郑州市三甲医院急诊科护士道德困境与职业倦怠的现状及相关性研究

目的 调查郑州市三甲医院急诊科护士的道德困境与职业倦怠的现状,并分析两者之间的相关性。方法 采用便利抽样法选取郑州市5所三甲医院的228名急诊科护士作为研究对象,采用一般资料调查表、中文版护士道德困境量表、护士职业倦怠量表对其进行问卷调查。结果 郑州市三甲医院急诊科护士道德困境总分为(49.41±13.35)分,职业倦怠总分为(63.51±17.25)分。单因素分析显示,不同学历、工作年限的急诊护士的道德困境得分比较,差异均有统计学意义(F=4.830,P=0.015; F=6.302,P=0.001);不同年龄急诊护士的职业倦怠得分比较,差异有统计学意义 (F=8.328,P=0.005),急诊科护士道德困境与职业倦怠呈正关性(r=0.412,P<0.05)。结论 郑州市三甲医院急诊科护士的道德困境与职业倦怠普遍存在,护士的道德困境与职业倦怠呈正相关。     

儿科护士道德困境研究进展

护理作为医学与人文学相结合的专业,其核心是减轻痛苦、促进健康,以实现职业道德.随着医疗技术进步、医学模式转变以及多元文化价值观冲突,医务人员不断面临愈来愈多的伦理问题[1].其中道德困境已证实普遍存在于医疗环境的各类医务群体中,而护士群体发生道德困境的严重程度及频率最高,尤其是工作于重症监护室及儿科环境下的护士[2]....     

浅谈急诊科护士的道德与素质修养

急诊科是医院抢救病人的核心，急诊科工作的好坏，直接关系到整个医院的医疗护理水平。作为急诊科护士，应做到急病人之所急，争分夺秒、全力以赴，根据不同病情，认真、机智、敏捷、镇定的处理病人，并能应付各种各样的突变。培养“急而不躁”“快而准”和“忙而不乱”的工作作风。我院成立急诊科几年来，在急诊抢救中，医生和护士密切配合，发扬救死扶伤的人道主义，挽救了许多患者的生命。     

急诊科护士评判性思维现状调查与分析

目的：调查和分析急诊科护士评判性思维能力现状,为急诊科护士评判性思维的培养提供有效依据。方法：采用一般情况调查问卷和中文版评判性思维倾向调查量表（CTDI—CV）对北京市4家三级甲等医院160名急诊科护士进行问卷调查。结果：急诊科护士CTDI-CV总分为（236．72±33．34）分,处于中等偏低水平,各特质均为中等水平。不同年龄中,30～39岁与≥40岁两组年龄段的“开放思想”特质得分差异有统计学意义（P〈0．05）。接受过与未接受过评判性思维培训的急诊科护士“开放思想”“自信心”和“分析能力”3个特质得分差异有统计学意义（P〈0．05）。结论：急诊科护士评判性思维处于中等偏低水平,有待提高;急诊科管理者须加强相关方面培训。     

急诊科护士针刺伤及其对策的调查分析

针刺伤是护理工作中最常见的一种职业性伤害。急诊护士常在患者未完全明确诊断前即投入对患者的处置和抢救，这其中包括处于潜伏期和诊断前的传染病患者，因此针刺伤对急诊护士来说，危害性更大。为此作者对急诊护士针刺伤情况及其应对方式进行了调查分析，现报告如下。     

急诊科护士排班方式的探讨

急诊科在一个综合性医院中是一个相对独立的科室,但是又与其它科室密不可分。我院急诊科主要负责急诊、急救及夜诊工作。随着现代生活方式的改变,急诊科的工作具有以下特点：夜诊显著多于日诊;急救患者相对较少,而普通病人相对较多。多是由于日间工作无暇就医,而夜间来急诊看病。急诊科抢救速度、成功率、工作质量的好坏,与护土的工作密不可分。一般急诊科的医生是由住院处的医生轮流值班,对急诊科的条件、要求不甚了解,而急诊科的护土在日常工作中起着决定性的作用。护士一个班组工作力量的强弱,以及同医生配合是否默契,直接关系…     

我院急诊科护士职业倦怠现状调查

目的了解我院急诊科护士的职业倦怠状况。方法采用问卷调查法，对我院64名急诊科护士及256名其他科室护士的职业倦怠状况进行调查。结果急诊科护士与其他科室护士相比，在情感耗竭、去人性化和个人成就感降低3个维度上得分较高，差异具有统计学意义（P〈0．05）。结论急诊科护士的职业倦怠程度较为严重，需要采取多种措施改变这种状况。     

急诊科护士职业防护现状调查

目的了解急诊科护士的职业防护意识,职业防护知识掌握情况。方法采用便利抽样方法,对三级甲等医院急诊科的96例护士应用自行设计的急诊科护士职业防护调查问卷进行职业防护知识和意识的调查,对相关资料数据应用SPSS11．5软件进行统计学分析。结果急诊科护士在职业防护知识方面掌握较好,职业防护意识总体较强。不同职称、学历、有无子女状况及工作年限的急诊护士在职业防护知识方面和职业防护意识方面差异无统计学意义（P〉0．05）。结论应进一步加强系统的职业安全教育,认真落实医院感染管理工作制度,建立和健全护理人员职业防护的保障制度,合理分配护理人力资源,是维护护理人员的职业安全的根本保证。     

三级医院急诊科护士焦虑现状调查分析

[目的]了解广西壮族自治区三级医院急诊科护士焦虑现状。[方法]采取整体抽样法,应用焦虑自评量表对广西壮族自治区12所三级医院386名急诊科在职护士进行问卷调查。[结果]386名护士SAS得分范围为32分~71分(49.68分±10.07分),高于国内常模(P0.05);不同年龄、不同护龄、不同学历、不同婚姻情况、不同收入的护士SAS得分比较差异有统计学意义(P0.05);年龄、学历和月收入为影响急诊科护士焦虑的主要因素。[结论]急诊科护士焦虑水平较高,应采取积极的干预策略降低护士焦虑水平。     

山东省急诊科护士情绪劳动的现状调查

目的调查山东省急诊科护士情绪劳动的现状,以期为护理管理者干预措施的提出提供现实依据。方法 2016年2月,采用便利抽样法选取山东省10所综合医院急诊科护士276名为研究对象,采用一般情况调查表及情绪劳动量表对其进行调查。结果急诊科护士情绪劳动的表面表现、深层表现、自然表现得分分别为(3.56±1.23)、(3.57±1.09)、(4.43±1.31)分。不同年龄的护士在情绪劳动表现策略的3个维度上的评分差异均有统计学意义(均P0.05)。不同护龄、任职方式的急诊科护士在情绪劳动的表面表现上得分差异均有统计学意义(P0.05或P0.01)。不同婚姻状况的急诊科护士在深层表现及自然表现上得分差异均有统计学意义(P0.05或P0.01)。结论急诊科护士在工作中最常采用的情绪劳动表现策略是自然表现,其次是深层表现,最后是表面表现,且低年资急诊科护士运用表面表现多于深层表现。护理管理者应关注年轻护士的情绪劳动状况,加大相关培训力度。     

护士道德困境与同情心疲乏的相关性研究

目的调查护士道德困境与同情心疲乏的现状,并分析二者的关系,为护理管理者有效应对护士道德困境和同情心疲乏提供依据。方法采用护士道德困境量表和专业生活质量量表对湖州市某三级乙等综合医院240名护士进行问卷调查。结果临床护士道德困境评分为(1.61±0.46)分;护士继发性创伤应激(20.76±5.02)分,工作倦怠(24.83±5.73)分,同情心满足(29.68±5.96)分。护士道德困境与同情心疲乏中工作倦怠、继发性创伤应激呈正相关(P0.01或P0.05)。结论护士的道德困境处于轻度水平,有发生同情心疲乏的危险,且护士道德困境与同情心疲乏呈正相关;提示护理管理者应采取针对性教育,克服道德困境,降低护士同情心疲乏的发生,以促进医护人员的身心健康,保证临床护理质量。     

急诊科护士护患纠纷预见性现状调查

目的了解急诊科护士对护患纠纷的预见性,为护患纠纷防范提供参考依据。方法抽取菏泽市10所医院的232名急诊科护士,应用急诊护士护患纠纷预见性现状调查问卷进行调查。结果急诊护士护患纠纷预见性总分(156.00±41.49)分。性别、年龄、学历、工作年限、职称是急诊科护士护患纠纷预见性影响因素。结论急诊科护士护患纠纷预见性处于中等水平,强化培训与演练,增强急诊护士护患纠纷的预见性,降低护患纠纷,能有效提升急诊护理质量。     

Unable to answer the call of our patients: mental health nurses' experience of moral distress

When health practitioners' moral choices and actions are thwarted by constraints, they may respond with feelings of moral distress. In a Canadian hermeneutic phenomenological study, physicians, nurses, psychologists and non-professional aides were asked to identify care situations that they found morally distressing, and to elaborate on how moral concerns regarding the care of patients were raised and resolved. In this paper, we describe the experience of moral distress related by nurses working in mental healthcare settings who believed that lack of resources (such as time and staff) leads to dispiritedness, lack of respect, and absence of recognition (for both patients and staff) which severely diminished their ability to provide quality care. The metaphors of flashlight and hammer are used to elaborate nurses' possible responses to intolerable situations.     

我国二级及以上医院急诊分诊依据现状调查

目的调查国内急诊分诊执行情况及分诊依据的现状。方法采用自制调查问卷,对国内113所医院的274名急诊科护士进行急诊分诊执行情况及分诊依据现状的调查。结果目前急诊分诊护士要求不统一,急诊分诊标准存在不足,急诊分诊护士现有培训不能满足临床需要。结论我国在急诊分诊护士培养和急诊分诊标准的建立等方面尚不完善,建立统一规范的分诊标准和专职分诊护士将成为急诊分诊发展的趋势。     

Deliberate self-harm: emergency department nurses' attitudes, triage and care intentions

Aim and objectives. This exploratory study investigates emergency department nurses’ attitudes towards patients who engage in deliberate self‐harm. It examines their attitudes towards, and triage and care decisions with, patients who self‐harm. Background. Emergency department nurses sometimes show unsympathetic attitudes towards patients who present with self‐harm and these can contribute to difficulties in assessing and providing appropriate care. Design. A modified version of the Suicide Opinion Questionnaire was used. A non‐probability sample of 43 emergency department nurses from a large Australian hospital participated in the study. Data were analysed using SPSS. Results. Most nurses had received no educational preparation to care for patients with self‐harm; over 20% claimed that the department either had no practice guidelines for deliberate self‐harm or they did not know of their existence and one‐third who knew of them had not read them. Overall, nurses had sympathetic attitudes towards patients who self‐harm, including both professional and lay conceptualizations of deliberate self‐harm. They did not discriminate against this group of patients in their triage and care decisions. Conclusions. The findings of this exploratory study are important because attitudes can affect care decisions. Recommendations are made for improving the educational preparation of emergency department nurses, for improving awareness and implementation of practice guidelines, and for improving attitudes towards patients with deliberate self‐harm. Further research is needed to confirm these results.     

Determinants of moral distress in medical and surgical nurses at an adult acute tertiary care hospital

AIM: To determine the prevalence and contributing factors of moral distress in medical and surgical nurses. BACKGROUND: Moral distress from ethical conflicts in the work environment is associated with burnout and job turnovers in nurses. METHOD: A prospective cross-sectional survey using the Moral Distress Scale tool was administered to medical and surgical nurses at an adult acute tertiary care hospital. RESULTS: The survey was completed by 260 nurses (92% response rate). The intensity of moral distress was uniformly high to situations related to physician practice, nursing practice, institutional factors, futile care, deception and euthanasia. Encounter frequencies for situations associated with futile care and deceptions were particularly high. Encounter frequencies increased with years of nursing experience and caring for oncology and transplant patients. CONCLUSION: Moral distress is common among nurses in acute medical and surgical units and can be elicited from different types of situations encountered in the work environment. Nursing experience exacerbated the intensity and frequency of moral distress. IMPLICATIONS FOR NURSING MANAGEMENT: Strategies aimed to minimize exposure to situations of moral distress and augment mechanisms mitigating its effect on nurses are necessary to enhance job satisfaction and retention.     

实施人性化护理管理减轻急诊护士心理压力

分析引起急诊护士心理压力的原因不良的工作环境、工作性质、人际关系和不良刺激.运用人性化管理对策改善环境、实施人性化管理模式和管理行为,减轻护士的心理压力,调动护士的工作积极性,提高急诊护理质量.     

临床实践护生道德困扰的研究进展

总结临床实践护生道德困扰的概念、测评工具、原因、影响因素及干预方式,旨在明确临床实践中护生道德困扰根源,以针对性地给予干预,帮助护生顺利渡过临床实践提供借鉴和指导。指出导致临床实践中护生道德困扰的原因来源于护生个体因素和临床实践因素;目前常用道德困扰的测评工具是护生道德困扰量表;影响道德困扰的因素包括护生年龄、性别、学历、职称、职务、所在科室及社会支持等;可通过提升教师能力、改变伦理教育方式、夯实护理伦理管理方式进行干预。