Moral Distress and Burnout: Clinicians
|
|
- Tobias Daniels
- 6 years ago
- Views:
Transcription
1 Moral Distress and Burnout: Clinicians Sean M Bagshaw, MD, MSc Department of Critical Care Medicine, University of Alberta, Edmonton, Canada CCCF, Toronto, Canada October 2, :30 13:50
2 2017 Disclosures Salary support: Canada government Grant support: Canada/Alberta government Speaking/consulting: Baxter Healthcare Corp. Steering Committee: Spectral Medical, Inc. Data Safety Monitoring Committee: CytoPherx, Inc. I am not an expert in moral distress or burnout I simply work in two busy ICUs
3 Calgary Herald/Edmonton Journal Sept. 13, affecting+their+ability+properly+care+patients/ /st ory.html
4 Tom Blackwell, Edmonton Journal, Nov
5 Moral Distress Definition providers experience painful feelings and/or psychological disequilibrium that occurs in situations in which the ethically right course of action is known but cannot be acted upon Characterized by frustration, anger, guilt, physical symptoms and anxiety due to the perceived threat to one s moral integrity The perception of compromise of one s core values or professional obligations separates moral distress from other concepts such as emotional distress, compassion fatigue and posttraumatic stress
6 Major Root Causes of MDS Hamric et al AJOB Prim Res 2012
7 Moral Distress Score Revised (MDS-R) Instrument Designed/validated for use in multiple settings across HCP disciplines 6 parallel versions: adult/pediatric; RN, allied health; MD Tool contains 21 items scored by participants across two levels: How often a situation arises (frequency) (scored 0-4; 0 for never; 4 for very frequently) How disturbing [it] is when is arises (intensity) (scored 0-4; 0 for none; 4 for great extent) Frequency and intensity examined each or as a composite score fxi = frequency x intensity (for each question; scores 0-16) then summing each item Composite ( fxi) to reflect overall moral distress score range from Hamric et al AJOB Prim Res 2012
8 Design: Web-based survey using validated moral distress tool (MDS-R) Population/Setting: Inter-professional HCPs at a single large academic institution (Jan 2011) Results: 592 respondents (response ~ 22%) (MDS score ~ 77.3) MDS was present across all providers (RN [82.0] > MD [65.8]) MDS negatively correlated with ethical workplace environment Highest ranking sources of MDS: 1. Watching patient care suffer due to lack of continuity 2. Poor communication MDS was higher in ICU settings (n=214; 89.0; range 2-272) MDS among those who left or were considering leaving their position Those with EOLC training experienced higher levels of MDS compared to those without such training Whitehead et al J Nurs Scholar 2015
9 Moral Distress in ICU Providers Professional Response Rate % (n) MDS-R score (med [IQR]) Nurse 49 (428/870) 83 (55-119) Allied Health 47 (211/452) 76 (48-115) Physician 44 (30/68) 57 (45-70) Highest ranking contributing items across MDS scores: Costs (Provide less than optimal care due to pressures from administrators or insurers to reduce costs) End-of-life care (Witness healthcare providers giving false hope to a patient or family) Age was inversely associated with MDS score (AH only) Experience directly associated with MDS score (RN only) Dodek et al JCRC 2015
10 Relationship between Frequency and Intensity of Disturbance MDS scores largely attributed to intensity or level of disturbance with items rather than frequency Dodek et al JCRC 2015
11 Relationship between MDS Score and Response to Questions on Leaving the Workplace MDS scores correlated with tendency to leave ICU (both past and present) but was only statistically significant for nurses Dodek et al JCRC 2015
12 Healthcare Professional Design: Prospective cross-sectional survey June 15-29, 2015 Survey: integration of validated tools for MDS, BOS, workplace satisfaction, pilot tested, clinical sensibility testing, online usability Sampling Frame: All health care professionals in MAZ CVICU MDS-R score (range 0-336) Median [IQR] Range Nurse/NP (n=130 [99%]) 80 (57 110) Respiratory Therapy (n=22 [55%]) 85 (61 104) Allied Health (n=9 [69%]) 54 (39 66) 0 66 Physician (n=8 [100%]) 66 (43 82) 8 90 Total* (n=169/193 [88%]) 78 (57 105) Johnson-Coyle et al CJCCN 2016
13 Level of Disturbance (Median) Level of Disturbance (Median) Relationship between Frequency and Intensity of Disturbance a) b) Frequency (Median) Frequency (Median) 3 4 MDS scores again were shown to be more associated with intensity or level of disturbance with items rather than frequency Johnson-Coyle et al CJCCN 2016
14 Root Causes of Moral Distress Among ICU Providers RN/NP: Initiate extensive life-saving actions when I think they only prolong death. Respiratory Therapy: Follow the family s wishes to continue life support even though I believe it is not in the best interest of the patient. Allied Health: Continue to participate in care for a hopelessly ill person who is being sustained on a ventilator, when no one will make a decision to withdrawal support. Physician: Watch patient care suffer because of lack of provider continuity. Witness healthcare providers giving false hope to a patient or family. Johnson-Coyle et al CJCCN 2016
15 Burnout Syndrome Definition syndrome where providers lose all concern, all emotional feelings for the people they work with, and come to treat them in a detached or even dehumanized way Characterized by emotional exhaustion, depersonalization and decline in desire for personal achievement Related to occupational factors (i.e., workload, control, fairness, reward)
16 EXPECTIONS REALITY Brindley et al JICM 2017
17 Symptoms of Burnout Syndrome Physical Behavioral Cognitive/affective Physical exhaustion Irritability Emotional numbness Chronic fatigue Anger and resentment Hypersensitivity Headaches and back pain Alienation Cynicism Gastrointestinal problems Sleep disturbance Marital and relationship difficulties Rigid thinking Apathy Helplessness and hopelessness Muscular tension Self-righteousness Depression Vulnerability to illness Increased alcohol or drug use Over-identification with patients
18 Maslach Burnout Inventory for Human Services (MBI-HSS) The MBI is a validated tool comprised of 22 items grouped into 3 subscales: Emotional exhaustion (EE) - measures feelings of being emotionally overextended and exhausted by one's work Depersonalization (DP) - measures an unfeeling and impersonal response toward recipients of one's service, care treatment, or instruction Personal accomplishment (PA) - measures feelings of competence and successful achievement in one's work Item are answered on 7-point Likert scale ranging from never (0) to daily (6) Results provide 3 separate scores (one for each domain) A combination of high scores on EE and DP, and a low score on PA, correspond to a high level of burnout Maslach et al Ann Rev Psychol 2001
19 Prevalence study in 165 ICUs in France n=2392 surveys completed (82.3%) Severe BOS identified in 33%. Associated with 4 domains: i) personal characteristics (age); ii) organization factors (choose days off); iii) quality of work relations (conflict); iv) EOLC factors (caring for a dying patient) Poncet et al AJRCCM 2007
20 1-day point prevalence study in 189 ICUs in France n=978 surveys completed (82.3%) BOS in 46.5% of intensivists Factors associated with BOS: Female sex Workload Impaired relationships and/or conflict Embracio et al AJRCCM 2007
21 Personal Characteristics PTSD and Other Psychological Symptoms ICU Environment Moral Distress Perceived Delivery of Inappropriate Care Compassion Fatigue Burnout Syndrome Decreased Patient Satisfaction and Quality of Care Organizational Factors Increased Rates of Staff Leave and Attrition Maslach stated: Imagine investigating the personality of cucumbers to discover why they had turned into pickles, without analyzing the vinegar barrels in which they d been submerged! Moss et al CCM 2016
22 Burnout is communicated from one nurse to another, both consciously and unconsciously In addition to unfavorable workplace environment, the prevalence of burnout complaints among colleagues contributes to explaining variance in individual nurses burnout levels Bakker et al J Adv Nurs 2005
23 Prevalence of Burnout Total RN/NP RRT Allied MD High Moderate Low Moral distress and burnout scores were positively correlated (0.31, p<0.001) Moral distress and burnout scores were negatively correlated with workplace satisfaction (-0.37, p<0.001; -0.56, p<0.001) Johnson-Coyle et al CJCCN 2016
24 Moral Distress/Burnout - Emergent Themes I have felt distress.where it has been decided to end life saving measures for a patient and the patient and family were not ready to accept or adjust to the decision. Transferring ICU patients to the ward hastily [prematurely] when there is no receiving bed available to meet the OR teams demands. [There should be] better communication between surgical team and ICU team in regards to patient prognosis, plan and information provided to family and patient. [There should be] more frequent debriefing sessions [and an increased ability] to understand certain decisions being made by physicians in regards to patient care Bed Capacity Strain End-of- Life Care Themes Contributing to Moral Distress Complex Patients Team Communication Non- Beneficial Therapy There is a lack of transparency regarding patient status and likelihood of [treatment]. Progress notes are vague and uninformative... Often the [treating] team talks to a family and reassures them and then leaves the room.only to tell the bedside RN that this patient is unlikely to receive [treatment]... [There should be] team discussion of [complex and] difficult cases I think sometimes we do wait to long to make a decision on end of life care. If the [team plan to do] surgery on patients who [are at risk of poor outcome], the patient and family need a realistic idea of their plausible outcome and suffering. Sometimes I feel like I'm torturing my long-term patients. Johnson-Coyle et al CJCCN 2016
25 Intervention Type Intervention Aim Example ICU organization Intensivist work schedule Improve workplace environment Change team composition Teambuilding and job rotation Weekend respite for intensivists* Shift work models* Comprehensive information + support program* Structure work shift evaluations* Person Practical Educational programs Educational seminars* Communication skills Relaxation exercises Mindfulness Intensive (EOLC focused) communication strategy Yoga* Facilitated discussion groups* Person Personal Personality and coping EI training* Social support and coping Counselling Facilitated peer support sessions
26 Proposed Response in CVICU 1. Formation of an inter-professional committee (supported by leadership) steered by frontline professionals (develop, implement, and evaluate strategies) 2. Evaluate the process for dissemination of patient care plans and changes to GOC status 3. Pre-briefs in anticipation of acute stressful unit events 4. Pauses immediately following acute stressful events 5. Facilitated debriefs at a later time (discretionary) not dependent on any one team member 6. Educational seminar series focused on issues identified by frontline professionals (i.e., EOLC, LVAD support) 7. Re-evaluation (repeated surveillance)
27 Final Thoughts MDS/BOS are prevalent among ICU providers* Common themes emerge as root causes for MDS: Care of complex patients, team communication, provision of nonbeneficial therapy, end-of-life-care and capacity strain ICU-wide screening can gauge the healthy well-being of professionals and workplace environment Effectiveness of interventions are varied likely require: Inter-professional engagement/acknowledgement Mixture of person-organization multi-faceted strategies Adaptation/implementation fit to local context
28 Thank You For Your
T211 Early Career Burnout in Physician Assistants: A National Survey. Amanda Chapman, MMS, PA-C
T211 Early Career Burnout in Physician Assistants: A National Survey Amanda Chapman, MMS, PA-C achapm@midwestern.edu Introduction Burnout Syndrome: Prolonged response to chronic emotional and interpersonal
More informationBurnout in Palliative Care. Palliative Regional Rounds January 16, 2015 Craig Goldie
Burnout in Palliative Care Palliative Regional Rounds January 16, 2015 Craig Goldie Overview of discussion Define burnout and compassion fatigue Review prevalence of burnout in palliative care Complete
More informationNothing to disclose. Learning Objectives 4/10/2014. Caring for the Caregiver: Taking Care of You (first) and Your Staff (second)
Caring for the Caregiver: Taking Care of You (first) and Your Staff (second) Judith S. Gooding VP Signature Programs March of Dimes NICU Leadership Forum: April 30, 2014 Nothing to disclose Neither I nor
More informationBurnout Among Health Care Professionals
Burnout Among Health Care Professionals NAM Action Collaborative on Clinician Well-being and Resilience Research, Data, and Metrics Taskforce Lotte Dyrbye, MD, MHPE, FACP Professor of Medicine & Medical
More informationDisclosures. From Burnout to Resilience: Building Capacity to Thrive at Work. Arif Kamal MD, MBA,
From Burnout to Resilience: Building Capacity to Thrive at Work Arif Kamal MD, MBA, MHS @arifkamalmd www.resilientclinician.org Disclosures 1 Objectives Learners will be able to describe the current prevalence
More informationChandni Dalia Gillian Colville Kirsty Abbas Joe Brierley Great Ormond St 2013
Chandni Dalia Gillian Colville Kirsty Abbas Joe Brierley Great Ormond St 2013 Setting Tertiary children s hospital PICU/NICU High acuity > 90% children invasively ventilated UK average 65 % Largest training
More informationWalking the Walk Individual Creative Tools for Transforming Compassion Fatigue & Vicarious Trauma
Walking the Walk Individual Creative Tools for Transforming Compassion Fatigue & Vicarious Trauma Kay Glidden, M.S., Certified Compassion Fatigue Specialist & Trainer Beth Reynolds-Lewis, B.S., Certified
More informationICU Strain: Perception of Health Care Providers
ICU Strain: Perception of Health Care Providers Sean M Bagshaw, MD, MSc Division of Critical Care Medicine University of Alberta CCCF October 27, 2015 Disclosures None to declare What is ICU Capacity Strain?
More informationARE PALLIATIVE CARE PROVIDERS: ON FIRE OR BURNED OUT?
ARE PALLIATIVE CARE PROVIDERS: ON FIRE OR BURNED OUT? Burnout happens to highly motivated and committed professionals the type of people who choose to go into hospice and palliative care. Eric Widera,
More informationIan Nisonson, M.D. 11/2/2017
Ian Nisonson, M.D., FACS Conference Director President of Baptist-South Miami Medical Staff (1997-1999) Senior Active Medical Staff, Baptist Hospital of Miami Adjunct Assistant Professor, Herbert Wertheim
More informationAdult Apgar Test. 1. I am satisfied with the ACCESS I have to my emotions -- to laugh, to be sad, to feel pleasure or even anger.
Adult Apgar Test Score 0=hardly ever 1=sometimes 2=almost always 1. I am satisfied with the ACCESS I have to my emotions -- to laugh, to be sad, to feel pleasure or even anger. 2. I am satisfied that my
More informationMANAGING TIME AND STRESS. There is an old saying that : time is money. In health care, time affects both money and quality
MANAGING TIME AND STRESS 1 There is an old saying that : time is money. In health care, time affects both money and quality 2 1 The Present Yesterday is History Tomorrow s a Mystery But Today is a Gift
More informationMoving beyond burnout to professional engagement and joy. Martina Schulte, MD February 10, 2018
Moving beyond burnout to professional engagement and joy Martina Schulte, MD February 10, 2018 Disclosures: None Can we use the word joy? Don Berwick, MD 2017 Perlo. IHI Framework for Improving Joy in
More informationEmergency Medicine Physician Satisfaction and Wellness Committee A Year in Review
Emergency Medicine Physician Satisfaction and Wellness Committee A Year in Review RAHUL SHARMA, MD, MBA, CPE, FACEP EMERGENCY PHYSICIAN- IN- CHIEF CHIEF, DIVISION OF EMERGENCY MEDICINE ASSOCIATE PROFESSOR
More informationBurnout, Renewal & Mindfulness. Joe Dreher MD, Frank Chessa, PhD & Christine Hein, MD
Burnout, Renewal & Mindfulness Joe Dreher MD, Frank Chessa, PhD & Christine Hein, MD 2 The Imperative There is a strange machismo that pervades medicine. Doctors, especially fledgling doctors like me,
More informationBurnout among UPM Teachers of Postgraduate Studies. Naemeh Nahavandi
Burnout among UPM Teachers of Postgraduate Studies Naemeh Nahavandi Introduction The concept of burnout has become an issue for a long time. At first it was introduced in health care professions; however,
More informationCommunication with Surrogate Decision Makers. Shannon S. Carson, MD Associate Professor University of North Carolina
Communication with Surrogate Decision Makers Shannon S. Carson, MD Associate Professor University of North Carolina Role of Communication with Families in the ICU Sharing information about illness and
More informationBuilding Teams and Preventing Burnout:
Building Teams and Preventing Burnout: Strategies to Maximize Effectiveness of the Pediatric Rehabilitation Team Rebecca A. Small, MSW, LCSW December 1, 2016 Objectives Identify the stages of burnout.
More informationWellness: an Opportunity or an Oxymoron for Medical Educators?
Wellness: an Opportunity or an Oxymoron for Medical Educators? APPD LEAD Conference Richard P. Shugerman, MD Rebecca R. Swan, MD Goal for this session: For leaders in education to recognize the importance
More informationText-based Document. The Effect of a Workplace-Based Intervention on Moral Distress Among Registered Nurses. Powell, Nancy Miller
The Henderson Repository is a free resource of the Honor Society of Nursing, Sigma Theta Tau International. It is dedicated to the dissemination of nursing research, researchrelated, and evidence-based
More informationSelf-care and burnout
Self-care and burnout Karen Brouhard, LICSW Faculty and Staff Assistance Office Boston University Resilience and Mindfulness Program for Physicians Bringing Intention, Attention and Reflection to Clinical
More informationPrevalence of Stress and Coping Mechanism Among Staff Nurses of Intensive Care Unit in a Selected Hospital
International Journal of Neurosurgery 2018; 2(1): 8-12 http://www.sciencepublishinggroup.com/j/ijn doi: 10.11648/j.ijn.20180201.12 Prevalence of Stress and Coping Mechanism Among Staff Nurses of Intensive
More informationPhysician Burnout and Distress: Causes, Consequences, and a Structure For Solutions
Physician Burnout and Distress: Causes, Consequences, and a Structure For Solutions January 5, 2017 Presenter: Colin P. West, MD, PhD Professor of Medicine, Medical Education, and Biostatistics Division
More informationCollaboration to Address Compassion Fatigue in Hospital Staff
Collaboration to Address Compassion Fatigue in Hospital Staff Presenters Sabrina Derrington, MD Jim Manzardo, STB, BCC Kristi Thime, RN, CNML Objectives Understand risk factors for compassion fatigue and
More informationObjectives. Integrating Palliative Care Principles into Critical Care Nursing
1 Integrating Palliative Care Principles into Critical Care Nursing It s the Caring, Compassionate, Holistic, Patient and Family Centered, Better Communication, Keeping my patient comfortable amidst the
More informationOutline 4/18/2018. Disclosure. Poll Everywhere Instructions. Journey to a Resilient and Thriving Pharmacy Workforce
Disclosure Journey to a Resilient and Thriving Pharmacy Workforce All planners, presenters, and reviewers of this content report no financial relationships relevant to this activity. Jennifer M. Schultz,
More informationFlorence Nightingale How little the real sufferings of illness are known or understood (Notes on Nursing, 1859, p. 57).
Marie Edwards, RN, PhD Faculty of Nursing, U. of M. Florence Nightingale How little the real sufferings of illness are known or understood (Notes on Nursing, 1859, p. 57). Moral Distress Code of Ethics
More informationAssessing the utility of the Oldenburg Burnout Inventory for staff working in a Psychiatric Intensive Care Unit. A Pilot Study
About the Authors Assessing the utility of the Oldenburg Burnout Inventory for staff working in a Psychiatric Intensive Care Unit. A Pilot Study Authors: Dr Ahmed Saeed Yahya, Dr Margaret Phillips, Dr
More informationPredicting the Risk of Compassion Fatigue: An Empirical Study of Hospice Nurses By Maryann Abendroth, MSN, RN Executive Summary September 1, 2005
Predicting the Risk of Compassion Fatigue: An Empirical Study of Hospice Nurses By Maryann Abendroth, MSN, RN Executive Summary September 1, 2005 Compassion fatigue (CF), is a secondary traumatic stress
More informationPhysician Margin, Overload and Burnout
Physician Margin, Overload and Burnout Black Hills Pediatric Symposium June 23, 2017 Craig J. Uthe, MD AAFP ASAM Sanford Family Physician, Internal Locum Tenens Sanford Medical Director of Clinic Services,
More informationPSYCHOSOCIAL ASPECTS OF PALLIATIVE CARE IN MENTAL HEALTH SETTINGS. Dawn Chaitram BSW, RSW, MA Psychosocial Specialist
PSYCHOSOCIAL ASPECTS OF PALLIATIVE CARE IN MENTAL HEALTH SETTINGS Dawn Chaitram BSW, RSW, MA Psychosocial Specialist WRHA Palliative Care Program April 19, 2017 OUTLINE Vulnerability and Compassion Addressing
More informationPREVALENCE AND LEVELS OF BURNOUT AMONG NURSES IN HOSPITAL RAJA PEREMPUAN ZAINAB II KOTA BHARU, KELANTAN
IN HOSPITAL RAJA PEREMPUAN ZAINAB II KOTA BHARU, KELANTAN Zaidah Binti Mustaffa 1 & Chan Siok Gim 2* 1 Kolej Kejururawatan Kubang Kerian, Kelantan 2 Open University Malaysia, Kelantan *Corresponding Author
More information03/24/2017. Measuring What Matters to Improve the Patient Experience. Building Compassion Into Everyday Practice
Building Compassion Into Everyday Practice Christy Dempsey, MSN MBA CNOR CENP FAAN Chief Nursing Officer First OUR GOAL: OUR GOAL: Prevent suffering by optimizing care delivery Alleviate by responding
More informationBurnout among Hematology/Oncology Nurse Practitioners
Burnout among Hematology/Oncology Nurse Practitioners Laura Bourdeanu, PhD, RN, ANP Barbara B. Pieper, PhD, RN Patricia Cannistraci, DNS, RN,CNE Stacey Faber, PhD Linlin Chen, PhD STTI 43rd Biennial Convention
More informationSection V Disaster Mental Health Services Team and Program Development
Disaster Mental Health Services Disaster Mental Health Services Team and Program Development Section V Disaster Mental Health Services Team and Program Development TEAM FORMATION AND SELECTION Staffing
More informationCOMPASSION SATISFACTION: SELF-PRESERVATION FOR ME. By: Sally Moore. Presented at: NACSW Convention 2014 November, 2014 Annapolis, Maryland
COMPASSION SATISFACTION: SELF-PRESERVATION FOR ME By: Sally Moore Presented at: NACSW Convention 2014 November, 2014 Annapolis, Maryland www.nacsw.org info@nacsw.org 888-426-4712 Self-Preservation for
More informationEnhancing Caregiver Resilience The Role of Staff Support
Enhancing Caregiver Resilience The Role of Staff Support Albert W. Wu, MD, MPH Johns Hopkins Bloomberg School of Public Health Bonn, 29 March 2017 Wu AW 2017 Burnout When passionate, committed people become
More informationMrs Catherine Smith RGN/RMN/MBA PHD Student University of Southampton UK
Mrs Catherine Smith RGN/RMN/MBA PHD Student University of Southampton UK Ahola et al (2009), described a positive experience of the work environment being related to work engagement and professional commitment,
More informationConsidering Care. A Descriptive Study of Moral Distress. Elizabeth Smith, MS, RN, PMHCNS-BC, CHPN Toby Bressler, PhD, RN, OCN
Considering Care A Descriptive Study of Moral Distress Elizabeth Smith, MS, RN, PMHCNS-BC, CHPN Toby Bressler, PhD, RN, OCN What is Moral Distress? Initial Definition: occurring when one knows the right
More informationWorkshop Framework: Pathways
2011 National Conference The National Association of Catholic Chaplains One Day at a time: Companioning Caregivers in Perinatal Loss Judy Friedrichs, MS, RN, CT Rush University Medical Center Workshop
More informationPHYSICIAN BURNOUT DISCLOSURES... A BURNING EPIDEMIC I HAVE NO DISCLOSURES TO REPORT.
PHYSICIAN BURNOUT A BURNING EPIDEMIC I HAVE NO DISCLOSURES TO REPORT. DISCLOSURES... HISTORICAL DEFINITION. FREUDENBERGER..1974 coined the term Burnout. PROCESS One Year Progression Historical term used
More informationUncovering the Silent Epidemic of Psychological Distress in Critical Care Healthcare Professionals
Uncovering the Silent Epidemic of Psychological Distress in Critical Care Healthcare Professionals National Academy of Medicine Collaborative on Clinician Well-being July 14, 2017 Marc Moss, M.D. Roger
More informationMEETING THE CHALLENGE OF BURNOUT. Christina Maslach, Ph.D. University of California, Berkeley
MEETING THE CHALLENGE OF BURNOUT Christina Maslach, Ph.D. University of California, Berkeley BURNOUT AMONG HEALTH CARE PROFESSIONALS Health care has been the primary occupation for research on burnout,
More informationPhysician Burnout: What Is It and What Causes It?
Physician Burnout: What Is It and What Causes It? By Michael Baron, MD, MPH, FASAM Editor's Note: This is part two in a four-part series on physician burnout. Part one was published in the January 2018
More informationWelcome. Self-Care Basics in HCH Settings. Tuesday, January 8, We will begin promptly at 1 p.m. Eastern.
Welcome Self-Care Basics in HCH Settings 1 Tuesday, January 8, 2013 We will begin promptly at 1 p.m. Eastern. Event Host: Victoria Raschke, MA Director of TA and Training National Health Care for the Homeless
More informationCourse Materials & Disclosure
E L N E C End-of-Life Nursing Education Consortium Module 7 Loss, Grief, & Bereavement Course Materials & Disclosure Course materials including handout(s) and conflict of interest disclosure statement
More informationJourney to a Resilient and Thriving Pharmacy Workforce
Journey to a Resilient and Thriving Pharmacy Workforce Amber J. Lucas, PharmD, MBA, BCPS, FASHP Chair, ASHP House of Delegates Pharmacy Operations Manager / Obstetrics-Neonatal Specialist Olathe Medical
More informationUNDERSTANDING DETERMINANTS OF OUTCOMES IN COMPLEX CONTINUING CARE
UNDERSTANDING DETERMINANTS OF OUTCOMES IN COMPLEX CONTINUING CARE FINAL REPORT DECEMBER 2008 CO PRINCIPAL INVESTIGATORS 1, 5, 6 Ann E. Tourangeau RN PhD Katherine McGilton RN PhD 2, 6 CO INVESTIGATORS
More informationThe Doctoral Journey: Exploring the Relationship between Workplace Empowerment of Nurse Educators and Successful Completion of a Doctoral Degree
The Henderson Repository is a free resource of the Honor Society of Nursing, Sigma Theta Tau International. It is dedicated to the dissemination of nursing research, researchrelated, and evidence-based
More informationLiving or surviving at work. complex working environments
Living or surviving at work Learning to develop professional resilience in complex working environments Dra.Eulàlia Masachs Fatjó Sra. Anna Mitjans Garcés EAPH Conference 2015 - Barcelona What is the Galatea
More informationOncology Professional Burnout
1 Oncology Professional Burnout Nancy W. Fawzy, DNSc, RN Board President, Triage Cancer This presentation is intended to provide general information on the topics presented. The author is not engaged in
More informationCompassion Fatigue. Robin Brown-Haithco Director of Spiritual Health and Staff Support. What is Compassion Fatigue?
Compassion Fatigue Robin Brown-Haithco Director of Spiritual Health and Staff Support What is Compassion Fatigue? Compassion fatigue is the natural consequence of stress resulting from caring and helping
More informationHow Do You Measure Resident Wellness TSVETI MARKOVA, MD, FAAFP R. BRENT STANSFIELD, PHD
How Do You Measure Resident Wellness TSVETI MARKOVA, MD, FAAFP R. BRENT STANSFIELD, PHD Objectives Background on measuring resident wellness and un-wellness Our institutional results from measuring burnout
More informationEliminating Perceived Stigma and Burnout among Nurses Treating HIV/AIDS Patients Implementing Integrated Intervention
The International Journal of Indian Psychology ISSN 2348-5396 (e) ISSN: 2349-3429 (p) Volume 3, Issue 3, No. 7, DIP: 18.01.127/20160303 ISBN: 978-1-365-11998-9 http://www.ijip.in April - June, 2016 Eliminating
More informationStress, Burnout, and Resiliency; Finding the Joy in Your Career! Jhaymie Cappiello MS RRT-ACCS
Stress, Burnout, and Resiliency; Finding the Joy in Your Career! Jhaymie Cappiello MS RRT-ACCS Barbara Taylor BSRT and Robin Reese BSRT SPECIAL THANKS Disclosure: none Objectives 1. The importance of Stress,
More informationCaregiver. Caring for the. Tips, Resources and Support for Those Caring for an Elderly Parent or Loved One
Caring for the Caregiver Tips, Resources and Support for Those Caring for an Elderly Parent or Loved One This educational information is proudly provided by Caring for the Caregiver According to the Family
More informationPrevalence and Determinants of Burnout among Primary Healthcare Physicians in Qatar
Prevalence and Determinants of Burnout among Primary Healthcare Physicians in Qatar Mohamed Salem (1) Muna Taher (2) Hamda Alsaadi (3) Abdulla Alnema (2) Samya Al-Abdulla (2) (1) Dr Mohamed Salem, Former
More informationPalliative Care Competencies for Occupational Therapists
Principles of Palliative Care Demonstrates an understanding of the philosophy of palliative care Demonstrates an understanding that a palliative approach to care starts early in the trajectory of a progressive
More informationBurnout in ICU caregivers: A multicenter study of factors associated to centers
Burnout in ICU caregivers: A multicenter study of factors associated to centers Paolo Merlani, Mélanie Verdon, Adrian Businger, Guido Domenighetti, Hans Pargger, Bara Ricou and the STRESI+ group Online
More informationReference Understanding and Addressing Moral Distress, Epstein & Delgado, Nursing World, Sept. 30, 2010
Moral Distress and Moral Resilience Nurses encounter many situations in their work place that can cause moral distress. Moral distress is defined by an inability to act in alignment with one s moral values
More informationCompassion Fatigue: Are you running on fumes?
Compassion Fatigue: Are you running on fumes? What is compassion? Feeling deep sympathy and sorrow for another who is stricken by suffering or misfortune, accompanied by a strong desire to alleviate the
More informationNURSING SPECIAL REPORT
2017 Press Ganey Nursing Special Report The Influence of Nurse Manager Leadership on Patient and Nurse Outcomes and the Mediating Effects of the Nurse Work Environment Nurse managers exert substantial
More informationNurses' Burnout Effects on Pre-operative Nursing Care for Patients at Cardiac Catheterization Centers in Middle Euphrates Governorates
International Journal of Scientific and Research Publications, Volume 6, Issue 7, July 2016 208 Nurses' Burnout Effects on Pre-operative Nursing Care for Patients at Cardiac Catheterization Centers in
More informationOVERCOMING RESISTANCE TO RESILIENCY PROGRAMS: ONE STEP AT A TIME!
OVERCOMING RESISTANCE TO RESILIENCY PROGRAMS: ONE STEP AT A TIME! CENTILE International Conference Washington DC, October 24, 2107 Emily Ratner, MD Director, Integrative Medicine Initiatives, MedStar Institute
More informationEthical Pain Management: Have the Tides Changed? Conflict of Interest Disclosure. Objectives 9/4/2014
Ethical Pain Management: Have the Tides Changed? Helen N Turner, DNP, RN BC, PCNS BC, FAAN Clinical Nurse Specialist, Pediatric Pain Management ASPMN President Elect turnerh@ohsu.edu Conflict of Interest
More informationText-based Document. Workplace Bullying: More Than Eating Our Young. Authors Townsend, Terri L. Downloaded 12-Apr :51:27
The Henderson Repository is a free resource of the Honor Society of Nursing, Sigma Theta Tau International. It is dedicated to the dissemination of nursing research, researchrelated, and evidence-based
More informationNebraska Lifespan Respite Caregiver Survey
Nebraska Lifespan Respite Caregiver Survey Welcome to the Nebraska Lifespan Caregiver Survey! Respite is planned or emergency care provided to a child or adult with special needs in order to provide temporary
More informationIS THERE A RELATIONSHIP BETWEEN NIGHT SHIFT AND NURSING ERRORS? Dr. Vickie Hughes, DSN, MSN, APN, RN, CNS
IS THERE A RELATIONSHIP BETWEEN NIGHT SHIFT AND NURSING ERRORS? Dr. Vickie Hughes, DSN, MSN, APN, RN, CNS Purpose The aim of this systematic review was to examine the evidence regarding nurse night shift
More informationThe True Cost of the Burnt Out Physician. Lisa Ellis, MD, FACP Chief Medical Officer- VCU Health Ambulatory Clinics
The True Cost of the Burnt Out Physician Lisa Ellis, MD, FACP Chief Medical Officer- VCU Health Ambulatory Clinics DISCLOSURES/DISCLAIMERS I have no conflicts of interest 2 The True Cost a Burnt Out Physician
More informationTBI and the Caregiver. TBI and the Caregiver. The Role of the Caregiver after Traumatic Brain Injury TBI TBI DR. CHIARAVALLOTI HAS NO
The Role of the Caregiver after Traumatic Brain Injury Nancy D. Chiaravalloti, Ph.D. Director of Neuroscience and Neuropsychology Director of Traumatic Brain Injury Research DR. CHIARAVALLOTI HAS NO DISCLOSURES
More informationPG snapshot Nursing Special Report. The Role of Workplace Safety and Surveillance Capacity in Driving Nurse and Patient Outcomes
PG snapshot news, views & ideas from the leader in healthcare experience & satisfaction measurement The Press Ganey snapshot is a monthly electronic bulletin freely available to all those involved or interested
More informationLiberating Restricted Visiting Policy in Greek Intensive Care Units: Is it that complicated?
Athanasiou A. RN, MSc 1 Papathanassoglou EDE. RN, MSc, PhD 2 Lemonidou C. RN, MSc, PhD 3 Patiraki E. RN, MSc, PhD 3 Giannakopoulou Μ. RN, PhD 3 1. ICU, 401 General Military Hospital of Athens 2. Cyprus
More informationThe Golden Circle. Why? 1/19/16. Objectives: Why. How. What
Objectives: 1. Define courageous care and why it is important to provide. 2. Explain the vital components of courageous care compassionate care, renewal, knowledge, and leadership. 3. Share a story of
More informationA division of Workplace Behavioral Solutions, Inc
Physician Wellness Services and Cejka Search : Cause, Effect, Cost and What You Can Do About It Alan Rosenstein, MD, MBA Medical Director Physician Wellness Services Vivian M. Luce, MBA Vice President
More information5/1/2018. The Role of Resilience and Mindful Leadership in Nursing. Learning Objectives. Common Terms Compassion and Compassion Fatigue
The Role of Resilience and Mindful Leadership in Nursing Cindy Rishel PhD RN OCN NEA-BC Clinical Associate Professor Learning Objectives Describe the concept of resilience and identify specific attributes
More informationPayment Reforms to Improve Care for Patients with Serious Illness
Payment Reforms to Improve Care for Patients with Serious Illness Discussion Draft March 2017 Payment Reforms to Improve Care for Patients with Serious Illness Page 2 PAYMENT REFORMS TO IMPROVE CARE FOR
More informationEstablishing Work-Life Balance to Keep Health Care Safe DR. MUNIDASA WINSLOW
Establishing Work-Life Balance to Keep Health Care Safe DR. MUNIDASA WINSLOW Introduction Dr. Munidasa Winslow Consultant Psychiatrist and Executive Medical Director at Promises Healthcare Adjunct Associate
More informationCaring for Carers. Includes Caregiver Health Checklists
Caring for Carers Includes Caregiver Health Checklists The role of carer can provide great satisfaction, but being a caregiver can also be very emotionally stressful between a third and a half of carers
More informationCaregiving: Health Effects, Treatments, and Future Directions
Caregiving: Health Effects, Treatments, and Future Directions Richard Schulz, PhD Distinguished Service Professor of Psychiatry and Director, University Center for Social and Urban Research University
More informationCritical Incident 5/7/2018. Defining Critical Incident. Defusing. Defusing and Debriefing
Critical Incident Defusing and Debriefing Defining Critical Incident Any event that overwhelms the normal coping abilities of an emergency worker such as EMS, Fire, Police, and Emergency room personnel.
More informationAfter Hours Support for Continuity of Care
After Hours Support for Continuity of Care A few good ideas for meeting the Standard of Care A. INTRODUCTION In June 2015, the College of Physicians & Surgeons of Alberta (CPSA) released an updated Standard
More informationPalliative Care Needs Assessment
Palliative Care Needs Assessment 1. Please choose your position: Staff Nurse 51.8% 100 Nurse Manager 7.8% 15 Advanced Practice Nurse/Nurse Educator 7.8% 15 Nursing Assistant/Patient Care Tech 13.0% 25
More informationSymptoms and stress in family caregivers of ICU patients. Hanne Birgit Alfheim RN, CCN, PhD student Photo:
Symptoms and stress in family caregivers of ICU patients Hanne Birgit Alfheim RN, CCN, PhD student Photo: oystein.horgmo@medisin.uio.no Why are the family caregivers so important for the patients? Family
More informationA story of resilience: being a pediatrician in Spain
A story of resilience: being a pediatrician in Spain Health, lifestyles and working conditions of pediatricians in Spain Working team Director: Lucía Baranda Supported by: Galatea Foundation: Anna Mitjans
More informationBenchmarking across sectors: Comparisons of residential dual diagnosis and mental health programs
University of Wollongong Research Online Faculty of Health and Behavioural Sciences - Papers (Archive) Faculty of Science, Medicine and Health 2009 Benchmarking across sectors: Comparisons of residential
More informationDownloaded from ijn.iums.ac.ir at 20:15 IRDT on Wednesday May 9th 2018 MBI.
:..... : :. ( ) Spilberger (MBI) Maslach ( ) MBI..... :. % ( % %) : %) ( % %).(P
More informationExploring the Presence of Moral Distress in Critical Care Nurses
Rhode Island College Digital Commons @ RIC Master's Theses, Dissertations, Graduate Research and Major Papers Overview Master's Theses, Dissertations, Graduate Research and Major Papers 2016 Exploring
More informationBuild Your Own Fire Extinguisher
Build Your Own Fire Extinguisher Practical Ways to Reduce Faculty Burnout AAIM Week March 20, 2017 Shannon Boerner, MD Jennifer Harsh, PhD Sarah Richards, MD Shannon Boerner, MD sboerner@unmc.edu Jennifer
More informationSyndrome Burnout. Syndrome Burnout Download or Read Online ebook syndrome burnout in PDF Format From The Best User Guide Database
Syndrome Free PDF ebook Download: Syndrome Download or Read Online ebook syndrome burnout in PDF Format From The Best User Guide Database Dec 3, 2013 - can also lead to a common syndrome among. ICU clinicians:
More informationProfessional Practice: Nursing as a Career, not a Job
Objective: Professional Practice: Nursing as a Career, not a Job Cheri Constantino-Shor, MSN, RN, CRNI, CMSRN Postoperative Clinical Nurse Specialist Swedish Medical Center At the end of this course, the
More information5/8/2018. World Class Atmosphere for Nurse Healing and Health Promotion. Outline. Khaled Alwardat MSc, RN
World Class Atmosphere for Nurse Healing and Health Promotion Khaled Alwardat MSc, RN 10 th Annual Nursing Research Conference Nursing Science and Practice: Finding Meaning in Our Work May 10, 2018 Elizabeth
More informationImproving family experiences in ICU. Pamela Scott Senior Charge Nurse Forth Valley Royal Hospital ICU
Improving family experiences in ICU Pamela Scott Senior Charge Nurse Forth Valley Royal Hospital ICU Family Burden in icu:- Incidence of anxiety symptoms range from 21% to 60.4% (median 40%) from ICU admission
More informationDignity & Compassion in Care
Dignity & Compassion in Care What is compassion A sensitivity to the suffering of self and others, with a deep commitment to try and relieve it The Dalai Lama (1995) The 6 C s People who use health and
More informationMore than 60% of elective surgery
Benefits of Preoperative Education for Adult Elective Surgery Patients NANCY KRUZIK, MSN, RN, CNOR More than 60% of elective surgery procedures in the United States were being performed as outpatient procedures
More information02/07/2013. Purpose of the Study. Employee Well-Being & Retention
A Time -lagged Analysis of the Effect of Authentic Leadership on Workplace Bullying, Burnout and Occupational Turnover Intentions Heather K Spence Laschinger, RN, PhD, FAAN, FCAHS The University of Western
More informationFROM MORAL DISTRESS AS A PSYCHOSOCIAL RISK
CÉLINE BAELE FROM MORAL DISTRESS AS A PSYCHOSOCIAL RISK TO MORAL RESILIENCE IN HEALTH CARE ORGANIZATIONS INCOSE CONFERENCE, BRUSSELS 15.09.2016 CÉLINE BAELE DORINE COOLEN HERLINDE DELY WHO ARE WE Céline
More informationThe original publication is available at at:
The original publication is available at www.springerlink.com at: http://www.springerlink.com/content/100428/ Editorial for Intensive Care Medicine: BURNOUT IN THE ICU: POTENTIAL CONSEQUENCES FOR STAFF
More informationWho are caregivers? What is caregiving? Webster s Dictionary persons who provide direct care to another individual
Presented at SaddleBrooke, April 5, 2013 by: Carol Wilson Director of Independent Living Services Pinal Gila Council for Senior Citizens Area Agency on Aging, Region V Who are caregivers? Webster s Dictionary
More information2016 Colleges of Medicine and Nursing Spring Symposium
2016 Colleges of Medicine and Nursing Spring Symposium Addressing Burnout and Wellness in Health Sciences Professionals Wednesday, June 1, 2016 8:00am to 5:00pm Meiling Hall, 370 W. 9 th Ave Time Topic
More informationBurnout Among Healthcare Professionals
RM296_p30-35_Features.qxd 11/5/07 9:48 M Page 30 Burnout Among Healthcare Professionals By Ben D. Wood, BSRT, RT(R) and Jeffrey B. Killion, PhD, RT(R)(QM) The credit earned from the Quick Credit TM test
More information