Burnout, job stress, anxiety, and perceived social support in neonatal nursing

Article Abstract:

Burnout is a syndrome of emotional and physical exhaustion that may occur in fast-pace and high-stress jobs. Neonatal intensive care nursing is a stressful occupation, full of new technical challenges, ethical problems involving life and death situations, and conflicts caused by personnel shortages and a very busy work environment. Previous studies that examined job stress and burnout have concluded that social support from a supervisor or coworker can minimize the negative effects of job stress. This article describes the results of a study designed to evaluate burnout, job stress, and anxiety among neonatal intensive care nurses. Forty-nine registered nurses that worked 30 hours or more per week in a neonatal intensive care unit participated in the study. Questionnaires were used to test for three aspects of burnout (emotional exhaustion, depersonalization, and lack of personal accomplishment). Other factors measured included anxiety, stress, and social support from a supervisor. The results indicated a moderate level of burnout for depersonalization and emotional exhaustion, and a high level of burnout for lack of personal accomplishment. The nurses felt that they received more social support from fellow nurses than from their supervisors. Less nursing experience was also associated with burnout. Emotional support for new nurses to help them develop coping strategies may help to reduce burnout. Other suggestions for reducing job stress include improving nurse-physician relationships through discussion and joint educational programs, and having a forum were feelings can be expressed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Job stress, Burn out (Psychology)

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Effect of level of patient acuity on clinical decision making of critical care nurses with varying levels of knowledge and experience

Article Abstract:

Patients in critical care units rely on critical care nurses to make accurate clinical decisions. Although many studies have been performed, little is understood about this clinical decision making process. Therefore, a study was performed to evaluate the clinical decision making of critical care nurses. The effects of patient acuity, prior nursing experience, and certification in advanced cardiac life support (ACLS), on decision making were evaluated using computer simulations of real life clinical situations. Sixty-eight critical care nurses completed two different computer simulations, both involving patients with tachydysrhythmias (abnormally fast heart beats). The first part of the simulation test consisted of patients with ventricular tachycardia (rapid contraction of the ventricles, the lower chambers of the heart) and was called the high-acuity situation. The second simulation involved patients with atrial flutter (rapid contraction of the atria, the upper chambers of the heart) and was called the low-acuity situation. In the low-acuity simulation, the proficiency test scores were higher, more information was collected to make a diagnosis, and more patients were cured than during the high-acuity simulation. Proficiency scores were similar for experienced and inexperienced nurses, but the nurses who were certified in ACLS had the highest proficiency scores and collected fewer data before making a decision. These results indicate that the specific nature of the task and the individual making the decision are major determinants in the decision making process. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Management, Usage, Education, Heart failure, Computer simulation

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Clinical decision making of critical care nurses managing computer-simulated tachydysrhythmias

Article Abstract:

Critical care nurses must be able to make rapid and accurate decisions and, in some cases, the lives of their patients may depend on it. A tachydysrhythmia is any type of heart condition that causes the heart to beat very fast (usually over 100 beats per minute). Atrial flutter (rapid contraction of the atria, the upper chambers of the heart) and ventricular tachycardia (rapid contraction of the ventricles, the lower chambers of the heart) are two distinct types of tachydysrhythmia that require different types of treatment. This article describes the results of a study designed to evaluate the knowledge and decision making capabilities of 142 critical care nurses in providing care for patients with atrial flutter or ventricular tachycardia. Computer simulations of real clinical situations were used to test proficiency in making the proper diagnosis and to determine patient outcome (cure or death). The average test scores, when compared with expert performance, were 51 percent for atrial flutter and 35 percent for ventricular tachycardia. Based on the test results, 13 percent of the patients with atrial flutter and 35 percent of those with ventricular tachycardia would have died if the situations actually occurred. Incorrect choice of medication was the cause of death in 87 percent of the cases that resulted in death. The results of this study indicate a need for greater emphasis on tachydysrhythmias in the critical care nursing curriculum. (Consumer Summary produced by Reliance Medical Information, Inc.)

Training, Drug therapy, Tachycardia, Nursing assessment

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