Clinical Integration Speciality Practice

Quesion: Discuss about the Clinical Integration Speciality Practice. Answer: Introduction The work inside intensive care unit (ICU) presents unique challenges for physician and nurses. Nurse working in ICU have the responsibility to take care of patient with life threatening condition and they have to witness stress in the job because of witnessing invasive surgery, patients trauma and even death in the ICU (Bienvenu, 2016). ICU is a highly challenging environment and nurse working in critical care setting have been found to have the highest rate of burnout syndrome compared to other nurses working in general setting (Usha, 2016). The situation in ICU often forces nurses to take decision which have high level of uncertainty associated with it. Intense stress in the job leads to burnout among ICU nurses and have affect on the motivation level and performance. It may also risk the life of patients and considering the impact of burnout on nursing performance, it is necessary to evaluate inter-related factors that lead to stress in ICU nurses (Van Bogaert et al., 2014). The c ritical analysis of three literatures will help in identifying the factors leading to burnout among nurse and plan effective counseling strategy to seek remedial action for exhausted ICU nurses. The main research question for the work is to analyze whether burnout has been caused only by environmental factors or also due to individual factors like attitude and physical health and resilience of nurses. Critical analysis of evidence based literature on burnout issue in nurses The research article by Myhren et al., (2013) can be useful evidence to predict the causes of burnout and stress in ICU nurses. A cross sectional quantitative research was done to evaluate the relationship between job stress, job satisfaction and burnout symptoms in nurses working in ICU hospitals in Australia. About 129 nurses participated in the study and their cause of stress was evaluated on the basis of job satisfaction scale, Coopers job stress questionnaire and Maslachs burnout inventory. One significant highlight of the study was the use of personality inventory to determine the nurse personal character contributing to burnout. Inclusion of basic character inventory in the research study is commendable and well thought as the researcher realizes the importance of nurse personal attitude and resilience behind stress in the job. Rees et al., (2016) has also stressed on the fact that resilience can also play a role in psychological adjustment of ICU nurses and level of burnout a nd stress in the job and use of this factor can help to give complete insight into the cause of burnout in nurse. The findings of the research showed that there burnout value is high in ICU nurse and female nurse were more vulnerable to stress. The burnout score varies according to experience in the job and personality trait of individual nurses. Job satisfaction also had a significant relation with burnout and nurses with high degree of job satisfaction scored lower in burnout dimension and emotional exhaustion. The research showed no link of burnout with personal accomplishment. Hence the study was useful in providing the predictors of burnout such as gender, experience, personality, attitude and job satisfaction. However the reliability of research cannot be established because of the use of Maslow burnout inventory as the clinical evaluation of burnout through this tool is low (Cooke et al., 2013). Another limitation is that it has not discussed extensive factor present in hospital that may lead to burnout among nurses and this factor has been extensively discussed in the research study by H alcomb Ashley, (2016). Therefore this research article gives useful insight for me as an ICU nurse to develop my resilience level in the job to enhance my performance and however I cannot find the detail factor leading to burnout in intensive care unit. Another useful insight into the cause of burnout among nurse can be understood by a research article which investigated the consequences of predictors and consequences of perceived non-beneficial treatment on ICU nurses. This research was done with ICU nurses working in 23 ICUs of Germany. The research was based on cross-sectional survey with ICU nurse to investigate their personal attitude, work related characteristics, perceived non-beneficial treatment, burnout trend and intention to leave. The survey based on questionnaire revealed that ICU nurse often perceived non-beneficial treatment due to increased workload and lack of appropriate collaboration with the other medical staffs (Schwarzkopf et al., 2016). Therefore, the study revealed that non-beneficial treatment perception of nurses was associated with dimension of burnout and intention to leave in ICU nurses. The limitation of the study is that experience of nurses were not considered in this study and this factor is importan t because newly placed nurse often have non-beneficial treatment perception and poor collaboration skills with staff. The study gave the implication that hospitals should put more stress on improving work environment and collaboration between staffs to reduce perception of non-beneficial treatment and burnout issues in ICU nurses. The third article investigated the associated factors of burnout in nursed working in ICU unit in Zimbabwe. ICU nurse are mostly exposed to life and death situations every day which lead to stress, anxiety and burnout issues in nurses. A descriptive study was conducted with 23 ICU nurses in three hospitals and most of them had less than five years experience in ICU. There were three male nurses and twenty female nurses and only three were ICU trained. The phenomenological research investigated attitude and interaction of nurses in hospital setting. The result of the research showed that level of emotional attachment with patients was a contributing factor in burnout issues. Many of them had spent long time in ICU without vocational leave and emotional exhaustion finally lead to burnout in about 40% nurses (Chitura Chitura, 2014). This research was useful as it considered the experience of nurse in ICU environment while conducting the research which helped in getting a valid data. On e limitation is that the study considered work related emotions of nurses but not the personal emotions of nurse which might also act as a factor leading to burnout. This study gave the recommendation that professional counseling should be given to nurse on a regular basis to eliminate feeling of burnout in nurse Conclusion The research done on investigating the cause of burnout among ICU nurses through critical review of three research article gave useful insight into the pattern of personal thought and attitude that leads exhaustion and stress among ICU nurse. The hospital factors such as lack of autonomy, low salary, non-beneficial treatment perception and traumatic situation in ICU environment were also identified as factor affecting performance of nurse. This information can useful for my own clinical placement as I realize the importance of resilience in the job and I will try to learn and cope with the pressure in the job by means of my passion for the job. Reference Bienvenu, O. J. (2016). Is this critical care clinician burned out?.Intensive care medicine,42(11), 1794-1796. Chitura, D., Chitura, M. (2014). Burnout syndrome in intensive care unit nurses in zimbabwe.European Scientific Journal,10(SI), 436. Cooke, G. P., Doust, J. A., Steele, M. C. (2013). A survey of resilience, burnout, and tolerance of uncertainty in Australian general practice registrars.BMC medical education,13(1), 1. Halcomb, E., Ashley, C. (2016). Australian primary health care nurses most and least satisfying aspects of work.Journal of Clinical Nursing. Myhren, H., Ekeberg, ., Stokland, O. (2013). Job satisfaction and burnout among intensive care unit nurses and physicians.Critical Care Research and Practice,2013, 1-6. doi:10.1155/2013/786176 Rees, C. S., Heritage, B., Osseiran-Moisson, R., Chamberlain, D., Cusack, L., Anderson, J., ... Hegney, D. G. (2016). Can we predict burnout among student nurses? An exploration of the ICWR-1 model of individual psychological resilience.Frontiers in Psychology,7. Schwarzkopf, D., Rddel, H., Thomas-Rddel, D. O., Felfe, J., Poidinger, B., Matthus-Krmer, C. T., ... Bloos, F. (2016). Perceived Nonbeneficial Treatment of Patients, Burnout, and Intention to Leave the Job Among ICU Nurses and Junior and Senior Physicians.Critical Care Medicine. Usha, P. (2016). A comparative study to assess levels of stress between general ward and ot nurses at selected hospitals, chittoor district. Van Bogaert, P., Timmermans, O., Weeks, S. M., van Heusden, D., Wouters, K., Franck, E. (2014). Nursing unit teams matter: Impact of unit-level nurse practice environment, nurse work characteristics, and burnout on nurse reported job outcomes, and quality of care, and patient adverse eventsA cross-sectional survey.International journal of nursing studies,51(8), 1123-1134.