CHALLENGES FACING NURSES

Challenges Facing Nurses

Challenges Facing Nurses

Introduction

Health care systems around the world are facing very significant challenges as they restructure and “reinvent” themselves in an effort to make more efficient use of available resources (ICN, 2001). As health care is a labour-intensive industry, the stresses experienced by these systems inevitably affect their employees. Nurses, as the most highly trained caregivers with regular patient contact, are at the heart of any health care system. Widespread anecdotal evidence suggests that the problems in health care have had a particularly negative effect on the workplace experience of nurses. News accounts regularly report on the challenges nurses face in the workplace. These range from low pay in Ireland, to safety and health problems in South Africa, to emigration in the Philippines, to mandatory overtime in the United States. These stories suggest that nursing is a profession in crisis and that this crisis extends around the world. However, there is little systematic, comparative evidence available as to the nature and extent of the problems nurses face and the strategies they employ to deal with those problems.

Dealing With Aggressive Residents Or Visitors

The level of violence against health care workers has become an important issue in recent years. In the UK, every National Health Service (NHS) Trust Executive has a legal duty under the Health and Safety at Work Act (1974) to ensure the health and welfare of their employees within their work environment and to assess the risk to staff under the Management of Health and Safety at Work Regulations (1999), including exposure to reasonably foreseeable violent attack. Research studies have identified nursing staff as a high-risk occupational group within the heath services. Further studies have also suggested that almost half of all nurses experience at least one physical assault a year, and a further 80% are verbally abused during the same time period.6,7 The potential implications of workplace violence include physical injury and emotional reactions, such as fear, shock, a n g e r, anxiety and disbelief.5 , 8 - 1 1 The long-term emotional sequelae experienced by employees include frustration, selfblame, helplessness, irrita b i l i t y, depression and difficulty sleeping,11-13 as well as post-traumatic stress disorder.14,15 The repeated exposure of nursing staff to occupational stressors can also cause professional 'burnout'( “ a syndrome of emotional exhaustion and cynicism that most frequently affects people working in helping professions”).19 This syndrome has been linked to a number of factors relating to the nurse's work environment, including the perception of a low degree of support from supervisors and high levels of job stress.1 6 , However, no previous research has explored the impact that exposure to violent and aggressive patients has upon the degree of burnout experienced by nursing staff . In North East Scotland, the incidence of violence and aggression against healthcare workers is a major concern, with nursing staff found to be at particular risk of verbal abuse and physical assault. 0 In one NHS Trust, which employs a p ...