NURSING C946 SG CURRICULUM PROPOSAL TEMPLATE, Exams of Nursing

Download NURSING C946 SG CURRICULUM PROPOSAL TEMPLATE and more Exams Nursing in PDF only on Docsity! NURSING C946 SG CURRICULUM PROPOSAL TEMPLATE Prevention and Management of Nurse Burnout Stephanie M Gill Western Governors University College of Health Professions Summer 2021 NURSE BURNOUT 2 Executive Summary (To be completed in C947) NURSE BURNOUT 5 Literature Review Literature Review Summary Table (Refer to Table 1. Literature Review Summary Table) Curriculum Gap and Potential Causes A review of the Governors University RN to BSN track was performed. The Contemporary Nursing Issues and Innovations syllabi was evaluated and revealed that a need- gap of nurse burnout, stress management and resilience training modules must be included in the course. The current curriculum does not include a module that focuses on the physical and mental consequences of prolonged exposure to high levels of stress experienced by nurses. The course also fails to introduce the term burnout and how to prevent or cure burnout. The proposed curriculum will educate students on how to recognize and understand nurse burnout by learning what burnout is comprised of and by identifying key stressors in the nursing practice. Student’s will discuss strategies for lifelong learning and resiliency to burnout. There may be a multitude of potential causes for the lack in education of burnout to nursing students. One such cause may be that the term burnout can be frightening to students and make them afraid to continue their education. Another potential cause for the lack of education in treating and preventing nurse burnout is the lack of interest from the students and course instructors. Students may not feel interested in the prevention of nurse burnout because of the mentality that it will not happen to them. Students may also believe they will not need to use the preventative measures for nurse burnout for many years, thus feeling as though their time is being wasted. Course instructors may feel as though there are far more important subject and course materials that need to be taught rather than nurse burnout. NURSE BURNOUT 6 With any proposal for change, it is essential to have a comprehensive plan in place for success. The three stages of Lewin’s Change Model are “unfreezing” or when change is necessary, “moving” or when change is initiated, and “refreezing” or when a balance is established. The use of Lewin’s change model can decrease the likelihood of challenges during implementation of the new course pertaining to burnout. The three stage change theory is justified in its capability of allowing stakeholders to unify and collaborate early in the process of change. In Lewin’s second stage challenges and resolutions are recognized, allowing participating parties to see the advantages of the proposed change. In the third and final phase the change becomes standard, and results are monitored and evaluated. Using Lewin’s Change Model to guide the implementation of education pertaining to nurse burnout can promote acceptance by students, course instructors, and administration by involving them in the planning and implementation phases. Incorporating Lewin’s model into the change process would integrate the burnout module to the Contemporary Nursing Issues and Innovations course. The stakeholders would be identified as the students, course instructor, and administration. Course instructors would then be educated on the new material pertaining to burnout. The instructors will create a course module for nursing students and professional nurses that focuses on burnout education and prevention, stress management, and resiliency training. Once the modules are a permanent part of the course, instructors, students, and previous graduates can be surveyed to assess the success of the proposed change. Research Findings and Support of Proposal A literature review table was completed using ten peer-reviewed, scholarly resources that support the implementation of education pertaining to nurse burnout in the Contemporary Nursing Issues and Innovations course. There are three common themes in the reviewed articles, NURSE BURNOUT 7 including burnout education and prevention, stress management, and resiliency training. Stress is usual and part of daily life. Stress in the workplace can affect both physical and mental health, personal well-being, job satisfaction, and incite burnout. “Stress has become an inherent aspect of the nursing profession, due to the regular witnessing of pain and death, lack of decision latitude, role stress, low support levels of supervisors, interpersonal conflicts, and communication problems” (Geuens et al., 2020). Nurses are considered high-risk for obtaining burnout, or the inability to cope with stressors over an extended period. Geuens and co-authors would agree with the research from Molina-Praena et al. (2018), when describing burnout as being “composed of the following elements- emotional exhaustion, depersonalization, and low personal accomplishment”. Gillet et al. (2019), go on to describe the link between emotional conflict and heavy workloads being negatively linked to relaxation and sleep quality. The lack in ability to relax or obtain adequate amounts of sleep has been linked to lower levels of presenteeism and increased emotional exhaustion, which are symptoms of burnout. Chullen (2018) and Brown (2018) both discuss the poor outcomes linked to nurse burnout. Burnout has increased healthcare organizations costs due to high turnover rates, absenteeism, and poor patient outcomes. Nurse burnout plays an undeniable role in high turnover rates in medical facilities. Both authors, along with others discuss the need for coping strategies and resiliency programs. In the study conducted by Guo et al. (2018), having high turnover rates can increase burnout rates and management need to understand the importance of low turnover intention and “…improve their management strategies by incorporating some effective measures, such as cognitive behavioral therapy, acceptance and commitment therapy, positive psychotherapy, education programs, and employee support systems to reduce their turnover rate”. Jackson et al. (2018) and Lee et al. (2016) support that stance that educating nurses on NURSE BURNOUT 10 Development Phase The development phase of the ADDIE model deals with constructing the course and is where creators or educators use the data collected from the previous phases to begin the production and testing methods used in the course. In this phase the proposed course content is created and integrated into the existing course. Training stakeholders is completed in the appropriate setting, and materials are supplied to meet the course goals and objectives. The educator develops this phase to define, construct, and assess course content by creating the course summary, content outline, resources, and assessments. Implementation Phase The implementation phase of the ADDIE model signifies the continuous revision and modifications of the course to ensure competence and positive outcomes are obtained. This is where the educators or course creators attempt to revamp, revise, and edit the course to ensure that it can be delivered successfully. Continuous monitoring is key in the implementation phase. Evaluation of the course, with essential and appropriate revisions, is accomplished in this phase. When educators, stakeholders, and student learners actively contribute during the implementation process, immediate alterations can be made to the course or subject, making the course more successful and fruitful. Evaluation Phase The final phase of the ADDIE model is the evaluation phase. This is the phase in which the course is subjected to final analysis, “regarding the what, how, why, when of the things that were accomplished (or not accomplished) of the entire project. This phase can be broken down into two parts: Formative and Summative” (Kurt, 2018). The preliminary evaluation happens during the development phase and the formative stage occurs while students and educators are NURSE BURNOUT 11 performing or overseeing the proposed course. The summative stage occurs at the conclusion of the course. The key objective of the evaluation phase is to determine if the goals have been met, and to determine what will be necessary to further the success and proficiency of the course. Proposal Analysis Phase Academic Setting Description Program level. The level of the program for the proposed course is a registered nurse to bachelors of nurse science course at Governors University. Governor’s University is a nationally ranked college of higher education. The university is associated with a major academic medical center and has a long history as a research university. The College of Nursing was at Governor’s University was established in 1945. The program boasts a track for both PhD and DNP degrees. The RN-to-BSN program allows for licensed nurses with associate degrees or nursing diplomas to earn a BSN degree. The RN to BSN course entitled Contemporary Nursing Issues and Innovations prepares students with the knowledge of major trends, issues, preparation for stressors facing nurses, and innovations in the professional nursing practice and in the United States healthcare delivery system. Knowledge and Skills. To enroll into the nursing program at Governor’s University students must have a cumulative GPA of greater than 2.5 and must maintain this GPA throughout the program. Upon completion of the nursing program, students will take on greater responsibilities within the health care field, embark on leadership roles, improve professional agility, and can consider graduate education in nursing. The Contemporary Nursing Issues and Innovations course is for licensed RNs who seek to expand their knowledge and skills. To enroll in this course students must first complete the Building Health Communities - Population Health course and the Community Health course. As this is an abridged class for RN to BSN NURSE BURNOUT 12 students it will be expected that students will have completed the core prerequisite courses including: anatomy and physiology, biology, chemistry, and microbiology. Students must also have previously completed courses in the fundamentals of nursing, health assessments, pediatric patients, medical and surgical patients, pharmacology, and mental health during their associates degree program. Learning Environment and Method of Delivery. Learners registered in the RN to BSN program are already practicing nurses that are looking to advance their degrees. The learning environment and method used to deliver instructions to learners include an online and in seat structure. When material is taught in the online format, student learners can complete coursework whenever, and wherever they would like. In the online setting student learners can view course materials, such as recorded lectures, PowerPoints, discussion boards, e-learning modules, and simulations from on online platform at any location they would like. When material is taught in class or in seat, learners must be present in class to obtain a letter grade for attendance. In seat learning can be beneficial for those learners that need hands-on education. Needs Assessment and Gap Analysis Creation Procedures Integrating a new course module into the current nursing curriculum at Governor’s University can be a lengthy process. A Needs Assessment is the systematic and disciplined approach that is performed to gather and evaluate data appropriate to develop a course module that speaks to all of the student learners needs and informational gaps found. A Gap Analysis is like a Needs Assessment, but it allocates for a more consistent process of determining what the need is. Performing a Gap Analysis is important because it can be used to justify the need for the course module adjustments and guide the techniques used to provide appropriate teaching and evaluation methods. To perform a Need Gap Analysis, one must form a taskforce, identify NURSE BURNOUT 15 Coursework includes an overview of the economics and regulatory issues in nursing and healthcare. Students will learn principles of case management, human genetics, technology, and other practice innovations. Current learning activities and resources include textbook readings, online discussion boards, WIKI assignments, reflections, case studies, and a portfolio assignment. The desired state of the curriculum is to incorporate a module into the Contemporary Nursing Issues and Innovations course that will allow students to learn to identify and understand nurse burnout. In partnership with key stakeholders, providing student learners with dynamic, engaging, and advanced educational methods that promote knowledge, skills, and attitude development required of a baccalaureate prepared nurse, is an important obligation that Governor’s University abides by. Cooperation with outside stakeholders, such as local healthcare facilities, can assist with improving the foundation of the nursing program. Reports from outside healthcare facilities note that nurse turnover rates are on the rise and new nurses are not adequately equipped with the right tools to combat the mental stressors of being a nurse. With the incorporation of the new module, students will learn what encompasses burnout and by identifying key stressors in the nursing practice and how to cope with these issues and stressors. Students will discuss the key factors related to nurse burnout, strategies for managing stress, and resiliency training. Incorporating this module into the current course will provide facilities with mentally capable nurses once they graduate. Curriculum Changes A brainstorming session with stakeholders, using the affinity analysis diagram was used to address the necessary curriculum change that will fill the gap. The unanimity resulted with the incorporation of a module into the Contemporary Nursing Issues and Innovations course at Governors University that addresses nurse Burnout, stress management, and resiliency training. This module will educate the RN to BSN students on burnout and prevent the cycle of burnout. (Refer to Diagram 1. Affinity Diagram) NURSE BURNOUT 16 Organizational Strength and Weaknesses (Refer to Diagram 2. Organizational Readiness for Curriculum Proposal) Proposal Design Phase Syllabus Creation Procedures Course Description Course Objectives Teaching Strategies, Instructional Delivery Methods, and Learning Materials Student Learning Outcome Analysis Course and Grading Policies Proposal Development Phase Course Material Creation Procedures Learning Resources and Learning Activity Formative Assessment Summative Objective Assessment Summative Performance Task Implementation Planning Phase (To be completed in C947) NURSE BURNOUT 17 Evaluation Planning Phase (To be completed in C947) Conclusion (To be completed in C947) NURSE BURNOUT 20 Molina-Praena, J., Ramirez-Baena, L., Gómez-Urquiza, J., Cañadas, G., De la Fuente, E., & Cañadas-De la Fuente, G. (2018). Levels of Burnout and Risk Factors in Medical Area Nurses: A Meta-Analytic Study. International Journal of Environmental Research and Public Health, 15(12), 1–16. https://eds.b.ebscohost.com/eds/pdfviewer/pdfviewer?vid=0&sid=1f3cf631-7dd7- 452e- 85c0-df438695053c%40sessionmgr101 Nursing Theory. (2020, July 19). Lewin’s Change Theory. Retrieved from https://nursing- theory.org/theories-and-models/lewin-change-theory.php Sutherland, K. (2013, June 5). Applying Lewin’s Change Management Theory to the Implementation of Bar-Coded Medication Administration | Canadian Journal of Nursing Informatics. Retrieved from https://cjni.net/journal/?p=2888 Tzanis, J. (2002). Online Course Development Process. Retrieved from http://www.tzanis.org/Courses/ADDIE/index.htm World Health Organization, “Burn-out an ‘”occupational phenomenon’”: International Classification of Diseases,” May 28, 2019: https://www.who.int/mental_health/evidence/burn-out/en/ NURSE BURNOUT 21 First Title Purpose Context Findings Relevance Strength of Appendix A Tables and Diagrams Table1. Literature Review Summary Table NURSE BURNOUT 22 Author (Pub Year) Evidence Kim (2019) “Elements of the Healthy Work Environment Associated with Lower Primary Care Nurse Burnout.” To investigate the relationship between nurses’ work environment and burnout. Population of interest was 120 Registered Nurses and 181 Licensed Practice Nurses who were surveyed in 23 primary care clinics. Findings from this study revealed a substantial correlation between perception of meaningful recognition and lower levels of nurse burnout. This article is relevant to the proposal because it explores the association of nurse burnout and their work environment as well as ways to prevent or stop burnout. Level of Evidence: Level 1 Meta-Analysis Strengths: Study evaluated RN’s and LPN’s as two separate entities. Weaknesses: The study did not explore the current involvement of management in nurse burnout or specific RN and LPN tasks. Lee (2016) “A Meta- Analysis of the Effects of Coping Strategies on Reducing Nurse Burnout” To evaluate literature on the effects of coping strategies in reducing nurse burnout. The population of interest in this study was 1,521 nurses who were assessed for the effectiveness of incorporating coping strategies into their lives to decrease nurse burnout. Findings from this study revealed that coping strategies were found to reduce nurse burnout and maintain effectiveness between 6 months and 1 year. This article is relevant to the proposal because it correlates the use of coping skills and the reduction in nurse burnout. Level of Evidence: Level 1 Meta-Analysis Strengths: Participants were evaluated multiple times, up to 4 years, after the coping interventions were used. Weaknesses: Very large timeframe between studies (1979 and 2014) that were analyzed. Molina- Praena “Levels of Burnout and To analyze associated The population of interest was Findings from this study This article is relevant Level of Evidence: NURSE BURNOUT 25 burnout. sufficient support and resources. questionnaires were completed in 2015, while the Australian questionnaires were completed in 2017. Thus, allowing room for inaccuracy. Jackson (2018) “Burnout and Resilience in Critical Care Nurses: A Grounded Theory of Managing Exposure” To better understand nurse burnout and resilience in response to workplace adversity. The population of interest was 11 female critical care nurses at a teaching hospital in Canada. Findings from this study revealed that burnout and resilience do not manifest through different processes and that burnout is a result of toxic workplace adversity. This article is relevant to the proposal because it supports the idea that managemen t must create a supportive work environment to address workplace adversity. Level of Evidence: Level 4 Cross-sectional study Strengths: Corbin and Strauss methodology used during open-ended interviews allowing for accuracy and consistency. Weaknesses: Small sample size of 11 participants, all were female and had the same nursing background. Brown (2018) “The Impact of Resiliency on Nurse Burnout: An Integrative Literature Review” To identify causes of nurse burnout and discover strategies that maintain a productive, healthy nursing workforce. The population of interest was peer reviewed 16 articles that included nursing students and nurses that held associate, Findings from this study revealed that nurses with children, many years of experience or an associate degree have a This article is relevant to the proposal because it reveals that resiliency research can Level of Evidence: Level 5 Literature Review Strengths: Recent research NURSE BURNOUT 26 bachelor’s, and master’s degrees. The articles were all published between 2012 and 2017. high resiliency level, whereas nurses with graduate degrees are more likely to experience PTSD. The articles also revealed that resiliency programs and support systems can prevent burnout. help leaders identify characteristi cs in new nurses and implement programs that will maintain a healthy work environment . articles were used, resulting in more accurate information. Weaknesses: Limited sample size and study designs were a limiting factor because not all articles used the same study design. Fitzpatri ck (2019) “Joy in Work and Reducing Nurse Burnout: From Triple Aim to Quadruple Aim” To understand what is driving clinical distress and burnout and make recommendatio ns to help solve the related problems. The population of interest are nurses located in the United States, and healthcare systems that incorporate the “Quadruple Aim” improvement process. Findings from this study revealed that implementing the “Quadruple Aim” improvement process, promoting joy in the workplace, staffing and healthy work environment, skilled communicatio n and collaboration, and leadership strategies to promote joy in the workplace, can allow staff to experience happiness in the workplace and improve This article is relevant to the proposal because it promotes the use of the “Quadruple Aim” improvemen t process to prevent and decrease nurse burnout. Level of Evidence: Level 7 Expert opinion Strengths: The information provided by this article can be used as a flagship for research into the use of “Quadruple Aim”. Weaknesses: No studies were cited in the article to endorse the claims that the authors made for the use of the “Quadruple Aim” improvement process. NURSE BURNOUT 27 patient satisfaction and safety. Table 2. Curriculum Need-Gap Analysis Table Forces FOR Curriculum Proposal Teaches students to maintain a well-balanced and healthy lifestyle. Gives Nursing students tools such as coping skills, to combat burnout. Teaches students to recognize signs of burnout, such as emotional fatigue, and can aid in stopping the development of burnout before it occurs. Forces AGAINST Curriculum Proposal Faculty resistance to change current curriculum. Students may become scared of the nursing field. Time and resources to expand the curriculum and allow the instructors to become efficient in the new material to enhance learning experiences. Incorporate Stress Management and Resiliency Training to combat Nurse Burnout into Governor University’s BSN Nurse module entitled: Contemporary Nursing Issues and Innovations syllabus. Curriculum Proposal NURSE BURNOUT 30 Diagram 2. Force Field Analysis Organizational Readiness for Curriculum Proposal NURSE BURNOUT 31 Appendix B Course Syllabus NURSE BURNOUT 32 Governors University Contemporary Nursing Issues and Innovations Course Syllabus Title: NUR 301 Contemporary Nursing Issues and Innovations Credits: 4 credit hours Length in hours/ Course length: 40 hours lecture/ 6 weeks Delivery Method: Online and In-Class Requirements Instructor: Stephanie Gill, R.N. Office Hours: Monday – Wednesday: 10:00AM - 2:00PM Thursday – Friday: 11:00AM-3:00PM Email Address: Sgill92@wgu.edu Pre-requisite: None Mission Statement: Through quality training and education, the mission is to prepare graduates with the necessary knowledge, skills, and dispositions to become competent professionals in their chosen field of study. Course Description: This course prepares the student with the knowledge of the major trends, issues, preparation for stressors facing nurses, and innovations in professional nursing practice and in the United States healthcare delivery system. Students will integrate knowledge from their prior learning and nursing experience as they explore the complexity of the healthcare system and practice innovations. Students will explore the key issues facing the US healthcare system and nursing staff and understand the role of nurse involvement in managed care. Students will learn to recognize and understand nurse burnout by learning what burnout is comprised of and by identifying key stressors in the nursing practice. Student’s will discuss strategies for lifelong learning and resiliency to burnout. Student’s will complete a formative, summative, and NURSE BURNOUT 35 Course Policies: 1. Students will show professionalism, courtesy, and netiquette at all times as outlined in the Online RN-BSN Completion Program Student Code of Conduct, the RN-BSN Student Handbook and Online RN-BSN Completion Program handbook. Students are especially required to show courtesy to all faculty, staff, and classmates. Lack of courtesy is grounds for probation and/or dismissal from the RN-BSN program. 2. Students are expected to participate actively in the online classroom and be prepared for learning. This includes completion of course assignments, projects, tests, quizzes, and evaluations as specified. 3. All students are required to follow acceptable standards of academic integrity. Cheating and plagiarism will not be tolerated. Evidence of cheating in any form may result in dismissal. Examples of misuse include but are not limited to: unauthorized use of another person’s computer account; posting inappropriate content in the online classroom or email system or attempting to monitor or tamper with another person’s electronic communications, or reading, copying, changing, or deleting another user’s files. Evaluation Method: The Course grade will be earned as follows: Assignments/Exams/Participation Percentage of Course Grade Participation during lecture 20% Case Study and Reflection Questions 20% Quiz- 5 questions 10% Assessment- 10 questions 20% Guided Meditation Participation 10% Concept Map 10% Discussion Board 10% Grading Scale: A = 90-100 B = 80-89 C = 75-79 D = 67-74 F = 66 and below A minimum grade of 76% is required to pass this course. NURSE BURNOUT 36 Grading Policy: Each student is responsible for maintaining a cumulative minimum average academic grade of 76% or above for the program. All classes require the student to achieve a 76% in order to pass the course. Failure to achieve satisfactory minimum grade levels will result in academic probation. Should a student need to repeat a course, that student is responsible for the associated costs; however, Federal Financial Aid may be available. Students should review the Online RN-BSN Completion Program regarding probation. Further information regarding academic probation is available through the office of the Nursing Program Director and information regarding costs is available through the Financial Aid office. Students may only repeat courses once during the RN - BSN degree completion nursing program. A student who fails more than one course (including general education, core courses or other nursing course requirements) or who fails the same course more than once will be dismissed from the program. Late Work: Due dates for all course assignments, quizzes, exams and discussion post will be listed in the course calendar. Any assignment turned in late will result in loss of points. A deduction of 10% of the points for each day the assignment is late will be made. Late assignments will not be accepted for credit after one week of the due date. Since the online class discussions require timely posting and interchange between classmates, no credit can be earned for late discussion posts to peers. If you are having issues with meeting deadlines, please reach out to faculty. Course Content Outline Weekly Topic Key Concept Required Readings Activities/Assignments/and Exams Week 5 The Cost of Nurse Burnout Burnout Monetary Decline Patient Safety Brown, S., Price, S., & Whichello, R. (2018). The Impact of Resiliency on Nurse Burnout: An Integrative Literature Review. MEDSURG Nursing, 27(6), 349– 379. Lecture with PowerPoint Case Study with Reflection Quiz Week 6 Resiliency Training and Stress Management Burnout Prevention Resiliency Training Stress Management “Quadruple Chullen, C. L. (2018). Should I Stay or Should I Go Now: Nurse Burnout & Turnover Intentions. SAM Advanced M Anagem Ent ]Ournal -, 83(3), 45– 61. Lecture with PowerPoint Guided Meditation Assessment NURSE BURNOUT 37 Aim” Fitzpatrick, B., Bloore, K., & Blake, N. (2019). Joy in Work and Reducing Nurse Burnout: From Triple Aim to Quadruple Aim. AACN Advanced Critical Care, 30(2), 185– 188. Waddill-Goad, S. (2016). Nurse Burnout: Overcoming Stress in Nursing (1st ed.). Indianapolis, Indiana: Sigma Theta Tau International. Appendix C Course Material NURSE BURNOUT 40 Waddill-Goad, S. (2016). Nurse Burnout: Overcoming Stress in Nursing (1st ed.). Indianapolis , Indiana: Sigma Theta Tau International. NURSE BURNOUT 41 Appendix D Assessments NURSE BURNOUT 42 Learning Activities: Guided Meditation with Self-Reflection Overview: Meditation can be described as a set of techniques that aim to encourage a intensified state of awareness and concentration. The main purpose of meditation is to strengthen your consciousness, which allow for the understanding of oneself. This understanding of self facilitates a better control over your mind and body and allows for the reduction or prevention of stress. Directions: Students will be instructed to sit in their seats or find a comfortable spot in class to be able to close their eyes and relax. The students will listen to the course instructor as he or she guides them through visualization meditation scenario. The students will not disturb or distract the other students in the class. Any students that are found to be disruptive during the class will be removed from the class. Students will be graded based on their participation in the medication session and by completing a one paragraph self-reflection on how meditation could be beneficial to their life now and in the future. Scenario: Nurses can be considered high-risk for work related stress due to many factors. Constant stress tends to lead towards negative mental, physical, and emotional symptoms. With the use of meditation students can create a technique that has a vast number of benefits on psychological well-being. Students will gain the knowledge to be able to perform meditation when they feel stressed or burnt out, providing relief from the burnout cycle. Concept Map Overview of activity: A concept map is a diagram that visually represents relationships or connections between concepts and ideas. Concept maps usually illustrate ideas as boxes or circles, that are then connected to sub ideas with lines or arrows. These lines can be labeled with connecting words or phrases that help explain the connections between the concepts. Students will be graded on participation and creativity of the concept map. Directions: Students will split into groups of 2-3 and create concept maps with the central idea being nurse burnout. The students must also include the sub ideas of signs/symptoms, prevention, and relief. Students will be provided 30 minutes of class time to complete the concept maps. Once completed each group will share their concept map with the rest of the class. Students will be given 5 minutes after each presentation to discuss what concepts may need further investigation. NURSE BURNOUT 45 6.) The three general categories of burnout symptoms are (Select all that apply): A) Depression B) Exhaustion C) Sense of low personal accomplishment D) Depersonalization 7.) Self-care includes (Select all that apply): A) Exercise B) Healthy Diet C) Meditation D) Spending time with friends 8.) Who can experience burnout (Select all that apply): A) Nurses B) Doctors C) Police D) Nurse Assistants 9.) What is an external cause of burnout? A) Abundance of resources B) Sufficient staffing C) Lack of support D) A balanced work and home life 10) What is the deep awareness of another’s suffering and the desire to alleviate it? A) Compassion B) Burnout C) Resilience D) Stress Answer Key: 1.) C 2.) B 3.) A,B,D 4.) A,B,C,D 5.) B 6.) B,C,D 7.) A,B,C,D 8.) A,B,C,D 9.) C 10.) A NURSE BURNOUT 46 Summative Performance Assessment: Directions: The summative performance assessment will be completed at the end of the term. The summative performance assessment will be portrayed as a case study with five open ended questions. Students will read through the case study thoroughly, taking notes and highlighting as much or as little as they would like. It is encouraged for students to make note of relevant information or key problems noted in the case study. Once the student feels as though they have gained all knowledge required from the case study, five open ended questions must be answered. Students must complete the assessment during the 90 minute class. Students must complete assessment alone and are not allowed help from student peers. All electronic devices must be stowed in a place that cannot be viewed by the student or their peers. Any student found to be cheating will immediately be removed from the class and receive a failing grade for the assessment. Description of Assessment: You are a nurse on a 30 bed med-surg unit. You have been a nurse for nearly 4 years and consider yourself a “seasoned” nurse. The average patient to nurse ratio is 4:1 on dayshift and the average patient to CNA ratio is 8:1. The unit has had high turnover rates the past 6 months and staff has been asked to pick up shifts to cover the shortage. The current patient to nurse ratio due to decreased staff is 6:1. Management has been interviewing and attempting to hire new nurses to the floor. Today is Tuesday, this is your fourth 12 hour shift in a row with a constant cycle of patients being admitted and discharged. You have three patients that are total cares, which require you to turn them every two hours, feed them, use a total lift to transfer to the chair, and provide incontinence care. Your fourth patient is an elderly patient who arrived on the unit several hours ago with intractable vomiting, you have given Zofran and Compazine with no relief. Your fifth patient is a young man who is in alcohol withdrawal and is requiring Ativan hourly to keep his CIWA score below 4. The charge nurse has just notified you that you will be receiving a sixth patient shortly from the emergency room who has stroke like symptoms. After changing one of your patients for the sixth time this shift due to an incontinence episode you finally find time to notify the doctor that your fourth patient has continued to vomit and is now having shortness of breath and decreased oxygen saturations. You obtain an order to insert an NG tube and STAT chest x-ray once the NG tube is in place. As you are placing the NG tube you are notified that the emergency room nurse has brought up your sixth patient and wants to give you bedside report. You leave your fourth patients’ bedside before calling for the STAT chest x-ray that was ordered. You obtain report on your newest patient, complete a quick assessment, and set of vitals. You then remember to call for the STAT chest x-ray on your other patient and find that the NG is in fact in place, but the patient has aspirated on her vomit. You obtain and order to connect the NG tube to low-intermittent suction. It has been three hours NURSE BURNOUT 47 since you have rounded on one of incontinent patients and find them lying in urine and feces and require a complete bed change. You continue your day and round on each patient every two hours. It is finally the end of your shift. Your patients are all stable, clean, dry, and resting comfortably. You drive home and are so exhausted you nearly drive right in front of another vehicle. You make it home and decide to head straight for bed because you have the next day off. 1.) What mistakes did you make during your shift that could have been prevented? 2.) Whom should you have addressed your concerns to when you were feeling overwhelmed? 3.) What are some practices that could help relieve stress while at work? 4.) What are some practices that can relieve stress or burnout outside of work? 5.) Why do you think it is so important to relieve stress and prevent burnout?