Mitigating emotional responses to stressors: coping strategies, modifiers and support

2021 ◽  
pp. 103985622110472
Author(s):  
D. Dennis ◽  
P.V van Heerden ◽  
C. Knott ◽  
R. Khanna
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Coping Strategies ◽  
Emotional Responses ◽  
Well Being ◽  
Environmental Stressors ◽  
Professional Help ◽  
Wide Range ◽  
Audio Recordings ◽  
Emerging Themes

Objective: The stressful nature of the intensive care unit (ICU) environment is increasingly well characterised. The aim of this paper was to explore modifiers, coping strategies and support pathways identified by experienced Intensivists, in response to these stressors. Method: Prospective qualitative study employing interviews with Intensivists in two countries. Participants were asked how they mitigated their emotional responses to the stressors of the ICU. Audio-recordings were transcribed and analysed by all researchers who agreed upon emerging themes and subthemes. Results: A wide range of strategies were reported. Although several participants had sought professional help and all supported its utility, few disclosed accessing such help to others indicating stigma. Many felt a sense of responsibility for the well-being of other staff but identified barriers that suggest alternate support pathways are required. Further implications of these findings to training considerations are described. Conclusions: Several approaches were described as regularly employed by Intensivists to mitigate ICU environmental stressors. Intensivists perceive themselves to have limited training to provide support to others; they also perceive stigma in seeking professional help.

Parent Psychological Distress in the Neonatal Intensive Care Unit Within the Context of the Social Ecological Model: A Scoping Review

2018 ◽  
Vol 24 (6) ◽  
pp. 495-509 ◽  
Author(s):  
Kristy Loewenstein
Keyword(s):  
Mental Health ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Psychological Distress ◽  
Neonatal Intensive Care Unit ◽  
Scoping Review ◽  
Neonatal Intensive Care ◽  
Family Cohesion ◽  
Ecological Model ◽  
Well Being

BACKGROUND: Neonatal intensive care unit (NICU) parents are at risk for psychological distress and impaired mental health, and statistics related to parent psychological distress vary. OBJECTIVE: To determine the scope of literature regarding the mental health and psychosocial well-being of parents in the NICU. DESIGN: A scoping review within the Arksey and O’Malley framework and the SEM was undertaken to answer, “What factors contribute to parent’s mental health in the NICU?” A systematic review of the literature was performed using the PRISMA methodology. RESULTS: Common socioeconomic factors and infant and parent characteristics may place parents at a greater risk for developing distress. History of mental illness, family cohesion, birth trauma, altered parenting role, gestational age, birth weight, and severity of prematurity/illness emerged as themes. CONCLUSION: Further research is required to provide a standard for the screening and assessment of parents’ mental health and psychosocial well-being during a NICU hospitalization. The experiences of nonbirth parents in the NICU should be explored to examine the effects of the hospitalization on all types of parents.

Adapting the Six-Part Storymaking Method for use with siblings of infants on the neonatal intensive care unit

2020 ◽  
Vol 7 (2) ◽  
pp. 223-242
Author(s):  
Rebecca Ann Versaci
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Emotional Expression ◽  
Neonatal Intensive Care ◽  
Well Being ◽  
Hospital Staff ◽  
Case Vignette ◽  
Profound Influence ◽  
Insight Into

When an infant is hospitalized on the neonatal intensive care unit (NICU) it can have a profound influence on the psychosocial well-being of the infant and their older sibling(s). This article presents a case vignette of the use of the Six-Part Storymaking Method with the sibling of an infant hospitalized on the NICU. The article reviews the therapeutic aims and benefits of the intervention, including: supporting emotional expression, providing opportunity for the sibling to be deeply witnessed by caregivers, therapist and hospital staff, empowering the sibling to inhabit the big sibling role and fostering insight into the sibling’s thoughts, feelings and behaviours as related to their infant’s hospitalization. Considerations for facilitation and assessment are also discussed.

scholarly journals The sound of potency: An observation study of nurses’ approach to sound in a pediatric intensive care unit

2017 ◽  
Vol 5 (2) ◽  
pp. 46
Author(s):  
Emma Mellgren ◽  
Janet Mattsson
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Well Being ◽  
High Tech ◽  
Noise Levels ◽  
Observation Study ◽  
Care Environment ◽  
High Noise

Objective: The objective of this study was to investigate the nurses’ approach to three sources of sound that contribute to high noise levels; alarms, doors that open and conversation.Methods: Methods used derived from a theoretical perspective based on interpretive phenomenology and caring culture. In the pediatric intensive care, the caregivers of the children work in a high-tech environment as they are surrounded by sound from several sources. How caregivers understand and acknowledge how these sounds negatively affect a child’s well-being depends on their individual knowledge and awareness of how children are affected by sound. In most cases, coming into an intensive care unit is a new experience for a child. This causes greater stress, both from the environment itself as well as from sound levels. The method was built on a phenomenological perspective and an interpretive non-participation, semi-structured observations were conducted in a pediatric intensive care unit (PICU) of one of Sweden’s metropolitan regions in the winter of 2014-2015.Results: The results show that noise is an overlooked phenomenon in the pediatric intensive care environment as it has given way to other priorities in the nurse’s work. It is also apparent that this depends on the department’s caring culture as it prioritizes other things, resulting in normalizing high levels of noise as a part of the pediatric intensive care environment.Conclusions: Noise levels are not a priority in the department’s caring culture. High noise levels are permitted unreflectedly and appears to be a token of potency and an accepted part of the health care environment.

scholarly journals Enablers and challenges of caring in the Intensive Care Unit--Part 2: In relation to nurses

2021 ◽  
Vol 12 (2) ◽  
pp. 18
Author(s):  
Hanan Subhi Al-Shamaly
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Quality Care ◽  
Optimal Level ◽  
Ethnographic Study ◽  
Personal Factors ◽  
Team Members ◽  
Educational Backgrounds ◽  
Wide Range ◽  
Different Sources

The concept of caring is vague and complex, especially in critical environments such as the intensive care unit (ICU), where technological dehumanisation is a challenge for nurses. ICU nursing care includes not only patients but also extends to patients’ families, nurses, other health team members and the unit’s environment. Caring in critical care settings is affected by enabling and impeding factors. To explore these enablers and challenges factors, a focused ethnographic study was conducted in an Australian ICU. The data was collected from 35 registered nurses through various resources: participants' observations, documents reviews, interviews, and additional participants’ notes. Data were analysed inductively and thematically. The study outlines comprehensively and widely a wide range of enablers and challenges affecting caring in the ICU - which originate from different sources such as patients, families, nurses, and the ICU environment. This paper is the second in a two-part series which explores the ICU nurses’ experiences and perspectives of the enablers and challenges of caring in the ICU. Part 1 was concerned with the enablers and challenges to caring that are related to ICU patients, families, and environment. While Part 2 introduces readers to the enablers and challenges factors that are concerned with the nurses in ICU. These factors include nurses’ educational backgrounds and professional experience, employment working factors, leadership styles, relationships, and personal factors. Nurses and other stakeholders such as clinicians, educators, researchers, managers, and policymakers need to recognize these factors and their implications for providing quality care, in order to enhance and maintain the optimal level of caring in the ICU.

scholarly journals Environmental Stressors Perceived by Patients in the Surgical Intensive Care Unit

2021 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
Murat Can Mollaoğlu ◽  
Olgay Karabulut ◽  
Yasemin Boy ◽  
Mukadder Mollaoğlu ◽  
Kürşat Karadayı
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Environmental Stressors ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care

Psychological distress and coping strategies in intensive care unit nurses and consultants

2022 ◽  
Vol 39 (1) ◽  
pp. 82-84
Author(s):  
Jennifer A. Foley ◽  
Panayiota Petrochilos ◽  
Andrew Paget ◽  
Lisa Cipolotti
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Psychological Distress ◽  
Coping Strategies ◽  
And Coping ◽  
Intensive Care Unit Nurses

Moral Distress of Staff Nurses in a Medical Intensive Care Unit

2005 ◽  
Vol 14 (6) ◽  
pp. 523-530 ◽  
Author(s):  
Ellen H. Elpern ◽  
Barbara Covert ◽  
Ruth Kleinpell
Keyword(s):  
Job Satisfaction ◽  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Moral Distress ◽  
Medical Intensive Care Unit ◽  
Well Being ◽  
Individual Characteristics ◽  
Medical Intensive Care ◽  
Distress Scale

• Background Moral distress is caused by situations in which the ethically appropriate course of action is known but cannot be taken. Moral distress is thought to be a serious problem among nurses, particularly those who practice in critical care. It has been associated with job dissatisfaction and loss of nurses from the workplace and the profession.• Objectives To assess the level of moral distress of nurses in a medical intensive care unit, identify situations that result in high levels of moral distress, explore implications of moral distress, and evaluate associations among moral distress and individual characteristics of nurses.• Methods A descriptive, questionnaire study was used. A total of 28 nurses working in a medical intensive care unit anonymously completed a 38-item moral distress scale and described implications of experiences of moral distress.• Results Nurses reported a moderate level of moral distress overall. Highest levels of distress were associated with the provision of aggressive care to patients not expected to benefit from that care. Moral distress was significantly correlated with years of nursing experience. Nurses reported that moral distress adversely affected job satisfaction, retention, psychological and physical well-being, self-image, and spirituality. Experience of moral distress also influenced attitudes toward advance directives and participation in blood donation and organ donation.• Conclusions Critical care nurses commonly encounter situations that are associated with high levels of moral distress. Experiences of moral distress have implications that extend well beyond job satisfaction and retention. Strategies to mitigate moral distress should be developed and tested.

scholarly journals Professional practices of education/training of nurses in an intensive care unit

2019 ◽  
Vol 72 (2) ◽  
pp. 321-328
Author(s):  
Ana Paula Morais de Carvalho Macedo ◽  
Katia Grillo Padilha ◽  
Vilanice Alves de Araújo Püschel
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Interpersonal Relationships ◽  
Scientific Evidence ◽  
Well Being ◽  
Education And Training ◽  
Close Relationship ◽  
Final Consideration ◽  
Education Training ◽  
And Training

ABSTRACT Objective: To understand the education/training of nurses working in an intensive care unit. Method: Case study with qualitative approach, with an intentional sample. Data collection and analysis used different research techniques, mainly document analysis, interview and field observation. Results: The data highlights feelings of well-being, satisfaction and motivation as important for education and training in a work context. Some organizational practices seem to promote interpersonal relationships and, consequently, increase the willingness of these professionals to adopt a reward perspective regarding continuing education and training, establishing a close relationship between the formal, the non-formal and the informal. Final Consideration: The attractiveness of this organization is related to the valorization and recognition that it can offer to the professionals. There is a reciprocity between a hospital that endorses up-to-date care and professionals who seek scientific evidence.

scholarly journals Conflict in the intensive care unit: Nursing advocacy and surgical agency

2016 ◽  
Vol 25 (1) ◽  
pp. 69-79 ◽  
Author(s):  
Kristen E Pecanac ◽  
Margaret L Schwarze
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Intensive Care ◽  
Personal Responsibility ◽  
Well Being ◽  
Ethical Review ◽  
Best Interest ◽  
Team Conflict ◽  
Nursing Advocacy ◽  
Life Sustaining Treatment

Background: Nurses and surgeons may experience intra-team conflict during decision making about the use of postoperative life-sustaining treatment in the intensive care unit due to their perceptions of professional roles and responsibilities. Nurses have a sense of advocacy—a responsibility to support the patient’s best interest; surgeons have a sense of agency—a responsibility to keep the patient alive. Objectives: The objectives were to (1) describe the discourse surrounding the responsibilities of nurses and surgeons, as “advocates” and “agents,” and (2) apply these findings to determine how differences in role responsibilities could foster conflict during decision making about postoperative life-sustaining treatment in the intensive care unit. Research design: Articles, books, and professional documents were explored to obtain descriptions of nurses’ and surgeons’ responsibilities to their patients. Using discourse analysis, responsibilities were grouped into themes and then compared for potential for conflict. Ethical considerations: No data were collected from human participants and ethical review was not required. The texts were analyzed by a surgeon and a nurse to minimize profession-centric biases. Findings: Four themes in nursing discourse were identified: responsibility to support patient autonomy regarding treatment decisions, responsibility to protect the patient from the physician, responsibility to act as an intermediary between the physician and the patient, and the responsibility to support the well-being of the patient. Three themes in surgery discourse were identified personal responsibility for the patient’s outcome, commitment to patient survival, and the responsibility to prevent harm to the patient from surgery. Discussion: These responsibilities may contribute to conflict because each profession is working toward different goals and each believes they know what is best for the patient. It is not clear from the existing literature that either profession understands each other’s responsibilities. Conclusion: Interventions that improve understanding of each profession’s responsibilities may be helpful to reduce intra-team conflict in the intensive care unit.

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