April is Stress Awareness Month and this seems like the perfect time to address the elephant in the room – work-related stress.
We know firsthand that nursing is one of the most stressful professions. The American Nurses Association, along with countless studies, confirms this. In fact, a report in the Journal of Caring Sciences found that nurses are under more work-related pressure because nursing is a “demanding job requiring high skill, constant alertness, strong team collaboration and the provision of 24-hour care.”
All that stress was exacerbated due to the COVID-19 pandemic. It put unyielding pressure on the entire health care system, with nurses being asked to take on herculean roles. For two years, their primary focus was caring for COVID first – other co-occurring conditions became secondary. Now, as nurses transition back to their original roles or take on a new responsibility, they may be feeling a bit insecure about their skills.
Stress Leads to Missed Care
Before the pandemic, nurses who worked consistently on the same unit could achieve prioritization competency quickly. However, the constant need to divert resources to COVID patients and emergent care situations has thrust routine into chaos, leaving nurses – especially new nurses – with little to no opportunity to build these skills.
Stressed, overwhelmed and preoccupied nurses have trouble deciding what to do next or hurry through their tasks. A study published in BMJ found that, on average, nurses missed 2.7 of 12 required care activities per shift and almost three-fourths of nurses reported missing at least one activity on their last shift.
When the cognitive load of patient care becomes muscle memory, nurses can efficiently and effectively deliver care that reduces the prevalence of missed care. Yet, prioritizing care and managing time is not necessarily information that can be memorized or easily taught in a textbook. It takes practice and repetitive training to make safe decisions.
Brushing Up on Skills Reduces Stress
Both the emerging nurse, as well as the established nurse, could benefit from additional training that streamlines their delivery of care. Sentinel U®’s products, such as our Prioritization of Care (POC) series, are designed not just for use in nursing education but also for professional development.
The content addressed in the POC series is invaluable as it comprises most medical surgical admission diagnoses. Using these products, nurses can practice care hierarchy: recognizing cues, analyzing them, making decisions based on the cues, and, finally, prioritizing care.
In one simulation scenario, there could be a patient complaining of shortness of breath who is also dehydrated. The nurse needs to determine what to do first.
For instance, in POC: Adult Medical you could encounter a patient with an open cut on their right calf that is now infected. In the scenario, the nurse is tasked with collecting blood and urine samples. The patient also happens to be a Type II diabetic with high blood pressure and high cholesterol, and lab work reveals the patient’s glucose level is 300. In this prioritization of care simulation program, the user must determine what the nurse should do first.*
Skills Reinforcement Benefits Novice and Experienced Nurses Alike
The POC programs are ideal for emerging nurses who are feeling high levels of stress because they are uncomfortable making clinical decisions on their own. Simulation scenarios are an invaluable tool offering reassurance when guidance from senior nurses may be unavailable.
On the other hand, established and expert nurses know the routines and standards. They have a skillset and years of experience, but what happens when they transfer to a new unit? If they previously only cared for neurological patients, those who had a stroke or underwent a craniotomy, and now they are transferring to ortho, these seasoned nurses could benefit from a refresher course.
We need to make sure all nurses are prepared for any situation they encounter. Being prepared to properly care for patients is paramount to creating a stress-free work environment. Let’s arm our nation’s nurses with tools to combat stress starting with knowledge and confidence. Knowing exactly what to do – and in what order – can help take away any extra pressure a nurse may be feeling in the moment.
*(By the way, in the prioritization of care simulation example shared above, the answer is to administer the IV first, then cultures, insulin, wound care, and finally patient education.)
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