CNA783 The Politics of Acute Nursing

Tina Evans posted 08 August, 2022 08:21

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Burn out, exhaustion, depersonlisation, depression and anxiety are far too common characteristics of Nurses at all levels of their careers, with increasing demands upon Australia’s health care system, dramatic Nursing shortages, and increased workload and expectation placed upon Nurses, how can burn out be reduced and resilience be fostered? Firstly, the most common causes of workplace stress and burnout need to be addressed, they are; policy related frustrations, conflict with colleagues, understaffing, increased workloads and inadequate institutional support (Hoffmeyer et al. 2020). Studies show, the single most important factor in fostering a positive and supportive workplace culture is an effective, empathetic and connected leader, where self-care is valued, clinical supervision is common and negative attitudes are challenged (Hoffmeyer et al. 2020, Badu et al. 2020). Leaders’ role-model positive behaviours and help to create a supportive environment in which colleagues work as a team and value each other, reducing workplace conflict and tension (Hoffmeyer et al. 2020). Importantly, not only is individual self-care encouraged but tools and education are promoted and made available through the workplace to promote mindfulness, positive attitude, coping with stress and workloads (Hoffmeyer et al. 2020, Badu et al. 2020). Work-life balance must be promoted, this includes appropriate staffing to cover leave, ensure adequate nursing ratios, flexibility with rostering and freedom to take leave when needed (Hoffmeyer et al. 2020). Importantly, promotion of positive workplace culture is the responsibility of everyone, self-reflection, regulation and care, as well as positive regard and support for colleagues is to the benefit of everyone.

References

Badu, E, O’Brien, P, Mitchell, R, Rubin, M, James, C, McNeil, K, Nguyn, K & Giles, M 2020, ‘Workplace stress and resilience in the Australian nursing workforce: A comprehensive integrative review’, International Journal of Mental Health Nursing, vol. 29, pp. 5-34.

Hoffmeyer, A, Taylor, R & Kennedy, K 2020, ‘Fostering compassion and reducing burnout: How can health system leaders respond in the Covid-12 pandemic and beyond?’, Nurse Educ Today, vol. 94, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7295512/pdf/main.pdf>

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Horizontal and lateral violence.

Andrew Young posted 09 August, 2022 11:08

Horizontal and lateral violence can be defined as a relational conflict between colleagues within the hierarchical structure of an organization (Rosi, et al., 2020). This form of violence is often associated with bullying, ranging in forms of verbal mistreatment, through to physical abuse (Heaton, 2018). Resulting effects of this callous behaviour include social and psychological implications for the victims (Heaton, 2018). At a ward level, the fallout of this mistreatment is negatively consequential in patient care (Anthony & Brett, 2020). Evidence suggests that victims of workplace violence have increased levels of stress and anxiety, affecting their ability to provide what they felt was an adequate level of care to their patients (Rosi, et al., 2020). The psychological sphere of feelings included not only enthusiasm for the job, but motivation to continue with their career, secondary to personal and interpersonal judgements of failure and defeat (Heaton, 2018). These sentiments impact the provision of quality patient care through increased sick and personal leave, while influencing voluntary resignations (Rosi, et al., 2020). Nursing students and newly graduated nurses’ have been validated as the most vulnerable cohort to experience negative workplace behaviour within the profession (Levvet-Jones, 2018). 

Unit managers and shift coordinators alike have both, a legal and moral responsibility in the provision of a safe and efficacious workplace (Fedoruk, 2018). Strategies to mitigate lateral and horizontal violence have been attributed to directly addressing group cohesiveness while promoting acceptable workplace behaviour models (Anthony & Brett, 2020). Reducing ward workload where able, coupled with the provision of education surrounding awareness, prevalence and the subsequent response to workplace violence aligns with studies recognised to improve interpersonal culture and workplace safety (Fedoruk, 2018). Active prevention is perceived as the gold standard in mitigating negative workplace behaviour (Anthony & Brett, 2020). This can be achieved through support systems such as nurse preceptors and mentors to provide strategies in resilience and personalised training implementations, emphasised on positivity, the creation and sustained efforts to work towards local health district codes of conduct (Anthony & Brett, 2020).