Theorist Application to Role Stressor
Acknowledgement
I am very grateful to have the opportunity to study at Spring Arbor University, College of Nursing. I will forever be grateful to my instructor Patricia Shedd for guiding me through this journey. I would also like to thank Dr. Roberts for taking his time to volunteer to help me and also provide guidance in writing papers.
Section 1
Professionalism in Nursing
Professionalism is said to be the skill, knowledge and behavior pattern portrayed in a structured field. It relates to how individuals explain the meaning of their actions. Professionalism according to Fantahun (2012), is defined as the conceptualization of obligations, attributes, interactions, attitudes, and role behaviors required of professionals in relationship to individual clients and to society. It can also be viewed as a process by which a person acquires the knowledge, skills, and sense of occupational identity characteristic of a professional and involves the internalization of the values and norms of a professional group (Alidina, 2013). It is an important characteristic of in service careers. For this paper, I will be discussing, what professionalism in nursing is, the value/important of professionalism in nursing practice and the importance of maintaining a good public image of nursing to professional practice. An analysis would be given on Compassion fatigue as a common role stressor and why self-care is important to maintaining professionalism in nursing. Lastly, I will be answering relevant questions to the Roy’s Adaptation Model as well the questions in Section 4 of this assignment as it aligns to requirements of the instructor.
Nursing as an occupation has a history virtually as old as humanity. When told to identify the core values in the nursing profession, virtually everyone in it shares the same values which include, honesty, responsibility, the pursuit of new knowledge, belief in human dignity, equality of all patients and the desire to prevent and alleviate suffering. Thus, professionalism in nursing focuses on helping those in need and improving the quality of life for everyone. It encompasses the responsibilities of nurturing, attention to hygiene, food, comfort, and safety (DeAngelis, 2014). It involves putting patients first, providing them with holistic care while educating patients and their families. It reflects nurses’ behavior, roles, and responsibilities towards ensuring every patient’s safety and wellness. The concept of professionalism in nursing refers to attitudes representing levels of identification with, and commitment to, the profession.
The Value/Importance of Professionalism in Nursing Practice
The nursing profession has been rated as one of the most trusted professions as nurses contribute to health care system through different specialties and skills. Professionalism is an important aspect in every career path most importantly in the nursing field. According to DeAngelis (2014) working with a team of healthcare professionals to provide care for patients in need requires discipline, internal and external composure that stays steady throughout the day. The nursing standard of practice governs and is accountable for every nurses’ action. It provides written guidelines that nurses are required to comply with and if they do not, there are sanctioned appropriately (DeAngelis, 2014). The level of professionalism demonstrated by nurses, and the image created, is crucial in attracting clients. As professional nurses, we are autonomous and accountable for our nursing practice. The practice is based on evidence, research and standards. We are empowered to make decisions about our nursing practice through our shared governance model. Our clinical practice is caring, comprehensive, accurate and reliable (Duffy, 2016).
The Importance of Maintaining a Good Public Image of Nursing to Professional Practice
Nurses play an important role in the healthcare system even though their competence, skill, knowledge, judgment, actions, and roles are sometimes invisible to the public. The public views of nursing and nurses are mostly based on people’s personal experiences with nurses, situations and sometimes the clinic they are dealing with. Duffy (2016) suggested that this experience may not provide an accurate picture of all that nurses can and do provide in the healthcare delivery process. In addition, this view is influenced by the fact that we as humans respond to things and situations differently. The public generally views nurses as good people who care others. For instance, when a person states that he or she is a nurse the reaction is generally positive. Nurses also represent the profession in their personal lives as soon as they say that they are Registered nurses. Nurses are cultivating a professional image through the way they present and represent the profession. Duffy (2016) emphasized the image of the profession is communicated through dress, appearance, name tags, and credential identification, how one communicates and introduces oneself, and how one performs and provides care, this increases visibility and professional growth.
Nurses improve the image of nursing with other healthcare professionals, they represent the profession in a variety of settings. This includes professional meetings, typically nursing meetings, participating in interprofessional meetings. Nurses are encouraged to take an active role in the profession to provide recognition in the healthcare system. According to Hoeve (2014), each year there is a National Nurses Week, and during this week there is a designated National Nurses Day, May 6, just as there is an annual recognition week for many other workers and professionals. This period was chosen because it coincides with Florence Nightingale’s birthday, May 12, which is International Nurses Day.
Section 2
Compassion fatigue
Compassion fatigue is a syndrome that caregivers may develop when they internalize pain or anguish related to other people in their work environment. Compassion fatigue has been described as the “natural consequent behaviors and emotions resulting from knowing about a traumatizing event experienced by a significant other – the stress resulting from helping, or wanting to help, a traumatized or suffering person” (Sabo & Figley, 2012). As nurses, the quality of patient care is important to us and is considered a prerequisite for contentment. Nurses are not robots as we all have a sense of feelings. A little connection to patients could build a sense of contentment in nurses, making them feel the service they provide is valued and appreciated. However, when performance exceeds capacity, connection with patients might become useless as nurses just like professionals in other fields, could get overwhelmed and jeopardize the well-being of their patients.
Ashton (2015) stated that the acute phase of compassion fatigue may impact performance while chronic compassion fatigue may weaken commitment to work which may potentially create negative effects on patient safety and quality of care. Nurses working mostly in intensive care unit (ICU) and emergency department experience traumatic event frequently, whether or not they acknowledge it. Nurses in these departments go through a higher level of stress compared to others as they are faced with unexpected crisis daily. What may be considered traumatic to one nurse may not be to another. Traumatic stressors are described as those things that might contribute to the development of the syndromes of compassion fatigue and burnout, and they can be primary or secondary in nature Todaro-Franceschi (2013).
To know if a person is traumatized, it is important to look out for some certain signs. Nurses are especially vulnerable to developing compassion fatigue because we are continually bearing witness to the suffering of others. An indication that one is experiencing compassion fatigue is feeling heart heavy and overburdened while continuing to do the work. Nursing staff at the workplace are faced with lots of pressure from work, high case load, and low staffing turnover. The feeling of overload that may arise from one’s work and which lead to the development of burnout can, and frequently do, spill over into our personal lives.
Mental
Repeated or prolonged exposure to trauma can affect nurses mentally. According to Todaro-Franceschi (2013), witnessing the suffering of others is considered secondary trauma. It has been noted that “all of us who attempt to heal the wounds of others, might be wounded ourselves; it is, after all, inherent in the relationship”. When nurses are unable to maintain balance of empathy and objectivity, it will result in depression
Emotions
Some emotional result of compassion fatigue according to Todaro-Franceschi (2013) includes: anger, blaming, irritability, chronic lateness, overworking, difficulty focusing or concentrating, substance abuse, eating disturbances, disrupted sleep patterns, avoiding or dreading work, calling out sick more often, low self-esteem, high self-expectations, helplessness, and hopelessness.
Physical
Physical changes resulting from compassion fatigue noted by Todaro-Franceschi (2013) includes: chronic fatigue exhaustion (physical, emotional, or both), frequent headaches, gastrointestinal complaint, hypertension, cardiac symptoms such as chest pain or tachycardia, sleep disturbances, muscle tension, aches, and pains, frequent or lingering illness, difficulty focusing and anxiety.
Why Self-Care is Important to Maintaining Professionalism in Nursing
Taking care of others is the most important duty of a nurse. However, to take care of others, nurses must be in a good health state themselves. When nurses are unable to care for themselves they end up becoming patients. Nurses experience work-related stress that may be related to moral issues and dilemmas and how they cope and adapt impacts their practice and overall sense of wellbeing. According to Ashton (2015), Coping is the process with which an individual respond to a threat to one’s self. How some individuals cope with situations and others, can have a major impact in all they do. The way nurses deal positively with situations at work can help them develop long lasting relationship with their co-workers as well as their patients.
Ashton (2015), discussed how moral distress can have a lasting effect on nurses. She recommends that nurses be guided and encouraged to do things to promote their personal self-care and rejuvenate themselves. If nurses are unable to utilize positive coping with the daily stressors, it could lead to poor outcomes and performances at work which affects both the patients, the well-being of nurses and their career, as well as the reputation of the healthcare center they work for.
Section 3
Roy’s Model
To understand how nurses, respond to compassion fatigue at work we can apply Roy’s adaptation model to provide a theoretical overview. The goal of nursing is the promotion of adaptation in each of the four adaptive modes defined by Roy, thereby contributing to health, quality of life, or dying with dignity. According to Ashton, (2015) adaptation is not the same as health which Roy defines as a “process and a state of being integrated and whole”. Nurses work in environments that are intense, these environments present nurses with many challenges that are both anticipated and unanticipated. Challenges that could occur because of overcrowding, short staffing, high acuity, unpredictable levels of care, violence, and the need to respond to rapidly changing situations. Regardless of the population of nurses studied evidence suggests that there are negative consequences of moral distress that include but are not limited to anger, frustration, sadness, depression, and helplessness
Physiological mode: Nurses work in environments that are highly charged and unpredictable in nature which makes them sometimes neglect self-care such as lack of adequate nutrition, elimination, activity, and rest. An unconducive work environment can lead to pain, either an acute or chronic. Roy’s model suggests when there’s an imbalance the physiological integrity of the body is compromised.
Self-concept mode: An individual self-concept is connected to their physical being. The physical well-being relates to other function of an individual and it can affect interactions with others in the environment. According to Ashton (2015), pleasant or unpleasant events that produce a response in the self-concept or role function mode have the capacity to cause a response in the physical being. Nursing sometimes finds alternative habits to deal with compassion fatigue they face at work. An example of such a habit is smoking cigarettes, drinking and even over eating as methods of distressing.
Role function mode: This involves the position one occupies in the society. A role consists of a set of expectations how a person in a position will behave in relation to a person who holds another position. Work related compassion fatigue hinders nurse who is attempting to progress into other roles such as leadership, continuity of education, culture, spirituality, the level of physical function, family dynamics. It can also affect decision making and fulfilling expected responsibilities.
Interdependence Mode: The interdependence mode applies to adaptive behavior for both individuals and co-workers. It is associated with one’s relationships and interactions with others. Compassion fatigue can affect intimate relationships (spouse, parent, God).
Assessment of stimuli
Focal stimulus affecting nurses
- Malnutrition, elimination, activity, and rest
Contextual Stimuli
- Culture, spirituality, level of physical function, family dynamics, economic status, knowledge base, values, support systems in place
Interventions to Alleviate Coping fatigue
Ashton (2015) indicated both providers and recipients of health care, are all stakeholders when it comes to safety and quality in health care. The nursing obligation to support safety and quality in health care is non-negotiable. Ackley and Ladwig (2014), suggested assisting nurses in the identification of stress overload in a stressful situation. Evidence-Based Nursing (EBN): Research suggests that role overload, associated with high-stress levels, among nurses and volunteer caregivers may negatively impact health, well-being, and job performance (Kath and Akintola, 2013). A change in diet, exercise, decreasing stress and not smoking will help restore the body to normal functions. According to Roy’s model, nurses coping processes are both innate and acquired that are used to respond to and influence the environment. Acquired coping mechanisms are learned through experience or chosen consciously (Ashton, 2015). It recommended that nurses be provided with guidance on how to manage their feelings related to self-concept. Self-care is vital to everyone and just like others, nurses should be encouraged to address various stimulus. Nurses are individuals that have five basic needs: oxygenation, nutrition, elimination, activity and rest, and protection.
Section 4
Roy was chosen because of her work. Her model emphasizes the importance of the connection of human being and the environment. It reveals that awareness of oneself and environment can be linked to the way we think and feel. Humans by their decisions are accountable for the integration of creative processes. Roy’s Adaptation Model can be easily applied to assess compassion fatigue encountered by individuals, nurses and patient’s behavior and several potential influences on that behavior. The model was reviewed for its qualitative work that has contributed to the understanding of compassion fatigue. Overall, the model demonstrated reliability and validity of compassion fatigue experienced by nurses. Roy’s model presents a unique nursing science concept of the control mechanism.
Utilizing Roy’s adaptation model, nurses can make decisions about how well adaptation is proceeding. A judgment is made after an assessment of behavior in the first step of Roy’s nursing process. The second step of the nursing process after assessment of stimuli, nurses can form a nursing diagnosis that provides a professional identification of the problem. Working together with patients, the nurse can develop goals that enhance adaptation. According to Ashton (2015), nurses intervene by manipulating the environment to facilitate positive responses. An evaluation of the effectiveness of the nursing intervention is necessary. When the nursing intervention is unsuccessful the nursing process needs to be repeated.
Conclusion
What can individual nurses do to influence the image of nursing? It is often easy to assume that professional issues, such as the image of nursing, are only the concern of the profession. The image of nursing comes from the day-to-day personal contact that the public has with nurses and other healthcare professionals in the workplace. The following are some actions that individual nurses should consider that might impact the image of nursing: assess the actions you take, maintain dress standards that communicate a professional image, consider how we respond to questions, and present ourselves to patients and family members.
Compassion fatigue can be reduced when administrators create work environments that provide staff with access to opportunity, information, resources, and support. It empowers nurse to take control of stressors. In this paper, I have discussed, what professionalism in nursing is, the value/important of professionalism in nursing practice and the importance of maintaining a good public image of nursing to professional practice. Analyzed Compassion fatigue as a common role stressor and why self-care is important to maintaining professionalism in nursing. I also answered relevant questions to the Roy’s Adaptation Model as well the questions in Section 4 of this assignment.
References
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Akintola, O., Hlengwa, W., & Dageid, W. (2013). Perceived stress and burnout among volunteer caregivers working in AIDS care in South Africa. Journal of Advanced Nursing, 69, 2738–2749
Alidina, K., 2013. Professionalism in post-licensure nurses in developed countries. Journal of Nursing Education and Practice, 3(5), pp. 128-137.
Ashton, K. (2015) The Orientation Period: Essential for New Registered Nurses’ Adaptation.
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Duffy, J. R. (2016). Professional Practice Models in Nursing: Successful Health System Integration. New York, NY: Springer Publishing Company.
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Sabo, B., Figley c. (2012) “Reflecting on the Concept of Compassion Fatigue” OJIN: The Online Journal of Issues in Nursing Vol. 16, No. 1, Manuscript 1.
Todaro-Franceschi, V. (2013). Compassion Fatigue and Burnout in Nursing: Enhancing Professional Quality of Life. New York: Springer Publishing Company.