Here is an article from NPR about how stress interferes with patient care. It also addresses the nurse’s desire to provide ethical care to the patient. This is a dilemma that all nurses face at one time or another and so far there is no solution.
As long as administrators view nurses as interchangeable and a drain on their budgets, this problem will continue. Doctors and nurses both have little say in hospital policies in most cases.
It seems sad to me when a nurse must be trained to deal with moral distress. Why do we have to have the distress in the first place. Please read this article and see what you think about the points brought up by this author.
April 15, 2016 5:00 AM ET
Jordin Purcell-Riess has worked as a registered nurse at the emergency department at St. Francis Hospital in Hartford, Conn., for three years. She describes her workplace as phones going off, voices everywhere, every room full. “You look around and the hallways are full of patients on stretchers; you walk out to the waiting room and you can see on our board that there’s 15 people signing in,” she says. “The second you can get your ICU patient upstairs, there’s another one waiting for you.”
She typically doesn’t get a chance to eat or drink or go to the bathroom during her 12-hour shift, Purcell-Riess says. And she’s not alone. Her nursing manager points out that a 2007 study in the American Journal of Respiratory and Critical Care Medicinefound that 24 percent of ICU nurses and 14 percent of general nurses tested positive for symptoms of post-traumatic stress disorder.
Nursing has long been considered one of the most stressful professions, according to a review of research by the National Institute for Occupational Safety and Health at the Centers for Disease Control and Prevention in 2012. Nurses and researchers say it comes down to organizational problems in hospitals worldwide. That includes cuts in staffing; some California nurses struck last month for a week over low staffing and wages.
But some researchers say that just hiring more people won’t fix things. Other proposed solutions include restructuring hospitals so that administrators pay more attention to what nurses have to say about patient care and work flow, and training programs to help nurses relieve their stress and deal with ethical dilemmas.
Theresa Brown is a clinical nurse in Pittsburgh who has written two books about what it’s like to be a nurse. She says nurses are often stretched to the limit.
“A friend said when she started working as a nurse, when she would drive, she would vomit on the way in to work just because of the incredible level of stress,” Brown says.
“One of the senior nurses said there is no place we can go to just be alone and be in a quiet room for five or 10 minutes, except for the bathroom … you could have a patient get really really sick, you could have a patient die, and there’s no break,” she says.
She adds that whenever hospitals start adding new forms of documentation or electronic health records, that work is often given to the nurses so their workload just gets larger. “It shouldn’t be this way, but the patient demands are the ones that can get put off.”
It’s not just a problem in the U.S., either. A recent study in Hong Kong found nurses to be at much higher risk for stress, depression and anxiety compared to the general population. The Guardian reported last January that the number of nurses in the U.K. taking time off due to stress has soared — 1 in 29 are off because of stress. The problem is that most hospitals aren’t organized to support nurses, or even doctors, says Linda Aiken. She is a professor of nursing and sociology at the University of Pennsylvania. “They’re highly bureaucratic, they’re very top-down organizations, they don’t really seek out clinicians’ solutions for solving problems in patient care,” Aiken says. “Therefore the problems exist over decades, and they’re basically not solvable by any individual nurse.”
If the work environment at a particular hospital is bad, just adding more nurses won’t address the problem, Aiken says. As an example of what hospitals…(read more here)