Discussion: The Roles of Nurse Informaticists

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NURS 6401

Discussion: The Roles of Nurse Informaticists

Just as the Internet and other technological innovations have radically changed the world, the constant evolution of informatics continues to transform nursing and health care. The nurse is at the forefront of this transformation, serving as a knowledgeable leader in system development, implementation, and management. As new technologies become integrated into health care settings, the nurse informaticist areas will continue to become more critical.

For this Discussion, you examine the informatics areas that have evolved to facilitate this transformation. You consider different functional areas and responsibilities that nurse informaticists may fulfill and how they contribute to technological progress throughout the health care field.

Note: There are many different terms used to refer to “nurse informaticist,” including informatics nurse, nurse informatician, and informatics specialist. In this specialization, the term “nurse informaticist” is applied, adhering to the American Association of Colleges of Nursing (AACN) terminology.

To prepare:

  • Review this week’s media presentation, The Role of Nurse Informaticists, reflecting on the impact that informaticists have on health care settings.
  • Using the American Medical Informatics Association web resource in this week’s Learning Resources, investigate the various working groups associated with nursing informatics.
  • Identify a nursing informatics role that is of particular interest to you. Conduct further research to find out how this specific role might contribute to patient safety, quality of care, nurse efficiency, the implementation of new informatics initiatives, and/or electronic health records.

By Day 3

Post a description of a nursing informatics role that that is of interest to you and why. In your posting, explain how the nurse informaticist in this role impacts one or more of the following: patient safety, quality of care, nurse efficiency, the implementation of new informatics initiatives, and/or electronic health records. Justify your reasoning by citing authentic examples and references to the research literature.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days using one or more of the following approaches:

  • Ask a probing question, substantiated with additional background information, evidence or research.
  • Validate an idea with your own experience and additional research.
  • Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

4) Evaluate both theories using the evaluation criteria provided in the Learning Resources.

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Middle Range or Interdisciplinary Theory Evaluation

Assignment 2: Middle Range or Interdisciplinary Theory Evaluation

As addressed this week, middle range theories are frequently used as a framework for exploring nursing practice problems. In addition, theories from other sciences, such as sociology and environmental science, have relevance for nursing practice. For the next few weeks you will explore the use of interdisciplinary theories in nursing.

This Assignment asks you to evaluate two middle range or interdisciplinary theories and apply those theories to a clinical practice problem. You will also create a hypothesis based upon each theory for an evidence-based practice project to resolve a clinical problem.

Note: This Assignment will serve as your Major Assessment for this course.

To prepare:

  • Review strategies for evaluating theory presented by Fawcett and Garity in this week’s Learning Resources (see under list of Required Readings and attached pdf file)
  • Select a clinical practice problem that can be addressed through an evidence-based practice project. Note: You may continue to use the same practice problem you have been addressing in earlier Discussions and in Week 7 Assignment 1.
  • Consider the middle range theories presented this week, and determine if one of those theories could provide a framework for exploring your clinical practice problem. If one or two middle range theories seem appropriate, begin evaluating the theory from the context of your practice problem.
  • Formulate a preliminary clinical/practice research question that addresses your practice problem. If appropriate, you may use the same research question you formulated for Assignment #4.

Write a 10- to 12-page paper (including references) in APA format and a minimum of 8 references or more, using material presented in the list of required readings to consider interdisciplinary theories that may be appropriate for exploring your practice problem and research question (refer to the sample paper attached as “Assignment example”). Include the level one headings as numbered below:

1)       Introduction with a purpose statement (e.g. The purpose of this paper is…)

2)       Briefly describe your selected clinical practice problem.

3)       Summarize the two selected theories. Both may be middle range theories or interdisciplinary theories, or you may select one from each category.

4)       Evaluate both theories using the evaluation criteria provided in the Learning Resources.

5)       Determine which theory is most appropriate for addressing your clinical practice problem. Summarize why you selected the theory. Using the propositions of that theory, refine your clinical / practice research question.

6)       conclusion

MY PRACTICE PROBLEM IS AS FOLLOWED:

P: Patients suffering from Type 2 Diabetes Mellitus

I:  Who are involved in diabetic self-care programs

C: Compared to those who do not participate in self-care programs

O: Are more likely to achieve improved glycemic control

THE THEORIES USED FOR THIS MODEL ARE:

Dorothea Orem Self-Care Theory and The Self-Efficacity in nursing Theory by Lenz & Shortridge-Baggett, or the Health Promotion Model by Pender, Murdaugh & Parson (Pick 2)

Required Readings

McEwin, M., & Wills, E.M. (2014). Theoretical basis for nursing. (4th ed.). Philadelphia, PA: Wolters Kluwer Health.

  • Chapter 10, “Introduction to Middle Range Nursing Theories”

 Chapter 10 begins the exploration of middle range theories and discusses their development, refinement, and use in research.

  • Chapter 11, “Overview of Selected Middle Range Nursing Theories”

 Chapter 11 continues the examination of middle range theories and provides an in-depth examination of a select set of theories

·         Chapter 15, “Theories from the Biomedical Sciences”

Chapter 15 highlights some of the most commonly used theories and principles from the biomedical sciences and illustrates how they are applied to studies conducted by nurses and in nursing practice.

·         Chapter 16, “Theories, Models, and Frameworks from Administration and Management”

Chapter 16 presents leadership and management theories utilized in advanced nursing practice.

·         Chapter 18, “Application of Theory in Nursing Practice”

Chapter 18 examines the relationship between theory and nursing practice. It discusses how evidence-based practice provides an opportunity to utilize research and theory to improve patient outcomes, health care, and nursing practice.

Gray, J.R., Grove, S.K., & Sutherland, S. (2017). Burns and Grove’s the practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.). St. Louis, MO: Saunders Elsevier.

  • Chapter 6, “Objectives, Questions, Variables, and Hypotheses”

 Chapter 6 guides nurses through the process of identifying research objectives, developing research questions, and creating research hypotheses.

·         Review Chapter 2, “Evolution of Research in Building Evidence-Based Nursing Practice”

·         Chapter 19, “Evidence Synthesis and Strategies for Evidence-Based Practice”

This section of Chapter 19 examines the implementation of the best research evidence to practice.

Fawcett, J., & Garity, J. (2009). Chapter 6: Evaluation of middle-range theories. Evaluating Research for Evidence-Based Nursing. Philadelphia, Pennsylvania: F. A. Davis.

 Note: You will access this article from the Walden Library databases.

 This book chapter evaluates the use and significance of middle-range theories in nursing research and clinical practice.

DeSanto-Madeya, S., & Fawcett, J. (2009). Toward Understanding and Measuring Adaptation Level in the Context of the Roy Adaptation Model. Nursing Science Quarterly, 22(4), 355–359.

 Note: You will access this article from the Walden Library databases.

 This article describes how the Roy Adaptation Model (RAM) is used to guide nursing practice, research, and education in many different countries.

Jacelon, C., Furman, E., Rea, A., Macdonald, B., & Donoghue, L. (2011). Creating a professional practice model for postacute care: Adapting the Chronic Care Model for long-term care. Journal of Gerontological Nursing, 37(3), 53–60.

 Note: You will access this article from the Walden Library databases.

 This article addresses the need to redesign health care delivery to better meet the needs of individuals with chronic illness and health problems.

Murrock, C. J., & Higgins, P. A. (2009). The theory of music, mood and movement to improve health outcomes. Journal of Advanced Nursing, 65 (10), 2249–2257. doi:10.1111/j.1365-2648.2009.05108.x

 Note: You will access this article from the Walden Library databases.

 This article discusses the development of a middle-range nursing theory on the effects of music on physical activity and improved health outcomes.

Amella, E. J., & Aselage, M. B. (2010). An evolutionary analysis of mealtime difficulties in older adults with dementia. Journal of Clinical Nursing, 19(1/2), 33–41. doi:10.1111/j.1365-2702.2009.02969.x

 Note: You will access this article from the Walden Library databases.

 This article presents findings from a meta-analysis of 48 research studies that examined mealtime difficulties in older adults with dementia.

Frazier, L., Wung, S., Sparks, E., & Eastwood, C. (2009). Cardiovascular nursing on human genomics: What do cardiovascular nurses need to know about congestive heart failure? Progress in Cardiovascular Nursing, 24(3), 80–85.

 Note: You will access this article from the Walden Library databases.

 This article discusses current genetics research on the main causes of heart failure.

Mahon, S. M. (2009). Cancer Genomics: Cancer genomics: Advocating for competent care for families. Clinical Journal of Oncology Nursing, 13(4), 373–3 76.

 Note: You will access this article from the Walden Library databases.

 This article advocates for nurses to stay abreast of the rapid changes in cancer prevention research and its application to clinical practice.

Mayer, K. H., Venkatesh, K. K. (2010). Antiretroviral therapy as HIV prevention: Status and prospects. American Journal of Public Health, 100(10), 1867–1 876. doi: 10.2105/AJPH.2009.184796

 Note: You will access this article from the Walden Library databases.

 This article provides an in-depth examination of potential HIV transmission prevention.

Pestka, E. L., Burbank, K. F., & Junglen, L. M. (2010). Improving nursing practice with genomics. Nursing Management, 41(3), 40–44. doi: 10.1097/01.NUMA.0000369499.99852.c3

 Note: You will access this article from the Walden Library databases.

 This article provides an overview of genomics and how nurses can apply it in practice.

Yao, L., & Algase, D. (2008). Emotional intervention strategies for dementia-related behavior: A theory synthesis. The Journal of Neuroscience Nursing, 40(2), 106–115.

 Note: You will access this article from the Walden Library databases.

 This article discusses a new model that was developed from empirical and theoretical evidence to examine intervention strategies for patients with dementia.

Fineout-Overholt, E., Williamson, K., Gallagher-Ford, L., Melnyk, B., & Stillwell, S. (2011). Following the evidence: Planning for sustainable change. The American Journal Of Nursing, 111(1), 54–60.

This article outlines the efforts made as a result of evidence-based practice to develop rapid response teams and reduce unplanned ICU admissions.

Kleinpell, R. (2010). Evidence-based review and discussion points. American Journal of Critical Care, 19(6), 530–531.

This report provides a review of an evidence-based study conducted on patients with aneurismal subarachnoid hemorrhage and analyzes the validity and quality of the research.

Koh, H. (2010). A 2020 vision for healthy people. The New England Journal Of Medicine, 362(18), 1653–1656.

 This article identifies emerging public health priorities and helps to align health-promotion resources, strategies, and research.

Moore, Z. (2010). Bridging the theory-practice gap in pressure ulcer prevention. British Journal of Nursing, 19(15), S15–S18.

This article discusses the largely preventable problem of pressure ulcers and the importance of nurses being well-informed of current prevention strategies.

Musker, K. (2011). Nursing theory-based independent nursing practice: A personal experience of closing the theory-practice gap. Advances In Nursing Science, 34(1), 67–77.

This article discusses how personal and professional knowledge can be used in concert with health theories to positively influence nursing practice.

Roby, D., Kominski, G., & Pourat, N. (2008). Assessing the barriers to engaging challenging populations in disease management programs: The Medicaid experience. Disease Management & Health Outcomes, 16(6), 421–428.

This article explores the barriers associated with chronic illness care and other factors faced by disease management programs for Medicaid populations.

Sobczak, J. (2009). Managing high-acuity-depressed adults in primary care. Journal of the American Academy of Nurse Practitioners, 21(7), 362–370. doi: 10.1111/j.1745-7599.2009.00422.x

This article discusses a method found which positively impacts patient outcomes used with highly-acuity-depressed patients.

Thorne, S. (2009). The role of qualitative research within an evidence-based context: Can metasynthesis be the answer? International Journal of Nursing Studies, 46(4), 569–575. doi: 10.1016/j.ijnurstu.2008.05.001

The article explores the use of qualitative research methodology with the current evidence-based practice movement.

Optional Resources

McCurry, M., Revell, S., & Roy, S. (2010). Knowledge for the good of the individual and society: Linking philosophy, disciplinary goals, theory, and practice. Nursing Philosophy, 11(1), 42–52.

Calzone, K. A., Cashion, A., Feetham, S., Jenkins, J., Prows, C. A., Williams, J. K., & Wung, S. (2010). Nurses transforming health care using genetics and genomics. Nursing Outlook, 58(1), 26–35. doi: 10.1016/j.outlook.2009.05.001

McCurry, M., Revell, S., & Roy, S. (2010). Knowledge for the good of the individual and society: Linking philosophy, disciplinary goals, theory, and practice. Nursing Philosophy, 11(1), 42–52.

Project: Group Presentation on Nursing Theorist

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project

Project: Group Presentation on Nursing Theorist

Overview of the Project

This course project requires you to complete a group task. As a group, you are required to submit a presentation on the theorist assigned to your group. Your final presentation is due in Week 4.

Group Formation

You will be organized into three groups, each of which will be assigned a nursing theorist. The theorists to be studied include, but are not limited to, Madeline Leininger—Transcultural Nursing Theory, Nola Pender; the Health Promotion Model, and Patricia Benner; From Novice to Expert, the Skill Acquisition ModelIf your group would like to study a different theorist, seek permission from your instructor. Each group will conduct a literature review to obtain material related to the assigned theorist and the model. The material should include research conducted in the theory or model, with clinical examples.

Click here to download a document that provides guidelines for the literature review.

Project Deliverables

The Project Deliverables include the following:

1. Packet of Materials

Each group will prepare a packet of materials that will be posted to the DQ section in Week 4 for peer critique and submitted to the W4: Assignment 2 Dropbox. The purpose of this packet is to support your PowerPoint Presentation. The packet should include a detailed outline of the presentation and a one-page summary of each of the five relevant articles on or about the theory. Also include any handouts, such as charts, diagrams, or definitions, which will facilitate understanding of the PowerPoint presentation and the theory itself. This packet should be submitted as a single document that contains the outline, summaries, and any additional handouts, charts, etc.

2. Power Point Presentation

Presentations will be made via PowerPoint and will be uploaded by the assigned due date.

Your presentation should have:

  • A brief overview of the theorist’s background.
  • Discussion of the theorist’s view of the four basic metaparadigms and two concepts unique to the theory.
  • The basic theoretical assertions or propositions.
  • An analysis and a critique of the model with a focus on elaboration of the theory’s implications for nursing practice, nursing education, and nursing research.

Click hereto download the Theory Critique template.

Please note: It is expected that each one of you will download and read each presentation, and will include relevant material about each theorist in your individual concept papers.

Working Ahead

In Week 1, your group will be assigned the theorist on whom you have to make the presentation. Your final group presentation is due in Week 4. However, it is recommended that in Week 2 you submit the work you have done on the project up to that point to the facilitator when necessary. The facilitator feedback will help you revise and refine the work already completed and apply the facilitator recommendations to the yet-to-be completed part of the project.

For ease of completion, it is suggested that in Week 1, you begin your literature search on the theorist and provide a brief overview of the theorist’s background. You could also complete a 1-page summary for each  of the five articles related to the theory and theorist, the top of the page should have the complete reference in APA format. In Week 2, you can focus on providing your findings on the theorist’s view of the four basic metaparadigms . In Week 3, you can concentrate on providing the basic theoretical assertions or propositions and you can conduct an analysis and a critique of the model with a focus on elaboration of the theory’s implications for nursing practice, nursing education, and nursing research. Click here to download the Peer Presentation Review Checklist Template.

Members of the group will be graded collectively. Grading of the presentation of the theory/conceptual model will be based on the following scale for each element:

In the ischemic stroke patient, what are the barriers to the administration of thrombolytic therapy within 3 hours of presentation to the emergency department when the last seen normal is within 2 hours?

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Course Project Overview   PICOT Question   In the ischemic stroke patient, what are the barriers to the administration of thrombolytic therapy within 3…

Course Project Overview

PICOT Question

In the ischemic stroke patient, what are the barriers to the administration of thrombolytic therapy within 3 hours of presentation to the emergency department when the last seen normal is within 2 hours?

P= barrier to administration

I= administration of t-PA

C= vs. not receiving thrombolytic

O= administration of thrombolytic

T= within 3 hours of Emergency room presentation when the last seen normal is within 2 hours.

Evidence-based practice involves a great deal more than simply reading nursing periodicals on a regular basis. Nurses can take a more proactive approach to evidence-based practice by identifying authentic problems and concerns, and then using that to guide their inquiries into current research. In this way, nurses can connect the results of relevant research studies to their nursing practice.

For the Course Project, you identify and apply relevant research to a specific nursing topic or problem. You begin by formulating an answerable question that is relevant to nursing and evidence-based practice. In later weeks of this course, you continue the course project by conducting a literature review and then determining how the evidence from the literature can be applied to nursing practice.

Before you begin, review this document, which contains information about all three parts of the Course Project.

The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references

Course Project: Part 1–Identifying a Researchable Problem

One of the most challenging aspects of EBP is to actually identify the answerable question. —Karen Sue Davies

Formulating a question that targets the goal of your research is a challenging but essential task. The question plays a crucial role in all other aspects of the research, including the determination of the research design and theoretical perspective to be applied, which data will be collected, and which tools will be used for analysis. It is therefore essential to take the time to ensure that the research question addresses what you actually want to study. Doing so will increase the likelihood of obtaining meaningful results.

In this first component of the course project, you formulate questions to address a particular nursing issue or problem. You use the PICOT model—patient/population, intervention/issue, comparison, and outcome—outlined in the weekly Learning Resources to design your questions.

To prepare:

  • Review the article, “Formulating the Evidence Based Practice Question: A Review of the Frameworks,” found in the Learning Resources for Week 2. Focus on the PICOT model for guiding the development of research questions.
  • Review the section beginning on page of the course text, 75 titled, “Developing and Refining Research Problems” in the course text, which focuses on analyzing the feasibility of a research problem.
  • Reflect on an issue or problem that you have noticed in your nursing practice. Consider the significance of this issue or problem.
  • Generate at least 5 questions that relate to the issue that you have identified. Use the criteria in your course text to select one question that would be most appropriate in terms of significance, feasibility, and interest. Be prepared to explain your rationale.
  • Formulate a preliminary PICOT question—one that is answerable—based on your analysis. What are the PICOT variables (patient/population, intervention/issue, comparison, and outcome) for this question? Note: Not all of these variables may be appropriate to every question. Be sure to analyze which are and are not relevant to your specific question.
  • Using the PICOT variables that you determined for your question, develop a list of at least 10 keywords that could be used when conducting a literature search to investigate current research pertaining to the question.

To complete:

Write a 3- to 4-page paper that includes the following:

  • A summary of your area of interest, an identification of the problem that you have selected, and an explanation of the significance of this problem for nursing practice
  • The 5 questions that you have generated, and a description of how you analyzed them for feasibility  
  • Your preliminary PICOT question and a description of each PICOT variable relevant to your question  
  • At least 10 possible keywords that could be used when conducting a literature search for your PICOT question and a rationale for your selections

Reference: Davies, K. S. (2011). Formulating the evidence based practice question: A review of the frameworks. Evidence Based Library and Information Practice, 6(2), 75–80. Retrieved from https://ejournals.library.ualberta.ca/index.php/EBLIP/article/viewFile/9741/8144

Evaluate research as the basis for decision-making to improve outcomes through translation into evidence-based practice.

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Assignment

 Review the student learning outcomes listed below for this course and discuss how you met these outcomes. The intention here is to provide you an opportunity to “reflect” on the learning achieved during this term and how you successfully met these learning outcomes. If you do not feel you successfully met the objective, discuss your plans to successfully complete the objective in the future.

Upon completion of this course, the student should be able to:

  1. Critically analyze current practice to formulate researchable problems.
  2. Evaluate research as the basis for decision-making to improve outcomes through translation into evidence-based practice. 
  3. Synthesize an understanding of the research process through development of a proposal to address a nursing problem or focus area identified in nursing practice.
  4. Investigate ethical issues related to the conduct of scientific research, including informed consent, data management, data analysis, and protection of human subjects.
  5. Explore national and international initiatives and research priorities.

Discussion: Trend Analysis and Forecasting

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Discussion: Trend Analysis and ForecastingGreen Hills Health System comprises a small community hospital and a primary care practice. Located in a rural area, the nearest large city is approximately 1

Discussion: Trend Analysis and Forecasting

Green Hills Health System comprises a small community hospital and a primary care practice. Located in a rural area, the nearest large city is approximately 100 miles away. Individuals age 60 and older constitute one of the largest patient populations Green Hills serves. Recently, members of the nursing staff have noticed that the numbers of geriatric patients admitted to the hospital seem to be increasing. Many of these patients have multiple comorbidities and need specialty care that is not available through Green Hills Health System. Some of the patients have commented that they lack the financial resources and transportation required to travel to the large metropolitan health care center that provides a variety of specialty services.

Imagine that you are a nurse leader-manager in the organization described above. How could conducting an internal and external scan of the environment help you and your colleagues to identify opportunities for change moving forward? What literature sources would you consult to learn about trends and emerging issues that are likely to affect the organization? What data would you examine?

In this Discussion, you analyze trends that are likely to have a significant impact on nursing and health care in the coming years. You may use this Discussion to formulate initial thoughts related to trends and unmet needs that you might choose to address through the Course Project, which is introduced this week.

To prepare:

  • Review the information on forecasting and trends in the Learning Resources.
  • Conduct a search of the literature to investigate trends and emerging issues in nursing and health care. Evaluate the research evidence in the literature.
  • Based on your research, identify three trends that are likely to impact nursing and health care in the coming decade.
  • Select one of these trends on which to focus in greater detail. Then, conduct additional research and analyze evidence-based issues related to this trend.
  • Based on your analysis, consider whether this trend creates or contributes to an unmet need that currently impacts, or will impact, a specific group, unit, or organization.

By Day 3

Post an analysis of the impact of your selected trend on nursing and health care in the coming decade. Explain how this trend creates or contributes to an unmet need that a specific group, unit, or organization may encounter now or in the coming years.

optional resources

Ursell, F. (2011). Care home funding: What to expect and what to do. Nursing & Residential Care, 13(2), 94–96.

Weiss, R. (2010, Summer). The forecast for health care. Marketing Health Services, 30(3), 7

http://www.forbes.com/sites/greatspeculations/2012/11/15/long-term-forecasts-are-mostly-worthless/
http://www.forbes.com/sites/bradpeters/2012/02/16/healthcare-forecast-increasing-clouds-with-a-chance-of-dramatic-improvement/

Sare, M. V., & Ogilvie, L. (2010). Strategic planning for nurses: Change management in health care. Sudbury, MA: Jones and Bartlett.

  • Review Chapter 7, “The Three Key Elements of the Strategic Planning Process: A Vision That Guides Nursing’s Future Action” (pp. 117–143)

Occupational Stressors, Stress Perception Levels, and Coping Styles of Medical Surgical RNs A Generational Perspective

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Research Article for homework assignment 1 of 2

Occupational Stressors, Stress Perception Levels, and Coping Styles of Medical Surgical RNs A Generational Perspective

Nada Wakim, PhD, RN, NE-BC

OBJECTIVE: The purpose of this study was to compare the occupational stressors, the perceived stress levels, and coping styles of 3 generations of medicalsurgical (MS) nurses.

BACKGROUND: The literature supports that the nurse’s role is stressful based on a variety of factors including physical labor, human suffering, work hours, staffing, and interpersonal relationships. Data indicate that there are generational differences in the response to stress. The 3 predominant nursing generations coexisting in the nursing workforce add to the complexity of the recognition and coping skills to address stress.

METHODS: A correlational design was used. A convenience sample of MS nurses participated in this study by completing 4 questionnaires.

RESULTS: Occupational stressors were found to be significant predictors for perceived stress among all generations of nurses in this sample. Also, the higher the level of stress perception among nurses, the higher the use of coping behaviors. Generation Y reported a higher level of perceived stress and higher use of escape avoidance coping behaviors, while baby boomers reported higher use of self-controlling coping behaviors. CONCLUSIONS:

By identifying the needs of each of the generational cohorts, nurse leaders, nurse educators, and policy makers can better assist the nursing workforce to remain at the bedside, improve patient outcomes, and maintain a positive work environment.

The nature and scope of stress and the effects on the generations of nurses in the workforce are unclear. Each generation possesses unique characteristics, values, and traits based on multiple variables.1 Currently, at least 3 nursing generations interact at the workplace. The generational values and ethics of these 3 cohorts of nurses result in differences in terms of work satisfaction and stress perception.1 Lack of understanding of the differences in the perception and handling of stress increases turnover, attrition, and nursing shortage.2 Data demonstrate clear relationships between increases in these areas related to nursing satisfaction1 and patient outcomes.1 Findings from this study will inform nurse leaders who are working with these generations.

Background:

Occupational stress negatively affects the nature of the caring relationship and healing environment, interfering with the nurse’s ability to observe, listen to, understand, and know the patient.2 The distraction and impact of occupational stress result in fewer opportunities for nurses to focus on patient’s safety, patient care, and optimal outcomes.2 Good stress management including the use of evidence-based coping skills has important implications for nurse retention, nursing satisfaction, and career longevity.2 Each of these areas is an important key indicator of optimal work environments and thus important for nurse leaders.

Occupational Stress:

Occupational stress affects individuals differently based on perceptions and personal characteristics.3 The way a stressful event is perceived is dependent on the individual’s characteristics and resiliency.3 Occupational stress creates a challenge in the nursing profession, given that our work is stressful. The handling and support of coping skills are an additional challenge for nurses because several generations work in concert to care for patients. The coexistence of at least 3 predominant generations in nursing has been reported to lead to intergenerational conflict in the workplace.3

To characterize the differences, baby boomers (born 1943-1960) are reportedly committed to their employer and enjoy meaningful work.1 Currently, baby boomers constitute 28% of the nursing workforce.4 Generation (Gen) Xers (born 1960-1981) view work as a job and believe that it is optimal to balance work and leisure.1 Gen Xers constitute 10% to 15% of the current nursing workforce.4 The literature reports that Gen Y or Millennials (born 1981-2003), which represent 12% of the US workforce,5 want flexible working arrangements and to achieve a work-life balance.1 These descriptors suggest differing views on values, work ethics, authority, and stress.1

Many studies have addressed occupational stress among nursing specialties (critical care and labor and delivery) and healthcare settings (acute care hospitals, long-term-care facilities, and nursing homes). Studies have frequently explored the relationship between stress and external variables such as shift length, gender differences, personal characteristics, family obligations, and work relationships. No studies have compared occupational stress among the 3 generations and in particular in the medical-surgical (MS) nurses. About the Study The purpose of this descriptive correlational study was to measure and compare the occupational stressors, the perceived stress levels, and coping styles among baby boomer, Gen X, and Gen Y MS nurses at 1 hospital.

Research Questions:

Research question 1: Will the variables of event (stressors) and personal characteristics (age, years of experience, educational level) be predictive of the appraisal of the event (stress perception)?

Hypothesis 1: Stressors, age, years of experience, and educational level, uniquely and as a linear composite, will be predictive of stress perception among MS nurses.

Research question 2: Will the appraisal of the event (stress perception) be positively correlated with the event outcome (coping)?

Hypothesis 2: Stress perception will be positively related to coping among MS nurses.

Research question 3: Will age cohort significantly affect perceived stress levels?

Hypothesis 3: The mean scores for perceived stress will positively differ significantly between age cohort groups of MS nurses.

Research question 4: Will age cohort significantly affect coping?

Hypothesis 4: The mean scores for coping will positively differ significantly between age cohort groups of MS nurses.

Theoretical Framework:

The stress and coping theory of Folkman and Lazarus6 was used as the framework for this study. The theory of stress and coping provides a testable model for understanding occupational stress among the 3 targeted nursing generations by 1st determining which antecedent variables explain stress appraisal as a loss/harm, challenge, or threat; then examining whether the primary appraisal and secondary appraisal are different from 1 generation to the next; and finally, determining the types of coping or the coping strategies characteristic of each generational cohort.

DiscussionPatients with endocrine and musculoskeletal disorders often require long-term treatment and care resulting i

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APA style with citation, needs 3 credible sources reference not later than 2013.DiscussionPatients with endocrine and musculoskeletal disorders often require long-term treatment and care resulting i

 APA style with citation, needs 3 credible sources reference not later than 2013.

Discussion

Patients with endocrine and musculoskeletal disorders often require long-term treatment and care resulting in the need for extensive patient education. By appropriately educating patients, advanced practice nurses can assist patients with the management of their disorders. In clinical settings, patients with endocrine and musculoskeletal disorders typically seek treatment for symptoms that pose problems to their everyday lives as ordinary tasks may become difficult to complete. For instance, patients might have difficulty walking short distances, preparing meals, or even running errands. To reduce these symptoms and additional health risks, it is essential to develop drug therapy plans with individual patient factors in mind.

To prepare:

  • -Select one of the following endocrine or musculoskeletal disorders: thyroid disease, osteoarthritis, rheumatic arthritis, gout, multiple sclerosis, or fibromyalgia. Consider the types of drugs that would be prescribed to patients to treat symptoms associated with this disorder.
  • -Select one of the following factors: genetics, gender, ethnicity, age, or behavior. Reflect on how this factor might impact the effects of prescribed drugs, as well as any measures you might take to help reduce negative side effects.

With these thoughts in mind:

By Day 3

Post a description of the endocrine or musculoskeletal disorder you selected including types of drugs that would be prescribed to patients to treat associated symptoms. Then, explain how the factor you selected might impact the effects of prescribed drugs, as well as any measures you might take to help reduce negative side effects.

Assignment: Conduct an assessment of the health care environment where you work (i.e. health department, long-term care facility, specialty clinic, inpatient hospital, etc). Specifically, examine pote

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Assignment: Conduct an assessment of the health care environment where you work (i.e. health department, long-term care facility, specialty clinic, inpatient hospital, etc). Specifically, examine pote

Assignment:

Conduct an assessment of the health care environment where you work (i.e. health department, long-term care facility, specialty clinic, inpatient hospital, etc). Specifically, examine potential barriers that may exist for a member of a minority group that has a significant presence in your community (i.e. Native American, Cubans, Hmong). Using the criteria below (and explained in greater detail on pages 39 and 40), assess the potential organizational barriers to care in your work environment. Explore ways to decrease barriers to health care for this minority group so that your organization can strive for cultural competency.

  • Availability
  • Accessibility
  • Affordability
  • Appropriateness
  • Accountability
  • Adaptability
  • Acceptability
  • Awareness
  • Attitudes
  • Approachability
  • Alternative practices and practitioners
  • Additional services

· Select one of the following factors: genetics, gender, ethnicity, age, or behavior. Reflect on how this factor might impact the effects of prescribed drugs, as well as any measures you might take to help reduce negative side effects.

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Patients with endocrine and musculoskeletal disorders often require long-term treatment and care resulting in the need for extensive patient education. By appropriately educating patients, advanced pr

Patients with endocrine and musculoskeletal disorders often require long-term treatment and care resulting in the need for extensive patient education. By appropriately educating patients, advanced practice nurses can assist patients with the management of their disorders. In clinical settings, patients with endocrine and musculoskeletal disorders typically seek treatment for symptoms that pose problems to their everyday lives as ordinary tasks may become difficult to complete. For instance, patients might have difficulty walking short distances, preparing meals, or even running errands. To reduce these symptoms and additional health risks, it is essential to develop drug therapy plans with individual patient factors in mind.

To prepare:

· Select one of the following endocrine or musculoskeletal disorders: thyroid disease, osteoarthritis, rheumatic arthritis, gout, multiple sclerosis, or fibromyalgia. Consider the types of drugs that would be prescribed to patients to treat symptoms associated with this disorder.

· Select one of the following factors: genetics, gender, ethnicity, age, or behavior. Reflect on how this factor might impact the effects of prescribed drugs, as well as any measures you might take to help reduce negative side effects.

With these thoughts in mind:

Post a description of the endocrine or musculoskeletal disorder you selected including types of drugs that would be prescribed to patients to treat associated symptoms. Then, explain how the factor you selected might impact the effects of prescribed drugs, as well as any measures you might take to help reduce negative side effects.