Nursing and Self-

Care

Why Be a Nurse?

Career freedom

I had an amazing nurse once who . . .

Opportunities to try lots of specialties

I like caring for peopleYou only work 3 days a week

Its easy to get a job

So I can be a CRNA

You can make a lot of money

Make a difference

Appreciation

Hospital Reality Sicker patients Higher patient-to-nurse ratios A reliance on confusing emerging

technology Administrative demands for cost-cutting Administrative demands for high customer

service scores Nurses do not make money. They earn it. Shortage does not mean recession-proof

Where We Stand (the old)

Annual turnover rate 14% 15% actively licensed nurses not nursing

Burnout Scheduling/Hours Pay Staffing and patient ratios Physical Demands

55% nurses are obese 50% exhausted/discouraged by end of shift 44% feel cannot provide fully for patients

Where We Stand (the new) Orientation $30K/new RN 90% start career in the hospital 13-26% attrition-rate for nurses in first year 10-20% leaving profession within 2 years “Reality shock”

Stress related to patient acuity Inadequate staffing Unsafe patient care Management-related issues (i.e. level of support) Amount of responsibility placed on new grads

http://www.pbs.org/now/shows/442/index.html

Transition to Practice:Being a Nurse, Staying a Nurse

Realistic job preview Preceptor and ongoing support Prevent burnout Staying Well Equality Be comfortable, but to too comfortable New graduates need 12 months to gain

comfort and confidence in their new roles and require professional development opportunities and support

Bullying “workplace behavior that could reasonably

be considered humiliating, intimidating, threatening or demeaning to an individual or group of individuals and that is usually repeated over time” (WorkCover NSW, 2008)

Repeated behavioral activity focusing on a target

Escalates in severity over time Perpetrator always known to the target Target unable to protect or defend self Stems from the nature of the work

Scope

65% of RNs reported frequently observing lateral violence behaviors among co-workers

10–30% of nurses experience workplace bullying

¾ of critical care nurses work with others who are condescending, insulting, or rude

Bullied nurses are more likely to leave their place of employment/higher absenteeism

Signs You Are Getting Nurse-Bullied

Unmanageable workload Ignored or excluded Rumors spread about you Ordered to carry out work below

your competence level (not due to staff-shortage)

Having your professional opinion ignored

Information relevant to your work withheld

Humiliated or ridiculed about your work

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Varieties of Nurse-Bullies

Super nurse Clique nurse Resentful nurse Jealous nurse Gossip-girl nurse Backstabbing nurse

http://www.cafepress.com/+mean_male_nurse_rectangle_magnet,322405637

Toxic Coworkers

Narcissists Borderlines OCD’ers Antisocials Personality-disordered people aren't

going to change, the key to coping is to change the way you respond to them.

http://consumer.healthday.com/encyclopedia/article.asp?AID=648028

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Some Light Reading

The 90-Day RuleDon’t Complain Unless You Know What You Are Talking

About!

Accept fair share of work Cooperate with others Give help when asked Ask for assistance and advice Don’t be inquisitive about others’ private lives Work willingly Don’t be too submissive Use initiative Take difficulties to a superior before complaining Accept relevant criticism when conveyed appropriately Don’t denigrate subordinates, peers, or supervisors

(aka anyone)

Reflective Practice

Self-assessment of practice / competence Identify areas for development and ultimately

improve competence Looking for learning points within the scenario

or situation Reflect and consider how to apply learning in

other situations to further enhance performance Identifying learning / development needs and

plan to meet them to improve practice Change/modify practice in response

Self-Nurturing for Nurses ADLs: The 3 free therapies

Right nutrition Right exercise Right mental and physical Rest

PTO – do not hoard it, use it EAP – its free, USE IT Set (and stick to) your boundaries Monitor codependency behaviors American Holistic Nurses Association Set SMART life goals

Holistic Goal Setting

Specific Measurable Attainable Relevant Time-Bound

Health- Family – Social – Career Education – Financial - Spiritual

References Black, L., Spetz, J., & Harrington, C. (2008). Nurses working outside of nursing:

societal trend or workplace crisis? Policy, Politics & Nursing Practice, 9(3), 143-157.

Black, L., Spetz, J., & Harrington, C. (2010). Nurses who do not nurse: Factors that predict non-nursing work in the U.S. Nursing Economic$, 28(4), 245-254.

Cavaiola, A. A., & Lavender, N. J. (2000).Toxic Coworkers: How to Deal with Dysfunctional People on the Job. New Harbinger Publications. Oakland, CA.

Han, K., Trinkoff, A., Storr, C., & Geiger-Brown, J. (2011). Job stress and work schedules in relation to nurse obesity. Journal of Nursing Administration, 41(11), 488-495.

Kovner, C. T., & Djukic, M. (2009). The nursing career process from application through the first 2 years of employment. Journal of Professional Nursing, 25(4), 197–203

Pascual, P. (2011). Quiz: Can you spot a toxic coworker? Retrieved from http://consumer.healthday.com/encyclopedia/article.asp?AID=648028

Raphael, T (2011). Nurse turnover rate in hospitals. Retrieved from http://www.ere.net/2011/06/08/nurse-turnover-in-hospitals/

WorkCover NSW. (2008). Preventing and dealing with workplace bullying: A guide for employers and employees. Sydney: NSW Government.