Vienna, Austria - The attractive venue of Nursing Education 2020

Nurses knowledge, practice and strain of care for delirium management among critical care nurses in Kuwait hospitals

     Jassim Al Barrak

This study aim to (i) assess ICU nurses’ knowledge of delirium, practice skills of delirium assessment and management, and strain of care when caring for patients having delirium in Kuwaiti ICUs; (ii) identify relations between ICU nurses’ knowledge, practice skills, and strain of care for delirium in Kuwait; and (iii) test for significant differences in nurses’ knowledge, practice skills, and strain of care between nurses’ different demographic characteristics groups. The target population of this study is critical care nurses working in adult ICUs in Kuwaiti hospitals. Study sample selected from the total population which is estimated to be 822 nurses who are working in different critical care units in Kuwait. The study found that (i) the sample ICU nurses of both Group 1 and Group 2 generally have average knowledge of delirium despite generally having several years of experience in ICUs, and (ii) Group 2 nurses have higher levels of knowledge of delirium than Group 1 nurses. The study found that perceptions of the sample nurses of the level of effectiveness of 20 practices in delirium management varied widely amongst members of each group and between the two groups and nurses of Group 1 rank the 20 investigated skills and practices for delirium management as about 60% effective in delirium management. Stated otherwise, almost 60.0% of the 20 listed practices are effective in delirium management. The study found that a nurse’s knowledge of delirium increases, his/her perception of the effectiveness of the 20 practices for management of delirium listed on the NPSDM instrument increases, and vice versa. The study results of testing for significant differences between the demographic characteristics groups of Group 1 ICU nurses in the main variables of the study (median scores on the NKD, NPSDM, and SCDI instruments) revealed that out of 24 potential combinations of variables and groups, only four significant differences between groups have been detected: Healthcare sector-NKD, ICU Category-NPSDM, Experience in Nursing-SCDI, Experience in ICU-SCDI.

Nurses Job Satisfaction in a Tertiary Medical Care Center, Riyadh, Saudi Arabia

    Dr. Ahmed Bahnassy

    King Fahad Medical City, Saudi Arabia

Job satisfaction is of interest to both people who work in organizations and people who study them. In the Kingdom of Saudi Arabia, the health care delivery system relies heavily on expatriate human resources; hence their job satisfaction is crucial for patient satisfaction and quality of care.

The objectives of this study are to: determine the overall job satisfaction and its correlates among nurses working in tertiary care.

Methodology: This is a cross-sectional study among nurses working in a tertiary care center. A stratified random sample with proportional allocation used to choose 980 nurses. A self-administered questionnaire was used. Descriptive, bivariate and multivariate analysis was used for data analysis using SPSS version 17 software. The level of significance was set to be <0.05 throughout the study.

The results showed that mean satisfaction scores for all participants was 105.2 out of 150 (70%satisfaction), males were less satisfied than females, Saudis were less satisfied than non-Saudis but the differences were not significant. Significantly higher satisfaction was associated with Staff nurse 2, nurses working in Women hospital, nurses with lower than doctorate qualification and nurses with higher salaries. In general, the overall job satisfaction of nurses is acceptable and comparable to similar medical care facilities.

The study recommends Revision of salaries and fringe benefits to make them more attractive in this competitive market and in-depth inquiry about the specific reasons and determinants of the poor satisfaction among nurses with doctorate qualification, nurses working in Rehabilitation hospital to boost their job satisfaction level.

Coping Skills for Nurses

1. Remember it’s not personal:

Being in the healthcare industry isn’t just stressful for the nurse, but also your patent and family members. If they lash out at you know that their frustration isn’t geared to you. Their stress could be a concern for their loved one, financial, or the facility. If you are put in this experience remember to first take a deep breath. You don’t want to overreact or say anything negative. Instead, find your floor manager and explain the situation to them. Cooler heads will prevail.

2. Practice deep breathing exercise:

Deep breathing exercises have proven to be an affecting coping skill. It will reduce stress, improve your mood, and allow you to not to hold onto things that are out of your control. There are plenty of resources out there to help you properly find deep breathing exercises. If nothing more, close your eyes, take inhale for a 5 count, and exhale for a 5 count. Then repeat.

3. Find a quiet place:

Taking breaks is a necessary requirement for people in all industries, especially for nurses. As a new nurse, it is important to locate a place where you can escape for a few moments. Find a quiet room at your facility or perhaps there is a garden where you can sit and collect your thoughts. Finding a quiet place will rejuvenate your mood and allow you to have a successful rest of the day.

4. Find a mentor:

Mentors help guide us and are there when we need them. As a new nurse, find a seasoned nurse that can show you the ropes of the facility will go a long way in coping for new nurses. Being a nurse is a stressful job so having someone you can lean on and get you up to speed is critical.

5. Master your skills:

The quickest way to feel confident as a nurse is to master your skills. Having this level of confidence will make handling any related task seem like second nature and give you satisfaction in your new role.

6. Eat well-balanced meals:

As a nurse, you are always on the go. This makes it easier to neglect to eat properly. The key to eating a well-balanced meal is prepared. Make your meals ahead of time. Don’t skip meals. The healthier you can eat will increase your energy and productivity.

7. Get enough sleep:

Your body needs time to rest. After a busy day of work, getting the proper amount of sleep is a necessity to take on the new day. You will find out that when you neglect sleep that you are not your normal self.

8. Maintain a positive attitude:

This supports the coping skill to not stress over things you cannot control. Try to replace negative thoughts with a positive one. When you have a positive attitude, you will feel like you can handle anything thrown at you.

9. Get organized:

One way to stay on top of your game is being organized. Nurses are handing a lot of responsibilities daily. Thus, taking the time to set your daily priorities can help you formulate a plan to complete everything.

10. Leave the day with a clear mind:

Your days are long and busy. You have accomplished a lot during your day. When the day is done don’t stress over things that weren’t accomplished. You can’t change anything at home. Reflect on your shift, plan out your next day, get a good night sleep, and take on tomorrow. Move on. Otherwise, you will carry that un-needed stress the next day.http://nursingeducation.pulsusconference.com/

The association of spiritual well-being and depression among patients receiving hemodialysis

       

               Mutaz Foad Alradaydeh

Health Care Department, The University of Jordan

Purpose: The purpose of this study was to identify the relationship between spiritual well-being (meaning/peace, and faith) and depression among Jordanian patients receiving hemodialysis. Methods: Cross-sectional descriptive correlation design was used to carry out on a nationally representative convenience sample of 158 patients receiving hemodialysis at five different hospitals in Jordan. Results: The mean total score of the depression was 17.8 of the 40. While the mean total score of the spiritual well-being was 36.9 of the 48. The Pearson's correlation coefficient test showed a significant negative correlation between spiritual well-being and depression (r = -.64, p < .005). Conclusion: Healthcare providers should consider spiritual well-being in their assessment and interventions by helping the patients to establish meaning, peace, and faith to reduce patients' depression.

The elderly and life’s channels: The threads of life

           Dr. Elma Jazz Macrohon

AssociateProfessor at Mekelle University

                      Philippines

This study was undertaken with the aim to validate the assumption in JEM’s Theory on Intergenerational Visits to the Elderly, which states that Intergenerational visits promote socialization, that spirals into family solidarity, quality time shared; that affords the elderly parents more meanings, purposes, significance in their lives, the feeling of successfully aging, and make family relationship tighter every time it happens. It is also to come up with narrative materials from the experiences of the informant-elderly during intergenerational visits, together with children, grandchildren, friends, and relatives, before, during, and after the visitation. The method used is the narrative inquiry. Interview schedules were used both in Filipino and English.  There were recorded interviews and later transcriptions of them, then a story was woven entitled: “The Elderly and Life’s Channels: The Threads of Life”.  There were six parents interviewed equally to six families.  The characters in the narrations are representatives from these families.  Findings proved that “intergenerational visits to the elderly”, is a key factor to improve the social relationship between children and parents and between and among parents and children.  Other findings were on the smooth and rough (conflicts) events in the family, but the latter mended by the faithful observance of intergenerational visits, which serve as the knot that binds family members together because the former promotes socialization. It is recommended that Intergenerational visits be included in the yearly activities for the elderly people or the senior citizens, by their respective family members, often or even far in-between.

Time Management Tips for Busy Nurses

Nursing is a demanding job and it can often feel as though there are not enough hours in the day to complete all your tasks. Unlike other jobs, priorities can change rapidly. When a patient is in urgent need of your attention, your to-do list can change rapidly. The hectic pace of the job is one of the reasons that many nurses get burned out and stressed out. Using these time management tips for nurses is one way to make your life a little easier, as well as getting more done.

1. Plan your day out in advance

Many nurses say that while planning is a good idea, their days are too unpredictable to plan. It is difficult to plan your day because your environment can change rapidly, and much of your day is spent responding to the needs of patients. However, nurses who do plan their day and the tasks they must accomplish will find that they get more done with less stress. Make a list of everything you must get done today. Then, make a note of how long it will take and rank the jobs in order of importance. Start looking at tasks and seeing when you will have time in your day to get one or two items done. When you have a few minutes, complete a task that you can get done in that time. You will also feel better knowing that you are not forgetting anything.

2. Focus on the most important activities first

When you make the list, focus on the items with the highest priority. Remember, you may not be able to get everything done. But by completing the most important tasks, you will be less stressed. Also keep in mind that if nothing is going on right now, you should be working on one of your tasks. Due to the unpredictable nature of your nursing job, you can’t be sure that you will have time later. As you complete tasks, check them off on your list. It will give you a sense of accomplishment and make your stress levels drop.

3. Don’t let interruptions disrupt your day

Nurses must deal with many interruptions, many of which can’t be helped. However, there are many interruptions that are not so important. Interruptions like long non-work-related chats with other staff members, checking non-work email, or other non-essential tasks can get you off track quickly. Make time to relax, visit, and do things to lower your stress. But don’t let those things become more important than your work.

4. Keep yourself and your workspace organized

Being organized saves time. If you have a desk, spend a few minutes at the end of the day to put papers where they belong so that you can find them when you need them. At the beginning of the day, make sure all equipment is clean and ready for use. This will lower your stress level and make your day easier.

5. Learn to delegate tasks

Remember that you can’t do it all, nor should you have to. Remember the five rights of delegation in nursing; right orders, right instructions, right skills, right tools, and the right time frame.

Practice Rationale Care Model: The Art and Science of Clinical Reasoning,Decision Making and Judgment in the Nursing Process

Jefferson Garcia Guerrero

Ph.D. NS, DNS, MAN, RN

          Saudi Arabia

Nurses must be enlightened that clinical reasoning, clinical decision making, and clinical judgment are the key elements in providing safe patient care. It must be incorporated and applied all throughout the nursing process. The impact of patients’ positive outcomes relies on how nurses are effective in clinical reasoning and put into action on clinical decision making occurs. Thus, nurses with poor clinical reasoning skills frequently fail to see and notice patient worsening condition, thus misguided decision making arises that leads to ineffective patient care and adding patients suffering. Clinical judgment, on the other hand, denotes on the outcome after the cycle of clinical reasoning. Within this context, nurses apply reflection about their actions from the clinical decision making they made. The process of applying knowledge, skills, and expertise in the clinical field through clinical reasoning is the work of art in the nursing profession in promoting patient safety in the course of delivering routine nursing interventions.  Nurses must be guided with their sound clinical reasoning to have an optimistic outcome and prevent iatrogenic harm to patients. Nurses must be equipped with knowledge, skills, attitude, and values but most importantly prepared to face the bigger picture of responsibility to care for every patient in the clinical field.

Nurse as second victim after adverse event

Essam Ezat Mahmoud

King Saud Medical City, Saudi Arabia

Background: Nurses is being a second victim after made error. They suffered from physical and psychological symptoms followed an event. Healthcare organization has a significant role in support nurses after an event. However, little attention is paid from governmental bodies, to support the second victims.

Aim: To describe nurses' experience followed adverse events and the importance of the organization to support them.

Methods: A descriptive study conducted at King Saud Medical City, a total of 355 staff nurses were selected from clinical areas. Data were collected between July, 2 to Dec 5, 2017, using a self-administered questionnaire.

Results: 33.8% of the participants were involved in an adverse event in their career, and 64.2% involved with no patient harm, while 19% with fetal harm. Also, 82% experienced physical and psychological symptoms. Flashback returned to work anxiety, difficult concentration, grief and depression were the most psychological symptoms reported. Sleep disturbances, unable to relax and Sweaty palms were the most physical symptoms reported by them. 42.3% of them spent one to three weeks till they rid all symptoms. 55.2% received informal support from Head Nurse (216%), Nurse Manager (18.9%), Director of Nursing (8%) and friend/ Family. Nurses were worried a lot about what their clinical peers would think about them after the events. They have not been adequately supported by the organization (77.6%). there was no designated member of the organization guiding them after an event.

Conclusions: Adequate support can work effectively to reduce symptoms, after an event. Lack of supports can lead to an emotional burden.

Keynote Speakers of Nursing Education 2019

 Title: Making a difference for staff and the patient

Sue Kitching

Director of Nursing
Northern Area Armed Forces Hospital
United Kingdom

  Title: Quality in decision making

Asma Hussein Rammal

Nursing Director 
Madina National Hospital 
Saudi Arabia

  Title: Critical Care Nurses' Perspectives toward Family Presence 

                                          during Resuscitation  

Abdulelah Alhaidary

Director of Nursing
king Abdul Aziz University Hospital
Saudi Arabia

  Title: Understanding and implementing EBP to foster and maintain

                                          safe and competent care

Rabie'e Al Rashdi

Planning and Development Expert
Oman Academic Accreditation Authority
Muscat

  Title: Nursing Education in Saudi Arabia: A 60 years of obstacles 

                                         and Opportunities

Adel Bashatah

Dean Of Skills Development 
King Saud University
Saudi Arabia

Making a difference for staff and the patient

Sue Kitching

Director of Nursing, Northern Area Armed Forces Hospital, Saudi

Statement of the Problem:

Taking on a new role in a Hospital that had not had much evidence based nursing utilized would for some be a step too far. For those who enjoy a challenge, it gives a great opportunity to lead and direct staff to strengthen their knowledge and more so patients outcomes. Transformational leadership is about transforming and Cummings et al 2009, 2011 have highlighted the links between patient outcomes and leadership. So how do you go about righting poor practice, limited understanding whilst leading and engaging a workforce? Well, the opportunity arose when the morning report kept highlighting pressure injuries but with no outcomes and solutions.  So, rather than being the leader I took on the role of clinical nurse with experience to go and investigate and see what change I could make. “Amazing,”  is a nice word  and one that sums up the effect of my transformation in the staffs understanding, ownership  and improvement leading to   better outcomes for their patients

Pressure injuries at Grade 4 and above are now reduced to Grade 2 and below and staffs have confidence in how to tackle pressure injury prevention and care.  Just through a leader changing focus and showing nursing skills are never lost and knowledge is a wonderful asset and what simple motivation and encouragement can do to a workforce.

Cultural influence in communication and nursing care: The case of UAE

JOHN NYAH MBOUT, SRN, BSN, HAAD-RN

UAE

The increasing diversity of the nation brings opportunities and challenges for health care providers, health care systems, and policymakers to create and deliver culturally competent services. Cultural competence is defined as the ability of providers and organizations to effectively deliver health care services that meet the social, cultural, and linguistic needs of patients.

“Culture" refers to integrated patterns of human behavior that include the language, thoughts, actions, customs, beliefs, and institutions of racial, ethnic, social, or religious groups (California Endowment, 2003). Every culture has beliefs about health, disease, treatment, and health care providers.

Health is a cultural concept because culture frames and shapes how we perceive the world and our experiences.

All cultures have systems of health beliefs to explain what causes illness, how it can be cured or treated, and who should be involved in the process. The extent to which patients perceive patient education as having cultural relevance for them can have a profound effect on their reception to information provided and their willingness to use it.

Business leaders know that intercultural savvy is vitally important – not just because they have to deal increasingly with globalization, but also because the workforce within their own national borders is growing more and more diverse.

Intercultural communication in its most basic form refers to understanding how people from different countries and cultures behave, communicate and perceive the world around them. Given the growing multicultural population in the UAE, intercultural communication research is actively being applied in healthcare settings so that doctors and their staffs can relate effectively to their patients from diverse cultural backgrounds.

The United Arab Emirates houses a diverse and vibrant community. The residing population originates from a number of Arab tribes. Over the time, the existing community has started to diversify with the arrival of the Iranians in the 1800s, followed by Indians (both Muslims and Hindus), especially in Dubai due to its prosperous pearl market, given its location on the coastline.3  The Emirati Arabic culture is a perfect blend of the Islamic, Persian and even Indian culture. This is evident in the architecture, dressing norms, cuisines, folk dances, and the usage of certain words in everyday language.  But the Arabic Islamic culture remains the strongest and the most obvious influence on the UAE community.

Delivering high-quality care to Muslim patients involves having an awareness of the ramifications of the Islamic faith and Islamic beliefs. Nurses need to understand the implications of spiritual and cultural values for clinical practice. They should be aware of the need for modesty and privacy, the appropriate use of touch, dietary requirements and use of medications.

For a better understanding, this presentation will provide a brief overview of the existing culture and beliefs in UAE, before wading into it influences in communication and nursing care.

This concept will be presented in the following sub-topics:

• The significance of the concept
• Critical analysis of the concept
• Overview of existing culture and beliefs in the UAE
• Application and influence of the concept in nursing care in the UAE: culture as a competency and influence of religion
• Way forward of the concept

Evaluation of the Application of Critical Thinking Skills of Students in the Context of Nursing Process in the College of Nursing of a Private University

   Dr. Gracila V. Ucag-Decena

   Philippines

Statement of the Problem: This study aimed to evaluate the application of critical thinking skills in the context of the nursing process of nursing students.  It sought answers to the following specific problems: (1) What are the frequency applied in critical thinking skills as perceived by the student-respondents and as evaluated by clinical instructor-respondents in the context of Assessment; Diagnosis; Planning; Implementation; and Evaluation? (2) Is there any significant difference between the student-respondents ‘perceptions and the evaluation of the clinical instructor-respondents on the application of the critical thinking skills in the context of the nursing process? (3) What measures can be proposed to enhance the application of critical thinking skills of nursing students?

Methodology & Theoretical Orientation: This study applied the mixed method of research and utilized the descriptive design for each quantitative aspect and content analysis for each qualitative aspect. This research was based on the humanistic nursing theory combined with the elements of critical thinking from the more recent studies. It adopted the Transactional Model of Critical Thinking (TMCT) which had successfully integrated humanistic nursing theory into a model of critical thinking.

Findings: Based on the quantitative data, student-respondents perceived that they ALWAYS APPLY critical thinking skills and clinical instructor-respondents evaluation showed students only OFTEN APPLY critical thinking skills needed in all phases of the nursing process (assessment, diagnosis, planning, implementation, and evaluation). Based on the qualitative data (NCP analysis), student-respondents need to enhance assessment process skills to ensure a complete database; formulated inappropriate diagnosis; need to enhance skills in formulating goals and outcomes; have the skills in identifying appropriate nursing but need to know how to prioritize each identified nursing intervention, and with skills in evaluating the effectiveness of interventions.

Conclusion & Significance: There is a significant difference in the application of critical thinking skills in the context of the nursing process as perceived by student-respondents and as evaluated by clinical instructor-respondents. Specific measures must be proposed to enhance the application of the critical thinking skills of nursing students in the context of the nursing process.

Understanding the need, value and role of Midwives in Healthcare

Increasing women’s access to quality midwifery has become a focus of global efforts to realize the right of every woman to the best possible health care during pregnancy and childbirth (WHO, 2018).

Midwifery is one of the most ancient practices in the world. It even features in early Egyptian and Roman scrolls. Its popularity had decreased and is now seeing an increase in global attention.

Globally, there have many reports on the increased demand for midwives as well the shortage of these midwives.  In 2018, the department of health and social care in the UK reported that more than 3000 training course places would be created over the next 4 years in the “largest ever” investment in midwifery training, as part of the plans to meet NHS staffing demands.  The Royal College of Midwifery chief executive and general secretary Gill Walton said:” This is a very long overdue acknowledgment by the government that England’s maternity services need more midwives.”  In addition to this, the World Health Organization has stated on numerous occasions that more midwives are needed to improve maternal and newborn survival.

In 2011, the United Nations Population Fund (UNFPA) published a report – The state of the world’s midwifery 2011: delivering health, saving lives- that offered a comprehensive look at midwifery around the globe.  The report's analysis of 58 countries showed that there was a global shortage of an estimated 350 000 midwives, at least a 3^rd of whom were needed in the world’s poorest countries.

Midwifery has come to the fore since maternal and newborn health was made the focus of the two Millennium Development Goals (MDG’s).  In 2006, the World Health Organisation estimated that the world needs 4.2 million more health workers, with 1.5 million of those needed in African countries alone.  The State of the World’s Midwifery (SoWMy) 2014 report, which examines the global midwifery landscape across 73 low-and-middle -income countries, calls for urgent investment in high- quality midwifery to prevent about two-thirds of all maternal and newborn deaths- saving millions of lives every year.  Therefore, one can gather that the world is facing an acute shortage of healthcare workers.

However, midwifery experts say that for a profession that is so old, it is remarkably poorly understood.  Midwives do far more than just catching babies. The impact that midwives have is not just on pregnancy outcomes, but extends to newborn care, breastfeeding, family planning, and sometimes also cervical and breast cancer screening.  Decades of neglect of the role of midwives, either because of the over-medicalization of pregnancy care or a lack of resources, has left a legacy of high rates of maternal and newborn mortality in developing countries (Bulletin of the World Health Organisation, 2013).

According to ITV News report in n2018, women who use the continuity model of care in the UK are 19% less likely to miscarry and 16% less likely to lose their baby and 24% less likely to give birth prematurely.  This report was based on the provision of a dedicated team of midwives that will be with the mother from pregnancy to labor to new parent.  In addition, statistics are clear that having a dedicated team of midwives reduces the occurrence of stillbirths, miscarriages and neonatal death.

- Ntombi Khaya Msimango

Deputy Chief Nursing Officer

Muscat Governorate, Oman

Quality in Decision Making

    Asma Hussein Rammal

Nursing Director at Madina National Hospital in Saudi Arabia

Quality in decision-making is very crucial issue in nursing. Since nurses have the voice to lead, strong leaders should support this leading. In order to have strong leaders they should have the proper knowledge and enough experience in the field. Multiple factors affect the decisions; outside factors and inside factors. The outside factors include the rules and regulations of MOH, Labor law, accredited organizations and the other hospital (competitors). Inside Factors; like policies and procedures of the hospital, the shortage of staff and the support of the higher management. Despite of all these factors the quality of care and patient safety should have the priority when make the decision otherwise; it will affect the health of patient. For instance, when decision was made to transfer patients from ICU to medical ward because their health status was improved a little, but they did not reach the level of being in normal ward. Their health status was deteriorated, and they were sent back to ICU. This type of decision has lots of side effect; 1- It did not take the quality of care in consideration. 2- This decision will affect the reputation of the hospital other than the legal situation that will affect the hospital. Other decision can be taken by higher management to increase the ratio of patient to nurse specially in critical areas other than the ward patient. In this situation, Nursing Director can stop this decision. In order to prevent medical mistakes, work overload on nurses, which in turn will increase the sick leave.

Nursing Directors who considered the leaders for the new nurses should present strong leadership with justified decisions that reflect the quality of care that should have the priority.

Maternity Nursing

What is Maternity Nursing?

The skills that nursing students learn in this course prepare them with a high level of specialized skills. Maternity nurses provide both pre-birth and post-birth care for mothers and their new-born babies. Nursing students receive training to prepare them to help mothers and their families know what to expect throughout the pregnancy.  Nurses provide mothers with caring for their babies and themselves after delivery.

Maternity nurses also care for those who suffer miscarriages and those who choose abortion.  They provide these women with assistance to care for themselves.  Maternity nursing courses also train nursing students in medication administration for patients.  Other skills learned include identifying the sign of complications during delivery, checking the patient’s vital signs, checking the patient’s dilation level, and evaluating and managing pain.

How a Labor and Delivery Nurse Uses Maternity Nursing on the Job

Labor and delivery nurses use the skills learned in their courses to care for mothers and their newborns. Their concern is not only the physical well-being of their patients; they also provide emotional care for their patients. Labor and delivery nurses use their skills to help the mothers learn the best was to dress, feed, and change the babies.  They also use the skills they learn to help mothers wash their babies and feel a high level of comfort when holding their babies. Labor and nurse pass their knowledge on to mothers to help them determine the pros and cons of various baby-related issues.

Labor and delivery nurses use their skills to identify the appropriate technology and tools needed for a successful delivery.  They also must understand how to read monitors and reports as well as perform certain procedures to maintain the good health of the mother and baby. Labor and delivery nurses also learn how to monitor the mother and baby during all stages of the pregnancy and report any changes to the head nurse and doctor.

Critical Care Nurses' Perspectives toward Family Presence during Resuscitation

 

   Abdulelah Alhaidary

   Director of Nursing

   king Abdul Aziz University Hospital

   Saudi Arabia

Introduction: Most of our hospital in Saudi Arabia are not allowing the family members to be presented during resuscitation of their loved one, because of many reasons, specifically the traumatic experience for the family members when they witness the resuscitation of their loved one and the unavailability of the space in the patient's room during the resuscitation, although in North America, Australia, and Europe there was a new movement has evolved gradually because of subjective evidence from family members supporting the notion of family presence during resuscitation in addition to emerging evidence from research by health professional,   add to that,  it was never investigated in Saudi Arabia , and if it will be done, it will diffidently add a lot to the practice and to the family members satisfaction.

Objectives: To answer the following: What is the profile of the respondents, to what extent of the perspective of critical care nurses toward family presence during resuscitation, is there a significant relationship between the level of perspectives of the respondents and their profiles, and to propose a well-established family presence during resuscitation guidelines. 

Methods: the study was conducted in the Intensive Care Unit, Prince Sultan Military Medical City, Kingdom of Saudi Arabia, from January to December 2016, this study involved 150 critical care nurses. it utilized the descriptive and qualitative methods of research. questionnaires were distributed, and data obtained were assessed statically and presented with interpretation.

Result: the tabulated data were subjected to a percentage, weighted mean, analysis of variance and t-test for two independent sample. results supported the family presence during resuscitation as a right not an option, permission should be secured, spiritually showed benefit. trauma was considered inevitable.

Mental Illnesses

Who Becomes Mentally Ill?

• It can affect anyone, regardless of age, ethnic background, income or gender.
• One in five Canadians has or will develop a mental illness.
• Sometimes mental illness is complicated by drug and alcohol use

Depression:

Refers to severe and prolonged feelings of discouragement, frustration and even a sense of despair. Multiple causes such as specific, distressing life events, a biochemical imbalance in the brain or persistent psychological factors such as a negative or pessimistic view of life. Common symptoms of depression:

• Irritability.
• Anxious mood.
• Trouble sleeping or sleeping too much.
• Loss of energy and excessive fatigue.
• Physical aches and pains.
• Diminished ability to think and concentrate.
• Feeling bored and not interested in many aspects of your life.
• Imagining you have an illness such as cancer when there are no physical indications.
• Feelings of worthlessness, hopelessness
• Possibility of suicidal thoughts
• Changes in personal grooming
• Isolation and withdrawal
• Inability to experience joy or pleasure

Bi-Polar Disorder:

Refers to the two poles of the continuum of mood with alternating periods or cycles of mania highs and depression lows as described previously. Common symptoms of mania:

• Persistently high or irritable
• Decreased need for sleep.
• Appetite disturbance.
• Excessive spending.
• Reckless and impulsive behaviour.
• Inflated ideas about what you are capable of doing – grandiose thoughts.
• Delusional and psychotic thinking.
• Hyper sexuality
• Heightened senses to colour, noise, and smell
• Accelerated thoughts and speech.

Psychosis:

The word psychosis is used to describe conditions that affects the mind, in which there has been some loss of contact with reality. When someone experiences the symptoms of psychosis, their condition is referred to as a psychotic episode. It affects an individual’s thoughts, feelings and behaviours. Some people experience psychosis as a part of their mental illness or because of using or withdrawing from drugs and alcohol. It is most likely to occur in young adults. About 3 out of every100 people experience a psychotic episode in their lifetime. It occurs equally in males and females and across all cultures and levels of socio-economic status. Most people make a full recovery from the experience. Common signs and symptoms of psychosis:

• Disorganized or confused thinking.
• Reduced concentration, attention
• Reduced drive and motivation, lack of energy
• Sleep disturbance
• Anxiety
• Social withdrawal
• Behavioural changes, irritability
• Hallucinations or delusions
• Disorganized speech

Anxiety Disorders

• A group of disorders which affect behaviour, thoughts, emotions and physical health. Caused by biological and situational circumstances. Heightened and continuing response to a perceived threat. Types of anxiety disorders:

General Anxiety Disorder

• Repeated and excessive worries lasting at least six months pertaining to routine life events and activities like work, relationships, finances and family.

Panic Attacks

• Fear of imminent death leading to heart palpitations, choking, nausea, faintness, dizziness, chest pain and sweating.

Panic Disorder

• Fear of situations which may cause a panic attack.

Phobias

• Overwhelming feelings of terror in response to a specific object, situation or activity.

Obsessive-Compulsive Disorder (OCD)

• Repetitive actions used to cope with recurring or unwanted thoughts.

Post-traumatic Stress Disorder (PTSD)

• A sense of re-experiencing a traumatic event for months and sometimes years after the incident.

Treatment & Recovery

Treatment for any mental illness, whether or not it is complicated by drug and alcohol misuse, should occur as soon as symptoms appear. Recommended treatment involves a combination of approaches:

1. EDUCATION – To help you and your family/support system understand the illness, its causes and effects and ways of dealing with symptoms.
2. MEDICATION – New ones are now available with fewer unpleasant side effects than older medications.
3. PSYCHOLOGICAL THERAPY OR COUNSELLING - To help you understand what is happening, change your lifestyle to optimize the chances for recovery and learn new skills such as problem solving and relaxation techniques.
4. SOCIAL, EMPLOYMENT AND EDUCATION SUPPORT – You may need support to stay at your job, or in school. This is important, so you maintain skill development and continuation of income and do not become cut off from friends and workmates. Research has shown that people who experience mental illness have fewer relapses when their family or other support system is involved in their care and treatment. The same is true when substance misuse is involved. If friends and family are knowledgeable and informed, they are in a better position to support you.