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Case Study

Nowadays, there are several reasons that might create the feeling of powerlessness among the emergency department staff. The fundamental cause of high turnover rate and poor morale has been the dramatic loss of stamina and considerable physical and emotional overstrain due to intensive intercommunion with patients when providing them with professional assistance. Such stress is a result of a long-term contact with the injured and terminally ill. The worst for nurses is to realize that the situation is so severe that no further treatment will help. Nurses who are to make crucial decisions related to end-of-life care and assist patients in dying have experiences described as upsetting, unusual, and sometimes life-altering events (Schwarz, K., 2003, p. 379). What contributes to the poor morale of the nursing professionals is too much responsibility and too little remuneration. In addition, their work is repetitive and has no career prospects. Last but not the least reason is that an ordinary nurse does not think she is much valuable for the society. This belief is the cause of burnout among nurses. Anyway, despite being often worn out and tired, the staff still does their best to help all sick people and save every life, which means that they are powerful.

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In fact, some of the sources of power may be found and worked out. Therefore, some preventive, curative and rehabilitative measures should be taken to eliminate the basic reasons of stress and, thus, avoid the constant weariness, increase job motivation, obtain the balance between the effort and the reward. Furthermore, it is vital to pay attention to such things as improving the working conditions (an organizational level), creating a friendly atmosphere and relationships in the team (an interpersonal level), and improving personal reactions of each worker (an individual level). Besides, the competition among the staff is not sensible since the situation can become uncontrollable when one is concentrated on getting perks and bonuses or gaining the best reputation. Also, emotional communication plays a vital role because when a nurse expresses her feelings and shares them with others, the level of burnout is likely to reduce. As far as the pauses or breaks are concerned, they are the most helpful and recommended measures. Indeed, a nurse should be energetic, follow the food intake rules and be in shape. Moreover, if the staff works at night or rotating shifts, the lack of sleep can put them at risk of accidents and health problems. Generally, a lively and not yawning nurse always does her work much better.

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Nancy could encourage the staff to become empowered by presenting the structured ways and a clear working plan, making them understand that their role is appreciated and giving a small but pleasant money reward. An efficient idea would be to set up a tradition of monthly personal development training and note that the nurses do not work just for the money income. It is important to understand that they expect is work satisfaction rather than the financial stability. As an emergency department nurse manager, Nancy should not give her workers extra tasks and responsibilities. Maslach and Leiter (2008) claim that the overload or a job that demands exceeding the human limits are the main sources of burnout. Moreover, raising awareness among the employees regarding burnout and powerlessness and discussing the reasons and possible solutions will help in improving the morale of the working team. Perhaps, the staff will manage to realize that they should work as much effectively as possible. In case Nancy aims to defuse some of the behaviors of others contributing to the staff’s feelings of powerlessness, it would be wise to establish some free vacation giveaways. It will undoubtedly help. In addition to this, encouraging the staff to cooperate and share their knowledge is actually a good way to create a team spirit. They say two heads are better than one.

 
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Prior to attending the meeting, it would obviously make sense to organize a prior meeting of the unit workers with the question of the possibility of returning to eight-hour shifts included into the agenda. The purpose of the appointment is to consult with the staff regarding the issue. This way, I would find out their opinion on the situation that does not seem to be much pleasant. The surveys show that the patients are not fully satisfied, and the nurse who has worked more than eight hours tends to make medication errors. Primarily, the employees are to be asked whether they cope with their work and what is the most difficult. All members of the meeting should express their ideas about the most tense and hard working hours. It will enable me to understand whether the nurse needs to work up to eight hours or it is still possible to preserve the usual working hours but with more pauses and lunch breaks. It is of the greatest importance to collect such information because a manager has to know what kind of working scheme would be the most suitable. I suppose, some of them would suggest increasing the number of employees and returning to eight-hour shifts or establishing some additional payment for those employees who would work twelve hours.

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Apart from this information from the staff, other data could be gathered about returning to eight-hour shifts before attending the policy-making council. The debate about eight-hour shifts has turned out to a heated discussion today, and scientists agree that such a working scheme is beneficial. Twelve-hour shifts represent a tough challenge to an employee, and it is clear that the longer hours the nurses work, the more exhausted they become. As a result, they have a tendency to make more mistakes, and the stress level is noticeably higher. According to Parkes (2007), individuals older than forty-five years experience an increasing difficulty in adjusting to altered sleep-wake cycles, reduced fitness, decreased restorative powers of sleep, and greater proneness to internal desynchronization of circadian rhythms, all of which contribute to the decreased shift-work tolerance.

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