Mental Health-Nursing Integrity

Discuss about the Mental Health-Nursing Integrity.

Mental health is a crucial topic in any workplace. It is believed that one in six working people will suffer from mental health issues in some point of their life. (Wang PS, 2004) These issues could be due to economic costs or personal problems. In Australia mental health issues are the leading causes of long term work incapability and sickness absence. Nursing has been considered one of the most stressful professions (Azmoon H, 2013). Nurses experience a range of safety and occupational health risks while providing comfort and care to the aged and sick. While many steps have been taken to identify the physical risks of this profession such as biological and chemical hazards, less success is achieved in recognizing the psychological risks that are experienced by the nurses. Occupational stress is largely attributed to emotional demands and suffering of the patients and their families, physical labour, shift work, work hours and interpersonal relationships conflicts. Health practitioners and researchers agree that nurses are exposed to a number of psychological stressors in their daily work life. Excessive exposure to these stressors produces various long and short term health issues. (Louise Peters, 2012)

Many studies have found out that high level of job stress could lead to feelings of self doubt, lower self esteem, somatic disturbances, feelings of inadequacy and irritability in nurses. Due to the intimate and personal nature of caring of the nursing profession, nurses may feel conflicted in their moral judgement and roles. (N, 2001)Moral distress can be caused by other factors such as policy constraints, and even institutional level constraints that nurses feel is affecting their ability to care for their patients. Compassion fatigue is a combination of spiritual, emotional and physical depletion that is associated with the caring of patients which results in significant physical pain and emotional distress. (Flugel Colle, 2010) It was Joinson, a nurse who first described compassion fatigue in the year 1992. According to her compassion fatigue is a unique burnout that affects people that are associated with caring others. This fatigue impact nurses when while providing empathic support to patients, they experience the pain of their patients and their families. Compassion fatigue is when a nurse becomes disengaged and psychologically disengaged from the caring side of this job. Moral distress can be caused while caring for end of life patients and depersonalizing patients (Hegney, 2014). Contemporary business politics and practices in healthcare have led to commercial or corporate value systems being instilled in a profession that used to be all about care and compassion. Compassion fatigue and moral distress have serious detrimental effects on nurse’s health as feeling of powerlessness, mental health issues, and feeling of dissatisfaction creeps in.

Burnout is another adverse effect of compassion fatigue. Many researchers have studied “Burnout” and “Job stress”. These studies define burnout as a syndrome of depersonalization, reduced personal accomplishment and emotional exhaustion. This emotional exhaustion is all about depleted energy, exhaustion and feeling of being overextended. These symptoms in hospital nurses have significant effects on their well being and health (Mealer M, 2009). As nurses who experience burnout reportedly eat poorly, abuse alcohol, smoke and take drugs. Mental health for any individual is being shaped to an extend by the physical, social and economical factors which they are surrounded with (McIntosh B, 2013). Social inequalities in population related to age, gender, geographic area, ethnicity, income and education are directly related to the presence of mental health issues in that sector of the population. According to the results of the studies conducted for mental disorders and low income families it was seen that 70% positive associations were found for poverty and mental illness (MM, 2009). Children as young as 3 years were found with mental health issues, behavioral problems and socio emotional difficulties in areas with low income families. Another hypothesis linked mental issues and social status by focusing on the frequency, and duration of the stressful episode. People who are low in social status are less likely to have support and advantages that are favourable for them. Adult mental disorders in working age have effects beyond the individual concern as it impacts community, family, partners, children and their economic development (Campion J, 2013). Poor quality employment is a risk factor for mental issues and has significant cases of inequalities in mental disorders. According to a report by Institute of Health Equity close association was found between symptoms of depression and job loss. Jobs such as nursing who have low control at work and low reward have significant effects on mental health.

There are numerous recent and dynamic changes in the health care influenced by reviews and analysis of the past literature. Mental health issues within the health care system is a topic that has been studied from quite a long time now as numerous studies across the world have shown that nurses form the largest percentage in health care. Working environments where the nurses lack discretion and lack autonomy have high levels of burnout and emotional exhaustion. Low reward, high workloads, and workplace stress also adds to the stress. These stressors are not limited to the individual person but can be dangerous for others involved with them. As in nursing workforce high mental disorders and low vitality have implications for patients as well. Stress can result in use of substance abuse which is due to unrealistic views of one and carries potential risk to the patients. There are some primary strategies like work design and cognitive restructuring that aim in eliminating stressors. Secondary strategies such as social support and relaxation techniques target responses to the stressors that are inevitable (Potter P, 2013). Tertiary strategies such as employee assistance program are those that help in healing the damages done by the negative effect of stressors. Usually primary and secondary strategies are used to limit the exposure to the stressors.  These strategies work on warning signs and symptoms that are indicative of stress. Stress signs are presumptive indicators that demand the attention whereas stress symptoms are definitive indicators that not only demand attention but also need prompt action. In the case of nurses the stress symptoms are classified emotional and somatic symptoms.

These somatic symptoms include muscle pain, disturbance in sleep, high blood pressure, headaches, frequent muscle cramps, headaches, pain in joints, gastric disturbances and fatigue. The emotional symptoms are uncontrollable anger, abnormal sweating, lack of enthusiasm, shaking or tremors in limbs, abnormal emotional bursts (anxiety, inconsolable weeping), avoiding socializing, tendency to overindulge, lack of sexual drive, and irritability. If a nurse is under a lot of stress they would experience memory problems, inability to make judgement, unable to concentrate and would look depressed or agitated.  It is crucial that any nurse going through these symptoms should self assess or should go through clinical assessment. Many methods like Maslach Burnout Inventory, and Holmes and Rahe Stress Scale are used to check changes in blood pressure along with galvanic skin response for stress assessment. Undergoing stress changes the blood pressure which is utilized to assess stress.

Resilience is the ability of a person to bounce back after a challenging or adverse episode in life. Adults who are resilient are able to cope effectively to stress. Resilience is a process that starts in early life but increases in adulthood when we face various adversities (Collins, 2009). Early research in resilience showed that personality and temperament are some personal factors that give positive outcomes in the face of an adversity. But recent theories have proven that resilience has a multidimensional construct that includes both personal characteristics as well as specific skills that allow a person to cope with adversities. ABC or Attachment and Bio-behavioral Catch up is an intervention that is specific to caregivers and health professionals that teach them to be responsive to young patients and their emotions. 

Resilience can be build through interventions and assessments such as the resilience scale and open ended questions. Heath workers should not neglect self care as it would drain the joy, resilience, enthusiasm and meaning out of their caring job. It would hurt their ability to practice in an ethical manner. Self care is about looking after your own mental wellbeing and health. We can understand about self care by taking the example of the safety instructions that are given in the plane “First fit your own oxygen mask before helping others”. Therefore by putting yourself first you would be able to help others more efficiently. Self care is about engaging in activities that contribute to your wellbeing, add to your energy and lower your stress levels. Self care should be practiced in all aspects of the life which will enable the individual to have a healthy, long and effective career. By committing to self care throughout your career you are valuing yourself, your professional work and your relationships.

Nursing has a tradition of relationship based care which directs the nurses to form an interpersonal relationship with their patients. It is crucial that healthcare workers are knowledgeable about compassion fatigue and job stress. Equally it is necessary that the healthcare systems invest in forming and creating work environments that encourage a healthy work life balance. For optimal family and patient care the carers have to be recognizing the warnings signs for compassion fatigue and job stress. This will allow them to meet both their as well as their patient’s needs.

References

Azmoon H, D. H. (2013). The relationship between thermal comfort and light intensity with sleep quality and eye tiredness in shift work nurses . J Environ Public Health , 159-163.

Campion J, B. D. (2013). Inequality and mental disorders: opportunities for action. The Lancet , 183-4.

Collins, G. M. (2009). Assessing Resilience. Journal of Psychosocial Nursing , 59-66.

Flugel Colle, K. F. (2010). Measurement of quality of life and participant experience with the mindfulness-based stress reduction program. Complementary Therapies in Clinical Practice , 36-40.

Hegney, D. G.-M. (2014). Compassion satisfaction, compassion fatigue, anxiety, depression and stress in registered nurses in Australia: study. Journal of Nursing Management. , 506-518.

Louise Peters, R. C. (2012). Is work stress in palliative nurses a cause for concern? A literature review. International Journal of Palliative Nursing , 561-567.

McIntosh B, S. B. (2013). Effects of stress on nursing integrity. Nurs Stand , 35-9.

Mealer M, B. E. (2009). The prevalence and impact of post traumatic stress disorder and burnout syndrome in nurses . Depress Anxiety , 1118-26.

MM, B. (2009). Addressing the Determinants of Positive Mental Health: concepts, evidence and practice. International Journal of Mental Health Promotion , 4-17.

N, P. (2001). Occupational stressors and coping as determinants of burnout in female hospice nurses. J Adv Nurs , 396–405.

Potter P, D. T. (2013). Evaluation of a compassion fatigue resiliency program for oncology nurses. . Oncol Nurs Forum , 180-7.

Wang PS, B. A. (2004). Effects of major depression on moment-in-time work performance. Am J Psychiatry , 1885-91.

The primary purpose of referencing in an essay is to acknowledge the sources of borrowed information from someone else’s work. But following Harvard referencing and oxford referencing can be tricky sometimes, and students are often found struggling with it. If you want reliable essay writing service, choose Myassignmenthelp.co.uk who has some of the finest editors in the UK in its team.

Get in touch with MyAssignmenthelp.co.uk today to get the best assignment help and writing service at the best price.