Текст книги "The Nurses: A Year of Secrets, Drama, and Miracles with the Heroes of the Hospital"

Автор книги: Alexandra Robbins

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Текущая страница: 30 (всего у книги 33 страниц)

Dansby left the patient . . . off of her. Interview with Dansby.

Shaken and injured . . . assailant is still free. Ibid.

When Dansby told her department Jessica Garrison and Molly Hennessy-Fiske; confirmed with Dansby.

Afraid of losing her job . . . “that hospital door.” Interview with Dansby.

“ward rage” See, for example Torri Minton, “Cry for Health: Poor Working Conditions Driving Nurses out of Hospitals,” San Francisco Chronicle, May 20, 2001.

On the rise See, for example, Staff Report, “Not in a Day’s Work,” National Nurse, November 2010; “Preventing Violence in the Healthcare Setting.” Sentinel Event Alert 45, The Joint Commission, June 3, 2010.

nine out of ten . . . “Emergency Department Violence Surveillance Study.” Emergency Nurses Association Institute for Emergency Nursing Research, November 2011. See also Jessica Gacki-Smith et al., “Violence Against Nurses Working in U.S. Emergency Departments,” Journal of Nursing Administration 39, no. 7/8 (July/August 2009); and Paula Zahn, “Nurses Under Attack,” Paula Zahn Now, CNN, July 11, 2007.

a quarter of ER nurses . . . past three years. “Emergency Department Violence Surveillance Study”; see also Jessica Gacki-Smith et al.

every nurse they know Interviews.

Experts have attributed the rise . . . crime or accident scenes. Interviews; see also, for example, “Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers.” U.S. Department of Labor: Occupational Safety and Health Administration; “Workplace Violence: Assessing Occupational Hazards . . .”; Jessica Gacki-Smith et al.

third-most dangerous profession An examination of the Bureau of Labor Statistics Survey of Occupational Injuries and Illnesses reveals that nurses rank behind only police officers and correctional officers in the number of nonfatal assaults that resulted in days off from work due to illness or injury. A separate set of BLS data that more explicitly specifies professions shows that the assault incidence rates (again resulting in days off from work due to illness or injury) for RNs, LPNs, and licensed vocational nurses rank behind only health technicians and health aides.

“nurses are nearly twice as likely . . .” Lois Berry and Paul Curry, “Nursing Workload and Patient Care,” Canadian Federation of Nurses Unions, 2012.

“the actual number . . .” “Guidelines for Preventing Workplace Violence . . .”

sixteen times more likely . . . See, for example, “Workplace Violence in Healthcare Settings,” Center for Personal Protection and Safety, August 2011; see also Alex Rose, “Protection Sought for Healthcare Workers,” Delaware County Daily Times, March 2, 2011.

In 2012, Douglas Kennedy . . . See, for example, Ann Curry and Carl Quintanilla, “Douglas Kennedy Speaks out for First Time Since Confrontation with Two Nurses,” Today, April 13, 2012.

hospital had not discharged . . . See, for example, “Statement on Northern Westchester Case Does Not Address Assault on Nurses,” Targeted News Service, April 4, 2012.

concerned maternity nurses . . . “through the air.” Ibid.

Kennedy went downstairs . . . welfare of a child. Ibid.

superiors told them not to report . . . Interviews.

Nurses who don’t keep . . . See, for example, Elizabeth Simpson, “Danger in the ER Health,” Virginian-Pilot (Norfolk), April 13, 2012; August Gribbin, “Hospital Health Hazard,” The Washington Times, February 10, 2002.

Tammy Mathews . . . hospital fired her. Lauren Auty, “Nurses Face an Epidemic of Violence in Hospitals,” Philly.com, December 1, 2011.

between 65 and 80 percent . . . “Workplace Violence in Healthcare Settings,” Center for Personal Protection and Safety, August 2011; Emergency Department Violence Surveillance Study, November 2011.

“incidents of violence . . .” “Guidelines for Preventing Workplace Violence . . .”

a Massachusetts judge . . . Elaine Thompson, “Hurt Healing Hands: Effort to Protect Health Workers,” Telegram & Gazette (Massachusetts), April 8, 2010.

hospitals that encourage nurses . . . See, for example, Emergency Department Violence Surveillance Study, August 2010; “ED Nurses Seeking Protection from Violence,” Hospital Employee Health, July 1, 2010; Emergency Department Violence Surveillance Study, November 2011.

“Victims are often untrained . . .” “Preventing Workplace Violence,” American Nurses Association Occupational Health and Safety Series, 2006.

In 2007, a drug-seeking patient . . . “actually getting worse.” JoNel Aleccia, “Swearing, Spitting, Choking: ER Nurses Endure This and More.” Vitals, msnbc.com, November 9, 2011. Nurses’ tolerance is expected to be even higher than patients’ tension. A New York ER nurse said that a patient scratched her, bit her, spit on her, and hit her so hard that her jaw broke. The attacker later told her, “I’m sorry. I was tired of waiting.” “Workplace Violence in Healthcare Settings,” Center for Personal Protection and Safety, August 2011.

“What I don’t have patience for . . .” Interview.

many hospitals aren’t providing . . . Interviews.

In nearly three-quarters of assaults . . .” Emergency Department Violence Surveillance Study.

“They want the nurses to ignore it . . .” Interview.

More assaults occur . . . See, for example, “ED Nurses Seeking Protection from Violence,” Hospital Employee Health, July 1, 2010.

target nurses. Examination of Bureau of Labor Statistics data on assaults causing occupational illnesses and injuries involving days away from work: 64 percent of assaults against healthcare practitioners and techs were against nurses. See also “Nonfatal Occupational Injuries and Illnesses Requiring Days Away from Work, 2010.” News Release. Bureau of Labor Statistics, November 9, 2011; “Occupational Hazards in Hospitals,” CDC Workplace Safety and Health, National Institute for Occupational Safety and Health, April 2002; “Workplace Violence in Healthcare Settings.”

hospitals don’t train their staff Interviews.

“My residents get more training” Interview.

Tennessee state senators . . . five to four vote Steven Hale, “Ford Lashes Out at Nurses,” Tennessee Report, February 15, 2012.

Attacking a nurse is still only a misdemeanor Ken Steinhardt, “Progress on Felony Workplace Assault Laws,” ENA Connection 8, no. 2, February 2014.

In 2006, Brenda Coney . . . killed a pharmacist. Charles Broward, “Jury Sides with Family of Killed Shands Pharmacist,” Florida Times Union, October 1, 2011.

trauma patient who had been stabbed Author correspondence with Paul Matera; see also August Gribbin, “Hospital Health Hazard,” The Washington Times, February 10, 2002.

punched Matera . . . what he was doing.” Author correspondence with Paul Matera.

The American Medical Association gave him August Gribbin

“The whole Nurse Jackie thing” Resources for nurses trying to stop substance abuse are listed in Chapter 10. For ease of reference, you can find a good preliminary list of links and contact information on this website: http://www.peerassistance.com/links.htm

Chapter 4

“The nurse treats colleagues” The ANA’s Code of Ethics For Nurses; see http://nursingworld.org.

“Somewhere along the line” Interview.

“I knew the minute” Interview.

Relationship-Based Care program Developed by Creative Healthcare Management; see http://chcm.com/relationship-based-care/.

“silent epidemic” Laura A. Stokowski, “A Matter of Respect and Dignity: Bullying in the Nursing Profession,” Medscape.com, September 30, 2010.

“professional terrorism,” Malcolm A. Lewis, “Will the Real Bully Please Stand Up,” Personnel Today, May 1, 2004.

“insidious cannibalism” Penny Sauer. “Do Nurses Eat Their Young? Truth or Consequences,” Journal of Emergency Nursing, January 2012.

“the dirty little secret of nursing.” Theresa Brown, “When the Nurse is a Bully,” The New York Times, February 11, 2010. Brown is also the author of Critical Care: A New Nurse Faces Death, Life, and Everything in Between. HarperOne (2010).

75 percent of nurses had been verbally Michelle Rowe and H. Sherlock, “Stress and Verbal Abuse in Nursing: Do Burned Out Nurses Eat Their Young?” Journal of Nursing Management 13, 2005.

only 23 percent said no. Shellie Simons, “Workplace Bullying Experienced by Massachusetts Registered Nurses and the Relationship to Intention to Leave the Organization,” Advances in Nursing Science 31, no. 2 (2008).

“Most of us could probably . . . ” “Bullying in the Workplace: Reversing a Culture,” American Nurses Association, Nursebooks.org, Maryland (2012).

Portugal See, for example, Luis Sa and Manuela Fleming, Issues in Mental Health Nursing, 29 (2008).

Finland See, for example, Mika Kivimäki, Marko Elovainio, and Jussi Vahtera, “Workplace Bullying and Sickness Absence in Hospital Staff,” Occupational and Environmental Medicine 57 (2000); Cheryl A. Dellasega, American Journal of Nursing.

Australia See, for example, Suzanne Lappeman, “Nurses Are the Bullies, Says Lucas,” Gold Coast Bulletin (Australia), November 24, 2010; Denise Cullen, “Nursing Initiative Pays Off,” Weekend Australian, January 15, 2011; Penny Sauer.

New Zealand Brian G. McKenna et al., “Horizontal Violence: Experiences of Registered Nurses in Their First Year of Practice,” Journal of Advanced Nursing 42; Janette Curtis, Isla Bowen, and Amanda Reid, “You Have No Credibility: Nursing Students’ Experiences of Horizontal Violence,” Nurse Education in Practice 7, no. 3 (May 2007).

Ireland See, for example, Eithne Donnellan, “Most Migrant Nurses Bullied—Study,” The Irish Times, May 7, 2010.

Canada, Taiwan . . . Turkey. “Bullying in the Workplace: Reversing a Culture,” American Nurses Association; Penny Sauer.

Taiwan See also H. C. Pai and S. Lee, “Risk Factors for Workplace Violence in Clinical Registered Nurses in Taiwan,” Journal of Clinical Nursing (May 2011).

Poland Dorota Merecz et al., “Violence at the Workplace—A Questionnaire Survey of Nurses,” European Psychiatry 21 (2006).

Japan Interviews. Thank you to Andrew Robbins and K.O. for assistance in Japan. See also, for example, Kiyoko Abe, “Hierarchical Models of Workplace Bullying Among Japanese Hospital Nurses,” Unpublished Dissertation, University of Minnesota, Minneapolis (May 2007).

“‘angels in white’” Interview. Other nurses in Japan shared similar sentiments in interviews for this book.

one in three nurses quits . . . See, for example, Martha Griffin, “Teaching Cognitive Rehearsal as a Shield for Lateral Violence: An Intervention for Newly Licensed Nurses,” Journal of Continuing Education in Nursing (November–December 2004).

bullying—not wages— See, for example, Shellie Simons, “Workplace Bullying Experienced by Massachusetts . . .”; Katrina Creer, “Nurses Scared Off,” Sunday Telegraph (Sydney, Australia), August 31, 2003.

nurse bullying is responsible . . . three years. Martha Griffin.

“It is destroying new nurses” Interview.

more nurses experience bullying Judith Vessey, “Bullying of Staff Registered Nurses in the Workplace: A Preliminary Study for Developing Personal and Organizational Strategies for the Transformation of Hostile to Healthy Workplace Environments,” Journal of Professional Nursing (September–October 2009); Lyn Quine, “Workplace Bullying in Nurses,” Journal of Health Psychology (2001); Janette Curtis.

nurses are verbally abused more Michelle Rowe and H. Sherlock, “Stress and Verbal Abuse . . . ”

“backbiting and unnecessary scrutiny” . . . “as my peers.” Alan H. Rosenstein and Michelle O’Daniel, “Impact and Implications . . .”

“nurses eat their young” J. E. Meissner, “Nurses: Are We Eating Our Young?” Nursing, March 1986.

practice festers . . . no nurse is immune. See, for example, Laura A. Stokowski. Interviews.

“There is a culture of treating” Interview.

nurse-on-nurse hostility . . . lateral violence. See, for example, “Workplace Violence: Assessing Occupational Hazards . . . ” Technically, experts say that “bullying” refers to repeated negative actions against a nurse by someone who has power over the victim, such as a charge nurse bullying a staff nurse, or an experienced nurse bullying a new graduate. Horizontal violence, by contrast, can characterize a single incident and occur without the hierarchy variable.

“back-door undermining . . . behaviors.” Alan H. Rosenstein and Michelle O’Daniel, “A Survey of the Impact . . .”

“being given an unmanageable . . . ” Shellie R. Simons, Roland B. Stark, and Rosanna F. DeMarco, “A New, Four-Item Instrument to Measure Workplace Bullying.” Research in Nursing and Health (2011).

“to stop talking . . . ” Cheryl Y. Woelfle and Ruth McCaffrey, “Nurse on Nurse,” Nursing Forum, July 2007.

“Nonverbal innuendo . . . a negative situation.” Martha Griffin; L. L. Veltman, “Disruptive Behavior in Obstetrics: A Hidden Threat to Patient Safety,”American Journal of Obstetrics and Gynecology (June 2007).

gossip; ignore Janice E. Hurley, Nurse-to-Nurse Horizontal Violence: Recognizing it and Preventing It, NSNA Imprint, September/October 2006; E. Duffy, “Horizontal Violence: A Conundrum for Nursing,” The Collegian, April 1995; C. Dunbar, “Managers Can Prevent Incidents of Horizontal Violence,” AORN Management Connections, 2005; Cheryl A. Dellasega. Connections, 2005.

Several other behaviors fall . . . condescend AACN Position Statement, “Zero Tolerance for Abuse.”

belittle . . . exclude a nurse from socializing. See, for example, Janice E. Hurley et al.

when nurses give hints . . . monitoring a peer’s work. See, for example, Shellie Simons, “Workplace Bullying Experienced by Massachusetts Registered Nurses and the Relationship to Intention to Leave the Organization,” Advances in Nursing Science (April–June 2008).

“manipulating . . . to turn against a nurse.” Cheryl A. Dellasega.

Verbal sexual harassment . . . less prominently. See, for example, Curtis et al.

“sexual harassment . . . behaviour from patients.” Brian G. McKenna, “Experience Before and Throughout the Nursing Career.” Horizontal Violence: Experiences of Registered Nurses in Their First Year of Practice.

The Workplace Bullying Institute . . . “car she drives.” Gary and Ruth Namie, The Bully at Work, Sourcebooks, 2000.

“the Troll” or “Bitch on wheels.” Interviews.

higher body mass index Mika Kivimäki et al.

making fun of their clothes . . . Interviews.

“make themselves feel better . . .” Interview.

“Structural bullying” . . . problem in the field. S. Simons and B. Mawn, “Bullying in the Workplace—A Qualitative Study of Newly Licensed Registered Nurses,” American Association of Occupational Health Nurses Journal (July 2010).

more than one-third of nurse respondents . . . Brian G. McKenna.

Nurses report that charge nurses . . . sick days. See, for example, S. Simons and B. Mawn, “Bullying in the Workplace;” ANA’s “Bullying in the Workplace: Reversing a Culture.”

“During my first pregnancy . . .” S. Simons and B. Mawn.

Virginia nurse called in sick . . . “they’re going to.” Interview.

“core values” Interview.

a nurse was sent . . . policies on physicians. Interview.

“nurses create a kind of hierarchy . . .” “‘Thick Divide’ Still Exists Between Many ED Staffs,” Hospital Access Management, February 1, 2007.

“Real Nurse” Interviews.

LPNs See, for example, http://www.nursinglicensure.org/articles/lpn-versus-rn.html

rivalries among specialties Interviews.

psychiatric nurses “eccentric.” Interviews.

because her specialty is known Interview.

“They think we don’t work” Interview.

“People think I put Band-Aids” Interview.

“I think the public generally” Interview, Carolyn Duff.

“I will absolutely admit” Interview.

Reason they prefer . . . “dump and run” Interviews.

“We don’t like taking patients” Interview.

For approximately half Interviews.

“We don’t just take vitals.” Interview.

“It’s not safe to leave . . .” Interview.

Horizontal violence may be directed . . . See, for example, S. Simons and B. Mawn.

nurses have been targets because of their accents See, for example, Denise Cullen, “Nursing Initiative Pays Off,” Weekend Australian, January 15, 2011.

or ethnicity . . . per diem nurse See, for example, S. Simons and B. Mawn.

because they received . . . undeserved. See, for example, Cheryl A. Dellasega.

puts them at a disadvantage . . . Interview.

male doctors treat male nurses . . . Susan Strauss, “A Study on Physician Bullying as Gender Harassment to Female and Male Operating Room Nurses in Minnesota (Part I),” Minnesota Nursing Accent (September–October 2008).

“I think I have better relationships . . .” Interview.

he is disproportionately assigned . . . Interview.

“I’m not really involved . . .” Interview.

comes from cliques . . . See, for example, C. Rocker, “Addressing Nurse-to-Nurse Bullying to Promote Nurse Retention,” OJIN: The Online Journal of Issues in Nursing, August 29, 2008; Malcolm A. Lewis, “Will the Real Bully Please Stand Up,” Personnel Today, May 1, 2004.

“Misuse of power . . . vulnerability of both.” ANA’s “Bullying in the Workplace: Reversing a Culture.”

nurses have higher job See, for example, Shellie Simons, “Workplace Bullying Experienced . . .”; Michelle Rowe and H. Sherlock.

“Some places have . . .” Interview.

nurse was tormented . . . Interview.

“something straight out of Mean Girls . . .” Interview.

“subjected to a despotic set . . . comes out strong” “The Hospital Tyrants and Their Victims, the Nurses: What Doctors Say of the Oppression of Young Women in These Institutions,” The New York Times, August 22, 1909.

“the abominable outrages . . .” Ibid.

“with statements like, ‘This is typical’” E. Duffy.

In 1970, Brazilian philosopher . . . See, for example, Linda Kay Matheson and Kathleen Bobay, “Validation of Oppressed Group Behaviors in Nursing,” Journal of Professional Nursing (July–August 2007).

As group members are made Shellie Simons, “Workplace Bullying Experienced . . . ”

Because the oppressed group . . .“oppressed group behavior.” See, for example, Linda Kay Matheson and Kathleen Bobay.

because of a history of submissiveness . . . an oppressed group. See, for example, Linda Kay Matheson and Kathleen Bobay; Woelfle, Y. Cheryl; Janice E. Hurley.

“The culture of the healthcare setting . . .” Center for American Nurses (part of ANA). Lateral Violence and Bullying in the Workplace. Approved February 2008.

“Unfortunately, many nurses . . .” Michelle Rowe and H. Sherlock.

Venting to doctors . . . See, for example, “Workplace Violence: Assessing Occupational Hazards . . .”; Dianne M. Felblinger.

when nurses are empowered . . . See, for example, H.K.S. Laschinger et al., “New Graduate Nurses’ Experiences of Bullying and Burnout in Hospital Settings,” Journal of Advanced Nursing 66 (December 2010).

does not empower employees . . . Penny Sauer.

keeps nurses short-staffed—nurse bullying increases Laurie Scudder, “Mean Nurses: Verbal Abuse of Early-Career Colleagues,” Disclosures, July 22, 2013.

environments with volatile workloads . . . workplace bullying. Penny Sauer.

become hostile toward . . . Diana Reiss-Koncar, “The War Against Nurses,” Salon, July 27, 2001.

“are more likely to vent . . .” Michelle Rowe and H. Sherlock.

If nurses are rarely afforded . . . See, for example, Laura A. Stokowski.

physically and emotionally worn out . . . G. L. Vonfrolio, “End Horizontal Violence,” RN, February 2005.

Nurses who are too drained . . . Johns Hopkins Children’s Center clinical nurse specialist Cynda Hylton Rushton has made this observation.

much higher levels of burnout . . . See, for example, H.K.S. Laschinger et al.; S. Einarsen, S. B. Matthiesen, and A. Skogstad, “Bullying, Burnout and Well-Being Among Assistant Nurses,” Journal of Occupational Health and Safety—Australia and New Zealand (1998); Luis Sa and Manuela Fleming.

“There is a sort of test . . .” Interview.

“Due to the broad base . . .” Interview.

“the fact that a new nurse . . .” Interview.

“Nurses put their own on steep . . .” Interview.

“sorority initiation” Interview.

OR’s tradition of initiating . . . Interview.

“a type of initiation . . .” The ANA’s “Bullying in the Workplace: Reversing a Culture.”

“ . . . the many challenges they will face” Interview.

“ . . . I wasn’t at that hospital . . .” Interview.

“ . . . My experience was awful.” Interview.

“Here, a select group . . .” Interview.

“Tolerance for some forms . . .’” Martha Griffin; see also Judith Vessey.

“are usually themselves past . . .” Janette Curtis et al.

“Why do we tear . . .” Interview.

“new nurses to prove themselves.” Interview.

“we’ve coddled these new young nurses . . .” Interview.

“Nurses take an immense . . .” Interview.

“. . . for the sake of the patients.” Interview.

a small number of nurse bullying Brian G. McKenna, “Experience Before . . . ”

“One nurse was so intimidating . . .” Interview.

nurses tend to keep quiet . . . See, for example, Brian McKenna; G. A. Farrell.

. . . don’t realize that it is unacceptable. See, for example, Shellie Simons, “Workplace Bullying Experienced. . .”; Martha Griffin.

when nurses confronted their aggressors . . . Martha Griffin.

“. . .explain it to her at that moment.” Interview.

“It all depends on where my head . . .” Interview.

A nurse in Singapore said . . . Wee Li Hong, “Nurses’ Day: Rookie’s Less Laudatory View,” The Straits Times (Singapore), August 6, 2008.

“We work hard . . .” Interview.

Younger nurses, new to the field . . . Malcolm A. Lewis, “Will the Real Bully Please Stand Up,” Personnel Today, May 1, 2004.

expected to take on massive responsibility See, for example, Sally Nicol, “Nursing in a State of Confusion,” The Courier Mail (Queensland, Australia), November 14, 2005.

pressured to work on critical patients Pauline C. Beecroft et al., “Outcomes of a One-Year Pilot Program,” The Journal of Nursing Administration (December 2001).

average nurse is forty-seven . . . See, for example, “Nursing Shortage,” American Association of Colleges of Nursing (updated April 24, 2014).

many nurses are delaying retirement David Auerbach, Peter Buerhaus, and Douglas Staiger, “Registered Nurses Are Delaying Retirement, a Shift That Has Contributed to Recent Growth in the Nurse Workforce,” Health Affairs, (August 2014).

“The younger nurses have good skills . . .” Interview.

“Today, baccalaureate degree nurses . . .” Author correspondence with Donna Yates-Adelman.

“New nurses are lumped . . .” Interview.

“older, diploma-prepared . . .” Linda Kay Matheson and Kathleen Bobay, citing I. Daiski, “Issues and Innovations in Nursing Practice: Changing Nurses’ Dis-empowering Relationship Patterns,” Journal of Advanced Nursing 48, no. 1 (2004). See also Judith Vessey.

“were those with university . . .” Cheryl Woelfle.

“I hate nursing students . . .” Interview.

just as psychologically damaging See, for example, “Workplace Violence: Assessing Occupational Hazards . . .”

Nurse victims can suffer See, for example, Brian G. McKenna, “Experience Before . . .”

shame See, for example, Dianne M. Felblinger, “Incivility and Bullying in the Workplace and Nurses ‘Shame’ Responses,” Journal of Obstetric, Gynecologic, and Neonatal Nursing 37 (2008) (A CE course on bullying); “Workplace Violence: Assessing Occupational Hazards . . .”

self-blame, guilt See, for example, “Workplace Violence: Assessing Occupational Hazards. . .”

post-traumatic stress disorder. Ibid.; Rebecca Catalanello, “Bullying at Work Can Make You Sick, but Remedies Are Few,” St. Petersburg Times, July 26, 2009.

eroded self-esteem. Michelle Rowe and H. Sherlock, “Stress and Verbal Abuse . . .” (2005); Janette Curtis et al.

substantial economic consequences See, for example, Mika Kivimaki et al.; Pauline C. Beecroft, Lucy Kunzman, and Charles Krozek, “Internship: Outcomes of a One-Year Pilot Program,” Journal of Nursing Administration (December 2001); Martha Griffin; Brian G. McKenna, “Experiences Before . . .”

higher rates of workplace . . . thousands of dollars. See, for example, Pauline C. Beecroftet et al., “Internship . . .”; Martha Griffin and Brian G. McKenna, “Horizontal violence . . .”

between $40,000 and $100,000 per nurse See Lois Berry and Paul Curry.

cause increased medical errors . . . See, for example, Michelle Rowe and H. Sherlock; G. A. Farrell, “Aggression in Clinical Settings: Nurses Views,” Journal of Advanced Nursing 25, no. 3, (1997); Cheryl Woelfle.

“lateral violence stops” . . . provide safe care. Martha Griffin.

“secret club” Interview.

advocates for patients . . . each other. Cheryl Woelfle,

their transition to practice. Penny Sauer.

“We may be fat, old . . .” Interview.

“are the foundation of hospital care . . .” Interview. One such description: “To explain congestive heart failure, she told us that the heart is like stretched-out underwear and, without the elasticity, cannot function properly and pump the blood throughout the body.”

“ . . . It’s just the way it is with nurses.” Interview.

Chapter 5

“The nurse owes the same . . .” The American Nurses Association, Code of Ethics For Nurses, http://nursingworld.org.

“I go home sometimes . . .” Interview.

“I love the free entertainment . . .” Interview.

Elena Uhls . . . . . . “it’s better that way.” Interview. This is not her real name.

nurses’ top health and safety concern . . . American Nurses Association, Nursing World 2011 Health and Safety Survey, LCWA Research Group, August 2011.

approximately 1.8 tons A. Nelson, A. Baptiste, “Evidence-Based Practices for Safe Patient Handling and Movement,” Online Journal of Issues in Nursing, September 30, 2004.

More nurses are concerned . . . “accident after a shift.” ANA Nursing World 2011 Health and Safety Survey.

The number of nurses reporting . . . “a frequent occurrence.” Ibid.

Other common nurse injuries . . . See, for example, Karyn Buxman, “Humor in the OR: A Stitch in Time,” AORN Journal (July 2008).

“Most women’s health nurses . . .” Interview.

“not only for the patient . . .” Interviews.

“If you can’t deal with it, you leave.” Interview.

nurses may be more susceptible . . . See, for example, Patrick Meadors, “Compassion Fatigue and Secondary Traumatization: Provider Self Care on Intensive Care Units for Children,” Journal of Pediatric Healthcare (January 2008); D. Boyle, “Countering Compassion Fatigue: A Requisite Nursing Agenda,” Online Journal of Issues in Nursing, January 31, 2011.

“Nurses are not only ‘first responders’. . . . ” D. Boyle.

“The patients become part . . .” Interview.

87 percent of nurses . . . Meredith Mealer et al., “The Prevalence and Impact of Post-Traumatic Stress Disorder and Burnout Syndrome in Nurses,” Journal of Depression and Anxiety 26, no. 12 (2009).

high rates of suicide . . . See, for example, Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, “Exposure to Stress: Occupational Hazards in Hospitals,” July 2008.

35 percent of nurses . . . 12 percent of emergency medicine residents. Darlene Welsh, “Predictors of Depressive Symptoms in Female Medical-Surgical Hospital Nurses,” Issues in Mental Health Nursing 30 (2009).

Occupational reasons for this depression Ibid.

Patient care can be taxing . . . people who aren’t nurses. Interviews.

“People don’t know . . .” Interview.

Workplace stressors . . . These are just a few of many examples.

In Quebec Brian Daly, “Rash of Suicides at a Quebec City Hospital,” QMI Agency, Torontosun.com, August 12, 2010.

At least one . . . “won’t be the last.” Marianne White, “Union Worried About Rash of Nurse Suicides,” Postmedia News, August 14, 2010.

82 percent of nurses . . . nurses to become ill. Charlie Cooper, “Stressed Nurses Are ‘Forced to Choose Between Health of Patients and Their Own.’” The Independent, September 30, 2013.

South African nurses . . . Tanya Jonker-Bryce, “‘Fatigued’ Nurses Threat to Patients,” WeekendPost (South Africa), June 11, 2011.

30 percent of nurses are burnt out See, for example, “Self-Care of Physicians: Strategies for Care,” Hospice Management Advisor, August 1, 2009.

defined as a “loss of caring.” M. McCreaddie and S. Wiggins, “The Purpose and Function of Humour in Health, Heath Care, and Nursing: A Narrative Review,” Journal of Advanced Nursing (March 2008).

irritability, difficulty concentrating See, for example, B. Lombardo and C. Eyre, “Compassion Fatigue: A Nurse’s Primer,” Online Journal of Issues in Nursing, January 31, 2011.

low energy, and thoughts of quitting. See, for example, Debra Wood, “How to Manage Compassion Fatigue in Oncology Nurses,” Oncology Nursing News, March 26, 2009.

related but lesser known condition See, for example, Laura Landro, “Informed Patient: Helping Nurses Cope with Compassion Fatigue,” The Wall Street Journal, January 3, 2012; Caitlin Crawshaw, “Caring Workers Pay the Price; Mind and Body Compassion Fatigue Flies Under the Radar.” The Telegraph-Journal (New Brunswick), June 20, 2009. Little research has been done on the emotional impact of patient care on nurses. See, for example, M. Bloomer, W. Cross, and C. Moss, “The Impact of Death and Dying on Critical Care Nurses,” Australian Nursing Journal (September 2010).

secondary traumatic stress disorder See, for example, M. McCreaddie.

empathetic nurses unconsciously absorb See, for example, D. Boyle.

experience the traumas emotionally . . .“spiritual depletion” See, for example, B. Lombardo, C. Eyre, and D. Boyle; Patricia Potter et al., “Compassion Fatigue and Burnout: Prevalence Among Oncology Nurses,” Clinical Journal of Oncology Nursing (October 2010).

“a state of psychic exhaustion.” D. Boyle.

“‘What is to give light” “Compassion Fatigue Program Gives Staff Skills to Be Resilient Against the Cost of Caring.” States News Service, January 3, 2012. Indeed, Tulane Traumatology Institute director Charles R. Figley has said, “There is a cost to caring. Professionals who listen to clients’ stories of fear, pain, and suffering may feel similar fear, pain, and suffering because they care. Sometimes we feel we are losing our own sense of self to the clients we serve.” See “Compassion Fatigue: Coping with Secondary Traumatic Stress Disorder in Those Who Treat the Traumatized,” Routledge Psychosocial Stress Series, 1995.

anxiety, depression . . . loss of objectivity B. Lombardo and C. Eyre.

less able to feel empathy . . . with certain patients See, for example, Laura Landro, “When Nurses Catch Compassion Fatigue, Patients Suffer,” The Wall Street Journal, January 3, 2012.