Operational definitions: Critical care nursing is defined as the field of nursing with an attention on the most extreme care of the unstable or critically ill patients following extensive surgery, injury and/or life-threatening diseases. (Australia 's Future Health Workforce - Nurses, 2014) Implications: The consistency in the reactions to moral distress experience among participants is remarkable and informative to those working in critical care units and for decision makers. Moral distress as defined by Leggett, 2013 is a state of the psychological disequilibrium that, ones experience when they know the right ethical decision to make but they cannot make it due to institutional constraints (Leggett, 2013). Additionally, Weinzimmer, et al, 2014 characterized moral distress as a phenomenon in which a healthcare professional perceives an ethically preferable or morally right course of action to take, yet internal or external constraints make it nearly impossible to pursue that course. (Weinzimmer, et al, 2014) Health Status: as defined in medical dictionary; A generic term for the health (good or poor) of a person, group or population in a particular area, especially when compared to other areas or with national data, which level of health of an individual person, a group or a population as assessed by that
Likewise in healthcare, oncoming staff generally does initiate not patient care delivery until a hand off process occurs. “Communication failures are increasingly being implicated as important latent factors influencing patient safety in hospitals.”(Sutcliffe, 2004, p. 187) Parker (1996) reports, “the nurses handing over had direct knowledge of the patient and were able to convey idiosyncratic and personal knowledge of the patient. This is a crucial element in professional nursing practice. The nurse can report on clinical judgments and can be held accountable for the judgments made” (Parker, 1996, p. 25) Critical evaluation of nursing actions can be evaluated and considered to be either continued or discontinued based on the rationales for the action and the patient outcome. In 2005, the Australian Council for Safety and Quality in Healthcare published a literature review of clinical handover and patient safety.
Abstract/Purpose: (please refer to separate file) The worsening problem of hospital nursing shortage has resulted to inadequate nurse staffing, which affects our nursing care to our patients and our satisfaction towards our job. Understanding how nursing staffing levels affect both patient and nurse outcomes prompted these researchers to conduct a study on hospital nurse staffing levels (Aiken, Clarke, Sloane, Sochalski, & Silber, 2002). The purpose of their study was to examine the relationship between the nurse-to-patient ratio and surgical patient outcomes, specifically patient mortality and mortality following complications nurse retention as well as the factors that influence nurse retention (Aiken et al., 2002). The study was conducted
Nurses are continually faced with the challenges of the treating pain. To ensure the best quality of care for patients, nurses need effective knowledge, skills, and attitudes to address pain issues (Stanley & Pollard, 2013). Despite the findings and recommendation of substantial past research, nurses continue to demonstrate inadequate knowledge of pain assessment and pain management interventions (Wells et al., 2008). From reports in the literature, knowledge about pain management and attitudes which underpin nurses’ pain management decisions are problematic. Nurses’ knowledge of the mechanism of pain, pain assessment and pharmacological and non-pharmacological management are essential components in promoting positive patient outcomes (Al Shaer et al., 2011).
Stressors are capable of producing negative effect on a person system and therefore alter the person lines of defense. JB’s flexible line of defense is compromised due to multiple stressors surrounding her life, which Neuman called wellness / illness continuum. The lines of resistance will be then activated to protect JB 's integrity and return her to a steady state. According to NSM, acceptance of the disease and adequate social support are primary interventions that will strengthen JB’s flexible lines of defense. As the nurse caring for JB, I understand how CD can negatively affect her physiological and psychosocial well-being, I provide JB with physical and emotional support along with adequate education that is important to help prevent
Yet, the social worker would be ask to breach confidentiality agreements when one is pursuing involuntary psychiatric hospitalization of a troubled client; or social contact with a former client (Company, 2016). Nonetheless, other ethical challenges relates to agency administration, community work, social policy, and research. For instance, administrators’ decisions about the distribution of scarce or limited agency resources, conflicts of interest among staff, and the use of ethically questionable marketing strategies to solicit clients. Still other ethical dilemmas involve relationships among professional colleagues. For examples social worker’s response to a colleague who has behaved unethically or who is impaired or incompetent or what’s Frederic G. Reamer refers to as the ethics of “whistle-blowing” (Company, 2016).
This is due to a fact that patients who self-harm stressed that nurses lack knowledge and suboptimal communication which is a factor affecting the quality of care provided (Taylor et al., 2009). Patients who self-harm report that they get high levels of stigma and negative attitudes since nurses call them attention seekers or manipulative as a result of self-injurious behavior (Martin and Chapman, 2014). It is therefore imperative that services for self-harm people are delivered with compassion and in a non-judgmental manner. This is an ethical issue in nursing practice, particularly as having a non-judgmental attitude is a core nursing value (Nursing and Midwifery Council,
These are two potential of nurses one is misconduct when guidelines are not adhered to and second is the factors that might promote or inhibit guideline adherence among nurses. (Davies, Edwards, Ploeg, & Virani, 2008) According to Ismaile Samantha (2014), there are similar and different promoter and barriers to adherence with clinical Practice guidelines. The two main factors that impact to adherence with clinical practice guidelines among nurses, one is environmental factors that are patient, organization, standard guidelines, and second is personal factors which included knowledge, attitude, and skills, intention. The primary promoters for adherence to clinical practice guidelines among clinicians ( Nurses) that can be helpful to utilizing the evidence base clinical practice guideline are focused on standardized patient care, optimize outcomes of patient care, clinicians are familiar with guidelines according to habit and routine, and guidelines are readily accessible and easy to utilize. (Keiffer,
That is, one must be willing to suspend judgments until one truly understands another point of view and can articulate the position that another person holds on an issue. So this will help nurses come to rational decisions so this will make can act competently in practice. The nurses continually monitor their thinking; questioning and reflecting on the quality of thinking should be occurring in what they want to achieve in nursing practice. However, the nurses with sloppy, superficial thinker can lead to poor nursing
In nurse’s perspective, the poor and inconsistent of pain assessment can lead to unrelieved pain and reduce patient mobility, resulting in complications such as deep vein thrombosis, pulmonary embolus, and pneumonia (Ed. Caltorn, 1997). Postsurgical complications related to inadequate pain management will affect the length of hospitalization; the risk of readmissions, and increase the cost care of treatment. Somehow, a poor documentation of current status pain assessment will delay the intervention and responses to the care plan (Gordon, 2005). Thus, to overcome this situation in clinical practice, The American Pain Society (2005), created the phrase “Pain: the fifth vital sign” to increased awareness of the important in pain management
Martin et al. (2006) in their study noted that some personal factors that reduced confidence in clinicians were due to inexperience with physical restraint, and a lack of knowledge of aggression. Nurses require good assessment skill to manage or prevent aggression and this skill can be acquired by having hands on training by experienced specialist. The nurse has to be aware of the triggers of aggression and moreover be able to recognise early signs of aggression. Of equal importance, developing a better understanding of the causes of aggression might lead to more effective treatment and preventive strategies (Shub, Ball, Abbas, Gottumukkala & Kunik, 2010).
The DSM-5 and prior versions are strongly biased toward a Western view of what is acceptable behavior. Some criteria considered as mental illness could, in fact, be considered normal in another culture. (Varcarolis, 102016, p. 15) The Cultural Formulation Model is a very much perceived tool to use to give an inside and out investigation of the patient 's issues with regards to culture. The model has five classes: social personality of the individual, social clarification of the individual 's disease, social variables identified with psychosocial environment and levels of working, and social components of the relationship between the individual and the clinician. This assessment tool gives a general social evaluation to advance socially capable determination and care (Jarvis, pg.24).
According to Graham, & Cvach (2010), some of these factors entail but not limited to; frequent levels of alarm rate, lack of adequate standardization of clinical alarms and presence of several bedside equipment’s which substantially contribute to desensitization and alarm fatigue. The alarms are designed in such a way that they are audible enough for the nurses not to miss any single alarm. The way in which some of these alarms are set is such that rather than helping medical attendants, they become a nuisance which adversely affects health care fraternity (Graham & Cvach, 2010). Evidence-based interventions to minimize alarm fatigue Due to the negative impact which it attributable to a greater percentage by the alarm fatigue, it is paramount for the healthcare fraternity to come up with satisfactory mitigation plans and approach to the issue. In the light of the above, evidence based approach should be adopted to mitigate the impact of nuisance alarms in hospitals.
Nurses that practice in telemedicine not only have to have state and national license to practice telemedicine, but they also need to have liability coverage (Kepler and McGinty, 2009). Risks in telemedicine comes with misdiagnosis from not being able to visualize the problem via a television screen, or computer monitor. Face-to-face contact does reduce risk of misdiagnosis compared to telemedicine, but telemedicine practice is close. Kepler and McGinty state that providers who practice in telemedicine need to consider government liability, professional liability, and alternative risk vehicles. The nurse needs to be aware of the cost and potential harm of liability coverage.
Furthermore, there is a vast need for additional research. There is a necessity to gain knowledge on risk factors and on ways to prevent suicide in order to aid nursing home residents (Bugeja et al., 2015, p. 811). The knowledge of preventing suicide in a nursing home can be helpful for residents as well as for social services. Suicide occurs in nursing homes partially fur to the lack of knowledge on depression. Current research depicts that physicians fail to recognize depression and tend to provide inaccurate treatment (Allgaier, Fejtkova, Hegerl, Kramer, & Mergl, 2009, p. 355).