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Emergency Department (ED) is a unit of a hospital that provides various types of emergency care, including reporting, response, field care, etc. One of the most common problems of emergency departments is staff burnout due to highly increasing stress levels, understaffing, and inappropriate scheduling. Specific policies that promote work-life balance, employee benefits, and provide support for staff’s mental health can improve the situation.
The department chosen for the analysis is Emergency Department in an XYZ hospital. The department’s input includes staff, patients, family members, supplies and equipment necessary for procedures, funding and grants, information about the type of injury/condition, patient feedback, and healthcare environment. The throughput includes various ED services, such as detection, reporting, response, field care, transit care, unit care, including specific services, e.g., burn, trauma, and stroke care and poison control.
The output includes patient volumes, data on the type of injury and care delivered (trauma-critical, urgent care), time of stay, any issues related to admission and discharge of patients, treatment time, and patient volumes (Meyer & O’Brien-Pallas, 2010). Cycles of events include expenditures and revenues, staff accreditation, programs focused on improvement of care effectiveness, coaching, workshops, etc. Negative feedback includes metrics related to organizational and staff performance, treatment efficiency, the impact of human error on care, etc.
The problem identified by the author is staff burnout, which can lead to further problems with mental health, e.g., acute stress, depression, and anxiety. Some causes of burnout might be “unpredictable workload, frequent disruptions to circadian rhythms, and caring for high acuity and high complexity patients” (Lu, Dresden, McCloskey, Branzetti, & Gisondi, 2015, p. 998). Staff burnout directly relates to the inflow of energy in the unit, resulting in disruption of care, worsened nursing condition, and less effective treatment and care; all these factors adversely influence inputs. Burnout is also related to the mental and physical health of the staff since it can lead to emotional exhaustion, potential bullying, nonsupportive working relationships, etc. (Laschinger & Grau, 2012).
The desired outcome of a proposed intervention would be decreased burnout, reduction in stress levels and turnover rates, improved working conditions and relationships, suitable scheduling, and lack of too extensive workload.
To facilitate the outcomes, the hospital will need to provide better life-work balance to staff by introducing the following policies:
- Understaffing cannot be addressed by increasing employees’ workload if they are unwilling to accept it.
- The work environment should be designed and structured in a way that does not interfere with the working process and is not potentially dangerous to staff and/or patients.
- Appropriate scheduling is provided to all staff and does not require them to undergo major changes in private life to adapt to those.
- Provide mental health support for employees in a specific center, where a counseling psychologist will be available to them during the working process.
- Launch a program that will directly relate to staff training and include cognitive behavioral interventions (e.g., relaxation training, cognitive restructuring) (Morse, Salyers, Rollins, Monroe-DeVita, & Pfahler, 2012).
The standards of practice for emergency nurses include the ability to collect comprehensive data, determine the diagnosis, identify the outcomes of a treatment plan, develop and implement the treatment plan, coordinate care delivery, promote health, consult patients and other professionals about the plan, use procedures, referrals, therapies in accordance with legal regulations, and evaluate progress (AMN Healthcare, 2014).
Burnout can interfere with the ability of nurses to provide comprehensive care, as well as coordinate it. Lack of motivation, stress, and inability to use complex decision-making can result in different mistakes, which will undermine the nursing standards of practice. Policies targeting work environment, relationships, and scheduling will improve teamwork, procedure implementation, and care delivery, also reducing the level of stress experienced by employees.
The proposed resolution can improve organizational culture by teaching the staff how to address negative aspects and challenges in a non-toxic way, e.g. instead of bullying or substance use they can use active coping, self-control, or problem-solving (Guveli et al., 2015). Furthermore, additional coaching and workshops will positively influence teamwork, resulting in decreased number of misunderstandings among staff.
Resolved issues in teamwork will also improve patient care and satisfaction, thus aligning with the hospital’s mission to provide quality care, care for safety and health of patients, ensure their satisfaction, and promote healthy habits and behavior to them. Monitoring the psychological well-being of employees and addressing any issues as early as possible will positively affect climate at the working place. Moreover, it will also decrease employees’ willingness to engage in unhealthy behaviors to reduce stress levels (i.e., drinking, smoking, absenteeism).
Professionals working in EDs need to understand the impact of burnout on their care and possible outcomes of it. The facility can address the problem via rescheduling, decreasing understaffing, providing psychological support, observing psychological well-being of employees, redesigning work environment, and ensuring proper work-life balance for employees. If all these policies are implemented, the facility will be able to provide more efficient and quality care.
AMN Healthcare. (2014). Professional nursing practice: An update. Web.
Guveli, H., Anuk, D., Oflaz, S., Guveli, M. E., Yildirim, N. K., Ozkan, M., & Ozkan, S. (2015). Oncology staff: Burnout, job satisfaction and coping with stress. Psycho‐Oncology, 24(8), 926-931.
Laschinger, H. K. S., & Grau, A. L. (2012). The influence of personal dispositional factors and organizational resources on workplace violence, burnout, and health outcomes in new graduate nurses: A cross-sectional study. International Journal of Nursing Studies, 49(3), 282-291.
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Lu, D. W., Dresden, S., McCloskey, C., Branzetti, J., & Gisondi, M. A. (2015). Impact of burnout on self-reported patient care among emergency physicians. Western Journal of Emergency Medicine, 16(7), 996-1001.
Meyer, R. M., & O’Brien‐Pallas, L. L. (2010). Nursing services delivery theory: An open system approach. Journal of Advanced Nursing, 66(12), 2828-2838.
Morse, G., Salyers, M. P., Rollins, A. L., Monroe-DeVita, M., & Pfahler, C. (2012). Burnout in mental health services: A review of the problem and its remediation. Administration and Policy in Mental Health and Mental Health Services Research, 39(5), 341-352.