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Patient-centered, high-quality health care relies on the well-being, health, and safety of health care clinicians. However, alarmingly high rates of clinician burnout in the United States are detrimental to the quality of care being provided, harmful to individuals in the workforce, and costly. It is important to take a systemic approach to address burnout that focuses on the structure, organization, and culture of health care. Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being builds upon two groundbreaking reports from the past twenty years, To Err Is Human: Building a Safer Health System and Crossing the Quality Chasm: A New Health System for the 21st Century, which both called attention to the issues around patient safety and quality of care. This report explores the extent, consequences, and contributing factors of clinician burnout and provides a framework for a systems approach to clinician burnout and professional well-being, a research agenda to advance clinician well-being, and recommendations for the field.
Properly performing health care systems require concepts and methods that match their complexity. Resilience engineering provides that capability. It focuses on a system’s overall ability to sustain required operations under both expected and unexpected conditions rather than on individual features or qualities. This book contains contributions from international experts in health care, organisational studies and patient safety, as well as resilience engineering. Whereas current safety approaches primarily aim to reduce the number of things that go wrong, Resilient Health Care aims to increase the number of things that go right.
" This is the first research-based book to confront workplace issues facing nurses who have disabilities. It not only examines in depth their experiences, roadblocks to successful employment, and misperceptions surrounding them, but also provides viable solutions for creating positive attitudes towards them and a welcoming work environment that fosters hiring and retention. From the perspectives and actual voices of nurses with disabilities, nurse leaders, nurse administrators, and patients, the book identifies nurses with disabilities (including sensory, musculoskeletal, emotional, and mental health issues), discusses why they choose to leave nursing or hide their disabilities, and analyzes how their disabilities may influence career choices. "
This work depicts the evolution of the wounded healer phenomenon and its impace on the practice of nursing. It explores how healing has been defined in the past, and emphasizes the changing focus necessary to meet the relevant health care needs of an increasingly wounded society in the 21st century.
"Suffering is an unavoidable reality in health care. Not only are patients and families suffering but also the clinicians who care for them. Commonly the suffering experienced by clinicians is moral in nature, reflecting the increasing complexity of health care, their roles within it, and the expanding range of available interventions. Moral suffering is the anguish experienced in response to various forms of moral adversity including moral harms, wrongs or failures, or unrelieved moral stress. Confronting moral adversity challenges clinicians' integrity: the inner harmony that arises when their essential values and commitments are aligned with their choices and actions. The most studied response to moral adversity is moral distress. The sources and sequelae of moral distress, one type of moral suffering, have been documented among clinicians across specialties. Recent interest has expanded to include a more corrosive form of moral suffering, moral injury. Moral resilience, the capacity to restore or sustain integrity in response to moral adversity, offers a path designing individual and system solutions to address moral suffering. It encompasses capacities aimed at developing self- regulation and self-awareness, buoyancy, moral efficacy, self-stewardship and ultimately personal and relational integrity. Moral resilience has been shown to be a protective resource that reduces the detrimental impact of moral suffering. Clinicians and healthcare organizations must work together to transform moral suffering by cultivating the individual capacities for moral resilience and designing a new architecture to support ethical practice. Used worldwide for scalable and sustainable change, the Conscious Full Spectrum Response, offers a method to solve problems to support integrity, shift patterns that undermine moral resilience and ethical practice, and source the inner potential of clinicians and leaders to produce meaningful and sustainable results that benefit all"--
More than two decades after Michael Rutter (1987) published his summary of protective processes associated with resilience, researchers continue to report definitional ambiguity in how to define and operationalize positive development under adversity. The problem has been partially the result of a dominant view of resilience as something individuals have, rather than as a process that families, schools,communities and governments facilitate. Because resilience is related to the presence of social risk factors, there is a need for an ecological interpretation of the construct that acknowledges the importance of people’s interactions with their environments. The Social Ecology of Resilience provides evidence for this ecological understanding of resilience in ways that help to resolve both definition and measurement problems.
After a traumatic experience, survivors often experience a cascade of physical, emotional, cognitive, behavioral, and spiritual responses that leave them feeling unbalanced and threatened. Building Resilience to Trauma explains these common responses from a biological perspective, reframing the human experience from one of shame and pathology to one of hope and biology. It also presents alternative approaches, the Trauma Resiliency Model (TRM) and the Community Resiliency Model (CRM), which offer concrete and practical skills that resonate with what we know about the biology of trauma. In programs co-sponsored by the World Health Organization, the Unitarian Universalist Service Committee, ADRA International and the department of behavioral health of San Bernardino County, the TRM and the CRM have been used to reduce and in some cases eliminate the symptoms of trauma by helping survivors regain a sense of balance. Clinicians will find that they can use the models with almost anyone who has experienced or witnessed any event that was perceived as life threatening or posed a serious injury to themselves or to others. The models can also be used to treat symptoms of vicarious traumatization and compassion fatigue.
The nursing profession is under pressure. Financial demands, student debt, the target culture, political scrutiny in the wake of major care scandals and increasing workloads are all taking their toll on professional morale and performance. This timely book considers the meaning of resilience in this adverse context and explains why measures to preserve individual nurses’ and students’ well-being are flawed if they don’t take into account wider political and organizational perspectives. Arguing that healthcare can be thought about and experienced differently, this book: provides a summary of the latest research on resilience, explaining its relevance and also limitations for nurses; considers debates about compassion and highlights the effects of policy agendas on nurse education and nursing work; re-evaluates nursing’s professional identity, including where nursing has come from and the effects of class, gender and race on its powerbase; assesses the role of politics and social media, both in driving change and feeding resistance; and introduces the idea of critical resilience as a complete framework for resisting bullying and fostering survival and change in the nursing workforce. Direct, upbeat, at times provocative and witty, this agenda-setting book enables nurses to understand why they feel the way they do. It also lists what opportunities are available to them to change, resist and survive in what has become a complex, challenging – if still deeply rewarding – line of work.
"In this latest insightful volume gathered and edited by Marilyn Luber, the authors have combined the lessons learned with personal accounts of how they proceeded. There is still much to be done to integrate mental health care effectively into disaster response worldwide, but this volume will help to point the way to best practices." --Robert Gelbach, PhD Past Executive Director at EMDR Humanitarian Assistance Programs Eye Movement Desensitization and Reprocessing (EMDR) is a method of psychotherapy that has been extensively researched and proven effective for the treatment of trauma. This book presents EMDR early-response intervention protocols for such traumatic events as earthquakes, mining accidents, tsunamis, and ongoing warfare. It also provides concise summary sheets to facilitate quick information retrieval in perilous circumstances. The book is authored by several of the first generation of therapists who successfully employed EMDR as a clinical treatment for acute stress following massive trauma events. They vividly describe their experiences and the protocols and models they developed to respond to disaster. The book describes two of the most commonly used resources: the Butterfly Hug and the Four Elements Exercise for Stress Management. Includes new information on acute stress, secondary PTSD, and vicarious traumatization growing out of interventions subsequent to natural disasters, warfare, and massacres in Turkey, Asia, the Middle East, South and Central America, and the United States. Interventions that can be put to use on site and posttrauma are presented for groups, including work with children, adolescents, and adults and with special populations. Additionally the book addresses working with first responders such as firefighters, EMS workers, and others when using EMDR. It facilitates the gathering and organizing of client data and contains updated and new scripted protocols, as well as summary sheets from EMDR Scripted Protocols: Basics and Special Situations and EMDR Scripted Protocols: Special Populations. Also included are templates for repeat use and an interactive PDF. Key Features: Provides EMDR early-intervention procedures for man-made and natural catastrophes Addresses EMDR and early interventions for groups of all ages and special populations Highlights international perspectives on how to organize a mental health response for recent traumatic events Includes early-intervention scripts and summary sheets for individuals, groups, and special populations, as well as self-care scripts for clinicians Offers concise summary sheets for quick information retrieval
This public inquiry report into serious failings in healthcare that took place at the Mid Staffordshire NHS Foundation Trust builds on the first independent report published in February 2010 (ISBN 9780102964394). It further examines the suffering of patients caused by failures by the Trust: there was a failure to listen to its patients and staff or ensure correction of deficiencies. There was also a failure to tackle the insidious negative culture involving poor standards and a disengagement from managerial and leadership responsibilities. These failures are in part a consequence of allowing a focus on reaching national access targets, achieving financial balance and seeking foundation trust status at the cost of delivering acceptable care standards. Further, the checks and balances that operate within the NHS system should have prevented the serious systemic failure that developed at Mid Staffs. The system failed in its primary duty to protect patients and maintain confidence in the healthcare system. This report identifies numerous warning signs that could and should have alerted the system to problems developing at the Trust. It also sets out 290 recommendations grouped around: (i) putting the patient first; (ii) developing a set of fundamental standards, easily understood and accepted by patients; (iii) providing professionally endorsed and evidence-based means of compliance of standards that are understood and adopted by staff; (iv) ensuring openness, transparency and candour throughout system; (v) policing of these standards by the healthcare regulator; (vi) making all those who provide care for patients , properly accountable; (vii) enhancing recruitment, education, training and support of all key contributors to the provision of healthcare; (viii) developing and sharing ever improving means of measuring and understanding the performance of individual professionals, teams, units and provider organisations for the patients, the public, and other stakeholders.