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Stress Influence in Emergency Nursing

The Article Review

Bragard, Dupuis, & Fleet (2015) conducted a qualitative review in which they analyzed the influence that stress has on nurses working in emergency departments (EDs) and methods to cope with it. Working in EDs is particularly stressful, as patients who are there need urgent medical assistance or they can die. Therefore, some nurses who work there suffer from acute stress every day, and others, especially those who have already been working for a long time, have acquired chronic stress. Working more than twelve hours a day and suffering from chronic stress can result in burnout and a poor quality of work-life (QWL) (Bragard, Dupuis, & Fleet, 2015).

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Then, the authors write about burnout stating that it is a syndrome that is connected with stress at work and job dissatisfaction and comprises emotional exhaustion, loss of productivity, and depersonalization. Additionally, the authors mention a positive aspect of burnout, namely, nurses who burnout exert themselves to achieve perfection at work, but when they are not provided with all the necessary resources, they become distressed and frustrated (Bragard et al., 2015).

The authors mention that according to various studies that are focused on the examination of burnout, physicians, and nurses working in ED demonstrated high levels of depersonalization and emotional exhaustion. The factors that reinforced burnout included personal issues, coping methods, and environmental factors. As for the latter, it included short staffing, trauma, violence, stressful situations, and workload. In terms of the personal issues, they were contradictory, as some studies showed that younger nurses suffered from greater depersonalization and emotional exhaustion, while the other ones showed contrariwise.

As for the coping strategies, it was found out that nurses and physicians suffering from emotional exhaustion were using chiefly short-term methods of coping with stress, such as daydreaming or crying rather than long-term methods such as developing alternative plans or speaking about problems with their friends and family. Additionally, the consequences of burnout, such as a negative impact on family life and low job performance, had a negative impact on patient care. Overall, burnout is very common among nurses and physicians in ED, and this problem is significant (Bragard et al., 2015).

Further on, the authors analyze external and internal stress factors that caused burnout. In terms of the external factors, burnout was mainly associated with considerable job demands such as night and long shifts, or psychological demands and bad job resources such as poor teamwork, lack of support, bad job control, and lack of constant education. Due to the short nature of the work in ED care, nurses and physicians cannot develop long-term relationships with patients.

Regarding night shifts, according to the studies on sleep deprivation, it decreases the ability to perform intellectual and challenging tasks and minimizes motivation in performing routine tasks. Thus, the fulfillment of routine tasks followed by long periods of intellectual tasks determines the quality of patient care in EDs, therefore, it is crucial for a nurse or a physician that their shift schedules are developed with a purpose to prevent sleep deprivation, thereby eliminating unnecessary risks to patients. Regarding job resources, the institutions should attempt to increase a sense of control in nurses and physicians on their job and provide better employee support.

In this respect, providing greater autonomy in more independent EDs is a good option. In addition, different rewards, permanent contracts, and compensations constitute better resources. Moreover, it is also important to improve multidisciplinary teamwork and collaboration in EDs and to give nurses and physicians enough time to participate in various education activities (Bragard et al., 2015).

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Then, the authors proceed with the description of the internal factors that cause burnout. Such internal factors as a worry to make a mistake at work are also a source of stress. Certainly, the risk of a professional misconduct lawsuit is rather frightening, therefore, many nurses and physicians in such cases express anger and disbelief that are followed by depression. However, many medical associations have support groups that help physicians and nurses fight litigation thereby alleviating their isolation. According to the studies, physicians and nurses working in EDs usually have a much lower level of burnout at the beginning of their careers (Bragard et al., 2015).

Further on, the authors emphasize on the factors that increase ED physicians’ and nurses’ career satisfaction. Thus, such factors as working in an independent division of ED or an academic center in comparison to regional centers, and working in a friendly atmosphere where every colleague is a member of one big family were positively evaluated by nurses and physicians (Bragard et al., 2015).

The authors conclude their article with the acknowledgment of certain limitations. The first limitation is that the authors focused mostly on a mental health of nurses and physicians suffering from burnout. Second, they did not include the gray literature. Third, some of the analyzed sources were from different countries such as France, Taiwan, and the USA where healthcare systems are different, therefore it is difficult to receive more general results (Bragard et al., 2015).

The Significance of the Article in Nursing Practice

The results presented in the given article play a significant role in nursing practice. Namely, they show how burnout influences the work of nurses and physicians in EDs and provide the strategies on how to prevent it.

The majority of nurses and physicians show a high or moderate level of burnout which means that this problem is very frequent in nursing practice and needs to be resolved, as the stress caused by this syndrome can directly affect patient care because nurses and physicians become less perceptive of patients’ needs. Moreover, this syndrome can aggravate and result in drug abuse, alcohol abuse, and in some cases even suicide. Thus, it can affect not only the health of patients but also that of nurses and physicians themselves (Roberts & Grubb, 2014).

Ethical Considerations

The study was designed to ensure that all ethical aspects of the problem are taken into account. It is a part of an ethical practice to take into account how the study can best be built on the previous works. The research literature is used to create debates on what should be studied and why (Roberts & Grubb, 2014). The analyses of the existing studies helped the researchers determine whether the previous studies had already answered the proposed question or not.

Due to the literature review, the authors managed to discover the gap between coping strategies and stress among physicians and nurses in EDs and the prevention of the consequences. As for the ethical issues, this information was not repeated from the previous studies. Additionally, the authors of the given research assure that findings and results from previous studies are reported without misinterpreting and misrepresenting. Appropriate credit was given to other researchers whose works were used in this study in order to avoid plagiarism.

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Bragard, I., Dupuis, G., & Fleet, R. (2015). Quality of work life, burnout, and stress in emergency department physicians: A qualitative review. European Journal of Emergency Medicine, 22(4), 227-234.

Roberts, R. K., & Grubb, P. L. (2014). The consequences of nursing stress and need for integrated solutions. Rehabilitation Nursing, 39(2), 62-69.

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