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NURS 3560 > Week 12: Healthy Work Environments and Moral Distress > Flashcards

Week 12: Healthy Work Environments and Moral Distress Flashcards

1
Q

Quality Practice Environments

A

“A quality practice environment supports the delivery of safe, compassionate, competent and ethical care while maximizing the health of clients and nurses

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2
Q

Characteristics of a Quality Practice Environment

A

Communication and collaboration
Responsibility and accountability
Safe and realistic workload
Leadership
Technology and tools
Professional development
Workplace culture

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3
Q

Workplace health and safety rights

A

Right to know about hazards
Right bring forward WHS concerns
Right to refuse unsafe work
Freedom from discriminatory action

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4
Q

Workplace health and safety responsibilities

A

Employee
Follow all health and safety rules
Cooperate with health and safety committee

Employer
Provide safety equipment
Training

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5
Q

Addressing disruptive behaviour

A
  • Policies and Procedures
    • Zero-tolerance/respectful workplace policies
    • Procedures re: disciplinary action
  • Education – awareness of issue, conflict resolution
  • Attention to communication skills
  • Confront the behaviors and report
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6
Q

Preventing violence in the workplace

A
  • Assessing risk
  • Developing violence prevention policy
  • Providing information to employees
  • Investigate incidents
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7
Q

Mitigating conflict situations

A
  • Support each other
  • Advocate for safe and healthy workplaces
  • Address specific incidents with the individual
  • Make a complaint through the proper channels
  • Confront – use facts and experiences
  • Rehearse responses
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8
Q

Nonverbal cues/ nonverbal innuendo

A

Eye rolling
Making faces in response to questions

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9
Q

Withholding information

A

Deliberately withholding information

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10
Q

Scapegoating

A

Blaming negative outcomes on one identified nurse without regard to their actual responsibility for those outcomes

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11
Q

Verbal remarks/ verbal affront

A

Snide, rude, demeaning comments
Shouting
Using a condescending or patronizing tone of voice

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12
Q

Sabotage

A

Deliberately setting up another nurse for failure

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13
Q

Passive aggressive behaviour

A

Backstabbing
Complaining to others about a person but not speaking to that person directly

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14
Q

Actions/ inactions

A

Refusing assistance
Allocating unrealistic workloads
Hoarding or hiding supplies

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15
Q

Infighting

A

Excluding members of staff from communication

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16
Q

Broken confidences

A

Gossiping
Sharing information that is meant to be private

17
Q

Unreasonable burden

A

“may exist when a nurse’s ability to provide care and meet professional standards of practice is compromised by unreasonable expectations, lack of resources or ongoing threats to personal and family well-being”

18
Q

Moral distress AKA ethical distress

A
  • Occurs when you know the ethically correct action to take but are constrained from taking it (AACN, ND)
  • When constraints interfere with acting in the way one knows to be ethically right (CNA 2003)
    • Physical, emotional and psychological symptoms
    • Causes can vary
19
Q

The factors or barriers that prevent nurses from doing what they believe to be morally right include:

A
  1. Clinical Situations
  2. Factors internal to the caregiver
  3. External/environmental factors
20
Q

Factors internal to caregiver preventing nurse from doing what is right

A

Nurse’s personal value (eg. MAID)
Lack of training
Relational issues (assignment is rude, racist, abusive or disrespectful)

21
Q

External factors preventing nurse from doing what is right

A

Power imbalances (lacking skill, knowledge, or resources to make values heard)
Policy, law or standards (be supportive or complicating)
Structural inequity (preventable differences in opportunities and outcomes due to social determinants of health)
Limited resources (working with too few staff, high nurse to patient ratio, not enough equipment)

22
Q

External factors preventing nurse from doing what is right

A

Power imbalances
Policy, law or standards
Structural inequity
Limited resources

23
Q

Consequences of moral distress

A

Physical symptoms, emotional turmoil, behavioural consequences
Job dissatisfaction
Disengage/ avoidance
Judge/ blame others
Desire to leave their job/ profession

24
Q

Four components of addressing moral distress

A
  1. Determine what you are experiencing
  2. Gauge the severity of your distress
  3. Identify the causes and constraints
  4. Take action to help you move forward
25
Q

Ways to reduce or prevent moral distress

A

System reform
Mediation, consultation
Education
Conflict resolution, interdisciplinary collaboration, debriefing
Grief counseling and EAP programs

26
Q

Whistleblowing

A

Disclosure of unethical or unsafe practice that creates substantial danger to the life, health or safety of persons, or to the environment
Code of ethics requires nurses to address the issue with the person if possible
Required to report concerns to the appropriate authority if unsuccessful
Disclosures are NOT anonymous
Whistleblowing carries significant personal risks despite protections in law

27
Q

Whistleblower protections

A

Public Interest Disclosure Act facilitates the disclosure of wrongdoing
Protects whistleblowers from reprisal

This means that it is illegal to punish or discipline anyone who reports a wrongdoing in good faith.

28
Q

Nurse burnout involves…

A

the emotional and physical exhaustion that comes with the stressful responsibilities required for nursing. In comparison, compassion fatigue results when prolonged emotional strain culminates in detachment and difficulties in providing empathetic care.

29
Q

Compassion fatigue comes from…

A

working with victims of trauma, although this is not necessarily the case for nurse burnout. Compassion fatigue can also appear more quickly than nurse burnout and can even cause anger or existential despair.

30
Q

Debrief

A
  1. Determine what you are experiencing.
    How would you know if this is moral distress, burnout, or compassion fatigue?
  2. Gauge the severity of your distress.
    How would you determine how significantly you are affected by the situation?
    How would you use this self-assessment to prioritize the actions you will take?
  3. Identify the causes and constraints.
    What was the ethically right thing to do?
    What constraints stopped that from happening?
  4. Take action to help you move forward.
    What resources or strategies might help to address your distress? – Code of Ethics encourages advocacy under Promoting Health and Well Being

NURS 3560 (7 decks)

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