Violence against nurses working in the emergency department

Workplace violence (WPV) in healthcare organizations can lead to serious consequences that negatively affect nurses’ lives and patient care | International Emergency Nursing

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Highlights:

  • Nurses who experience WPV complain of mental and physical health problems.
  • Nurses’ social and professional lives were affected negatively after facing WPV.
  • WPV consequences negatively impact nurses and the entire healthcare organization.
  • The serious consequences of WPV ultimately harm patient care.
  • Preventing violence will ensure a safe workplace and safer patient care.

Full reference: Hassankhani, H. et al. (2017) The consequences of violence against nurses working in the emergency department: A qualitative study. International Emergency Nursing. Published online: 31 July 2017

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Occupational stress in the ED

Occupational stress is a major modern health and safety challenges. While the ED is known to be a high-pressure environment, the specific organisational stressors which affect ED staff have not been established | Emergency Medicine Journal

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Methods: We conducted a systematic review of literature examining the sources of organisational stress in the ED, their link to adverse health outcomes and interventions designed to address them. A narrative review of contextual factors that may contribute to occupational stress was also performed. All articles written in English, French or Spanish were eligible for conclusion. Study quality was graded using a modified version of the Newcastle-Ottawa Scale.

Results: Twenty-five full-text articles were eligible for inclusion in our systematic review. Most were of moderate quality, with two low-quality and two high-quality studies, respectively. While high demand and low job control were commonly featured, other studies demonstrated the role of insufficient support at work, effort–reward imbalance and organisational injustice in the development of adverse health and occupational outcomes. We found only one intervention in a peer-reviewed journal evaluating a stress reduction programme in ED staff.

Conclusions: Our review provides a guide to developing interventions that target the origins of stress in the ED. It suggests that those which reduce demand and increase workers’ control over their job, improve managerial support, establish better working relationships and make workers’ feel more valued for their efforts could be beneficial. We have detailed examples of successful interventions from other fields which may be applicable to this setting.

Full reference: Basu, S. et al. (2017) Occupational stress in the ED: a systematic literature review. Emergency Medicine Journal. 34:441-447.

Emergency medicine: what keeps me, what might lose me?

EDs are currently under intense pressure due to increased patient demand. There are major issues with retention of senior personnel, making the specialty a less attractive choice for junior doctors | Emergency Medicine Journal

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This study aims to explore what attracted EM consultants to their career and keeps them there. It is hoped this can inform recruitment strategies to increase the popularity of EM to medical students and junior doctors, many of whom have very limited EM exposure.

Methods: Semistructured interviews were conducted with 10 consultants from Welsh EDs using a narrative approach.

Results: Three main themes emerged that influenced the career choice of the consultants interviewed: (1) early exposure to positive EM role models; (2) non-hierarchical team structure; (3) suitability of EM for flexible working. The main reason for consultants leaving was the pressure of work impacting on patient care.

Conclusion: The study findings suggest that EM consultants in post are positive about their careers despite the high volume of consultant attrition. This study reinforces the need for dedicated undergraduate EM placements to stimulate interest and encourage medical student EM aspirations. Consultants identified that improving the physical working environment, including organisation, would increase their effectiveness and the attractiveness of EM as a long-term career.

Full reference: James, F. & Gerrard, F. (2017) Emergency medicine: what keeps me, what might lose me? A narrative study of consultant views in Wales. Emergency Medicine Journal. 34:436-440

Role of Resilience in Mindfulness Training for First Responders

Kaplan, J.B. et al. Mindfulness | Published online: 19 April 2017

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First responders are exposed to critical incidents and chronic stressors that contribute to a higher prevalence of negative health outcomes compared to other occupations. Psychological resilience, a learnable process of positive adaptation to stress, has been identified as a protective factor against the negative impact of burnout.

Read the full article here

Workplace aggression as cause and effect

Wolf, L.A. et al. International Emergency Nursing. Published online: November 9, 2016

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  • Fatigue compromises nurses’ personal lives and creates a toxic unit environment.
  • Fatigue compromises safe patient care.
  • Below-adequate staffing levels are a major source of fatigue.
  • Lateral violence (workplace bullying) is both a cause and effect of fatigue.

Read the abstract here

Active Intervention Can Decrease Burnout In Ed Nurses

Wei, R. et al. Journal of Emergency Nursing. Published online: September 16 2016

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Introduction: The aim of this study was to evaluate whether active intervention can decrease job burnout and improve performance among ED nurses.

Methods: This study was carried out in the emergency departments of 3 hospitals randomly selected from 8 comprehensive high-level hospitals in Jinan, China. A total of 102 nurses were enrolled and randomly divided into control and intervention groups. For 6 months, nurses in intervention groups were treated with ordinary treatment plus comprehensive management, whereas nurses in the control group were treated with ordinary management, respectively. Questionnaires were sent and collected at baseline and at the end of the study. The Student t test was used to evaluate the effect of comprehensive management in decreasing burnout.

Results: All ED nurses showed symptoms of job burnout at different levels. Our data indicated that comprehensive management significantly decreased emotional exhaustion and depersonalization (P < .01).

Discussion: The findings suggest that active intervention with comprehensive management may effectively reduce job burnout in ED nurses and contribute to relieving work-related stress and may further protect against potential mental health problems.

Read the abstract here