Workplace Stress and Ethical Challenges Experienced by Nursing Staff in a Nursing Home

VonDras, Dean D.; Flittner, Diane; Malcore, Sylvia A.; Pouliot, Gregory S.

doi:10.1080/03601270802605382

Cited by 42 publications

(36 citation statements)

References 39 publications

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“…The moral indignation that they expressed showed the same kind of moral emotions that have been found in previous studies. 5,6,[8][9][10] That nurses caring for older people experienced other strong emotions that may be harmful has also been previously documented. 4,7 In nursing research these feelings and reactions have been discussed in terms of moral stress and distress.…”

Section: Discussionmentioning

confidence: 94%

“…3,4 Nursing staff in nursing homes have been reported to experience stress resulting from interaction with residents and from intrapersonal relationships. 5 Other studies have shown that care workers suffer from consuming emotions such as shame, guilt, anger, being undervalued, having too much responsibility, and being exhausted by impossible demands. 6,7 They may ease their burden by mastering their work, neutralizing negative feelings by the use of humour, protecting themselves and recovering mentally.…”

Section: Introductionmentioning

confidence: 99%

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The meaning of vulnerability to nurses caring for older people

Stenbock-Hult

Sarvimäki

2011

Nurs Ethics

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Research concerning work on caring for older people shows that care providers experience a variety of consuming emotions and stress. They can be said to be in a vulnerable position. It is not known, however, how the care providers themselves understand vulnerability. The aim of this study was to illuminate the meaning of vulnerability to care providers caring for older people. A qualitative interpretive approach was adopted. Data were collected through tape-recorded interviews with 16 female registered and practical nurses who were experienced in caring for older people. Qualitative analysis resulted in one core theme and six themes with subthemes. The core theme showed that, for the participating nurses, vulnerability essentially meant being human. The meanings of being human were illustrated by the six themes: having feelings; experiencing moral indignation; being harmed; having courage; protecting oneself; and maturing and developing. Analysis showed that vulnerability was a resource as well as a burden.

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Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

The meaning of vulnerability to nurses caring for older people

Stenbock-Hult

Sarvimäki

2011

Nurs Ethics

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“…This points to a genuine need for CES activities in this area of health and care services: the ethics activities deal with complex and central matters, the handling of which most likely makes a difference for patients/users and next of kin. Apparently, the most common ethical challenges are also encountered in similar services in other countries, as other research indicates [9, 25, 26]. …”

Section: Discussionmentioning

confidence: 96%

The Norwegian national project for ethics support in community health and care services

et al. 2016

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BackgroundInternationally, clinical ethics support has yet to be implemented systematically in community health and care services. A large-scale Norwegian project (2007–2015) attempted to increase ethical competence in community services through facilitating the implementation of ethics support activities in 241 Norwegian municipalities. The article describes the ethics project and the ethics activities that ensued.MethodsThe article first gives an account of the Norwegian ethics project. Then the results of two online questionnaires are reported, characterizing the scope, activities and organization of the ethics activities in the Norwegian municipalities and the ethical topics addressed.ResultsOne hundred and thirty-seven municipal contact persons answered the first survey (55 % response rate), whereas 217 ethics facilitators from 48 municipalities responded to the second (33 % response rate). The Norwegian ethics project is vast in scope, yet has focused on some institutions and professions (e.g., nursing homes, home-based care; nurses, nurses’ aides, unskilled workers) whilst seldom reaching others (e.g., child and adolescent health care; physicians). Patients and next of kin were very seldom involved. Through the ethics project employees discussed many important ethical challenges, in particular related to patient autonomy, competence to consent, and cooperation with next of kin. The “ethics reflection group” was the most common venue for ethics deliberation.ConclusionsThe Norwegian project is the first of its kind and scope, and other countries may learn from the Norwegian experiences. Professionals have discussed central ethical dilemmas, the handling of which arguably makes a difference for patients/users and service quality. The study indicates that large (national) scale implementation of CES structures for the municipal health and care services is complex, yet feasible.Electronic supplementary materialThe online version of this article (doi:10.1186/s12910-016-0158-5) contains supplementary material, which is available to authorized users.

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“…Research has shown that it is time-consuming to provide care for a person with dementia [4], and that many of the behavioral and psychological symptoms of dementia, such as aggression, can lead to increased levels of stress and burnout [5], which can result in more negative attitudes and less empathy [6]. Such findings have worrying implications for the quality of care provided, particularly in terms of the increased risk of abuse and neglect [7,8]. However, there are also implications in relation to the recruitment and retention of staff, which continues to be a challenge for LTC facilities [9].…”

Section: Introductionmentioning

confidence: 99%

The effect of foot massage on long-term care staff working with older people with dementia: a pilot, parallel group, randomized controlled trial

et al. 2013

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BackgroundCaring for a person with dementia can be physically and emotionally demanding, with many long-term care facility staff experiencing increased levels of stress and burnout. Massage has been shown to be one way in which nurses’ stress can be reduced. However, no research has been conducted to explore its effectiveness for care staff working with older people with dementia in long-term care facilities.MethodsThis was a pilot, parallel group, randomized controlled trial aimed at exploring feasibility for a larger randomized controlled trial. Nineteen staff, providing direct care to residents with dementia and regularly working ≥ two day-shifts a week, from one long-term care facility in Queensland (Australia), were randomized into either a foot massage intervention (n=9) or a silent resting control (n=10). Each respective session lasted for 10-min, and participants could receive up to three sessions a week, during their allocated shift, over four-weeks. At pre- and post-intervention, participants were assessed on self-report outcome measures that rated mood state and experiences of working with people with dementia. Immediately before and after each intervention/control session, participants had their blood pressure and anxiety measured. An Intention To Treat framework was applied to the analyses. Individual qualitative interviews were also undertaken to explore participants’ perceptions of the intervention.ResultsThe results indicate the feasibility of undertaking such a study in terms of: recruitment; the intervention; timing of intervention; and completion rates. A change in the intervention indicated the importance of a quiet, restful environment when undertaking a relaxation intervention. For the psychological measures, although there were trends indicating improvement in mood there was no significant difference between groups when comparing their pre- and post- scores. There were significant differences between groups for diastolic blood pressure (p= 0.04, partial η2=0.22) and anxiety (p= 0.02, partial η2=0.31), with the foot massage group experiencing greatest decreases immediately after the session. The qualitative interviews suggest the foot massage was well tolerated and although taking staff away from their work resulted in some participants feeling guilty about taking time out, a 10-min foot massage was feasible during a working shift.ConclusionsThis pilot trial provides data to support the feasibility of the study in terms of recruitment and consent, the intervention and completion rates. Although the outcome data should be treated with caution, the pilot demonstrated the foot massage intervention showed trends in improved mood, reduced anxiety and lower blood pressure in long-term care staff working with older people with dementia. A larger study is needed to build on these promising, but preliminary, findings.Trial registrationACTRN: ACTRN12612000659808.

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Workplace Stress and Ethical Challenges Experienced by Nursing Staff in a Nursing Home

Cited by 42 publications

References 39 publications

The meaning of vulnerability to nurses caring for older people

The meaning of vulnerability to nurses caring for older people

The Norwegian national project for ethics support in community health and care services

The effect of foot massage on long-term care staff working with older people with dementia: a pilot, parallel group, randomized controlled trial

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