400218 Mental Health Nursing

Introduction

Secondary traumatic stress is another name for compassion fatigue that is indicated by compassion loss gradually over time. It is common among people who work with trauma patients directly like nurses, therapists, psychologists, first responders, health unit coordinators an anyone who assists others. Compassion fatigue has negative results on both the care provider and the patient. It has been present in Melbourne in recent years. It is also essential to ensure that there are important workplace cultures which helps the nurses to be aware of the values, attributes and enabling factors in their practice. Proper recommendations are required to enhance compassion fatigue.

Overview

The compassion and empathy described by health care, emergency and service experts in regards to the community can prove physically, economically costly and mentally. Exposure to victims experiencing trauma or distress can have adverse impacts on the experts’ cognitive and physical health well-being and safety. Compassion fatigue is characterized by exhaustion, irritability, negative coping behaviors like the use of alcohol and drug abuse, anger, decreased capability to sympathize and empathize and minimized satisfaction sense at work and lack capability to create decisions and care for the sufferers (Cocker & Joss, 2017).  These adverse impacts of giving care are agitated by the traumatic substance severity to which the care provider is exposed like having a contact directly with the sufferer especially when vulnerability whose nature is graphic. The nurses give compassionate care to sufferers who encounter sicknesses and occurrences that are often sudden, disfiguring and life-threatening. Though nurses get professional satisfaction from their job, their recurrent aftermath of crucial diseases put them at high risk for compassion exhaustion.

Nursing practice in Melbourne has shown compassion fatigue in recent years. Moreover, the nurses have been exposed to adverse conditions especially in the hospital emergency departments and intensive care units. Furthermore, despite the technological use in hospitals, the nurses are outnumbered by the patients hence they become exhausted. Additionally, there is an intense workload and short rest time periods between shifts, repeating tasks, poor resilience, lack of meaningful recognition and lack of support from the management (American Nurses Association, 2015). As a result, healthcare managers and employers have very little conclusive evidence to prevent compassion fatigue. Studies have indicated that emotional intellectual and physical effects of giving expertise services have been addressed by focusing on the identification the prevalence and predictors of compassion fatigue in a specialized occupational team like nurses and community health experts.

Patient-centered nursing in intensive care differs from other healthcare departments. This critical setting and challenges faced by nurses have turned out to compromise the capability of providing effective patient-centered nursing. Critical care health experts have compassion satisfaction and fatigue mid-range levels.  The working environment, training, maturity, and experience also have an implication on the level of compassion satisfaction and exhaustion.  Nurses remain in their role as health care givers despite the high levels of compassion fatigue (Boyle, 2011).

 Research has shown that the nurses also get a sense of compassion satisfaction that is known as the absolute feels received from assisting others through experiences that are traumatic.  Supportable professional quality of life is attained by sustaining a healthy balance between the good and bad caring aspects. The balance place between compassion satisfaction and compassion fatigue must be attained in the workplace and encouraging the essentiality of a positive work-life balance (Chassin & Loeb, 2013). Moreover, the degree of knowledge and skill and low risk for compassion fatigue depends on the maturity of the nurse and the experience. It is vital for the nurse to have the required experience so that they can cope up with the challenges of working in the medical field.  Compassion fatigue in Australia is always measured using the approved Professional Quality of life (ProQoL) scale. The whole concept of ProQol is a complicated milieu of attributes of the work settings, the victim’s symptoms and their vulnerability to primary and secondary trauma in the working environment. The hospital management believes that all nurses are leaders in any context from the bedside to the boardroom. They need leadership skills regardless of the background so that they can assist every victim on his or her journey to health.

Evidence of analysis

I observed that as an ER nurse, one is in the first hour of a shift and a baby is brought in that has been in an accident. The sufferer is five years old and in a horrific figure and distress. Everybody rushes to prepare the trauma room. As the baby is being rushed in and place onto the table, she is pronounced dead by the lead doctor. The rest of the shift will be spent in assisting to console and support the family members of the patient as they file into the waiting area one by one. It is a way of helping the family to get through the night.  The nurse is bound to be exhausted because he or she will spend a lot of time with one person  

Also, a development nurse in a new post was allowed to assess the number of occurrences recorded on one of the wards. The number of sufferers falling in a month was high. On talking to the staff, there was an acceptance that it happens when individuals get old. I noticed that nothing changed and that no one seemed to take responsibility for the problem. The personnel seemed to be careless about this experience, and I had a strong feeling that individuals just wanted to preserve the status quo and not to focus on the practice essentially. There was a lack of creativity in how individuals worked, and there was lack of communication between professional authorities. There was no comprehension of the values underpinning how the personnel worked. After some time, there was a new ward nurse who was collaborating, and her decision making was transparent. As development nurse, she helped in developing practice and enhance care for the patients. Her responsibility was clear, and she also took accountability of the personnel. The ward personnel was now willing and committed to improving the care for the victims. The energy and the commitment in the team were terrific and worked together to achieve the goal of the organization.  

Analysis of the current compassionate culture

Workplace culture in healthcare context affects the motivation and success of the staff. The impacts of unsuccessful and toxic cultures have resulted in critical results for the sufferers’ results, personal wellbeing and also wastes good economic resources. Workplace culture and its capable effects relationship highlight the demand to recognize, comprehend and make best cultures in healthcare particularly at the level of providing care, service users and staff interface (Flarity, Gentry & Mesnikoff, 2013). Culture is not about people but societal surroundings that affect the way individuals behave and the societal norms that are accepted. Five attributes are identified that will be considered necessary for productive workplace culture.

The first attribute is specific values shared in the workplace. This has been acknowledged as designating successful culture in healthcare and business (Harris & Griffin, 2015). The concept of analysis validates the requirement for a consistent set of value and principles that are common and shared in the healthcare workplace. This means that the hospital ensures that the nurses and other experts have values that are respected to ensure the safety of the patient and the victim. The benefits are safety, leadership development, and participation with all stakeholders encompassing service users, high support and challenge, lifelong learning and person-centeredness. In Melbourne healthcare settings, individuals learn not to blame others but correct their mistakes.  The experts are assisted to both learn from and examine into their practice and develop their effectiveness and also develop others’ effectiveness (Hinderer et al., 2014). These values helped in valuing both patients and caregivers which in turn assisted in achieving respect, mutual trust and instill faith. Respect is paramount in all areas of health.

The second attribute is that the ten values are realized and exposed in practice, some visions and missions are with individual and collective responsibility. The hospital management ensures that they practice what they say hence all the values are realized in practice, and the sufferers experience them. There is a reflection of the mission and the vision every day with motivated, self-directing, collaborative personnel who take individual and shared responsibility and accountability (Houck, D, 2014). The values help in guiding the decision-making process in different activities within the hospital.

The following attribute is adaptability, innovation and creativity maintain workplace effectiveness. Research has indicated that strong cultures alone do not ensure efficiency. A positive attitude helps in preserving flexibility with continuous development. It encourages the staff and stakeholders to enhance creativity and innovation. Moreover, changes create a way of solving issues within the facility and create new opportunities for individuals to showcase their skills. The technological innovations have become an essential driver in attaining more effective use of resources. Creativity enhances workforce and creates change which also encompasses working methods. It also helps in preventing exhaustion among nurses during their practice (Maiden, Georges& Connelly, 2011).

The next attribute is the needs of victims and communities to drive necessary change. Adjustments are required for nursing practice, and they are also inspired by the societal and the victim’s needs (Occupational Safety and Health Administration, 2015). Additionally, both nurses and the community deserve better healthcare services to enhance their wellbeing. The hospitals in Melbourne protects its workers though they have some challenges.  The exhaustion reduces their power to serve the patients accordingly.

The last attribute is formal systems exists to enable constantly and assess learning achievement and shared governance endlessly. There are legal systems present to ensure that values are realized (Hegney et al., 2014). The formal systems assess the attainment of individual-centered, secure and successful care that is a key to professional healthcare focus. It also executes all learning in and from practice to make sure that revolution of practice is ongoing (Potter et l., 2010). Furthermore, it enables the participation of the stakeholder in decision making through executing the shared governance. It also contributes the environment of respect for the personnel and decision making. The systems also encourage and recognize active learning results and ascribe work-based learning l from a work-related activity like quality enhancement, practice enhancement and even innovation to attain practice transformation in the healthcare setting.

Enabling factors

There are two enablers categorized as either personal or organizational in their focus. The personal element encompasses the presence of transformational leadership, especially inward managers. Leadership plays an essential role in cultural change. The hospital leadership management pays attention to role modeling values, culture, and attaining the common a shared vision through the engagement of hearts and minds (Stamm, 2010). Transformational leadership facilitates the effectiveness of the workforce and is more influential in attaining satisfaction of the job and the engagement of their organization.  The leaders act with moral integrity using psychological and learning approaches and different intelligence which ensures people and teams adjusts themselves and their settings for the better. Plans for developing clinical facilitators an leaders with necessary skills and values are vital for attaining cultural change.

The experts need assistance to explore their effectiveness to help the nurses and those aspiring to be nurses to become more active. Besides, transparent expectations and roles are recognized as vital enablers to a vibrant culture (The Schwartz Center for Compassionate Care, 2015). The hospital displayed their positions so that the nurses can identify their strengths and find solutions for their weaknesses. The nurses also gave feedback to the management of the hospital to make sure that necessary measures were taken to create a conducive working environment that ensures the safety of the patient.

The organizational disaster involves transparent management that enables an approach to decision making and leadership, the readiness of the organization and human resource department that is supportive. The administration which is transparent is identified by devolved, participative and processes where the experts are seen as seen as partners in a solution, not a challenge (Smart et al., 2014). Excellent leadership at all levels, participative management, with organizational and managerial aid for consistency, trust, mentorship, and empowerment assisted in fixing values in nursing practice.

Organizational preparedness in regards to evidence-based practice and cultural change is known as a preparation state for adjustment that is influenced by the history of the evolution of the organization and its capability through its societal and technical plans to institute and maintain the adjustment. The last organizational enabler is the human resource department aid (Lieshout van & Cardiff, 2011). This is a crucial department because it helps in maintaining the values of the organization in regards to recruitment and selection, the performance of the staff and the expectations as well as playing a role in enabling the organizational learning and enhancement.

Consequences

The likelihood of developing a productive workplace culture within its attributes will be increased by the enabling elements. This can be categorized into those that have impacts on stakeholders and those affecting on other workplace culture. The objectives of the stakeholder requirements would be attained and shown through the endless confirmation that sufferers, service users and societies have their requirements met in a person-centered method involving the receipt of both clinically successful and person-centered care (McCance, McCormack &Dewing, 2011). The hospital ensured that the patients are cared for in an appropriate manner that provides their safety. Person-centered is encouraged because it creates a good relationship among the service users as well as the patients. The staff also show commitment and empowerment which promotes the well-being of the team as well. It is associated with the victims’   positive experiences and results. The personnel and individuals attain pre-stated goals in areas of the victims’ safety, decreased waiting period, enhanced access and improved results (Sacco, Ciurzynski, Harvey & Ingersoll, 2015). Besides, creativity is increased and the staff is motivated to ensure effective workplace and culture.  

Workplace culture has significant effects for various organizations and creating social norms based on the values of all workers. Over the years in healthcare, there has been a concern on organizational culture relating it to performance. Healthcare managers have ensured that the workplace cultures and ensure that they positively influence the behaviors of the employees (McCormack &McCance, 2010). The enabling elements have impacted the nursing practice by helping them to serve their patients effectively. The culture programmes hence need to be enabling and not prescriptive so that the enabling factors, values and characteristics and other cultures can be nurtured.

Recommendations

The framework aims at helping healthcare personnel to develop a productive workplace culture. The hospital management can encourage the improvement of nursing practice by investing in the event of transformational leadership and facilitation skills through the development of skills and the resource. This is important for the nurses and patients because it enhances the healthcare services (Royal College of Nursing, 2011). Nurses play an essential role in maintaining the health care quality and the safety of the patient. A conducive environment is necessary for nurses to carry out the required services that enhance compassion satisfaction. Furthermore, nurses need time to rest and should not be overworked.

High levels of compassion satisfaction help to reduce the possibility of getting compassion fatigue. It is fueled by the capability to give health care to those in custody and become a successful assistant (Patterson et al., 2011). Compassion satisfaction helps the nurses to connect with the patients and experience empathically that creates emotional connections that evoke a response of kindness concern and warmth. This will make the patients to respond to them in a peaceful manner. It is vital for nurses to identify personal coping strategies to prevent compassion fatigue when they are offering their services.

The nurses must also rediscover the passion and the purpose of their work. This will determine whether the nurse is willing to work or not. The hospital management must ensure that the nurses are aware of the purpose to avoid unnecessary challenges. Their passion for serving other people drives them to offer more services willingly without prejudice (Manley, Sanders, Cardiff & Webster, 2011). The nurses help individuals to understand their health care choices and take what is better for them.

Moreover, the nursing leadership must always understand and create opportunities for them to showcase their skills and make sure that they pose knowledge in regards to health. The values of the hospital must be maintained to create a conducive environment for the nurses. Their passion determines their level of compassion satisfaction which improves the services that they have to offer. They have to know when they start not to be okay and create solutions that will help them solve their issues   (Moeller, 2018). It is essential for the nurses to understand themselves so hence enhancing and improving the healthcare systems. This will enable them to have endless empathy in regards to the safety of the patient. The hospital management must make sure that every nurse is comfortable with their working conditions to reduce the levels of compassion fatigue.

Technological advancement is also recommended since it encourages creativity to enhance compassion satisfaction. This will give the nurses the opportunity to take responsibilities of managing their work and provide personal care to the patient. Creativity and innovation strengthen compassion satisfaction by creating new ways in the nursing practice. Clinical leaders and facilitators must transform. Useful work cultures enable creativity that manifests human flourishing which is its pointer ( Hunsaker, Chen,  Maughan & Heaston, 2015). It attains person-centeredness, the safety of the patient to enable all to flourish. Working with the enabling elements, values and characteristics ensure that the nurses will work to enhance compassion satisfaction.  

In conclusion, compassion and empathy are essential to all individual. Compassion fatigue characteristics are irritability, exhaustion, irritability, anger and reduced ability to sympathize and emphasize. It is necessary for the nurses to have compassion satisfaction to ensure the safety of the patient.

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