Self Care

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New graduate nurses experience a significant "reality shock" as they transition from the student to professional role. Awareness of potential issues and development of preventative self-care strategies helps ensure a good foundation for life-long career satisfaction. This presentation explores common first-year practice struggles and provides methods to cope with stressors.

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  • stresses novice nurses experience during their first months of practice; 25% leave the profession33 percent of new graduate nurses under the age of 30 plan to leave their positions within one year of hiring. Their findings are corroborated by other researchers. report that 35 to 69 percent of newly hired graduate nurses leave their place of employment within the first year. Nationwide, nurse turnover rates are estimated to range from 55 percent to 61 percent . • The cost of nurse turnover to health care agencies is significant. Orientation programs are estimated to cost agencies more than $30,000 per participating new registered nurse hire. And, needless to say, the productivity of a newly hired RN is less than that of an experienced nurse
  • (nurse-patient ratios)
  • Triggers: honor or promotion, receiving special attention from MDs, severe understaffing, or having difficulty working effectively with others
  • headaches, stress, irritability, anxiety, sleep disturbance, excessive, worry, impaired social skills, depression, fatigue, loss, of concentration, helplessness, psychosomatic complaints, and, post-traumatic stress disorder
  • over checking, the silent treatment, belittling, criticism, scapegoating, sabotaging, and being blamed for things that are not within your control.
  • Practice what you preach! Treat yourself as well as you would treat your patients:bathroom, sleep, breaks
  • Self Care

    1. 1. Nursing and Self-Care
    2. 2. Why Be a Nurse?I like caring for people Appreciation So I can be a CRNA You can make a lot of money
    3. 3. Hospital Reality Sicker patients Higher patient-to-nurse ratios A reliance on confusing emerging technology Administrative demands for cost-cutting Administrative demands for high customer service scores Nurses do not make money. They earn it. Shortage does not mean recession-proof
    4. 4. Where We Stand (the old) Annual turnover rate 14% 15% actively licensed nurses not nursing  Burnout  Scheduling/Hours  Pay  Staffingand patient ratios  Physical Demands 55% nurses are obese 50% exhausted/discouraged by end of shift 44% feel cannot provide fully for patients
    5. 5. Where We Stand (the new) Orientation $30K/new RN 90% start career in the hospital 13-26% attrition-rate for nurses in first year 10-20% leaving profession within 2 years “Reality shock”  Stress related to patient acuity  Inadequate staffing  Unsafe patient care  Management-related issues (i.e. level of support)  Amount of responsibility placed on new grads http://www.pbs.org/now/shows/442/index.ht ml
    6. 6. Transition to Practice:Being a Nurse, Staying a Nurse Realisticjob preview Preceptor and ongoing support Prevent burnout Staying Well Equality Be comfortable, but to too comfortable New graduates need 12 months to gain comfort and confidence in their new roles and require professional development opportunities and support
    7. 7. Bullying “workplace behavior that could reasonably be considered humiliating, intimidating, threatening or demeaning to an individual or group of individuals and that is usually repeated over time” (WorkCover NSW, 2008) Repeated behavioral activity focusing on a target Escalates in severity over time Perpetrator always known to the target Target unable to protect or defend self Stems from the nature of the work
    8. 8. Scope 65% of RNs reported frequently observing lateral violence behaviors among co-workers 10–30% of nurses experience workplace bullying ¾ of critical care nurses work with others who are condescending, insulting, or rude Bullied nurses are more likely to leave their place of employment/higher absenteeism
    9. 9. Signs You Are Getting Nurse-Bullied Unmanageable workload Ignored or excluded Rumors spread about you Ordered to carry out work below your competence level (not due to staff-shortage) Having your professional opinion ignored http://store.sho.com/californication-do- as-i-say-jumbo- mug/detail.php?p=255166 Information relevant to your work withheld Humiliated or ridiculed about your work
    10. 10. Varieties of Nurse-Bullies Super nurse Clique nurse Resentful nurse Jealous nurse Gossip-girl nurse Backstabbing nurse http://www.cafepress.com/+mean_m ale_nurse_rectangle_magnet,3224056 37
    11. 11. Toxic Coworkers Narcissists Borderlines OCD’ers Antisocials Personality-disorderedpeople arent going to change, the key to coping is to change the way you respond to them. http://consumer.healthday.com/encyclo pedia/article.asp?AID=648028
    12. 12. Some Light Readinghttp://electricpulp.com/guykawasaki/arse/
    13. 13. The 90-Day RuleDon’t Complain Unless You Know What You Are Talking About! Accept fair share of work Cooperate with others Give help when asked Ask for assistance and advice Don’t be inquisitive about others’ private lives Work willingly Don’t be too submissive Use initiative Take difficulties to a superior before complaining Accept relevant criticism when conveyed appropriately Don’t denigrate subordinates, peers, or supervisors (aka anyone)
    14. 14. Reflective Practice Self-assessment of practice / competence Identify areas for development and ultimately improve competence Looking for learning points within the scenario or situation Reflect and consider how to apply learning in other situations to further enhance performance Identifying learning / development needs and plan to meet them to improve practice Change/modify practice in response
    15. 15. Self-Nurturing for Nurses ADLs: The 3 free therapies  Right nutrition  Right exercise  Right mental and physical Rest PTO – do not hoard it, use it EAP – its free, USE IT Set (and stick to) your boundaries Monitor codependency behaviors American Holistic Nurses Association Set SMART life goals
    16. 16. Holistic Goal Setting Specific Measurable Attainable Relevant Time-Bound Health- Family – Social – Career Education – Financial - Spiritual
    17. 17. References Black, L., Spetz, J., & Harrington, C. (2008). Nurses working outside of nursing: societal trend or workplace crisis? Policy, Politics & Nursing Practice, 9(3), 143- 157. Black, L., Spetz, J., & Harrington, C. (2010). Nurses who do not nurse: Factors that predict non-nursing work in the U.S. Nursing Economic$, 28(4), 245-254. Cavaiola, A. A., & Lavender, N. J. (2000).Toxic Coworkers: How to Deal with Dysfunctional People on the Job. New Harbinger Publications. Oakland, CA. Han, K., Trinkoff, A., Storr, C., & Geiger-Brown, J. (2011). Job stress and work schedules in relation to nurse obesity. Journal of Nursing Administration, 41(11), 488-495. Kovner, C. T., & Djukic, M. (2009). The nursing career process from application through the first 2 years of employment. Journal of Professional Nursing, 25(4), 197–203 Pascual, P. (2011). Quiz: Can you spot a toxic coworker? Retrieved from http://consumer.healthday.com/encyclopedia/article.asp?AID=648028 Raphael, T (2011). Nurse turnover rate in hospitals. Retrieved from http://www.ere.net/2011/06/08/nurse-turnover-in-hospitals/ WorkCover NSW. (2008). Preventing and dealing with workplace bullying: A guide for employers and employees. Sydney: NSW Government.

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