Introduction
During their practice, nurses in various fields face stress, which can result in severe mental health problems. Transplantation nurses who work with patients requiring solid organs and blood transplants have an even greater stress level due to the great responsibility. They must allocate transplants between patients and provide them care, considering that they are often terminally ill.
The ongoing COVID-19 pandemic, while not so severe today, still has consequences such as higher levels of nurse overload, burnout, and short-staffing issues. Barrett’s theory of power-as-knowledge and its applications will be analyzed and discussed to elucidate how it can help transplantation nurses cope with their overload and stress.
Description of the Theory
Barret’s theory of power is connected to Roger’s theory of unitary human beings and explores power and responsibility from materialistic and spiritualistic perspectives, analyzing both. Each field contains four dimensions of power: awareness of actions, choosing the right action, freedom to act intentionally, and involvement in creating change (Smith, 2020).
The materialistic perspective is called power-as-control, based on careful control over the situation and directing it most efficiently: patients’ behavior, medical equipment, and consumables.
On the contrary, the spiritualistic perspective is the power-as-freedom, as it follows from the acausal plane of human consciousness and is based on the free will of every person. An example is empowering patients and giving them advice on improving their lives. While both types of power are used during nursing practice, the power-as-freedom is much more efficient and should be used whenever possible.
The principle of power-as-knowledge is the unification of both perspectives: it means knowing what should be changed and how to change it. Based on both materialistic and spiritual perspectives, one can act intentionally and freely, participating in change and improving the quality of one’s life (Smith, 2020).
From the patient’s health point of view, a nurse can analyze the patient’s problems and help them recover by giving advice, such as daily exercises or medication. From the nurse’s perspective, the theory can help to evaluate the level of stress and overload and show how they can be overcome. The model will elucidate their reasons and distribute the responsibility among nursing staff in the most efficient way.
Therefore, the reason for choosing this theory for this research is that it works with power and responsibility. The main problem among transplantation nurses, especially during the pandemic, is the overloading by responsibility. Stress and mental health problems, such as apathy and derealization, are consequences of this overload and subsequent burnout (Neumann et al., 2018; Yang et al., 2018).
Barrett’s theory helps nurses and the management staff to evaluate how the responsibility is distributed and decide how to redistribute it more efficiently, ensuring that all nurses can freely participate in these changes.
Application of the Theory: Short-Staffing and Stress in Transplantation Nursing
Responsibility and Stress
In the transplantation industry, especially considering solid organs, the demand is much more than the supply, and shortages are frequent. There are various ethics of transplantations, for example, to prefer curing those whose diseases are caused by actual problems over those who destroyed their health by bad habits such as drugs (Oedingen et al., 2019).
Transplantation nurses coordinate the allocation process and care for patients waiting for their transplants; often, they should provide end-of-life care to those patients with tiny chances of obtaining transplants (Yang et al., 2018). The world’s demand for transplants, especially hematopoietic cell transplantation, is rising, and this field is clearly short-staffed (Neumann et al., 2018). Transplant nursing jobs are connected with a high level of responsibility and stress that has increased greatly due to the COVID-19 pandemic.
In addition, solid and blood transplant receivers are more vulnerable to COVID-19 problems. Victims of the terminal pneumonia stage, which is a possible consequence of COVID-19, can be cured only by transplanting lungs to them, and there should be no complications, which are frequent (Zhang et al., 2020).
Hematopoietic stem-cell transplantation recipients who develop COVID-19 have lesser chances of recovering and only less than 70% survival rates (Sharma et al., 2021). Transplantation nurses’ responsibility for their patients, while being high, increases due to the pandemic, and therefore, their situation is actually very hard.
As Barrett’s theory of power works with responsibility on various levels, adopting it would help decrease the stress level, which is connected with over-responsibility. There is evidence that mindfulness applications, which provide instructions and music for meditation, help transplantation nurses cope with their stress. Burnout rates decreased for those nurses who used the app for more than two months, which means that mindfulness and brain relaxation help nurses recover (Knill et al., 2021).
Barrett’s theory uses the power-as-knowledge model, enabling the nursing staff to evaluate how the responsibility is distributed in the collective and how it can be redistributed without burnout (Smith, 2020). Combined with the mindfulness app, which helps nurses recover their mental and spiritual health, the theory becomes a valuable tool for transplantation nursing practice.
Understaffing and Overloading
Nurses, in general, have been overloaded since 2020, as the flow of patients is significantly higher, while the staff size is often not enough. The distribution of overloaded hospitals in the U.S. is uneven, as when the number of infected patients in one hospital is high enough, the infection starts to spread rapidly. Nurses should work more hours to satisfy the hospital’s needs as they experience stress (Gorges & Konetzka, 2020). While these problems were much more actual in 2020 – 2021, now, in 2023, the issue of overloaded nurses with high stress and low productivity and life quality is present.
In the field of transplantation nurses, the problem is sharper, as the problem with short-staffing was actually long before the pandemic (Neumann et al., 2018). They also experience a higher level of stress working with severely ill patients, often with diseases such as cancer (Knill et al., 2021). Thus, staff shortages and subsequent overloading are severe among transplantation nurses.
Barrett’s theory of power explores the distribution of power and responsibility, and it will be beneficial for the exploration of the problem of overloading. Based on the four dimensions of power, awareness, choices, freedom to act intentionally, and involvement in change, nurses and management staff can evaluate the level of the problem and which actions are necessary (Smith, 2020).
As mentioned, meditation helps nurses relax and recover much more efficiently, and the theory can determine when the nurse needs to recover (Knill et al., 2021). The usage of meditation apps becomes the action of change, which restores the nurse’s health and enables them to work safely and efficiently.
Therefore, the usage of Barrett’s theory is especially useful in the field of transplantation nursing, where responsibility becomes so high that it leads to high levels of burnout and subsequent mental health issues. It works with power-as-knowledge and provides four dimensions to analyze the power: awareness, choice, intention, and involvement (Smith, 2020).
Awareness in this context means evaluating the situation, while choice and intention are the choices of the right action for stress reduction. The whole nursing collective involvement in the act requires motivation, such as the possibility to reduce stress and increase resilience (Yang et al., 2018).
To summarize, two actions may help: using mindfulness apps for meditation to reduce stress and relax and redistributing the responsibility among nurses to ensure that none of them is overloaded.
Conclusion
Transplantation nurses face significant challenges in their work due to the high-stress level while working with severely ill patients, staff shortages, and pandemic complications. All of them are based on the increased responsibility they must bear, allocating transplants between patients and often providing end-of-life care for terminally ill patients.
Barrett’s theory of power helps to evaluate the responsibility distribution among nurses, based on the power-as-knowledge model and shows what can be done to decrease the overload and stress levels. It can be efficient to use it with mindfulness apps that provide instructions and music for meditation.
For example, overloaded nurses can take a break from work and recover their mental and spiritual health using such an app before taking their networking hours. In addition, they can redistribute the responsibility among the collective to ensure that all nurses are loaded according to their current ability to be involved in action and that no one is overloaded.
These two actions would increase their work efficiency and decrease the stress level, and the usage of the theory of power enables monitoring the nurse’s responsibility and, subsequently, stress and overloading.
Reference
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