Self-Care Of Nurses To Prevent Work-Fatigue Syndrome

As much as we want to portray a “superhero” persona to the public, nurses are mortal beings who are also capable of experiencing wear and tear of the body. The job itself is hailed as one of the most dangerous jobs because of the many elements that a nurse encounters in their working environment. Some of these factors include strenuous and physical exertion on the job, work hazards like getting exposed to diseases, radiation, and surgical smoke, combative and aggressive patients and their demanding and impatient families. Nurses also experience stress concerning their employment status and relationship with colleagues and the administration they are working with. Understaffing concerns and the increased rate of turnovers in hospitals and nursing homes  leave nurses in a state of fatigue and dissatisfaction in their work. To overcome the implications of stress, nurses should be able to practice the art and skills of self-care. As soon as these skills are practiced, it can help to lessen the effects and seriousness of the negative implications of their work, enhance their dealings with other people in the workplace, and gives a positive outlook in their daily working lives.

Work-Fatigue Syndrome

Everybody gets tired from work especially after a very tiring day. The endurance of the body is only limited to a certain number of hours until the energy levels wear down and the body feels the effects of work. Persons who work and deal with emergency and life-threatening situations are much prone to suffer from the work-related fatigue compared to those who are employed in regular work environments. As an example, healthcare professionals are cited to have an increased risk of work-related hazard and can experience work-fatigue syndrome as much as soldiers in the battlefield. Unlike doctors and other ancillary staff, nurses stay with the patients and their families most of the time. This condition alone already places the nurse in a stressful situation due to the many tasks that they need to implement to the patient. Studies revealed that nurses who are exposed extensive work-related stress can suffer from burnout and psychological imbalance (Smith-Miller, Shaw-Kokot, Curro, & Jones, 2014). These effects on the nurse can lead to some further serious complications such as compromising patient safety secondary to errors in nursing care practice, medication safety administration, documentation errors, and even interpersonal relationship of the nurse with other members of the healthcare team (Martin, 2015). As such, there are also many research on how to help nurses lessen the burden of their clinical work and focus more on the self first before taking care of others.

It’s Not Being Selfish

You cannot give what you do not have. This old time saying proves everything about nursing and other service-oriented profession. One must remember that to be effective and successful in your chosen career, you must entail enough preparations – intellectually, physically, emotionally, and psychologically. Failure to do so can lead to being unprepared and can compromise your skills and performance in doing your job. Taking care of oneself first is not selfishness. In fact, this just proves that you value your work more and by doing the necessary self-care allows you to offer more of yourself. The following strategies can help in minimizing stress on the job and helps with taking of yourself both in mind and body.

Apply The Nursing Process

Nursing process is not only for patients. You can also utilize this approach in solving your self-care deficit problems. The first thing that should be done is to conduct a thorough assessment of yourself:
  • Do you always feel tired? Are you having more tired days now compared to your previous experiences?
  • Are you gaining or losing weight?
  • Do you have trouble in sleeping?
  • Are you committing mistakes on the job?
  • Are you feeling inadequate in your present work?
  • Do you encounter personal or work-related confrontations?
  • Do you have more time in work than spending personal time?
  • Are you always not present in family and friends’ celebrations?
  • Do you feel stagnant in your present job?
  • When was the last time you have taken a long vacation?
The questions posted above will give you a head start on how to examine your present situation. It is not a standardized questionnaire that can diagnose whether you lack self-care or not, rather a simple introjection of thoughts and feelings about how you are doing with your present work. If most of the questions here are answered with a yes, then it is time to pause and plan for your self-care interventions. As you go along, some strategies can be effective while some are not. You can gauge the effectiveness of every strategy if there are some improvements in your work and wellness state. Otherwise, your evaluation will tell you to do away with this method and look for alternative ways to help you with self-care practices.

Helpful Strategies

Physical Dimension. In this aspect, the focus would be your eating and sleeping habits as well as physical strength and endurance. Incorporate healthy meals into your daily food intake. Don’t rely much on the vending machine for your breakfast, lunch or dinner. Get enough rest before your shift starts. A 2-hour sleep before your work-schedule can boost one’s energy. Power naps are also proven ways to restore energy, but you need to check the policy of the administration if they allow short time breaks for sleeping while on the job. You don’t need to enroll in an exclusive gym to get enough exercise. You can apply simple exercise regimen even while at work. Park your car far from the employee’s entrance to give you ample time to walk. If your workplace is just near to your place, it is better to walk than commute. Psychological Dimension. Mental clarity is achieved if the senses and brain functioning are well-rested. Experts recommend exploring a hobby or engage oneself in travel and adventure. Our five senses need a break from the routinely activities. Travel to new places and discover wonderful sights, taste new dishes, indulge in long massages, and bask in many variations of aromatherapy.

Final Words

There are many other ways that nurses can help themselves in attaining physical and mental wellness to help them with their work and prevent from succumbing in work fatigue syndrome. All it takes is the commitment and determination to partake in self-care routines and get connected with the outside world other than work alone. References: Martin, C. J. (2015). The effects of nurse staffing on quality of care. MedSurg Nursing24(2), S4-S4. Smith-Miller, C. A., Shaw-Kokot, J., Curro, B., & Jones, C. B. (2014). An integrative review: fatigue among nurses in acute care settings. Journal of Nursing Administration44(9), 487-494.  

Nurse Staffing Ratios in Long Term Care Facilities

Nurse staffing is often a hot button for skilled nursing facilities. The need to balance costs with care occurs on a daily basis. For the nursing administrator, the ability to make a case for staffing increases often rests on the ability to provide solid rationales for the increased personnel costs.

CMS Findings on Staffing

The Centers for Medicare and Medicaid Services (CMS) issued a comprehensive report in that focused on nurse staffing in nursing facilities, including skilled nursing facilities and other long term care facilities. At that time, 97 percent of facilities did not have sufficient nursing staff to meet one or more federal staffing requirements or to prevent avoidable harm to residents. In addition, 91 percent didn’t have sufficient nursing staff to meet five important process requirements – dressing/grooming, exercise, feeding assistance, changing wet clothing and repositioning, and toileting. The Center for Medicare Advocacy (CMA) notes, “The report found insufficient numbers of professional nurses as well as insufficient numbers of aides. Although resident acuity has increased in the decade since the CMS report was issued, staffing has not significantly changed, in terms of either absolute numbers of nursing staff or the professional qualifications of staff.”

Further, CMA notes that reduction of unnecessary hospital readmission is one of the goals of health care reform. Recent data from the Centers for Disease Control and Prevention indicates that eight percent of nursing home residents in the US had an emergency department visit in the previous 90 days. Eighteen percent of that number had two or more visits.

Forty percent of those visits were found to be preventable. Falls – previously found to be directly linked to staffing ratios – were the most common reason for nursing home residents to be admitted to the emergency room.

Since 2015, CMS has been collecting and reporting data on all-cause 30-day readmission rates for long-term care facilities across the US. Beginning in fiscal year 2019, long term care facilities will receive incentive payments based (Skilled Nursing Facilities Prospective Payment System (SNF PPS)) which are tied to the quality of the care and the re-admission rate to acute care facilities.

To find out more information on how using appropriate staffing levels can increase Long Term Care Facility reimbursements, check out “How Staffing Makes a Difference”

References:

https://medicareadvocacy.org/more-nurses-in-nursing-homes-will-mean-fewer-patients-headed-to-hospitals/

https://medicareadvocacy.org/preventable-emergency-department-visits-by-nursing-home-residents/

https://www.cdc.gov/nchs/data/databriefs/db33.pdf

https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/SNF-VBP/Downloads/SNFRM-TechReportSupp-2019-.pdf

 

 

How Nurse Staffing Makes A Difference

Appropriate Nurse Staffing levels can make a significant increase in facility payment reimbursement, especially with the Skilled Nursing Facilities Prospective Payment System (SNF PPS) slated to launch in early 2019. All of the measures currently in use by CMS are positively affected by increased Nurse staffing ratios. They include such measures as the percent of residents with new or worsened pressure ulcers, administration of seasonal flu vaccine, falls, drug regimen review, care planning and mobility for patients on ventilator support.

In a document prepared for the American Nurses Association (Nursing World, 2015), Avalere Health LLC, notes, “Nurse staffing systems are often antiquated and inflexible. Greater benefit can be derived from staffing models that consider the number of nurses and/or the nurse-to-patient ratios and can be adjusted to account for unit and shift level factors. Factors that influence nurse staffing needs include: patient complexity, acuity, or stability; number of admissions, discharges, and transfers; professional nursing and other staff skill level and expertise; physical space and layout of the nursing unit; and availability of or proximity to technological support or other resources.”

According to the ANA, appropriate nurse staffing can:
• Reduce medical and medication errors
• Decrease patient mortality, hospitable admissions and length of stay
• Decrease patient falls, pressure ulcers, infections and other complications related to hospitalization
• Decrease patient care costs by reducing unplanned hospital admissions
• Promote better nurse safety, retention and job satisfaction.

In acute care hospitals, McHugh et. al. (Health Affairs, 2013) reported data indicates that those hospitals that use higher levels of RN staffing to ensure manageable workload have lower readmission rates. When staffing is inadequate, care processes such as discharge preparation, care coordination and patient education are hampered due to inadequate time and resources. Nurses are less able to monitor for complications, especially those subtle signs in the early stages of a problem such as an infection, which may result in readmission.

One study by Cimiotti et.al. (American Journal of Infection Control, 2012) found that healthcare-associated urinary tract and surgical site infections were higher in those hospitals in which nurses cared for more patients. Data from this study showed that when a nurse’s workload was increased by a single patient above the average, both urinary tract and surgical site infections increased.

Making the case for better nurse staffing requires good data on the benefits in quality and costs. Unnecessary hospital readmissions are more expensive to the health care system, but they also result in lost revenue for the skilled nursing facility. In addition to the loss of direct revenue, there is a high potential for lost revenue from incentive payments.

Is your facility able to saff up or down based on your frequent fluctuations in acuity or seasonality of your Nurse’s vacation requests? IntelyCare’s On-Demand Staffing platform has some great options for facilities needing the flexibility to adjust their Nurse staffing in as little as 4 hours prior to shift start.

References:
https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/LTCH-Quality-Reporting/LTCH-Quality-Reporting-Measures-Information.html
http://www.nursingworld.org/DocumentVault/NursingPractice/Executive-Summary.pdf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4315496/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3509207/

Awesome IntelyPros

Being a care provider can sometimes feel like a thankless job. Hard work is put into every shift, and it is common to feel as if you are not getting the recognition you deserve. IntelyCare wants to change that. Oftentimes, an IntelyPro does something that really stands out from the crowd. They go above and beyond their call of duty to lend an extra hand and show their dedication to their profession in a way that is far beyond what is expected of Thank You from IntelyCarethem. To recognize our Awesome IntelyPros, we will be giving them a shout out on our social media channels, as well as a $50 gift card. Keep up the great work, and stay tuned for heartwarming stories about our Awesome IntelyPros.

IntelyCare’s #WinItWednesday

win it wednesdayCan I get a drum-roll please?  No need to dream of winning the lottery – IntelyCare is giving away a $500 Visa gift card to one lucky IntelyPro during each week in December, and a grand prize of an $1,000 Visa gift card.

How does it work?

Beginning on December 4, all IntelyPros must work 1 shift per week and have perfect attendance. If both requirements are met, your name will be entered to win a $500 Visa gift card. The promotion will occur each week in December, and reset after a winner was announced. Each additional shift worked past the 1 shift minimum will allow for additional entries: 5 shifts = 5 entries.

Did someone say a grand prize?

Sure did. If you pick up a minimum of 1 shift every week and have perfect attendance throughout December, you will be entered to win a $1,000 Visa gift card. Heighten your chances to win the grand prize by picking up multiple shifts per week, and receiving multiple entries.

Is it possible to win this promotion and the Nutcracker promotion?

Absolutely. Pick up as many shifts as you desire, and you may be walking away with a $500-$1,000 gift card, and tickets to see Boston Ballet’s performance of The Nutcracker or a special, holiday gift basket. Learn more here.

When will the winners be announced?

The week of December 4 to 11: December 13 The week of December 11 to 18: December 20 The week of December 18 to 25: December 27 The grand prize winner will be announced on January 3