ICU nurses' coping measures: response to work-related stressors

1992 ◽  
Vol 12 (2) ◽  
pp. 18-23 ◽  
Author(s):  
DJ Lewis ◽  
JA Robinson
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Critical Care Nurses ◽  
Work Related Stress ◽  
Work Related ◽  
Related Stress ◽  
Work Related Stressors

Stress is an integral part of every workplace. The environment of an intensive care unit exposes critical care nurses to a proportionately greater amount of work-related stress than most occupations. Several components contributing to stress as well as coping measures are discussed in this article.

Some health effects of work-related stress among nurses working in critical care units

2021 ◽  
pp. 074823372097741
Author(s):  
A Seif Eldin ◽  
Dina Sabry ◽  
Marwa Abdelgwad ◽  
Mona Abdallah Ramadan
Keyword(s):  
Critical Care ◽  
Health Effects ◽  
Critical Care Nurses ◽  
Exposed Group ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Work Related Stress ◽  
Work Related ◽  
Related Stress ◽  
Stimulating Hormone

Occupational stress is a major health problem among nurses. Critical care nurses appear to experience more stress at work compared to others. Stress is associated with multiple system disorders, hormonal, and immunological disturbances, and genetic effects. The aim of our study was the detection of health effects of work-related stress and to investigate the link between stress and immune response, alterations of hormones, and expression of micro-RNA (miRNA) among critical care nurses. An exposed 80 critical care nurses matched to 80 controls were involved in our study. Full history, psychological assessment using the General Health Questionnaire (GHQ12) and a complete clinical examination were done for both groups. Serum interleukin (IL)-6, IL-10, luteinizing hormone (LH), follicle-stimulating hormone, thyroid-stimulating hormone (TSH), free triiodothyronine, and free thyroxine (FT4) were measured by enzyme-linked immunosorbent assay, micro-RNA26, and 142 extractions. The exposed group had a mean age of 41 ± 10 years old and mean work duration of 22 ± 9.7 years, matched to 80 controls. The exposed group (32.5%) was associated with severe psychological distress (GHQ scores > 20) compared to only 5% among controls. In addition, the exposed group had a significantly higher level of miRNA 26, miRNA 142, TSH, LH, and IL-6 when compared to the control group. However, there a significantly lower level of FT4 among the exposed group compared to the control group, there were no statistically significant differences between the studied participants regarging FT3,FSH and IL-10 levels. Stress is prevalent among critical care nurses and is reflected on their psychological health with an increase in inflammatory cytokines and disturbances in endocrine functions.

scholarly journals Family Behaviors as Unchanging Obstacles in End-of-Life Care: 16-Year Comparative Data

2020 ◽  
Vol 29 (4) ◽  
pp. e81-e91
Author(s):  
Renea L. Beckstrand ◽  
Jasmine B. Jenkins ◽  
Karlen E. Luthy ◽  
Janelle L. B. Macintosh
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
End Of Life ◽  
Health Care Providers ◽  
End Of Life Care ◽  
Critical Care Nurses ◽  
Life Care ◽  
Care Providers ◽  
Over Time

Background Critical care nurses routinely care for dying patients. Research on obstacles in providing end-of-life care has been conducted for more than 20 years, but change in such obstacles over time has not been examined. Objective To determine whether the magnitude scores of obstacles and helpful behaviors regarding end-of-life care have changed over time. Methods In this cross-sectional survey study, questionnaires were sent to 2000 randomly selected members of the American Association of Critical-Care Nurses. Obstacle and helpful behavior items were analyzed using mean magnitude scores. Current data were compared with data gathered in 1999. Results Of the 2000 questionnaires mailed, 509 usable responses were received. Six obstacle magnitude scores increased significantly over time, of which 4 were related to family issues (not accepting the poor prognosis, intrafamily fighting, overriding the patient’s end-of-life wishes, and not understanding the meaning of the term lifesaving measures). Two were related to nurse issues. Seven obstacles decreased in magnitude, including poor design of units, overly restrictive visiting hours, and physicians avoiding conversations with families. Four helpful behavior magnitude scores increased significantly over time, including physician agreement on patient care and family access to the patient. Three helpful behavior items decreased in magnitude, including intensive care unit design. Conclusions The same end-of-life care obstacles that were reported in 1999 are still present. Obstacles related to family behaviors increased significantly, whereas obstacles related to intensive care unit environment or physician behaviors decreased significantly. These results indicate a need for better end-of-life education for families and health care providers.

scholarly journals Practice of Expert Critical Care Nurses in Situations of Prognostic Conflict at the End of Life

2006 ◽  
Vol 15 (5) ◽  
pp. 480-491 ◽  
Author(s):  
Catherine McBride Robichaux ◽  
Angela P. Clark
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
End Of Life ◽  
Narrative Analysis ◽  
Critical Care Nurses ◽  
Realistic Picture ◽  
Inappropriate Treatment ◽  
Expert Nurses ◽  
End Of Life Decision

• Background Prolonging the living-dying process with inappropriate treatment is a profoundly disturbing ethical issue for nurses in many practice areas, including the intensive care unit. Despite the frequent occurrence of such distressing events, research suggests that critical care nurses assume a limited role in end-of-life decision making and care planning. • Objectives To explore the practice of expert critical care nurses in end-of-life conflicts and to describe actions taken when the nurses thought continued aggressive medical interventions were not warranted. • Methods A qualitative design was used with narrative analysis of interview data that had a temporal ordering of events. Interviews were conducted with 21 critical care nurses from 7 facilities in the southwestern United States who were nominated as experts by their colleagues. • Results Three recurrent narrative plots were derived: protecting or speaking for the patient, presenting a realistic picture, and experiencing frustration and resignation. Narratives of protecting or speaking for the patient concerned preventing further technological intrusion and thus permitting a dignified death. Presenting a realistic picture involved helping patients’ family members reframe the members’ sense of the potential for recovery. Inability to affect a patient’s situation was expressed in narratives of frustration and resignation. • Conclusions The transition from curative to end-of-life care in the intensive care unit is often fraught with ambiguity and anguish. The expert nurses demonstrated the ability and willingness to actively protect and advocate for their vulnerable patients even in situations in which the nurses’ actions did not influence the outcomes.

Pain in Intensive Care Unit: Italian critical care nurses' best practice

2021 ◽  
Vol 87 (7) ◽  
Author(s):  
Alessandro GALAZZI ◽  
Gian D. GIUSTI ◽  
Nicola PAGNUCCI ◽  
Stefano BAMBI ◽  
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Best Practice ◽  
Critical Care Nurses

Decisions Made By Critical Care Nurses During Mechanical Ventilation and Weaning in an Australian Intensive Care Unit

2007 ◽  
Vol 16 (5) ◽  
pp. 434-443 ◽  
Author(s):  
Louise Rose ◽  
Sioban Nelson ◽  
Linda Johnston ◽  
Jeffrey J. Presneill
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Critical Care ◽  
Intensive Care ◽  
Interdisciplinary Collaboration ◽  
Multiple Organ ◽  
Critical Care Nurses ◽  
Royal Melbourne Hospital ◽  
Adult Intensive Care Unit ◽  
Fraction Of Inspired Oxygen

Background Responsibilities of critical care nurses for management of mechanical ventilation may differ among countries. Organizational interventions, including weaning protocols, may have a variable impact in settings that differ in nursing autonomy and interdisciplinary collaboration. Objective To characterize the role of Australian critical care nurses in the management of mechanical ventilation. Methods A 3-month, prospective cohort study was performed. All clinical decisions related to mechanical ventilation in a 24-bed, combined medical-surgical adult intensive care unit at the Royal Melbourne Hospital, a university-affiliated teaching hospital in Melbourne, Victoria, Australia, were determined. Results Of 474 patients admitted during the 81-day study period, 319 (67%) received mechanical ventilation. Death occurred in 12.5% (40/319) of patients. Median durations of mechanical ventilation and intensive care stay were 0.9 and 1.9 days, respectively. A total of 3986 ventilation and weaning decisions (defined as any adjustment to ventilator settings, including mode change; rate or pressure support adjustment; and titration of tidal volume, positive end-expiratory pressure, or fraction of inspired oxygen) were made. Of these, 2538 decisions (64%) were made by nurses alone, 693 (17%) by medical staff, and 755 (19%) by nurses and staff in collaboration. Decisions made exclusively by nurses were less common for patients with predominantly respiratory disease or multiple organ dysfunction than for other patients. Conclusions In this unit, critical care nurses have high levels of responsibility for, and autonomy in, the management of mechanical ventilation and weaning. Revalidation of protocols for ventilation practices in other clinical contexts may be needed.

scholarly journals Factors Affecting Resilience and Development of Posttraumatic Stress Disorder in Critical Care Nurses

2017 ◽  
Vol 26 (3) ◽  
pp. 184-192 ◽  
Author(s):  
Meredith Mealer ◽  
Jacqueline Jones ◽  
Paula Meek
Keyword(s):  
Intensive Care Unit ◽  
Posttraumatic Stress Disorder ◽  
Critical Care ◽  
Intensive Care ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Critical Care Nurses ◽  
Burnout Syndrome ◽  
Cumulative Exposure ◽  
Graduate Degree

Background Job stress and cumulative exposure to traumatic events experienced by critical care nurses can lead to psychological distress and the development of burnout syndrome and posttraumatic stress disorder. Resilience can mitigate symptoms associated with these conditions. Objective To identify factors that affect resilience and to determine if the factors have direct or indirect effects on resilience in development of posttraumatic stress disorder. Methods Data from 744 respondents to a survey mailed to 3500 critical care nurses who were members of the American Association of Critical-Care Nurses were analyzed. Mplus was used to analyze a mediation model. Results Nurses who worked in any type of intensive care unit other than the medical unit and had high scores for resilience were 18% to 50% less likely to experience post-traumatic stress disorder than were nurses with low scores. Nurses with a graduate degree in nursing were 18% more likely to experience posttraumatic stress disorder than were nurses with a bachelor’s degree. Conclusion Because of their effects on resilience, working in a medical intensive care unit and having a graduate degree may influence the development of posttraumatic stress disorder. Future research is needed to better understand the impact of resilience on health care organizations, development of preventive therapies and treatment of posttraumatic stress disorder for critical care nurses, and the most appropriate mechanism to disseminate and implement strategies to address posttraumatic stress disorder.

scholarly journals Counterbalancing work-related stress? Work engagement among intensive care professionals

2018 ◽  
Vol 31 (4) ◽  
pp. 234-241 ◽  
Author(s):  
Margo M.C. van Mol ◽  
Marjan D. Nijkamp ◽  
Jan Bakker ◽  
Wilmar B. Schaufeli ◽  
Erwin J.O. Kompanje
Keyword(s):  
Intensive Care ◽  
Work Engagement ◽  
Work Related Stress ◽  
Work Related ◽  
Related Stress ◽  
Stress Work
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