Thursday, 14 May 2020
Hand Hygiene
Tuesday, 12 May 2020
Nurses And Their Mental Health
Mental health encompasses our emotional, social and psychological wellness. The general state of our mental health directly affects our thoughts, feelings, behaviors, actions, decisions and relationship with others. People who can handle mental stress and adapt effectively are less likely to suffer from severe mental illnesses. Failing to take proper care of your mental health can lead to serious health issues as the World Health Organization (WHO) rightly stated that “there is no health without mental health”.
Nursing is difficult, fast paced and requires tremendous amounts of focus, energy, and responsibility making nurses prone to mental health problems (Portia Wofford, 2018). Being a nurse in any part of the world is never easy; even in highly developed countries. The scope of work and roles nurses play on and off professional practice greatly affects their mental health as it sometimes become too much for them to bear. Due to short-staffing of nurses in clinical areas, the employed ones usually work longer hours, overtime or more than 2 shifts a day and sometimes face both physical or emotional abuse from colleagues, clients and their relatives (as there are no strict rules and policies in place demanding hospitals and facilities nurses work to protect them from unwarranted abuses physically and emotionally). This occupational stress experienced by nurses in their work environment contributes to their poor mental health. This is proven true as to the recent suicide acts committed by nurses around the world. Nursing is now one of many occupations with growing rates of suicide since 2016. A study released in 2017 revealed that about 23% of nurses are more likely to commit suicide than women in general and are four times more likely to commit suicide than people working outside of medicine. From such statistics, it potentiates horrendous results in the future if appropriate measures aren’t put in place.
Most times, nurses even tend to forget about caring for their own mental health and stability due to enormous work demands which could later result into depression, anxiety, stress and a lot more. As a nurse, sometimes the job deprives you of the regular social, fun and carefree lifestyle other persons enjoy. “Nurses are known not to care for themselves as much as they care for others, it’s just a part of who we are” Davidson, a nurse scientist told BUSINESS INSIDER USA during a survey conducted in August 2019.
Hence, when a nurse experiences such anomalies which affect her mental health, it could lead to so many negative effects poor nursing judgements, malpractice and negligence in work environments.
This mental stress affecting nurses today started a long time ago, I must say. Speaking from experience, I’ll say it started from their days in nursing school and universities. From the college days, learning anatomy, physiology and biochemistry aside core nursing courses can be pretty bulky as students try to strike a balance between their physical, social and academic life. As from college to graduation, it becomes tougher with courses such Medical-Surgical Nursing, Public and Environmental Health, Maternal and Child Health and Pharmacology, preparing for nursing council exams, writing numerous assignments, client case studies and projects, seeking ways to pay up for numerous fees and charges with very short deadlines and lots more. With all these, nursing students have little to no time to attend to other important things, sometimes ending up frustrated and depressed.
WHAT’S THE WAY FORWARD? WHAT ASSISTANCE CAN BE RENDERED?
As earlier stated, while caring for others, nurses tend to neglect their personal health which is inappropriate because to be efficient in healthcare delivery, nurses have to be physically, mentally and emotionally sound. Hence their health should be made a priority. Ill suggest that the following opinions could improve nurses’ general health.
- Professional help should be made available in health institutions. Personal and Mental health support systems should be established which would prioritize the services of a psychiatric nurse or health psychologist whose primary role to provide support to improve physical and mental health of nurses. Nurses should be compelled and given at least one-off day each month to visit these specialists for checkups.
- Nurses should be able to plan their schedules although its tight most of the time, to also participate in other activities which would distract them from the stressors experienced while at work. They should learn to create time for exercise, therapies, social activities, learning new hobbies, socialize with others outside your work area or profession, reading and signing up for courses that would be beneficial to them and their career.
- Strict policies should be put in place to protect all employees, not only nurses, from physical and emotional abuse from either colleagues or clients. This is a major contributor to occupational stress experienced by employees. Nurse should likewise speak up when they are abused, undervalued and disrespected.
- Suitable alternatives should be discussed about to reduce nurse burnout during shifts.
Finally, there is nothing much to say. Self-Care is important for a nurse in order to function well in her capacity. They deserve it. Yes, they deserve the same therapeutic care they give to their clients and patients.
It’s high time nurses start getting the respect and value they deserve for all their magnanimous and selfless humanitarian jobs. Once again, I commend the World Health Organization (WHO) for declaring the Year 2020 as “THE INTERNATIONAL YEAR OF THE NURSE AND MIDWIFE”.
I hope it ushers in a decade of tremendous progress in the advancement of nursing practice and healthcare in general.Cheers and Thanks for Reading!!!
The Nurse
A Nurse is a person who is trained to give care (help) to people who are sick or injured. Nurses work with doctors and other health care workers to make patients well (not sick) and to keep them fit and healthy. Nurses also help with end-of-life needs and assist other family members with grieving.
WHAT IT TAKES TO BE A ” NURSE”?
An aspiring RN can earn a bachelors of Nursing Science (BNSC) in a 4 years at a college or university. If you’re already an RN, you can enroll in an RN-to-BsN program which is geared specifically for RNs who has nursing diploma. This path usually takes about two to three years.
WHAT IS THE ROLE OF A NURSE?
In summary,
📌as caregiver, a nurse provides hands-on care to patients. ….
📌As a patient advocate , the nurse’s responsibility is to protect a patient’s rights, act on patient’s behalf, and support their decisions.
WHAT SKILLS DO U NEED TO BE A “NURSE”?
Essential Nursing skills compassion. A nurse must be drawn to caring for sick and injured. Communication Ethics Critical Thinking Attention To detail confidence adaptability stamina
WHAT ARE D FOUR CONCEPTS OF NURSING THEORY?
The nursing paradigm consist of four main concepts: Person, Health, Environment, and Nursing. Each theory is regularly defined and described by a Nursing Theorist. The main focal point of nursing out of the four various common concepts is the person (patient)
WHO IS THE FATHER OF NURSING?
Nightingale birthed nursing around the late 1850s(Crimean War), early 1860s (American Civil War), and early 1870s (beginning of formal nursing schools in America). So to put things on an equal footing, the father of Nursing should be more or less her contemporary.
HAS NURSING TRULY ATTAINED PROFESSIONAL STATUS?
Typically in most developed countries, professions are distinguished by certain characteristics; these includes:-
✒Institution of Higher Education
✒Autonomy
✒Code of Ethics
✒Increasing Knowledge
✒Culture and Norm
COMMON NOMENCLATURES USED TO ADDRESSED NURSE
✔Nursing Officer
✔Chief
✔Sister
✔Mummy
✔Daddy
✔In charge
✔Mallam
✔Matron just to mention but few
IS RN A TITTLE?
Registered Nurse (RN) is a nurse who has graduated from an accredited nursing program with a BsN, Associator diploma from a hospital based program in nursing. To obtain RN license, an individual needs to pass the Nursing Council Exam in the state where they wish to obtain licensure. RN is a licensure credentials which goes after your name not before your name e.g. Musty RN, Bscn.
PROFESSIONAL TITTLE/ACRONYM OF NURSE?
-The professional title of RN is Nurse, so address us as a Nurse not doctors because we are not doctors or chief , sister and so on. For example Nurse Otieno ,Nurse John.
-The acronym of the title Nurse is Nr. Which is the pre-nominal abbreviation of a nurse e.g Nr. Otieno, Nr. Maria.
Mr., Mrs., Miss are not suppose to be use by a professional because they are business and social title acronym.
-CNO, PNO, SNO etc; these are ranking post in the hospital but is not actually a title of a nurse.
SUMMARY
We are all crying for public recognition of the Kenyan Nursing profession why sadly we deliberately refuse to add Nurse(Nr.) in our beautiful names and don’t address our colleagues as such. So if we aren’t happy and proud of our titles how do we expect the society to feel we are important. The change has to start with the way we address ourselves in public regardless of our years of experience and specialization E.g. am Nurse Otieno is a pleasure meeting you.
WISDOM WORD
No single doctor will accept the title nurse but why are we accepting their title upon all the peculiarity of our professional title. We are nurses and care for patient as a whole not as a machine.
Bullying And Harassment In Nursing: The Solution
When the word bullying is mentioned, the scene that comes to play in your mind is most likely a tough, angry young boy, with his friends cheering him up to beat a weaker boy. A lot of us were once victim of bullying in secondary school, so we do know what it looks like to meet a bully. However, the evil act called bullying did not stop in the secondary school; a lot of nurses are victims of bullying and harassment in their place of work.
Bullying is referred as an unwanted and aggressive behavior that can occur anywhere, in school, work or even in a relationship. Workplace bullying is known as a major threat to the workforce, and about 85% of nurses are victims of bullying by a fellow nurse.
This is truthfully sad, however, nurses do not only eat their young, and they also harass them till they are frustrated.
I know what it feels like to work 12 hours shift, yet you have to face the bitter senior nurse who wants to keep you waiting for some more hours. We all know that this is bad; however, the fact it is generally called a bad thing is not enough to stop this menace.
📌Speak Up: I know how difficult this can be, however a bully gets more strengthened in your silence. Have you ever seen a dog barking at you because you are a stranger? If you start running, it chases you till you either escape or gets bitten. On the other hand, when you have a stick in your hands, or show the dog some stunts that you are not afraid, but rather challenged, it will be calm and you will forever walk freely on that path.
Well, am I referring the senior nurse who bullies everyone in your unit a dog? No, that was just an analog to enlighten you on the need to speak up.
✔How do you speak up?
Make sure that you are knowledgeable. Most victims of bullying are people who are weak at one particular thing. A victim may be the most brilliant person in a unit, yet a bully picks on him using his weakness. Make sure you find your weakness and strengthen it.
✔Speak up when you need to.
Never keep quiet when you ought to speak up. Although, you have to be diplomatic to speak amidst your nursing colleague.
📌Unity is Key: United we stand, divided we fall. If bullying and harassment must be curbed amidst nurses, then everyone must be willing to stand for each other. It does not matter if you are not a victim of bullying and harassment now. You will most likely be a victim someday if you do not stand fighting against it.
📌Report every form of bullying to the right authorities: Reporting to the authorities like the hospital’s management or the nursing body may not be effective, because it may never be considered a threat or a major problem for young nurses. However, it is the right thing to do. Many times, young nurses fail victims of bullying at their place of work, and the regulatory bodies mentions that nothing of such problem has been mentioned before.
Never give room to be manipulated: Not all bullies abuse a person verbally or throw punches or sharp objects. Some bullies are technically manipulators, they manipulate you to do things that are wrong, and make you believe it is the best. Bullies who are emotional manipulators may seem like the nicest person in your unit, however a second look at their motives, you find out that they are only after your downfall.
📌Nurse Managers should stand for younger nurses: Senior nurses must also play their part in recognizing potential bullies in the unit and prevent them as much as possible. In addition, senior nurses and regulatory bodies should implement policies that will enable every nurse have easy access to the authority, so they can report every bully.
The Common 4 simple ways to stop nurse bullying:
✔Prevent bad behavior by modeling good behavior.
✔Make it (really) easy for bullying victims to report their experiences.
✔but don’t confuse constructive criticism with bullying.
✔Show victims that you have their back.
Proper Documentation Ad Panacea To Quality Nursing Care
DOCUMENTATION is vital to safe, ethical, and effective nursing practice in clinical areas. Nursing Practice requires documentation to ensure continuity of care, planning and accountability, as well as in the promotion and uptake of evidence-based practice. Ideally through documentation, nurses track changes in a patient’s condition, make decisions about needs and ensure continuity of care. However, nursing documentation has often not met these objectives.
DEFINATION OF TERMS
✍Documentation : encompasses all written and electronic entries reflecting all aspects of patient care communicated, planned or given to that patient.
✍Nursing: the unique function of a nurse is to assist individual seek or well in the performance of those activities contributing to health or its recovery (peaceful death) they would have perform unaided if they have the necessary skills strength or wills to make them gain independences as rapidly as possible (virgina Herdanson)
✍Nursing Documentation; is the record of nursing care that is planned and delivered to individual clients or patients by qualified nurses or other caregivers under the direction of a qualified nurse.
∆= Panacea : a solution or remedy for all difficulties
OVERVIEW OF NURSING DOCUMENTATION
The history of nursing documentation has started since the early days of Nightingale (Gogler et al. 2008). Documentation started with Florence Nightingale who documented diagrammatically causes of mortality during the Crimean War as sicknesses rather than wounds. Since this humble beginning, nursing documentation has evolved into an essential element in achieving holistic nursing care and has brought with it the obligation to document not only the performed interventions (acts of commission), but also decision processes, explanation of acts of omission, and care outcomes.
It is worth to mention that nursing documentation was improved with the introduction of the nursing process into the clinical setting (Oroviogoicoechea Elliott B, Watson S., 2008). Documentation is generally recognized across the world as one of the important duties underscoring professional autonomy and assisting nurses to apply the nursing plan of care and theories in their clinical settings (Cheevakasemsook A, Chapman Y, Francis K, Davis, 2006).
Documentation is not a task most nurses look forward to but it is something that is necessary as a health professional. It is required by legislation, regulatory bodies and employers. Documentation acts as a permanent, accurate and complete account of the care provided to each patient. In addition, it provides valuable data to assist with administrative, utilization and research efforts, and acts as legal evidence to substantiate care rendered.
PRINCIPLES OF NURSING DOCUMENTATION
Appropriate nursing documentation has various principles including:
👉Objectivity
👉specificity
👉clearing and consistency comprehensive
👉respecting confidentiality recording errors.
(Dinah, Tecla, Millicent, Alex, Robert et al., 2013).
IMPORTANCE OF NURSING DOCUMENTATION
✍serves as communication tools within health care team
✍its ensure continuity of care
✍use to assess the quality of care rendered
✍use to assess the improvement or deterioration in patients condition
✍its serves as decision making tool in patient care
✍its serves as important evidence in legal matters
✍useful in case of legislation and regulation
✍for research purposes
✍for quality process and performance improvement
✍for nursing audit
✍it is also useful in job performance evaluation
IMPLICATION OF NURSING DOCUMENTATION ON NURSES
🤝its serves as communication tools among nurses
🤝its protect nurses against litigatio
🤝it makes nurses accountable for their action
IMPLICATION OF NURSING DOCUMENTATION ON PATIENT
🤝its improve quality of care rendered to the patient
🤝its reduce mortality and morbidity related to care rendered
🤝its allows for continuity of care
NURSING DOCUMENTATION TIPS TO STAY OUT OF COURT.
👌Write legibly
👌Use ink
👌Never obliterate
👌Fill in all blanks and lines
👌Date and time all entry
👌Document through process
👌Be objective
👌Document all assessment
👌Document physician contact
👌Describe behavior
👌Develop your own method of documentation, in essence do not follow routine method of documentation like; taken over in a fair condition due nursing care rendered, state exactly what nursing care rendered.
ASSUMPTION FACTORS THAT INFLUENCE NURSING DOCUMENTATION
✍Inadequate and poor staffing patterns on the wards
✍Lack of in service training on nursing documentation
✍High workloads
✍Lack of resources; insufficient or lack of enough/appropriate sheets for documentation
✍Poor appreciation of its advantages.
RECOMMENDATION
My recommendation is that all nurses should develop their own method of documentation to ensure that an accurate and complete information about the patients condition and care rendered are provided and that decision makers in nursing profession in Africa should act regarding staffing condition as its influences the nursing practice.
CONCLUSION
Nursing documentation is very crucial in health care settings and reflects various aspects including the awareness level of nurses in their roles in providing health services in a good quality. However improper documentation does not only put the nurse at risk of litigation but also influences patients recovery. Nursing documentation have two main forms: paper based documentation and electronic based documentation. Paper based documentation has certain drawbacks such as lacking the comprehensiveness and clarity. Accordingly, a strong trend to shift paper based documentation towards electronic documentation has been witnessed in some countries but yet to be adopted in Kenya.
Competencies In Nursing
The first time I saw the word competencies, it was in a managerial book, and I realized that competencies are important tools, and skills for every professional. Moreover, nursing profession is a delicate, fragile and versatile profession, thus competencies are important.
Competence is the set of demonstrable skills and characteristics that enable professionals to improve the efficiency, and performance of their job. Moreover, competency is a capacity obtained through understanding and learning.
The idea of capability is in two different form:
1) Potential capacities that may work viably in specific situations
2) Inspiration to give one’s helpfulness utilizing those capacities.
Then again, competency is a social trademark that depends on one’s inclinations and encounters affected by his/her inspiration and mentality. It is an ideal social quality that reasonable prompts accomplishments. Capability (capacity) is a reason for creating competency (conduct attributes).
If competency leaves a trade mark for people in their career, how useful do you think it will be for nurses?
Nursing competency incorporates center capacities that are required for satisfying one’s job as a medical attendant. In this manner, it is essential to plainly characterize nursing competency to set up an establishment for nursing training educational program. Notwithstanding, while the ideas encompassing nursing competency are significant for improving nursing quality, they are as yet not yet totally created. In this way, challenges stay in building up definitions and structures for nursing competency, competency levels vital for nursing experts, preparing strategies, etc.
The world is changing everyday, and there are several issues coming up in the healthcare industry, competencies in nursing enables nurses to strive for the best.
Nursing competencies are integral part of the nursing profession that helps you provide a quality healthcare service to your clients, and patients.
📌Emotional Intelligence:
This is a core competence for nurses. You cannot successfully understand people’s emotion, care for people, or show empathy on others, if you lack emotional intelligence.
“People may not remember what you said, but they will remember how you made them feel”
― Maya Angelou
Certainly, not every of your patient will remember the words you said to them, however they will remember the way you made them feel. An emotionally intelligent nurse, knows how to care for her patients, without hurting the patient in any form.
To master the act of emotional intelligence, I will recommend the book on “Emotional Intelligence by Daniel Coleman” for you.
📌Effective Communication:
Many of us are talkers, but few are communicators, while many of us hear the words of others, but few are listeners. Have you ever had to shun a patient when they are asking annoying, and supposedly stupid questions? What about you listening to those seemingly foolish questions? What about smiling, and making gestures as you listen?
Effective communication differs from speaking, and listening, it has to do with conveying clear messages to someone. There are many misinterpretation in nursing, and the healthcare system today, because many people lack communication skills.
Communication skills are wide, however, you can master the act of the following
✔Listening attentively
✔Marinating eyes contact
Smiling often
✔Avoid interrupting your clients when they are talking
To master the act and art of effective communication, read “How To Win Your Friends and Influence People”, by Dale Carnegie.
📌Self –awareness:
Do you know what you do best? Do you know the shift that favors you best? Do you just nurse people the way others do?
Self-awareness is the way to creativity, and competencies. It helps you to become better, and even more confidence. Self-awareness also helps to maintain self-control when necessary, and maximize emotional intelligence.
I recommend “Insight” by Dr. Tasha Eurich, and any emotional intelligence book.
📌Ability to apply knowledge:
What do you when you are faced with the reality of a disease, or condition? Application of knowledge is a skill, and not every nurse has it. You need confidence, and the ability to take risk, to apply your knowledge.
In a continents like Africa, where nurses are almost relegated to nothing, you are expected to. I recommend “The Year of No Nonsense” by Meredith Atwood, and “The Dauntless Nurse” by Arna Robins, Rn Msn and Kathleen Bartholomew
📌Acquisition of knowledge:
How often do you read books? When was the last time you carried out a research on a disease condition?
Knowledge is importance, and it is a core competency for nurses. Have a research, and reading routine, ask questions, and find out what is going on around you.
You can read the following books to help you acquire knowledge:
✳Notes on Hopsitals, by Florence Nightingale
✳Patients Come Second by Paul Spiegelman and Britt Berrett
✳An American Sickness by Elisabeth Rosenthal
✳Management Lessons from Mayo Clinic by Leonard L. Berry and Kent D. Seltman
✳A3 Problem Solving for Healthcare by Cindy Jimmerson