Current Issues
And
Current Trends in Nursing
BY: DARLENE D.R. ROSARIO, R.N.
Nurse’s Health Amidst
Pandemic
How COVID-19 is affecting nurses’
mental health, and what to do about
it?
Working in healthcare is a stressful occupation and can
cause stress-related health problems. It's important for you
to relax and take time away from work to help you unwind.
Along with being mentally exhausting, working as a nurse
is physically strenuous. Many nurses suffer from back
problems and sore feet.
It seems inevitable that caring for patients in the
high-stakes context of COVID-19 will take its toll
on the mental health of nurses.
A public health emergency on this scale makes the threat
personal for nurses, as well as one they manage
professionally: with inadequate and insufficient personal
protective equipment (PPE) reported in many areas, nurses
are anxious about their own welfare and that of their
families.
One of the many challenges of nursing is that those hours are spent on one’s feet
for most of the time. Nurses have physically demanding jobs and are required to
help lift patients (from a wheelchair to a bed, for instance, or from the bed to the
bathroom).
They do have access to equipment that can make these physical aspects less
strenuous, such as slide sheets or mechanical lifts. However, nurses experience a
high rate of work-related injuries. One of the most chronic workplace hazards is
back injuries.
Shoulder injuries and leg pain are also common ailments. According to the
American Journal of Critical Care, the nursing profession is the profession most
at risk for back injuries.
This is one of the challenges of nursing that can force nurses to abandon the
career they love and leave the profession for good.
Here are some of the issues preying on the minds of nurses in this
pandemic and explore ways to help ease the psychological burden
and promote mental health:
As a nurse, is it normal to feel anxious and worried
about coping with the pandemic?
Feelings of stress among healthcare workers are likely and are no
reflection on their ability to do the job, the World Health
Organization (WHO) says.
It has issued guidance on COVID-19 and mental health that recognises the
particular needs of healthcare workers. Crucially, it puts their mental well-
being on a par with their physical health.
The guidance states: ‘Feeling stressed is an experience you and many of
your colleagues are likely going through; in fact, it is quite normal in the
current situation. Managing your stress and psychosocial well-being during
this time is as important as managing your physical health.’
What are some of the particular
anxieties facing nursing staff?
•Worries and uncertainties about personal safety and
the lack of PPE, workload, case complexity, skills
mix, and loved ones’ health are among a vast range
of stressors that cut across professional settings, but
are perhaps most clearly seen in intensive care units
(ICUs).
COPING MECHANISMS FOR
NURSES
DURING THE PANDEMIC
Psychological well-being and management of stress levels are as
important as physical health, says the RCN, echoing the emphasis WHO
places on healthcare workers' mental health.
The college advocates healthy lifestyle strategies including staying
hydrated, maintaining healthy eating and sleeping patterns, and keeping up
social contact with your support networks, even if that contact is virtual.
It advises sticking with strategies that have worked well for you in the
past, rather than trying to learn new ones. These might include deep
breathing, taking regular exercise, practising mindfulness, relaxation
techniques or simply talking to a colleague or friend.
Slow the cycle of stress: stop, breathe, then think
The Intensive Care Society has produced practical guidance that can be applied across
the workforce.
It says: ‘Stop, breathe, then think – slowing your breathing slows the stress cycle and re-
engages your frontal lobes, then you can think.’
Other tips, include:
Consider your psychological energy levels and the need to ‘fill up’ after emptying the
tank
Be aware of your ‘bandwidth’ and that it may take longer to think things through and
make sense of them if you are feeling overwhelmed
Beware of using dramatic language that could panic your colleagues
Source: Intensive Care Society
MANDATORY OVERTIME
FOR NURSES
The use of extended work shifts and overtime has escalated as
hospitals cope with a shortage of registered nurses (RNs).
Mandatory overtime is defined as any work that the nurse is asked
to work beyond a “regularly scheduled shift.” Scheduled shifts must
be agreed to by the nurse or CNA and the healthcare facility.
An employer can require a nurse to work overtime if the nurse is
participating in a medical procedure or surgery that has begun but
has not completed.
Additionally, mandatory overtime can be required if there is an unforeseen
emergency situation.
An emergency situation is defined as a situation that could jeopardize patient safety.
It must be an emergency situation that is unusual, unpredictable, or unforeseen.
That can include an act of terrorism, disease outbreak, natural disaster, major
disaster, or disaster emergency.
Over time, this can leave nurses feeling drained. Stress and exhaustion (both mental
and physical) can present as secondary challenges in nursing, leading to the
potential for costly medical mistakes.
If a nurse is juggling both a family and a career on top of the challenges in nursing,
new problems present themselves. After a strenuous day of seeing patients, it can be
tough to devote undivided attention to the needs of one’s own family, much less
find time for self-care.
To help make up for staffing shortages, nurses are often required to work long shifts.
Sometimes, nurses must work extended hours and overtime, risking fatigue that
could lead to medical errors.
"We know nurses should not work more than 40 hours a week, and we believe they
should be working no more than 12 hours in a day or less if possible, because you
reach a point where you start to have cognitive decline," she said. " Nurses will stay
late, work extra hours or come back to work after little sleep if their workplace needs
them. But in reality, that's at odds with evidence we have about being the most
productive and safest healthcare professionals."
According to Labor Code of the Philippines:
Art. 83. Normal hours of work. The normal hours of work of any employee shall
not exceed eight (8) hours a day.
Health personnel in cities and municipalities with a population of at least one
million (1,000,000) or in hospitals and clinics with a bed capacity of at least one
hundred (100) shall hold regular office hours for eight (8) hours a day, for five (5)
days a week, exclusive of time for meals, except where the exigencies of the
service require that such personnel work for six (6) days or forty-eight (48) hours,
in which case, they shall be entitled to an additional compensation of at least thirty
percent (30%) of their regular wage for work on the sixth day. For purposes of this
Article, “health personnel” shall include resident physicians, nurses, nutritionists,
dietitians, pharmacists, social workers, laboratory technicians, paramedical
technicians, psychologists, midwives, attendants and all other hospital or clinic
personnel.
Art. 87. Overtime work. Work may be performed beyond eight (8) hours a day
provided that the employee is paid for the overtime work, an additional
compensation equivalent to his regular wage plus at least twenty-five percent (25%)
thereof. Work performed beyond eight hours on a holiday or rest day shall be paid
an additional compensation equivalent to the rate of the first eight hours on a
holiday or rest day plus at least thirty percent (30%) thereof.
Art. 88. Undertime not offset by overtime. Undertime work on any particular day
shall not be offset by overtime work on any other day. Permission given to the
employee to go on leave on some other day of the week shall not exempt the
employer from paying the additional compensation required in this Chapter.
Art. 89. Emergency overtime work. Any employee may be required by the employer to
perform overtime work in any of the following cases:
When the country is at war or when any other national or local emergency has been declared
by the National Assembly or the Chief Executive;
When it is necessary to prevent loss of life or property or in case of imminent danger to
public safety due to an actual or impending emergency in the locality caused by serious
accidents, fire, flood, typhoon, earthquake, epidemic, or other disaster or calamity;
When there is urgent work to be performed on machines, installations, or equipment, in order
to avoid serious loss or damage to the employer or some other cause of similar nature;
When the work is necessary to prevent loss or damage to perishable goods; and
Where the completion or continuation of the work started before the eighth hour is necessary
to prevent serious obstruction or prejudice to the business or operations of the employer.
CURRENT TRENDS
IN
NURSING
INCREASED SPECIALIZATION
AND
CAREER PATH OPTION
Healthcare needs are becoming increasingly complex. As a result, the scope of
specializations that nurses are able to practice is widening. A nurse who specializes
is in higher demand than the lower ones. As the world continues to grow, and more
research and technological advancements come out, nurse career path options
become endless.
Becoming specialized in a particular area of nursing requires a considerable amount
of time, resources and dedication. Many nurses choose to obtain a specialty
certification in their field of interest or experience. Examples of specialty areas may
include oncology, cardiac care, emergency, hospice and many more.
Becoming certified in a nursing specialty provides many benefits to both the nurse
and the patients they care for. Specializing demonstrates a depth of knowledge in the
given area. Obtaining specialty certification can also contribute to personal and
professional growth, clinical confidence, decision-making ability, and increased job
satisfaction. Taking pride in your area of expertise can give you a sense of
accomplishment and mastery. This positive step can inspire peers to do the same.
Additional benefits to certification in a given specialty include a potential increase in
earnings. Some hospital systems and employers offer incentives to becoming
specialized and may even help cover the cost of testing or study materials. Pursuing
certification can exhibit your continued desire to learn and keep knowledge current,
a desirable trait for any nurse. Management and administration may be more likely to
promote nurses who have taken an interest in specialty certification(s), validating
those nurses' competency and credibility within their profession.
Choosing a Nursing Specialization
Patient Services Administrators
Nursing Educators
Clinical Nurse Leaders
Advanced Practice Registered Nursing
Ambulatory Care Nursing
Cardiac Nursing
Case Management Nurse
Critical Care Nursing
Dialysis Nursing
Genetics Nursing
Mental Health Nursing
Neonatal Nursing
Pediatric Nursing
Oncology Nursing
Other Specializations
There are many possible fields that a nurse may choose to specialize in, including:
Gastroenterology nursing
Holistic nursing
Medical-surgical nursing
Midwifery nursing
Neuroscience nursing
Obstetrical nursing
Occupational health nursing
Orthopedic nursing
Ostomy nursing
TRAVEL
NURSING
Travel nurses are RNs from various clinical backgrounds who work for independent staffing
agencies. They are assigned to different care areas on a temporary basis to fill in short-term
employment gaps.
Travel nursing is a specialty that took root when the field of nursing faced a nationwide
shortage. Hospitals, clinics, and other care areas had unfilled positions, yet had patients
needing care. To try and attract nurses to the open positions, employers offered higher pay,
housing, and covered the cost of relocating.
Due to these shortages, health care facilities have vacancies that need to be filled—and
travel nurses are often the ones to fill open positions. Not only do travel nurses work in
health care in any state in the country, but they also work outside of the United States as
international travel nurses. The adventure and excitement of new opportunities, along with
higher-than-average pay, are facets of travel nursing that many RNs find attractive.
Why Are Travel Nurses Important?
Travel nurses are an important part of the health care team because they help bridge
the gap between supply and demand in the field of nursing. While this is a positive
finding, and more and more states are passing legislation to implement staffing
ratios, there are not enough nurses to fill the openings. Travel nurses assigned those
open positions help to increase patient safety and improve patient outcomes.
Additionally, nurses from different educational backgrounds, care areas, and
geographic location brings a great deal to the practice of nursing. Sharing ideas and
practices not only benefits patients, but also other nurses.
A travel nurse should have the following characteristics to excel in the role:
Enjoys experiencing new cities, towns, and organizations
Enjoys freedom. Travel nurses choose when and where they work, and choose their
duration of employment
Enjoys flexibility. Travel nurses create their schedules, benefits packages, and
income based on which agency they choose to work
Thrives on challenges. Moving to different states or overseas and being "the new
nurse" repeatedly is challenging. Learning new organizational systems and
workflows are particularly challenging
Loves learning new things. Each assignment takes travel nurses to new health care
facilities, some with higher levels of technology or different standards of practice.
Each experience helps nurses build upon their knowledge base
No additional exams are required for travel nursing. Based on the specialty,
certification(s) may be required. Examples include:
Medical/Surgical nursing
Basic Life Support (BLS)
Advanced Cardiac Life Support (ACLS) may be required
Stroke care certification
Telemetry certification
Intensive Care (ICU) nursing
Basic Life Support (BLS)
Advanced Cardiac Life Support (ACLS)
Pediatric Advanced Life Support (PALS)
Critical care nursing (adults, pediatric, neonatal)
Women's Health/Labor and Delivery nursing
Basic Life Support (BLS)
Advanced Cardiac Life Support (ACLS) may be required
Pediatric Advanced Life Support (PALS) may be required
Neonatal Resuscitation Program (NRP) certification
Emergency Room nursing
Basic Life Support (BLS)
Advanced Cardiac Life Support (ACLS)
Pediatric Advanced Life Support (PALS)
Neonatal Resuscitation Program (NRP)
Trauma Nurse Core Course (TNCC) certification
