“What happens when you have a 300lb male patient wake up from heavy sedation, angry and ready to start roughhousing people? What happens to the 120lb nurse who is in his immediate vicinity upon waking? It’s so common and so obvious, but we do very little to prepare.” Chuck Meyers, BSN, RN, CCRN shared this with us when discussing why he founded Martial Arts Medicine to help nurses and other healthcare staff better prepare for uncalled for situations.
It’s a reality that is all too real for many nurses out there, and yet, the journey to do something about it has barely begun. On a daily basis, a nurse may face a violent patient, a verbally abusive patient, or one who is not in any headspace to follow simple directives.
While there’s a lot that can be done proactively to mitigate violence -- positioning, communication, and CPI training -- a nurse should never have to come to work expecting it: “There shouldn’t be any excuse to be ‘ok’ with open threats,” says Meyers. Nurses must be hyper aware, prepared to de-escalate, and in the worst case, evacuate the situation safely.
In fact, constant threats to nurses’ safety, among other issues, can lead to burnout:
“The prevalence of [workplace violence] in nursing undoubtedly influences job performance, recruitment, desire to stay in nursing… [and] burnout (BO), which reflects the emotional exhaustion, frustration, feelings of hopelessness and difficulties dealing with the job.”
Burnout impacts between 35-54 percent of nurses. Long hours, physical, mental, and emotional challenges, chronic overwork, and oftentimes lack of support are largely to blame. Unfortunately, as Lauren Rodriguez, RN states, “the challenges and shortcomings in creating the foundational legislation and culture for healthier work environments is significant.”
“Pressures within organizations to downsize, use nurses employed under alternative arrangements (pool and traveling staff), and the turnaround time for patient care (early discharge, higher patient loads) are examples of factors that are determined at an organizational level.”
Change depends on the better distribution of hospital budgets, and more adequate hospital staffing. Staffing that matches nurse skill, competency and career goals to the patient care needs. But what can we do today? “Advocate for yourself… take the compassion and empathy you give to strangers and turn it inwards. Our jobs are not easy, so feeling emotionally or physically taxed by your role does not make you weak. It makes you human,” says Rodriguez.
2020 provides us with the chance to continue making strides to improve conditions across hospital settings. Dr. Dan Weberg, Phd, RN explains the reality of today:
“The healthcare system in the United States is being completely transformed under our noses. It's hard to see day-to-day, but Amazon, Google, CVS, and Walmart are all quietly building things that will change the entire landscape of care. The problem is that legacy healthcare systems are not keeping up. Sure, more telehealth apps and wearables have been introduced, but there are very few examples of any legacy system really transforming itself. This includes legacy staffing companies.”
We have the opportunity to push for changes at both the micro and macro level: improved preparedness for bedside nurses, beginning in school; a better understanding and respect for the wellness needs of nurses themselves, nurses should lead the advancement brought forward by novel technologies and companies.
According to Weberg, the future of healthcare entails three major truths:
- Everyday life is the new care setting.
- Teams are linked to people and populations, not hospitals or other care facilities
- Personal health is (or can be) enabled by technology.
With the improved distribution tech-enabled nurses able to link their passions to their profession, burnout will reduce, supply and demand will even out, and the future of nursing will be as bright as ever. Let’s get to it.
Continue on to Part IV, the final part of this series!