and controlled environments are necessarily different from those in which clinicians constantly have to adapt and respond to changing circumstances. This work is supported by the Health Foundation. The Health Foundation is an independent charity committed to bringing about better health and health care for people in the UK. The charity’s aim is a healthier population in the UK, supported by high quality health care that can be equitably accessed. The Foundation carries out policy analysis and makes grants to front-line teams to try ideas in practice and supports research into what works to make people’s lives healthier and improve the health care system, with a particular emphasis on how to make successful change happen. A key part of the work is to make links between the knowledge of those working to deliver health and health care with research evidence and analysis. The aspiration is to create a virtuous circle, using what works on the ground to inform effective policymaking and vice versa. Good health and health care are vital for a flourishing society. Through sharing what is known, collaboration and building people’s skills and knowledge, the Foundation aims to make a difference and contribute to a healthier population.
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
ISBN: 0309452961
Category : Medical
Languages : en
Pages : 583
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Book Description
In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.
