HNN301 Mental Health Promotion

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HNN301 Mental Health Promotion

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HNN301 Mental Health Promotion

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Course Code: HNN301
University: Deakin University

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Country: Australia

Discuss about the Impact Of Workplace Factors On The Mental Health Of Nurses.

Nursing is one of the most noble and respectable profession, a nursing professional helps individuals that are dealing with some form of ailments by caring for them and supporting them throughout their journey to recovery. Hence, it is a professional that is heavily emotionally demanding and causes a lot more occupational stress (Greenglass, Burke & Moore, 2003). Although the negative impact of the stress affects the professional competency and wellbeing of the nurses at large. And in a profession where nurses are required to think on their feet to be able to handle any kind of situation, not having a sound mental health can be extremely detrimental.
There are a lot of workplace factors that negatively impact the mental health of the nurses, one of the pioneer factors are workload, fatigue, bullying, workplace aggression and organizational bias (Greenglass, Burke & Moore, 2003). All of these factors impact the mental health of the nurses significantly and generates stress disorders that destroy the professional competence and engagement of the nurses to the work that they do. This assignment will discuss in detail the impact of three key workplace factors, workload, fatigue and bullying, on the mental health of nurses and what strategies can be implemented to combat these factors.
Nursing is a type of profession that just not demands a professional to be physically absolutely engaged at the task at hand but it requires the individual to be emotionally invested as well. In this situation where the nurses already carry a huge burden, excessive workload can be the breaking point for many (Ayling, 2006). Excessive workload and the resultant burnout, is considered to be the biggest contributing factor to deteriorating mental balance of the nurses and is also known to destroy the competence and organizational engagement of the nurses.
Workload can be defined as the chronic imbalance between the daily job responsibilities of an individual and the professional capabilities coupled with the resources provided to nurses by the organization. There are a lot of factors that leads to excessive workload in the nursing workforce; one of the major reasons is the inadequate nurse staffing which clashes alarmingly with the health care demands of different regions, other than that excessive influx of patients, inadequate number of facilities and increased demands can also lead to excessive workload (Barton, 2009) The health care industries rarely meet the safe-staffing requirements of the Nursing and Midwifery Federation, and the as a result the staffs are unethically and unjustifiably swamped with extra workload which inevitably results in extreme burnout. It has to be understood that increased workload would be translated to caring for more patients than a single nurse can handle in the nursing workforce, which will inevitably lower the time and attention spent on each patient. This will eventually lower the care standards and patient satisfaction, which will be dealt by the nursing staff only and pile up the mounting stress that they already are under (Barton, 2009).
All these interlinked variables associated with excessive workload impact the mental health of the nurses diversely. For instance the burnout leads to extreme exhaustion, irritability and anger in the nursing staff which is reflected in their professional approaches. This distress mounts until it paves way for incompetence and inability in the nursing staff eventually leading to depression and extreme lack of self worth in the nurses. The depression and extreme sensitivity it brings forth can also lead to nervous breakdowns as well, as it happened in Australia in 2002. Empirical research states that in the year of 2003, Melanie Garrod, an Australian nurse relapsed to depressive illnesses due to the excessive workload she had been forced to deal with (Greenglass & Burke, 2016). She had been dealing with both her and her colleague’s workload and the resultant burnout had her sacked for medical incompetency. This is not the only example; there are countless such examples of nursing staff being pushed from the precipice by the immense workload and the situation is deteriorating every day (Ayling, 2006).
Fatigue is a workplace factor intricately linked to the workload and results in compromising the sanity and competence of the nursing staff and leads to compromised and unsafe patient care. Fatigue can be defined as the physical or psychological exhaustion that renders the professional incapable of competent performance. This factor is more of a result of excessive workload and generates incompetence, anger, cynicism and lack of self confidence in the staff. This exhaustion and incompetence leads to anxiety and eventually paves way for depression in the nursing staff and alters their sanity and sense of contentment (Greenglass & Burke, 2016).
The statistics suggest that 85% of the total nursing workforce suffer with chronic fatigue and the numbers are not decreasing by any means, and 36% out of which are the rotating shift nurses who are swamped with workload the most. 35% percent of fatigue ridden nurses belong to the night shift working nurses and the rest belong to the regular shift working nurses. The lack of sleep has been reported the biggest reason contributing to burnout in the nursing workforce and condition deteriorates further every day (Greenglass, Burke & Moore, 2003).
Another very important factor that contributes to the negatively impacting the mental health of the nurses is the bullying they face in the nursing environment. Bullying can be defined as any form of abusive action that is repeated time and time again in the professional environment. There are several kinds of bullying activities that a bully victim can suffer with such as verbal abuse, humiliation, threats, intimidating behaviour, physical assault and harassment. Any professional field can be associated with bullying and nursing is no exception to it. Especially due to the team working pattern in nursing, the chances of workplace bullying in this profession is even more heightened (Ariza-Montes et al., 2013).
Workplace bullying in the context of nursing, can occur between the nursing staff and his or her superior, between team mates, between teams and their manager or between different teams themselves. The targeting of bullying can be for various reasons; the societal stereotypes are the most important contributing factors to bullying like age, gender, race, ethnicity, background and other such demographics. Other than that organizational behaviour of a particular nurse can evoke bullying as well, like differing from workplace culture or norm. Experience is often a ground for workplace bullying where more experienced nurses bully junior nurses on the ground for their lack of knowledge and expertise (Farrell & Shafiei, 2012). Whatever may the reason be, the impact of bullying is paramount in nursing, and it generates anxiety, fear of embarrassment and lack of self worth in the victim. A bully victim in the initial stages might live in the constant fear of not aggravating their bully by adjusting every action of them and this preoccupation impacts their performance. With consistent bullying the self esteem of the victim is destroyed and slowly loses any purpose in pursing their career and eventually drop out. However the experience lingers leading them to acute depression, which ultimately destroys the professional qualities that the nurse initially possessed. The statistics suggest that almost 57% of nurses undergo some form of bullying or aggression in the workplace in the Australian context, and the bigger picture is even worse (Thompson & George, 2016).
Evidence based strategies:
The impact of all this workplace factors on the mental health of nurses leads often to resignation, depression, anxiety, PTSD and in extreme cases even suicide. The rates of suicide has been increasing at an alarming rate, and keeping that aside the impact of this mental stress is lowering the life expectancy of the nurses frighteningly (Drapeau et al., 2017). Therefore, there is dire need of coping strategies that will establish self resilient traits in the nurses. REFERNCE
Mindfulness strategy:
The physical and psychological burnout or exhaustion is considered to be a psychological syndrome and mindfulness strategy functions by management of this psychological trauma to minimize its impact by engaging the individual in mind-ful activities (Watanabe et al., 2015). The most commonly used variables of this strategy are intentional awareness, judgment refusal and present focused approaches. Studies suggest that implementation of mindful strategies like timeouts, intentional avoidance and interpersonal support has been highly effective in restoring the normalcy in nurses who had been struggling through depression and withdrawal tendencies due to burnout (Montero-Marin et al., 2014). This strategy allows the nurses to disengage their mind from the work related stress and allows them to invest onto activities unrelated to their job responsibilities. Other more contemporary mindfulness strategies like mind-ful meditation and calming activities can help significantly in reducing anxiety and exhaustion and can do wonders for calming the mind and clearing out all negative thoughts and insecurities. In a recent study, nurses who practiced regular and frequent meditating practices were found have established more professional resilience than the others and it can be expected that mindfulness strategies, if carefully and diligently implemented, can be immensely helpful in restoring mental balance and establishing professional resilience in nurses (Watanabe et al., 2015).  For example, taking frequent breaks in between extreme work pressure can also bring mental peace to the nurses and help them cope with exhaustive work stress and burnout.
Positive professional relationship and seeking out help:
Another very important strategy that can effective reduce the chances of workplace bullying behaviour in the nursing workforce is establishing a nurturing professional relationship with the co-workers and the superiors to minimize the impact of these stressors. According to empirical studies, the positive impact of a close knit professional bond and friendship among the co-workers cannot just help with uplifting the paramount that stress bully victims are under, having approachable co-workers will also allow a bully victim to share his and her grievances and overcome the terrifying impact of bullying (Perry et al., 2015). Other than that having nurturing relationships within the workplace where compassionate and cooperative working environment is exercised effectively, seeking help had been much more frequent in various examples (Shin et al., 2014). Hence in order to overcome bullying the strategy of sharing grief has been proved to be extremely effective, and for that a positive and nurturing professional environment is a prerequisite. Having a sound employee harassment investigative body in the workplace can also be a huge step for reducing workplace bullying where the employees can complain about any bullying behaviour they are facing anonymously to safeguard their privacy. Hence the successful implement this strategy and its elements to establish a compassionate and supportive workplace environment can improve the confidence of victims and can give them the courage to come forward and fight the bullying (Drapeau et al., 2017)
There are a multitude of other strategies and techniques that can help nurses cope with the emotional trauma they face in the workplace in the form of humiliation, workload, or exhaustion. However the nurses dealing with depression or self harming tendencies due to workplace stress need support and compassion the most from their surroundings. And with conscious effort from all the stakeholders this situation can be dealt with effectively so that the nursing workforce can get the helping hand they need as effectively as they extend to the rest of the society.
Ariza-Montes, A., Muniz, N. M., Montero-Simó, M. J., & Araque-Padilla, R. A. (2013). Workplace bullying among healthcare workers. International journal of environmental research and public health, 10(8), 3121-3139.
Ayling, N. (2006). Workload caused mental illness, health visitor tells High Court.
Barton, A. (2009). Patient safety and quality: an evidence-based handbook for nurses. Aorn Journal, 90(4), 601-602.
Drapeau, M., Blake, E., Dobson, K. S., & Körner, A. (2017). Coping Strategies in Major Depression and Over the Course of Cognitive Therapy for Depression. Canadian Journal of Counselling & Psychotherapy/Revue Canadienne de Counseling et de Psychothérapie, 51(1).
Farrell, G. A., & Shafiei, T. (2012). Workplace aggression, including bullying in nursing and midwifery: a descriptive survey (the SWAB study). International journal of nursing studies, 49(11), 1423-1431.
Greenglass, E. R., & Burke, R. J. (2016). Stress and the effects of hospital restructuring in nurses. Canadian Journal of Nursing Research Archive, 33(2).
Greenglass, E. R., Burke, R. J., & Moore, K. A. (2003). Reactions to increased workload: Effects on professional efficacy of nurses. Applied psychology, 52(4), 580-597.
Montero-Marin, J., Prado-Abril, J., Demarzo, M. M. P., Gascon, S., & García-Campayo, J. (2014). Coping with stress and types of burnout: explanatory power of different coping strategies. PloS one, 9(2), e89090.
Perry, L., Lamont, S., Brunero, S., Gallagher, R., & Duffield, C. (2015). The mental health of nurses in acute teaching hospital settings: a cross-sectional survey. BMC nursing, 14(1), 15.
Shin, H., Park, Y. M., Ying, J. Y., Kim, B., Noh, H., & Lee, S. M. (2014). Relationships between coping strategies and burnout symptoms: A meta-analytic approach.
Thompson, R., & George, L. E. (2016). Preparing new nurses to address bullying: the effect of an online educational module on learner self-efficacy. MedSurg Nursing, 25(6), 412-418.
Watanabe, N., Furukawa, T. A., Horikoshi, M., Katsuki, F., Narisawa, T., Kumachi, M., … & Matsuoka, Y. (2015). A mindfulness-based stress management program and treatment with omega-3 fatty acids to maintain a healthy mental state in hospital nurses (Happy Nurse Project): study protocol for a randomized controlled trial. Trials, 16(1), 36.

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