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Her current title is Transitional Care Unit Registered Nurse, and she holds a Bachelor of Science in Nursing. She practices In Transitional Care unit. She has been practice in this field for about two years. Professionally she has CPRM and CALLS certification. As a treatment for medical Issue, she said: “l do whatever Is the needs of that particular patient like dressing change for any other patient or cardiac or patient with pulmonary have specific treatment related with their disease.

But as techniques r Interventions to make them feel better I listen to their problem, needs and give my best care as possible to satisfy their needs, and show empathy and compassion. ” Most ethical challenge for her as a nurse Is that when patient Is not cooperative with treatment she/he supposes to do to improve their condition, but refused to do so.

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As a nurse she always wanted to do best for her client, but to convenience them with her reason with there is sometime very challenged, because she didn’t want her patient upset and missed important treatment. Her main responsibilities are to fulfill ere patient’s needs as individual, and then give medication as their doctor ordered and do the treatments. The least satisfying about the Job is that she feels bad when patient is in pain or in any condition that she couldn’t help.

As she said: “sometime, I feel so hopeless and wish I can Just take that pain away. “(This is when pain pill is not effective) The most satisfying about her Job is when patients are recovered fully and discharging for home, because she said: “at the time, I can see happiest smile in their face which make my day, and the thank me or give me biggest hug” She decided o get into this field as a child. ” I always want to do something that make deference in people’s life and also practice compassion as Buddhist. ” Said in very seriously. L had bachelor of science in nursing as education and during my four year of nursing school, I have hundreds of hours in clinical actually hand on with patient with supervise by my clinical instruction and also training in simulation lab with real life scenario. All these training and education preparation me who I am today and helped me to be better nurse. ” as she told me. In order enter in this field to have mom experience related to nursing like nursing assistance experience or any health related that you prepare you better and help you realized what you really want from this field..

Skills and personal qualities that you need to be successful In nursing are have to be very good listener, people person that people can easily approach you for anything, good communication and observation, ability to answer questions and offer advice, As a nurse you will be part of a multidisciplinary team that Includes doctors, physiotherapists, anesthetists, pharmacists, tattletales and many more. You need to know how all these different people work together and have to be a good team worker.

Nursing can sometimes Involve managing distress. Nurses play a key part In deal with emotional changed situation. Her typical workday are -Take report from previous shift RAN, give report to CAN. -Check labs and page Meds for any labs that need reported right away. -Assess patients, order of assessments based on acuity of patient, pain, or if they’re all stable, get any unpleasant patients over with so I don’t put if off forever. Give AM meds during assessments.

Usually done by 1030 or then so some treatment like dressing for particular pet. Do some charting in between and also process doctors new orders. -Lunch when I can. -Give noon medication and PORN pain medications. Then charting again then give report to next shift. In nursing, there are lots opportunities for promotions or advancement like you can be charge nurse, supervisor, nurse manager or director of nursing or so much more. And for advancement you can do further study as to be nurse practitioner.

Yes, in nursing is not Just bedside care, it dependent on what you eke, you can expend your interest like if you like kids you can work with them, if you are interest in teaching, you can become clinical instructions or so much more sometimes you have to take couple extra course or training for particular Job description. Entry level is depending on each facility and insurance are pretty good and it do accept most treatment. You should Join American nursing association to get more information and it’s free for student to Join. She said: “So far I love everything about my Job and I am so glad that I choose nursing as my career. “

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Causes of stress 4 Types of stress 4 Coping with stress 4 Managing stress 5 Organizational approach to stress management Types of stress management interventions 5 References 7 Synopsis 5 This project is the study of effects of stress and its management in individuals as well as in an organization. Stress can have consequences far beyond temporary feelings of pressure.

A person’s response to events that are threatening or challenging Is called stress.. Although stress can come from an ongoing, routine, and chosen activity Like long work hours or a hurried work pace, It Is often associated with an Intense reaction to an event In our lives which can be either pleasant or unpleasant known as “fight or flight” reaction. His strength, biographical assets and social supports. Stress in a workplace has often been viewed as individual rather than stresses themselves being identified in a workplace.

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Although organizations are investing in stress management programmer, many currently lack understanding of sources of strain and of effective strategies to deal with them. Stress in a workplace has negative effect on the performance of an individual and as well as an organization. It reduces the efficiency of the organizations. A workplace that supports stress management through workplace wellness programs not only helps their employees to handle pressure better and stay healthier during times of stress, it also sends a message that their company cares about them.

This provides emotional support as well as physical support for fighting the effects of stress. Stress management Introduction The word stress is derived from Latin word “stringers”, meaning to draw tight. Stress is a condition or feeling experienced when a person perceives that “demand exceed he personal social resources that individual is able to mobile”. Stress can have consequences far beyond temporary feelings of pressure.

Although stress can come from an ongoing, routine, and chosen activity like long work hours or a hurried work pace, it is often associated with an intense reaction to an event in our lives which can be either pleasant or unpleasant known as “fight or flight” reaction. “Any stimulus playing upon the body results in certain physiological changes in the body which is cumulatively termed as stress”. Degrees of stress Each individual has a personal view of stress based upon his perception of events, is strength, biographical assets and social supports.

Other factors that influence the outcome of stress include race, gender, age, economic status etc. People experience stress in different ways and for different reasons. The reaction is based on your perception of an event or situation. If a person views a situation negatively, he will likely feel distressed?overwhelmed, oppressed, or out of control. Distress is the more familiar form of stress. The other form, stutters, results from a “positive” view of an event or situation, which is why it is also called “good stress. Stutters helps to sis to a challenge and can be an antidote to boredom because it engages focused energy. Causes: Stress is conventionally divided into two types. Physiological stress: Physiological or short term stress includes factors like temperature, noise, hunger, disease, smoking, drinking and similar habits are considered generally life stresses Psychological stress: Psychological or long term stress includes psychological factors such as low self esteem and social factors such as life events, career satisfaction, relationships.

Types of stress 1 . Acute stress Acute stress is the most common form of stress. It comes from demands and pressures of the recent past and anticipated demands and pressures of the near future. Acute stress is thrilling and exciting in small doses, but too much is exhausting. 2. Episodic acute stress Episodic acute stress is a more severe type of acute stress. This type of stress is often more difficult to diagnose. People who suffer from this type of stress experience symptoms every day, not Just once in awhile.

They’re always in a rush, but always late. It may come from excessive competitive drive, aggressiveness, impatience, ceaseless worry and a harrying sense of time urgency. 3. Chronic stress While acute stress can be thrilling and exciting, chronic stress is not. Chronic stress destroys bodies, minds and lives. It’s the stress of poverty, of dysfunctional families, of being trapped in an unhappy marriage or in a despised Job or career. It’s the stress that the never-ending. Chronic stress comes when a person never sees a way out of a miserable situation.

It’s the stress of unrelenting demands and pressures for seemingly interminable periods of time. With no hope, the individual gives up searching for solutions. Coping with stress Managing stress is vital for survival and the health of a person. Following are the says of coping with stress: Managing the stresses Manage your behavior Manage your time Manage your stress Exercise and nutrition Relaxation Social support Managing stress Stress is not itself an illness but it can cause serious illness if not tackled.

Stress can affect how you feel, how you think, how you behave and how your body works. Sleeping problems, sweating, loss of appetite and difficulty concentrating are Oriented Approaches 2. Emotion-oriented Approaches Stress in a workplace has often been viewed as individual rather than stresses themselves being identified in a workplace. Although organizations are investing in tress management programmer, many currently lack understanding of sources of strain and of effective strategies to deal with them.

Stress management programmer are unlikely to maintain employee health and well-being without procedures being put in place for reducing or preventing environmental stresses. There has been an increasing awareness that stress management can be investigated in organization perspective. Stress management interventions (Simi) consists of prevention strategies and are defined as “any activity, program or opportunity initiated by an organization which focuses on reducing the presence of work related stresses or an insisting individual to minimizing negative outcomes of exposure of stresses. Organizations as well as individual stand to gain from minimizing stress in a workplace. Equally both can suffer when stress is mismanaged. The alternatives for minimizing the workplace stress can be referred as primary, secondary and tertiary levels of stress interventions. Primary intervention: it is an attempt to minimize source of stress by changing the socio-political environment to match individual needs which often results in the individual having more control over their work situation. Typically in organizational stress management this will involve management style or processes.

Examples of primary intervention are improvement in communication, modifying Job plans and involving employees in decision making within their organization. Primary interventions are often seen as the preventive approach to stress management Secondary intervention: Secondary interventions are those which help individuals to manage stress without altering the individual workplace stresses. An example would be the provision of stress management programmer to help individual identify stress and the effects on themselves. Such programmer are helpful in individual coping skills.

Tertiary intervention: These are hose designed to help individuals who develop symptoms resulting from stress at work. The purpose of these strategies is to help individuals is to adapt their behavior and lifestyle without changing without changing organizational practices. Types of stress management interventions (Semi’s) Organizational level interventions Selection and placement is the most effective way for organizations to ensure that individuals are suitable to fulfill the demand for the Jobs required to them. Organizations are also obligated to assess and ensure worker safety.

Training and education programmer help reduce stress by effective training and communicates he use of new work methods. Training may involve Job specific factors such as role issue, ambiguity and workload. Physical and environmental characteristics may prevent individuals from efficiently carrying out their work and can subject them to hazardous situations. Risk assessment and task analysis would assist employers to recognize any hazards prior to developing interventions to help deal with the risks. Organizational change. This helps to limit uncertainty.

Job design/restructuring increases the potential for employee’s empowerment in the degree to which employees have choice in their work. Low level of employee empowerment is associated with high level of stress such as anxiety, distress and heath complaints. Individual/organizational level interventions Co-worker support groups provide a supporting workplace environment that helps reduce stress by ‘sharing the load’. Personal environment fit is concerned with the principle that individual outcome are influenced by interaction of individual with their environment.

Thus there can be a mismatch between the expectation of individual and environmental resources required to fulfill those expectation or stress caused when the environmental demands overweight individual abilities. Role issues once clarified, as to individual place in an organization and task required to them, can minimize stress level. Conversely role conflict has been identified as a major source of work-related stress. Participation and autonomy involve collaboration between various organization members to achieve the shared desired outcome.

Individual level programmer can aid employees on individual basis by using any one of the following: Relaxation and meditation are generic methods used to help the individual develop coping mechanism to combat stress. This method can be delivered in an educated way to a group, by the development of stress management sessions. Biofeedback is useful intervention to provide individuals with a mean of self awareness which can often be developed under attendance on a stress management programmer.

Cognitive behavioral therapy (CUB) is a more structured and specialized psychological intervention which involves imagined exposure, graded self-exposure and cognitive (thought) therapy for beliefs about symptoms and the subsequent dropping of excessive safety behaviors. Emotional disturbance is caused by cognitive distortion that people make in dealing with their life experience. This theory consists of helping people to reconstruct their thinking. Stress can have consequences far beyond temporary feelings of pressure.

Stress in a workplace has negative effect on the performance of an individual and as well as an organization. It reduces the efficiency of the organizations. There is no doubt that stress is one of the leading factors in the illness of employees. It cannot be avoided but it can be leant to manage it by developing skills to cope with stress situations and events. A workplace that supports stress management through workplace wellness programs not only helps their employees to handle pressure better and stay healthier during times of tress, it also sends a message that their company cares about them.

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Company Directors to the issues of stress surrounding Johnston employees, offering solutions to ensure that company policies are kept up to date with moving times. This report is being written from the aspect of the new HRS Director at Johnston and will look at the day to day running of the packing department and what possible reasons might have led to an employee feeling stressed.

Once these issues have been established, the report will continue to look at practical solutions to resolve the highlighted issues and where total eradication is not possible, to dramatically reduce the effect of stress as far as humanly possible within his department. Finally, the report will go some way to introduce stress management techniques to the Company Directors, that when approved, can be implemented within the company to show that Johnston are proactively taking their “duty of care” seriously.

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Potential Solution With any company where the management show a lack of commitment to its workforce, they run the risk that the company will not adhere to current legislation I areas such as length of shift, the correct number of breaks etc etc. Of course, Johnston have three 8-hours shifts, but are these adhered to, or do employees woo longer due to increased demands? This should be reviewed and the results fully communicated not only to the Company Directors, but eventually to the employees, tit strict compliance guidelines. Fairness to all employees should also be considered.

Rotation of the 8-hour shifts I an option to be reviewed. Although from the author’s experience, varying the pattern too much can bring on or enhance ill health, due to upheaval of the body’s clock. Giving consideration to the medical point regarding changes to metabolism, Johnston should consider including in its recruitment process, a section on unsuitability for shift work on medical grounds, e. G. If a person already has metabolism issues, or suffers from bowel problems, then they run a high risk of suffering further by doing shifts. A final point that would assist shift workers at Johnston is support.

It is again by experience, that the author has assumed that the nightshirt do not receive the Sam support as the dissatisfy. This needs to be considered. 2. 2 Majority of Workforce is Female Due to a high percentage of employees being female, the author theorists that I turn, many of these workers may have prior commitments to family life and lead a “dual role” (www. Personality. Com/articles, 10/05/2006). This can have a knock o effect to make workers feel stressed at work. For example, a change in hours, even a dinner hour, might cause problems for a hillier in her lunch hour.

Britton and Gold support this theory by explaining that:- “A carefully worked out timetable can be upset and life thrown into chaos when your lunch hour is switched or you’re required to do overtime without notice” (Britton and Gold, 1994 p. 100). Potential Solutions Consider equality. Why do Johnston not have any or many male workers? At recruitment, this point should be considered further. It is possible to carry out a survey on the kind of people you have working for you, and with the results attempt to put into teams, those deemed to be compatible.

Should this be a project that the Company Directors wish to consider then as the HRS Director, the author can ensure that this is put in place. Expert, Elton Mayo noted that “work is a group activity’. (Carded, n. D. Week 3 handouts, p. L). Teamwork, therefore, may assist the female to socialist with the female workers they might otherwise “gossip” about and currently deal with on a “work only’ basis, as it is commonly known that some women prefer working with men rather than other women. 2. Intense working conditions With anything, if you are requested to work at a pace that is above a comfortable ace, then this pace cannot be kept up without having side effects. At work, should this continue for a period of time that is unsuitable to the individual worker (each worker will have different thresholds), with unrealistic deadlines, then this will cause the worker to feel overworked and consequently stressed; a feeling that they cannot cope with the working conditions for much longer. Incidentally, it is noted that work “does not activate employee’s upper level needs… ND may cause stress” (Britton & Gold, 1994, p. 98), where that work is repetitive and has a limited variety of tasks (e. . A packing department). Combined, the above two examples make for a high risk of stress within the packing department. Consideration should be given to increasing the workforce to ensure comfortable working conditions. (New legislation would demand this in any event). Profits may be affected by this, of course, but should employees feel that they are working to targets that are realistic, then common sense would suggest that stress and Shorter but more regular breaks may assist with repetitive work.

Just five minutes to compose yourself, can give you an extra lease of life. 2. 4 Casual workers Casual workers are employed to assist when the business is at its busiest. The permanent workers may feel put out to find that these workers are on a higher hourly rate than they are. To make matters worse, casual workers do not always put in the same time and effort and, therefore, do not always produce the same results as the permanent staff. On this basis, permanent workers may feel dissatisfied about the situation they are in.

Possibly having to rectify problems caused by the casual workers, yet knowing that the same workers get a higher rate of pay. This is a common problem that may cause disharmony between the workers. Greater monitoring of casual workers, (so the permanent workers do not feel they have to continually rectify mistakes) should be implemented. Should casual workers not be up to Johnston standard, then they should be dismissed, so the permanent workers can see that Johnston are taking steps to ensure that the high standards expected by the permanent staff, are also expected by casual workers.

Regarding rates of pay, there is little that can be done to match this as temporary staff are always paid at a higher rate due to the temporary nature of work. However, management could consider giving all permanent workers, some thank you vouchers, or possibly a bonus at the end of these busy contracts. Not only would this make the permanent workers feel appreciated, it would also work as an incentive. 2. 5 Unsuccessful Bonus Scheme It is good to have a bonus scheme.

This can be a beneficial incentive to show that workers are appreciated and their hard work does not go unnoticed. However, when you clearly have a bonus scheme that does not work, the opposite can occur. Bonus target is unrealistic, then it no longer becomes an incentive, but acts as a totally, to fuel unrest and resentment. In the packing department, due to the frequent breakdown of machinery, together with inadequate material and poor management (which will be covered in more detail below), it is not surprising that the targets cannot be met.

For those workers where the bonus is a very important aspect of their Job (some workers Just reside themselves to the fact that they will never get bonus and Just live with it), this can worker actually starts to feel stressed. Looking at the setbacks:- 0 Computer breakdown. As computers continually break, Johnston should look at avian an IT department permanently on site, who can fix most problems immediately, or invest in new hardware as required. This will have an impact on other parts of the business at the same time, to include better client service and an increase in productivity. Lack of materials. As the packing department continue to run out of materials, documented stock takes need to be carried out and be monitored by management. Why does stock continue to run out? Is it due to an increase in sales? These need to be considered further and the problem resolved, by possibly increasing stock levels. Lack of interest from management. By implementing the above two examples, this will send a message to the employees that the management have taken efficiency seriously. 0 Length between bonuses.

It is in the author’s experience that 6-monthly bonuses keep employees motivated far longer than a yearly bonus. On this basis, the author would like consideration to be given to amending the length between bonuses. Of course, bonus targets should be realistic despite the problems above. If the current targets set for Johnston are unrealistic then no matter how much stock you eve on site, or how good the machinery is, if the worker has no way of reaching the bonus, the result will be, “what is the point in trying! “. 2. Poor and Disinterested Management With poor and/or disinterested management, comes a breakdown in communication. Imagine trying to get a problem resolved and knowing that the person you need to report this problem to is not interested and/or will do little if nothing about it to help. This is the impression that must be eradicated from Johnston packing In order for an employee to feel that they are appreciated and their work is of importance, management need to show an interest in what is being done and on occasions where things genuinely do need changing, to make those changes with the employees on board.

Inevitably, after a period of the employee feeling they are being ignored, a “why to the best of their ability and have a compound effect on the remaining employees. However, Fontana argues that, “In certain circumstances, some people find it less stressful if they have no powers of decision… And do not have to antagonist over which choice to make” (Fontana, 1990 p. 34). Regular team briefings should be held by management, with possible updates on regress during the year, to include financial progress.

Possibly, if one or two particular workers have far exceeded their colleagues in a particular month, then Johnston could consider an “employee of the month” award, where it is noted that a particular worker has excelled in all they have done for that month and at the same time, they could receive an added bonus. Management should take the time out to speak to the employees and then using their own initiatives, they should seek to solve problems, such as the broken machinery and poor bonus schemes.

Actions speak louder than words and by the management fixing these problems, the employees will see that the management are listening and taking on board any comments made. A social committee would be a good way to bring workers together, possibly having 3 or 4 events during the year. These prove to be very successful team building exercises. It has already been established in 2. 2 above that teamwork may assist in reducing stress. 2. 7 Staff Absenteeism on the increase What happens if you wake up in the morning and get pit in the bottom of your stomach at the thought of going into work?

The thought of working in the same conditions makes you feel sick. You have a day off. Continue to feel this way and you will continue to have more days off. This is the problem that Johnston are experiencing excessively on a daily basis. Where the employee feels so stressed at work, they shall simply have more time off. Where this situation is not reviewed by management, then the situation will get worse, with the employee taking their complaint to the Doctor, where the employee may be signed off work due to long-term stress.

Absence due to stress is high, but generally there are reasons. Find out what the This is not as simplistic as it sounds, but it is achievable. The human relations movement would assist when reviewing staff absences, even in relation to stress. Motivation was deemed to play an important part for workers (Moscow and Herbert for example), each worker having their own motivational needs that if met, would ensure that their work was completed to a higher standard and that the worker was a happy one, (I. E. Stress free! ).

They continue to state that “One in five workers report feeling extremely stressed at work. This equates to 5 million in the UK”. (www. Cupid. Co. UK/sub]sects/health/stress, 18. 5. 06). This cannot be ignored. It is wise that Johnston are reviewing certain aspects of its business at this present time. Two fundamental areas should be included within the review:- Eradicating stress by liaising with the employees; Eradicating stress by reviewing the firm’s systems in general. Liaising with Employees 3. 1 The HOSE have produced a questionnaire of the top 35 reasons why an employee may feel stressed.

This is attached at Appendix 1. It would be sensible for Johnston to carry out this exercise, or a similar exercise, to collaborate the information and to thereafter meet to discuss the results. Ensuring that the questionnaire can be completed anonymously will ensure honest results are obtained. The HOSE have done a similar exercise to determine patterns of stress in the workplace. In 2005, they carried out a Psychological Working Conditions Survey. A further survey is being carried out in Spring 2006 and this will be covered in the What did they find?

The survey does not give details of the different types of Jobs, but does confirm that regional samples were taken. Stress Level Number of Employees Percentage Not at all stressful 246 16. 7% Mildly stressful 518 35. 1% Moderately stressful 487 33. 0% Very stressful 175 1 1. 9% Extremely stressful 48 3. 3 % 1474 (www. Hose. Gob. UK/statistics/stress, 18. . 06). It can be seen from the above, that 16. 7% of workers in this survey did not express feeling stressed at all. Although it is good to see the other end of the scale, where only 3. 3% of workers felt extreme stress, the reality is in this instance that 81. % of staff have and do experience stress. Of course, the results may vary should this be assigned to Johnston mail order packing department, but the author would strongly recommend such measures be taken to determine the results for Johnston. Looking at it in a different way (using the same information), it can be seen from the Histogram above, that “mildly” and “moderately” stressful far exceed all other categories. According to the HOSE “females were more likely to discuss stress with their line manager than males”. (www. Hose. Gob. UK/stress 18. 5. 06).

As Johnston workforce in the packing department are mainly female, this may prove to assist in dealing with the responses once collated. 3. 2 Reviewing the Systems in General 3. 2. 1 It is noted that employees are disheartened by constant breakdown of computers. Should calculations be carried out to determine how much lost time is accountable to broken machinery, this could go towards Johnston having an on-site IT department, which it is assumed they do not currently have. As computers are essential for the packing department, having an IT department should be seriously 3. . 2 Having reviewed the various packing materials on the market at this current time in relation to mail order, as the packing is done on site and for customers who could pick absolutely anything from Johnston mail order catalogue, the packing is mostly done by hand. Computers assist in order picking, and machines may assist in sealing, however, lack of packing materials is simply due to poor management and should not happen. There are many suppliers of packing materials, who can deliver “within 24 hours”:- 0 (www. Packaging. Co. UK,18. 5. 06,), or 0 (www. Spanking. Co. UK,18. 5. 06). The line managers will be requested to do a stock take in future, and to train staff regarding minimum stock levels. 3. 2. 3 Business Structure It is, of course, important to have a structure so that employees at all levels know what department they are in and who they are to report to. However, having the wrong structure can have its own problems. For example, a functional structure would not necessarily suit a small company with say 5 employees. Certain parts of the functional structure are not needed in this instance.

It is not clear what structure is currently in place at Johnston, however, in the way that tasks have been performed and by reviewing the information provided in order for this report to be prepared, it is highly likely that the mechanistic approach is in place , e. G. “no perceived confidence in superiors… Decision occurs only at the top of the organization… Managers not committed to developing organization’s human resources” (wry. Irreproachableness. Com/mechanistic, 19. 5. 06). This is an essential part of the business that should now be reviewed.

A structure needs to be defined and all employees, including managers, need to be informed of where their position is within the company, informing them to whom they report and what they should do should a problem arise. Having reviewed various structures, the author suggests that both functional and organic structures are possibilities for Johnston, ensuring decentralized authority, departments that can think for themselves and make suggestions that might be taken on board, getting away from the bureaucratic nature of the mechanistic approach.

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