Changing Worklife
Job satisfaction for nurses is important for retention and performance. “If a job is fun to do, it is more satisfying and performance improves” (Thomas, 1993, p. 36). However, because nurses are in a profession that is continually evolving and often have limited control over job changes, job satisfaction is often difficult to achieve. In fact, many workplace issues have been identified by the nursing profession as having an impact on work environment and job satisfaction.
Stress or stress related health conditions are becoming a major health concern in North America. The National Institute for Occupational Safety and Health has produced a paper on Stress at Work. Work related stress is an important issue facing everyone. People are faced with increased demands and decreased resources in the workplace. This results in stress leading to a myriad of emotional, mental and physical health problems. These problems can include increased absenteeism, low moral, eating disorders, asthma, depression and heart disease. Workplace stress, especially chronic stress, is leading to burnout. Nurses are at the Breaking Point and there seems to be no end in sight in the near future.
The International Labour Organization (ILO) has developed an extensive web site on Stress in Nursing.
The Nurses Union in Manitoba has published a survey that shows the impact of the nursing shortage on the quality of health care and the increase in burnout. This report mirrors similar results in other areas.
Another study that has looked at the impact of stress and worklife on client safety was done by Agency for Health Care Research and Quality.
Many hospitals have programs to help nurses support each other. There are a number of activities that an individual can do to reduce stress. The first step is to recognize stress in oneself, then to bring about change and finally by learning to accept that some stressful situations can not be changed and one needs to accept the situation and give up unrealistic goals and expectations. Nurses are starting to realize that they need to start "Looking out for No. 1" . Nurses are recognizing the importance of exercise, diet and relaxation to reduce the stress in their lives.
Optimum Health Resources is a web site that is devoted to stress management, both personal and workplace. Stress Busters by the Center for Anxiety and Stress Treatment has some useful suggestions on how to manage stress. An effective way to deal with stress is laughter.
Substance Misuse/Abuse
Stress can be dealt with in a positive manner or stress can be handles negatively. Drug and alcohol abuse/misuse can lead to serious consequences for both the nurse and her clients.
Substance misuse/abuse is a problem is all sectors of society, including the nursing profession. The stress in the workplace and the availability of drugs make nurses, and other care professionals, vulnerable substance misuse/abuse. The American Nursing Association estimates that 10% to 20% of nurses may have a substance problem. The Canadian Nurses Association has a Policy Statement about Substance Misuse and Chemical Dependency in Nursing. (Position Statement - Protection of the Public).
The most common substance misused/abused by nurses is alcohol.
Patterns of substance misuse/abuse include:
Alcohol Drugs - lack of enthusiasm - workaholic - arrive late, leave early, sick time -readily volunteer for extra shifts - prefer to have a light assignment - care for clients with decreased level of awareness - tend to isolate themselves - sick time - incoherent charting -sloppy charting - "black-outs" - wear long sleeve (especially with IV use)
Some behaviors that should alert others to a nurse who may have a drug problem include:
sign out more narcotics that peers
offers to do the narcotic count
medication errors
bathroom break immediately after giving a medication
wants to be alone when opening narcotic cupboard
change in appearance
mood swings
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