Nursing Challenges and Self-Care (NUR 104)

Concept of Nursing (NUR 104) - Lecture 13

• Objectives:
  • Review personal/societal challenges in nursing anticipated during the next decade.
  • Describe major challenges for the nursing profession.
  • Explain trends in nursing education needed to meet society's future nursing needs.
  • Describe four major components/beliefs of the American Nurses Association for the future of nursing's agenda.

Personal Challenges (Caring for Yourself)

• Self-care: The ability to engage in healthy relationships, listen to one's body, and recognize signs of exhaustion.
• Challenges for Nurses engaging in Self-care:
  • Poor organization support
  • Lack of time
  • Poor work-life balance
  • Difficult workload
  • Limited access to stress reduction activities
  • Numerous daily scheduled meetings
  • Frequent emergencies needing immediate attention
  • Feelings of guilt due to understaffing

Consequences of Poor Self-Care

• Mental Health: Frustration, irritability, anxiety, confusion, poor concentration, helplessness, hopelessness, depression, low morale, fatigue, guilt.
• Physical Health: Stress-related illnesses (hypertension, ulcers, acid reflux, heartburn, skin rash).
• Relationships: Conflict, tension, misunderstandings, anger, emotional/physical abuse.
• Work/Practice Impacts: Increased absenteeism, diminished productivity, team conflict, turnover.

Social Challenges (Caring for your Community)

• A - Demographics: The science of studying vital statistics and social trends examining birth rates, morbidity and mortality rates (illness).
  • Four important demographic trends for nursing: Aging population, Poverty, Cultural diversity, Urbanization

1. Aging Population

• This is a growing issue. The number of people over 60 is increasing significantly.
• Aging is a natural process (not a disease), but some problems and accidents can be avoided with care and attention.
• Two-thirds of accidents suffered by older people occur in their own homes, such as falling. Accidents are a key cause of disability.
• Some types of disabilities could be treated in a way that limits dangerous accidents.

2. Poverty

• Working poor cannot meet basic needs.
• Medically indigent people who do not qualify for Medicaid.
• Disenfranchised people with limited healthcare access due to political factors.
• Governments need strategies for healthcare of vulnerable populations.

3. Cultural Diversity

• People from various backgrounds (racial, ethnic, religious, social, geographic).
• Nurses need to consider cultural beliefs, values, and practices
• Important to have similar and diverse beliefs among the team to achieve culturally sensitive care.

4. Urbanization

• Increased movement from rural to urban areas;
• Decaying inner cities with large populations of poor people.
• Social problems like homelessness, drug use, gangs, single-parent households, mental illness, violence, and crime.

B - Environment

• Gradual deterioration of the world's air, water, and plant/animal life.
• Acute and chronic respiratory diseases, allergic reactions, and cancers are increasing.
• Epidemiologists link environmental decline with increased disease incidence.

C - Disasters and Bioterrorism

• Disaster is greater than an emergency, can be natural or man-made.
• Bioterrorism is the use of biological or chemical agents as weapons.
• Unhealthy lifestyles, stress, HIV/AIDS, and drug use also significantly impact communities.

D - Unhealthy lifestyles

• Includes obesity, tobacco use, lack of exercise, eating disorders, stress, HIV/AIDS and drug use.

E - Healthcare reform

• Nursing roles will need to expand in prevention, community-based care, and advanced practice and costs.
• School nurses are one approach to cost effective health care for children.

Challenges in Nursing Practice (Caring for your Profession)

• A. Autonomy and accountability: As community settings increase, autonomy and accountability will be essential.
• B. Differentiated practice levels: Nurses with different degrees should have different roles, potentially different licensure levels, with competency standards at each level.
• C. Health care reform: Cost containment requires demonstrating care effectiveness. Nurses work with assistive personnel and delegate tasks.
• D. Practice in community settings: Clinics, school and hospice nurses, nurses specializing in conditions like gerontology, and chronic illnesses are needed. Community-based primary care is expanding due to cost-effectiveness. Flexible scheduling benefits nurses working outside traditional settings.
• E. Technology and Nursing Informatics:
  • Computerized health info networks provide immediate access to patient data to improve care plans.
  • Two-way TV systems/telephones allow remote patient care and treatment.
  • Genetic engineering/genomic revolution enables tailored treatments for genetically predisposed patients.
  • Genomic nursing programs prepare nurses for family history assessment, screening, and case coordination.

F. Cultural competence

• Cultural sensitivity starts with healthcare providers.

G. Maintaining a Healthy Work Environment

• Nurses need to take positive action to ensure dignity and safety in the workplace. This includes addressing issues like needle sticks, latex allergies, shift work, violence risks, bloodborne diseases, and back injuries.

Challenges in Nursing Education (Caring for Your Education)

• A. Outcome-based Education: Measuring patient outcomes and adopting evidence-based practice is essential for accreditation. Modifying old teaching strategies to new methods like critical thinking, problem-solving, and simulations are needed for education.
• B. Diversity: Nursing education should reflect the diversity of the population served, including foreign language requirements for courses like a BSN. Culturally competent care should be a criterion for graduation.
• C. Technology and Nursing Informatics: Computer skills and internet use are needed. Lifelong learning is also needed to keep up with changes in technology.
• D. Collaboration: Joining of nursing faculties, managers, and practitioners is essential to strengthen the educational experience for students and improve the work experience for nurses.
• E. Reforms in Health Care & Higher Education: Graduate education is needed to meet the increased needs of consumers. Curricula needing to be standardized and improved for student mobility is also important. Nurses need to understand the costs, budgeting, and finance of healthcare.

Challenges to the Entire Nursing Profession

• Essential healthcare is a basic human right.
• Health policies should aim for safe, effective, patient-centered healthcare.
• Healthcare systems need to transition away from expensive and technology-driven acute and hospital-based care to more balanced models with greater community-based and preventive services.
• A single-payer system is a desirable option as it can address the affordability and effectiveness of the system for all.

This quiz focuses on Lecture 13 of the Nursing Concept course (NUR 104). It reviews personal and societal challenges anticipated in nursing, outlines major challenges in the profession, and discusses essential trends in nursing education. Participants will also explore the importance of self-care for nurses amidst these challenges.