Emerging Models
Open Resources for Nursing (Open RN) and Amy Ertwine
With the increased emphasis on the impact of stress for health care professionals, many organizations and nursing programs have identified resources for formal stress reduction and mitigation. See Figure 12.7[1] for an illustration of stress management. Many of these models and resources have emerged as a professional necessity to help facilitate coping for individuals encountering innumerable job-related stressors. The U.S. Department of Veterans Affairs developed a Stress First Aid (SFA) framework to improve stress management in oneself and in others.[2] Many organizations are moving to frameworks such as the Stress First Aid framework and other stress management programs to help provide health care professionals with the knowledge, skills, and resources to aid in stress management reduction.
The Stress First Aid (SFA) framework offers the health care professional an opportunity to examine stress along a continuum, from normal stress that allows for adaptive functioning to signs of harmful stress requiring intensive intervention. It provides health care professionals with core functions for progressing through stress identification and resolution. The seven core functions are: Check, Coordinate, Cover, Calm, Connect, Competence, and Confidence.[3] The SFA model encourages health care professionals to self-reflect on a stress experience and take action to facilitate self-resolution and resource identification.
Many health care organizations embrace wellness as a foundational tenet of workplace culture. They have dedicated wellness committees or wellness champions who promote initiatives aimed at improving stress management among staff.[4] These formalized committees or positions reflect organizational commitment to the importance of self-care and personal wellness. When nursing graduates are interviewing for their first nursing positions, wellness initiatives may be a consideration when exploring professional employment benefits and organizational support structures.
The impact of wellness and stress-reduction strategies is often included in new hire orientation and nurse residency programs. Many nurse residency programs formally acknowledge in their curriculum that novice nurses must be educated about the signs of stress.[5] Novice nurses are particularly vulnerable to harmful stressors during their role transition. Many organizations provide training about strategies and resources to assist with coping and stress reduction, which is referred to as resiliency training programs.[6] Resiliency training fosters feelings of mindfulness, sensitivity to self, and professional development techniques that contribute to long-term engagement in the profession.
Read about ways to manage stress from the U.S. Department of Health and Human Services Office on Women’s Health.
Media Attributions
- stress-management
- “stress-management.html” by Nick Youngson is licensed under CC BY-SA 3.0 ↵
- U.S. Department of Veteran Affairs. (2021, September 21). Stress first aid: Manual and resources for health care workers. https://www.ptsd.va.gov/professional/treat/type/stress_first_aid.asp ↵
- U.S. Department of Veteran Affairs. (2021, September 21). Stress first aid: Manual and resources for health care workers. https://www.ptsd.va.gov/professional/treat/type/stress_first_aid.asp ↵
- Mayzell, G. (2020). The resilient healthcare organization: How to reduce physician and healthcare worker burnout (1st ed.). Productivity Press. https://doi.org/10.4324/9780429286025 ↵
- Chesak, S. S., Morin, K. H., Cutshall, S., Carlson, M., Joswiak, M. E., Ridgeway, J. L., Vickers, K. S., & Sood, A. (2019). Stress management and resiliency training in a nurse residency program: Findings from participant focus groups. Journal for Nurses in Professional Development, 35(6), 337-343. https://doi.org/10.1097/NND.0000000000000589 ↵
- Chesak, S. S., Morin, K. H., Cutshall, S., Carlson, M., Joswiak, M. E., Ridgeway, J. L., Vickers, K. S., & Sood, A. (2019). Stress management and resiliency training in a nurse residency program: Findings from participant focus groups. Journal for Nurses in Professional Development, 35(6), 337-343. https://doi.org/10.1097/NND.0000000000000589 ↵
Concept: Perfusion
Definition: Perfusion is defined as the exchange of blood, gases, and fluids between the vessels, tissues, and organ systems
Exemplars:
- Vascular dysfunctions (hypertension, vascular insufficiency)
- Cardiac dysfunctions (heart failure, infectious / inflammatory heart disease)
- Hematologic dysfunctions (clotting disorders, anemia, blood transfusions)
Course Objectives: related to Perfusion
Upon completion of this course students will be able to:
- apply the nursing process to meet the homeostasis, perfusion, oxygenation, and metabolism needs of patients in acute care settings; [I, II] (7)
- recognize abnormalities when performing focused patient assessments then effectively communicate and document this information appropriately; [I] (7, 11)
- use informatics to assist patients in improving health outcomes; [II, IV] (4)
- design patient-centered teaching plans for patients with alterations in homeostasis, perfusion, oxygenation, and metabolism; [I] (12)
- apply pharmacodynamic principles when administering medications that affect perfusion; [I, II, IV] (8, 10, 11)
- compare the abnormalities that can occur in the arterial and venous circulatory system; [II] 13)
Overview: Perfusion
This unit introduces the student to the concept of Perfusion from assessment through evaluation. Assessment of normal physiology and the recognition of and interventions for common abnormalities will be discussed. Nursing care focuses on optimizing circulation and teaching methods to maintain circulation and prevent interruption of movement of blood, fluids, and gases throughout the body. Emphasis will be placed on assessment skills and working with IV therapies. Medication knowledge and administration plays an important part within this concept Exemplars for this class regarding perfusion are hypertension, vascular insufficiency, heart failure, infectious/inflammatory heart disease, clotting disorders, anemia, and blood transfusions.
Unit Objectives: Perfusion
At the conclusion of this unit the student will be able to:
Assessment
- summarize the exchange of blood, gases, and fluids between the vessels, tissues, and organ systems;
- compare and contrast between normal and abnormal perfusion assessments;
- discuss major patient risk factors across the life span that could interfere with optimal perfusion;
- discuss nursing care to support psychosocial concepts related to patients with perfusion dysfunction;
- explain the pathophysiology of the select perfusion exemplars;
- interpretpertinent laboratory and diagnostic findings for patients experiencing perfusion disturbances;
- compare and contrast blood products available for transfusion;
Plan
- describe Complementary and Alternative Medicine (CAM) agents that can influence perfusion;
- develop a plan of care, utilizing the nursing process, for patients with perfusion dysfunction;
- identify the priority nursing diagnoses most appropriate for a patient with a perfusion dysfunction;
- describe the health promotion activities that decrease the incidence of perfusion dysfunction;
- identify community-based health care resources to assist a patient that requires support to meet perfusion needs;
Implementation
- describe the nursing interventions and the related evidence based practices that can be used to optimize perfusion;
- discuss the collaborative modes of therapy and the nursing management of patients with
perfusion dysfunction;
- apply essential pharmacological principals to the management of patients with perfusion
dysfunction;
- identify the specific learning needs that promote self-management in the patient with
perfusion dysfunction;
- describe the nursing interventions for safe administration of blood products;
Evaluation
- discuss related bio-physical concepts and how they are used to evaluate the care of
patient with perfusion dysfunction;
- evaluate the effectiveness of nursing care in patients with a perfusion dysfunction; and
- evaluate the potential problems which could cause adverse reactions during the
transfusion of blood products.
