Self-care Strategies to Combat Burnout Among Pediatric Critical Care Nurses and Physicians

2020 ◽  
Vol 40 (2) ◽  
pp. 44-53 ◽  
Author(s):  
Holly Wei ◽  
Hadley Kifner ◽  
Melanie E. Dawes ◽  
Trent L. Wei ◽  
Jenny M. Boyd
Keyword(s):  
Health Care ◽  
Critical Care ◽  
Health Care Professionals ◽  
Self Care ◽  
Well Being ◽  
The United States ◽  
Professional Burnout ◽  
Pediatric Critical Care ◽  
Qualitative Descriptive ◽  
Nurses And Physicians

Background Professional burnout is a widespread phenomenon in health care. The health of patients and organizations begins with the well-being of health care professionals. Identifying and understanding self-care strategies that professionals perceive to be helpful is crucial to combat burnout. Objective To determine perceptions of self-care strategies to combat professional burnout among nurses and physicians in pediatric critical care settings. Methods This was a qualitative descriptive study with a phenomenological overtone. The study was conducted in a 20-bed pediatric intensive care unit and an 8-bed intermediate care unit of a children’s hospital in the United States. Information flyers and emails were used to introduce the study. A combination of convenience and purposive sampling methods was used to recruit participants who were full-time nurses and physicians in the 2 units. Information saturation was used to regulate sample sizes, resulting in 20 participants. Data were collected through a onetime face-to-face interview with each participant. A qualitative descriptive approach was used to analyze the data. The first author was the primary coder and discussed the codes with the coauthors throughout the coding process. Results Six major self-care strategies were identified: finding meaning in work, connecting with an energy source, nurturing interpersonal connections, developing an attitude of positivity, performing emotional hygiene, and recognizing one’s uniqueness and contributions at work. Conclusions Developing effective self-care strategies helps promote health care professionals’ physical and psychological well-being and reduce burnout. It is vital for health care professionals to care for themselves so that they can best care for others.

scholarly journals Improving community well-being through collaborative initiatives at a medical library

2019 ◽  
Vol 107 (3) ◽  
Author(s):  
Melissa C. Funaro ◽  
Rahil Rojiani ◽  
Melanie J. Norton
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Self Care ◽  
Well Being ◽  
Physical And Mental Health ◽  
Structural Problems ◽  
Harvey Cushing ◽  
Medical Library ◽  
Negative Impacts ◽  
Survey Responses

Background: In an increasingly digital age, the role of the library is changing to better serve its community. The authors’ library serves health care professionals who experience high levels of stress due to everyday demands of work or study, which can have negative impacts on physical and mental health. Our library is committed to serving the needs of our community by identifying opportunities to improve their well-being.Case Presentation: Librarians at the Harvey Cushing/John Hay Whitney Medical Library at Yale University developed a group mindfulness program and a space for self-defined personal care to assist health care professionals in alleviating stress. Surveys were used to evaluate the mindfulness program and self-care space.Conclusions: We successfully implemented two collaborative wellness and self-care initiatives with students and other stakeholders, as demonstrated by program attendance, diverse space use, and positive survey responses for both initiatives. While these endeavors do not replace the need to challenge structural problems at the root of stress in the health care professions, this case report offers a blueprint for other medical libraries to support the well-being of their communities.

Hispanics, Mental Health, and Discriminating Policies: Brief Report

2019 ◽  
Vol 17 (4) ◽  
pp. 178-180
Author(s):  
Francisco Brenes
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Care Professionals ◽  
Health Care Disparities ◽  
Minority Group ◽  
Well Being ◽  
The United States ◽  
Physical Disorders ◽  
Positive Correlations ◽  
Immigrant Policies

Hispanics, the largest minority group in the United States, are a heterogeneous group that contains a large portion of immigrants from Latin America. Recently, anti-immigrant policies and anti-Hispanic discriminatory practices have heightened at state and national levels. These policies and practices serve to endanger the mental health of Hispanics and play a major role in health care disparities. Positive correlations have been found between chronic discrimination and depression as well as other comorbid conditions, such as anxiety and substance use, and physical disorders. This report provides an overview of the changes in law/policy in recent history that negatively affect the well-being of Hispanics. Recommendations for health care professionals, educators, and researchers are presented.

scholarly journals Easier and Faster Is Not Always Better: Grounded Theory of the Impact of Large-Scale System Transformation on the Clinical Work of Emergency Medicine Nurses and Physicians (Preprint)

2018 ◽  
Author(s):  
Elaine Zibrowski ◽  
Lisa Shepherd ◽  
Kamran Sedig ◽  
Richard Booth ◽  
Candace Gibson
Keyword(s):  
Health Care ◽  
Emergency Medicine ◽  
Grounded Theory ◽  
Health Care Professionals ◽  
Large Scale ◽  
Clinical Work ◽  
Well Being ◽  
Clinical Workflow ◽  
Nurses And Physicians ◽  
The Impact

BACKGROUND The effectiveness of Lean Thinking as a quality improvement method for health care has been contested due, in part, to our limited contextual understanding of how it affects the working conditions and clinical workflow of nurses and physicians. Although there are some initial indications, arising from prevalence surveys and interviews, that Lean may intensify work performed within medical environments, the evidence base still requires detailed descriptions of the changes that were actually introduced to individuals’ clinical workflow and how these changes impacted health care professionals. OBJECTIVE The aim of this study was to explore ways in which a Lean intervention may impact the clinical work of emergency medicine nurses and physicians. METHODS We used a realist grounded theory approach to explore the clinical work of nurses and physicians practicing in 2 emergency medicine departments from a single teaching hospital in Canada. The hospital has 1000 beds with 128,000 emergency department (ED) visits annually. In 2013, both sites began a large-scale, Lean-driven system transformation of their practice environments. In-person interviews were iteratively conducted with health care professionals from July to December 2017. Information from transcripts was coded into categories and compared with existing codes. With repeated review of transcripts and evolving coding, we organized categories into themes. Data collection continued to theoretical sufficiency. RESULTS A total of 15 emergency medicine nurses and 5 physicians were interviewed. Of these, 18 individuals had practiced for at least 10 years. Our grounded theory involved 3 themes: (1) organization of our clinical work, (2) pushed pace in the front cell, and (3) the toll this all takes on us. Although the intervention was supposed to make the EDs work easier, faster, and better, the participants in our study indicated that the changes made had the opposite impact. Nurses and physicians described ways in which the reconfigured EDs disrupted their established practice routines and resulted in the intensification of their work. Participants also identified indications of deskilling of nurses’ work and how the new push-forward model of patient care had detrimental impacts on their physical, cognitive, and emotional well-being. CONCLUSIONS To our knowledge, this is the first study to describe the impact of Lean health care on the working conditions and actual work of emergency medicine nurses and physicians. We theorize that rather than support health care professionals in their management of the complexities that characterize emergency medicine, the physical and process-based changes introduced by the Lean intervention acted to further complicate their working environment. We have illuminated some unintended consequences associated with accelerating patient flow on the clinical workflow and perceived well-being of health care professionals. We identify some areas for reconsideration by the departments and put forward ideas for future research.

INTERNATIONAL PERSPECTIVES ON WELL-BEING AND BURNOUT WITHIN HEALTH SYSTEMS

2021 ◽  
Vol 9 (1) ◽  
pp. 11-25
Author(s):  
James Appleyard
Keyword(s):  
Health Care ◽  
Work Environment ◽  
Health Systems ◽  
Professional Education ◽  
Health Care Professionals ◽  
Health Care Systems ◽  
Well Being ◽  
The United States ◽  
Clinical Event ◽  
Individual Doctor

Objectives: To reflect on the present international culture of professional burnout in health care systems and the need for a radical new approach with an increased understanding of a person- and people-centered attitudes in the promotion of training in wellbeing and the prevention and management of burnout among physicians and health care professionals Methods: A literature search worldwide was undertaken for significant research papers on professional education related to burnout with particular reference to both medical staff resilience and health care system factors. Findings: Burnout among doctors is a global phenomenon. The incidence of burnout reported in a selection of studies among pediatric residents and staff are 25% in Argentina, 37% in the United Kingdom, and 70% in Saudi Arabia. In a national survey in the United States where the overall rate was 59% burned out residents reported significantly increased stress, poorer mental health, and decreased empathy, mindfulness, resilience, self-compassion, and confidence in providing compassionate care Three levels of change that should be the focus of training in prevention, health promotion, and stress reduction awareness have been recommended to reduce the risk of burnout: (1) modifying the organizational structure and work processes; (2) improving the fit between the organization and the individual doctor through professional development programs so that better adaption to the work environment occurs; and (3) individual-level actions to reduce stress and poor health symptoms through effective coping and promoting healthy behavior. Discussion: The history of burnout shows important links with increased work complexity. Narrow training interventions such as debriefing after an adverse clinical event have not been found effective. A more comprehensive personcentered approach with a variety of measurable interventions has resulted in a reduction of 50% in the pediatric faculty in one study. A person- and people-centered cybernetic approach is needed with six standards are to establish and sustain a healthy work environment (1) authentic leadership (2) meaningful recognition, (3) skilled communication, (4) true collaboration, (5) effective decision making, and (6) appropriate staffing. Conclusion: With such high levels of burnout, health systems worldwide can be viewed as failing their populations on a grand scale. Only an organizational paradigm change to a person- and people cybernetic centered system that incorporates complexity is adaptive and integrative will a health system be effective in preventing and ameliorating the effects of burnout and reduce the increasingly unaffordable misuse of human resources.

scholarly journals Cyberincivility in the Massive Open Online Course Learning Environment: Data-Mining Study (Preprint)

2018 ◽  
Author(s):  
Jennie C De Gagne ◽  
Kim Manturuk ◽  
Hyeyoung K Park ◽  
Jamie L Conklin ◽  
Noelle Wyman Roth ◽  
...  
Keyword(s):  
Health Care ◽  
Learning Environment ◽  
Health Care Professionals ◽  
A Priori ◽  
Well Being ◽  
The United States ◽  
General View ◽  
Discussion Forums ◽  
Massive Open Online ◽  
Health Related

BACKGROUND Cyberincivility is a pervasive issue that demands upfront thinking and can negatively impact one’s personal, professional, social, and educational well-being. Although massive open online courses (MOOCs) environments could be vulnerable to undesirable acts of incivility among students, no study has explored the phenomena of cyberincivility in this learning environment, particularly in a health-related course in which mostly current or eventual health professions students enroll. OBJECTIVE This study aimed to analyze the characteristics of text entries posted by students enrolled in a medicine and health care MOOC. The objectives were to (1) examine the prevalence of posts deemed disrespectful, insensitive or disruptive, and inconducive to learning; (2) describe the patterns and types of uncivil posts; and (3) highlight aspects that could be useful for MOOC designers and educators to build a culture of cybercivility in the MOOC environment. METHODS We obtained data from postings in the discussion forums from the MOOC Medical Neuroscience created by a large private university in the southeast region of the United States. After cleaning the dataset, 8705 posts were analyzed, which contained (1) 667 questions that received no responses; (2) 756 questions that received at least one answer; (3) 6921 responses that applied to 756 posts; and (4) 361 responses where the initiating post was unknown. An iterative process of coding, discussion, and revision was conducted to develop a series of a priori codes. Data management and analysis were performed with NVivo 12. RESULTS Overall, 19 a priori codes were retained from 25 initially developed, and 3 themes emerged from the data—Annoyance, Disruption, and Aggression. Of 8705 posts included in the analysis, 7333 (84.24%) were considered as the absence of uncivil posts and 1043 (11.98%) as the presence of uncivil posts, while 329 (3.78%) were uncodable. Of 1043 uncivil posts analyzed, 466 were coded to >1 a priori codes, which resulted in 1509 instances. Of those 1509 instances, 826 (54.74%) fell into “annoyance”, 648 (42.94%) into “disruption”, and 35 (2.32%) into “aggression”. Of 466 posts that related to >1 a priori codes, 380 were attributed to 2 or 3 themes. Of those 380 posts, 352 (92.6%) overlapped both “annoyance” and “disruption,” 13 (3.4%) overlapped both “disruption” and “aggression,” and 9 (2.4%) overlapped “annoyance” and “aggression,” while 6 (1.6%) intersected all 3 themes. CONCLUSIONS This study reports on the phenomena of cyberincivility in health-related MOOCs toward the education of future health care professionals. Despite the general view that discussion forums are a staple of the MOOC delivery system, students cite discussion forums as a source of frustration for their potential to contain uncivil posts. Therefore, MOOC developers and instructors should consider ways to maintain a civil discourse within discussion forums.

Teaching Interspiritual Dialogue to Health Care Professionals

2017 ◽  
Author(s):  
Kelly R. Arora
Keyword(s):  
Health Care ◽  
Doctoral Students ◽  
Health Care Professionals ◽  
Well Being ◽  
Course Structure ◽  
Beliefs And Practices ◽  
Pedagogical Choices ◽  
Dimensions Of Teaching ◽  
Contemporary Context ◽  
Made In

Interspiritual conversations are becoming more common in health care settings as providers recognize that patients’ diverse spiritual/religious values, beliefs, and practices may influence their health care decision-making and general well-being. This essay explores the practical dimensions of teaching health care professionals how to use an interspiritual dialogue approach grounded in values and particularism through a course entitled “Faith, Spirituality and Culture in Health Care,” which was designed for and taught to doctoral students at a Denver, Colorado, School of Pharmacy. After considering the contemporary context for teaching interspiritual dialogue to healthcare professionals, the essay reflects upon and relates the pedagogical choices made in designing and teaching the course, as well as the course structure, outline, objectives, and schedule.

Direct Primary Care: A Successful Financial Model for the Clinical Practice of Lifestyle Medicine

2021 ◽  
pp. 155982762110066
Author(s):  
Amy R. Mechley
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Care Delivery ◽  
Health Care Systems ◽  
Well Being ◽  
The United States ◽  
Fee For Service ◽  
Financial Model ◽  
Lifestyle Medicine ◽  
Direct Primary

Primary care has been shown to significantly decrease the overall cost of a population’s health care while improving the quality of each person’s well-being. Lifestyle medicine (LM) is ideally positioned to be delivered via primary care and has been shown to improve short- and long-term health outcomes of patients and populations. Direct primary care (DPC) represents a viable alternative to the fee-for-service reimbursement model. It has been shown to be economically and financially sustainable. Furthermore, it has the potential to fulfill the Quadruple Aim of health care in the United States. LM practiced in a DPC model has the potential to transform health care delivery. This article will discuss the need for health care systems change, provide an overview of the DPC model, demonstrate a basic understanding of the benefits, and review the steps needed to de-risk the investment of time, money, and resources for our future DPC providers.

Critical Care in Critical Access Hospitals

2015 ◽  
Vol 35 (5) ◽  
pp. 62-67 ◽  
Author(s):  
Teresa J. Seright ◽  
Charlene A. Winters
Keyword(s):  
Health Care ◽  
Critical Care ◽  
Rural Areas ◽  
Tertiary Care ◽  
Safety Net ◽  
The United States ◽  
Infusion Therapy ◽  
Critical Access Hospitals ◽  
Hospital System ◽  
Critical Access Hospital

What began as a grant-funded demonstration project, as a means of bridging the gap in rural health care, has developed into a critical access hospital system comprising 1328 facilities across 45 states. A critical access hospital is not just a safety net for health care in a rural community. Such hospitals may also provide specialized services such as same-day surgery, infusion therapy, and intensive care. For hospitals located near the required minimum of 35 miles from a tertiary care center, management of critically ill patients may be a matter of stabilization and transfer. Critical access hospitals in more rural areas are often much farther from tertiary care; some of these hospitals are situated within frontier areas of the United States. This article describes the development of critical access hospitals, provision of care and services, challenges to critical care in critical access hospitals, and suggestions to address gaps in research and collaborative care.

Caring for Gravely Ill Children

PEDIATRICS ◽  
1994 ◽  
Vol 94 (4) ◽  
pp. 433-439 ◽  
Author(s):  
Alan R. Fleischman ◽  
Kathleen Nolan ◽  
Nancy N. Dubler ◽  
Michael F. Epstein ◽  
Mary Ann Gerben ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care Professionals ◽  
Treatment Plan ◽  
Ethics Committees ◽  
Well Being ◽  
Pediatric Health Care ◽  
Spiritual Well Being ◽  
Primary Focus

Background. Much has been written about the care of the hopelessly ill adult, but there is little guidance for pediatric health care professionals in the management of children who are critically or terminally ill. Methods. Through a 3-day meeting in Tarrytown, NY, attended by a group of pediatricians and others directly involved in these issues, a principled approach was developed for the treatment of, and health care decision-making for, children who are gravely ill. Results. The group agreed that the needs and interests of the child must be the central focus of any treatment plan and that the child should be involved to as great extent possible, consistent with developmental maturity, in the decision-making process. Quality of future life should be viewed as being relevant in all decisions. Parents are believed to be the natural guardians of children and ought to have great latitude in making decisions for them. However, parental discretion is not absolute and professionals must maintain an independent obligation to protect the child's interests. Conclusions. Decision-making should be collaborative among patient, parents, and professionals. When conflict arises, consultation and ethics committees may assist in resolution. When cure or restoration of function is no longer possible, or reasonable, promotion of comfort becomes the primary goal of management. Optimal use of pain medication and compassionate concern for the physical, psychological, and spiritual well-being of the child and family should be the primary focus of the professionals caring for the dying child.

INTRODUCTION

PEDIATRICS ◽  
1993 ◽  
Vol 91 (5) ◽  
pp. ii-ii
Keyword(s):  
Health Care ◽  
Chronic Illness ◽  
Child Development ◽  
Health Services ◽  
Cultural Sensitivity ◽  
Health Care Professionals ◽  
Research Policy ◽  
The United States ◽  
Policy Formulation ◽  
Full Account

In June 1992, 35 health care professionals, child and disability advocates, researchers, clinicians, and parents met at Wingspread Center in Racine, Wisconsin, for an invitational conference on Culture and Chronic Illness in Childhood. The meeting had as its goal the identification of the state of knowledge on the interface between culture, chronic illness, child development, and family functioning so as to lay the foundations for "culturally appropriate" health policy formulation, "culturally sensitive" services, and "culturally competent" clinicians. The purpose of this special supplement is to establish a national agenda for research, policy, service delivery, and training in addressing the needs of all children with chronic illnesses and disabilities that takes the family, ethnicity, socioeconomic status, and culture into full account. To meet this task, five papers were commissioned. The first, by Newacheck et al, addresses the changes in incidence and prevalence of chronic illness and disability among children and youth by ethnic group. The second paper, by McManus et al, focuses on the trends in health services organization, delivery, and financing as they vary among ethnic groups in the United States. What emerges is a rhetoric of cultural sensitivity not paralleled in the organization or financing of health services. Groce and Zola's paper addresses how cultural attitudes and beliefs are the foundations of our perceptions about health and illness. Those perceptions at times are predisposed to conflict with a health care professional who, coming from a different culture, may hold different norms and beliefs. Brookins grounds her discussion within the context of child development and argues that for a child of color or one whose ethnic heritage is other than mainstream, the key to developmental success is bicultural competence—the ability to walk in and between two worlds.

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