Expanding knowledge and roles for authority and practice boundaries of Emergency Department nurses: a grounded theory study

Social shaming and bullying of mental health staff by patients: A survey in a mental health centre

WHAT IS KNOWN ON THE SUBJECT?: Public shaming, especially by consumers of healthcare, is getting worse and has become a specific case of bullying Despite extensive research on physical and verbal violence directed towards mental health workers, the issue of social shaming and bullying by patients or relatives has not been sufficiently researched WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE: Mental healthcare workers are exposed to the threat of social shaming and bullying on a regular almost weekly basis Abusive behaviours by patients are associated with professional burnout, decreases in professional functioning and even a tendency to leave the workplace among mental health workers WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The stability and strength of the therapeutic alliance between healthcare giver and psychiatric patient are critical to the success of the treatment There is a need to develop a dedicated organizational policy for the prevention, early detection, intervention and support for teams exposed to social shaming and bullying An emphatic response, and effective intervention in a case of social shaming may improve professional functioning and reduce burnout and intention to leave.

ABSTRACT

INTRODUCTION: Social shaming can impair caregivers' performance. The prevalence of shaming experienced by mental health workers and the relationships to their function or burnout is unknown.

AIM

To examine the associations between exposure to social shaming and bullying by patients, the risk appraisal of negative impact of this behaviour, burnout, professional functioning and intention to leave among mental health workers.

METHOD

In this cross-sectional study, 122 workers from a psychiatric hospital completed a questionnaire.

RESULTS

Participants reported exposure to social shaming and bullying by patients on a regular basis. Shaming and bullying were significantly associated with lower professional functioning and higher intention to leave, while burnout may at least partially mediate the association between these variables.

CONCLUSIONS

The phenomenon of shaming and bullying of mental health workers by patients is common and is associated with lower functioning and higher burnout, which have a negative impact on the patient-caregiver interaction.

IMPLICATIONS FOR PRACTICE

There is a need to establish a policy for early detection of shaming of mental health workers in order to prevent burnout or intention to leave. Evidence based interventions, such as the Safewards model, accompanied by assessment of their effectiveness, may help in this effort.

Emergency Nurses' Competency in the Emergency Department Context: A Qualitative Study

Background

The availability of clear emergency nurses' competencies is critical for safe and effective emergency health care services. The study regarding emergency nurses' competencies remained virtually limited.

Purpose

This study aimed to explore the emergency nurses' competencies in the clinical emergency department (ED) context as needed by society.

Methods

This qualitative study involved focus group discussions in six groups of 54 participants from three EDs. The data were analysed using grounded theory approach including the constant comparative, interpretations, and coding procedures; initial coding, focused coding and categories.

Results

This study revealed 8 core competencies of emergency nurses: Shifting the nursing practice, Caring for acute critical patients, Communicating and coordinating, Covering disaster nursing roles, Reflecting on the ethical and legal standards, Researching competency, Teaching competencies and Leadership competencies. The interconnection of the 8 core competencies has resulted in 2 concepts of extending the ED nursing practice and demanding the advanced ED nursing role.

Conclusion

The finding reflected the community needs of nurses who work in ED settings and the need for competency development of emergency nurses.

Emergency department nurses' role transition towards emergency nurse practitioner: A realist-informed review

BACKGROUND

The integration of emergency nurse practitioner (ENP) services in emergency departments (EDs) has been well established, especially in high-income countries such as the United Kingdom, the United States and Australia. Different types of reviews, including integrative, literature and systematic, have been carried out to examine evidence regarding the impact of ENPs on the quality of ED services. Unfortunately, there is still limited explanation of the influencing factors that may result in a successful transition process from Registered Nurse to Emergency Nurse Practitioner. This review aims to understand these factors.

METHODS

A realist approach (RAMESES) guided this review. CINAHL Plus, MEDLINE, PsycINFO, EMBASE and Web of Science databases were searched to capture studies from 1990 to 2020, combined with policy documents from professional bodies and government websites and relevant references from identified sources. Realist data analysis was carried out on the included articles to understand how context, mechanism and outcomes related to the ED nurses' role transition.

RESULTS

Forty-eight articles were included. There were differences in preparatory education and scope of practice of the role. The review configured various contexts, mechanisms and outcomes of the role transition along with their interactions.

CONCLUSION

The findings provide a comprehensive understanding regarding the emergency nurses' role transition, with a view to providing better insights and explanations to interested parties who would like to integrate the ENP service in their ED.

Nursing Development in Indonesia: Colonialism, After Independence and Nursing act

Introduction

Stereotyping of nurses still occurs nowadays in Indonesia. Society and healthcare think nursing is a doctor helper service. The public image of a nurse as a doctor's helper is hard to erase. Thus, the nursing development in Indonesia needs to be explored in describing the stereotyping and the nursing conditions in the current situation.

Methods

The study used a narrative review with 45 sources analyzed and extracted.

Results

Nursing education has been developed since colonialism. The first time the Netherland Indies built the hospital and they used Babu or a helper as a nurse. The result showed it had a negative impact, which showed as they started to train nurses. They trained male nurses to be Mantri nurses as hulpgeneesheeren (ancillary doctors). After independence, the project HOPE influenced the development of nursing in Indonesia. Indonesian nurses focused on technical aspects and added the nursing process to the education curricula in 1986. However, nurses’ practice culture did not change for a long time because of a lack of research and literature being evaluated during 1990–2010. Indonesia nursing started to increase the education, practice, and research afterward, with specifically the declaration of the Indonesian Nursing Act. It brought nurses into the professionalism of healthcare which the Indonesian government recognized. Then, nurses have faced new problems, including practice and education gaps.

Conclusion

The development of nurses will increase autonomy and dignity. Increasing education curricula, practice competency, and research impact will change the perspective of society with the support of recognition and education from the nursing organization. In addition, the nursing organization has an essential role in nursing development in each country.