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Stress Management in ICU in Hospitals

Discuss about the Interventions to Prevent and Reduce Physician.

Health care industry has been an important and the most essential part in the society. However working in a hospital with patients and care users increases stress level of the doctors and nurses working there. Patients require quality level care services especially in the Intensive Care Unit (ICU) (Bernstein et al., 2015). These patients are already in a critical situation that might case to death of the patient. Therefore, the stress level in the ICU is maximum. Various risks and threats are integrated with the work place at hospitals related to the health of the patients in the ICU. Wok-stress has been increasing in the ICU with the critical condition of the patients. According to survey, approximately 4.4 million patients are admitted in the ICU annually. Therefore, there is a huge number of critical patients in the ICU (Sandhu, Colon Barlow & Ferris, 2016). This create stress in the care providers in the hospitals.

This paper analyses the stress management for the ICU staffs in the hospitals. Various factors creating stress among care workers in the ICU will be analyzed and discussed. The research will focus on how health care providers manages their stress in the ICU. The study will use quantitative findings related to the workers in the ICU in hospitals.

Stress management has been an important topic among the researchers. Stress management in ICU in hospitals has been creating many disturbances in the services provided by hospitals. Stress can be defined as a scientific term for representing force that constrain excessive pressure on mental condition of human being (Hall et al., 2016). It might result in poor quality of care services provided to the patient. Stress negatively affect the person working in the ICU.

According to the survey, 75% of nurses have reported about decline in quality of services provided in the hospitals. 41% of the nurses have resigned from their jobs due to poor management in the hospitals (Kapoor et al., 2018). There have been difference in the ratio of the private and governmental hospitals. However, 63.8% nurses are working in the private sector and 36.2% nurses are in governmental sector. Therefore, the retention in the private sector hospitals has been more than that of governmental sector (Pruskowski et al., 2017).

In the context of UAE, the socioeconomic development of healthcare has been undergoing through massive expansion by its quality of services provided by care service providers. However, it has been reported about there has been shortage of experienced care workers in UAE. The redefinition of the care workers in the hospitals have been a major problem for the country. The major cause for might be the stress of staffs in the ICU (Chiang et al., 2016). The shortage in the nurses and staffs in the ICU has been creating problems in providing care services to the patients in the ICU. This research will throw light in the major issues in the hospitals for the retention of staffs in hospitals. The factors creating stress in staffs of ICU have been identified in the research. The impact of stress management in the staffs at ICU will be critically analyzed in the study. There will be some strategies recommended for mitigating these issues in the staffs at ICU.

Staff Shortage in Hospitals

The primary problem in the research has been the stress management in staff in the ICU. Stress has been the main problem for the staffs in the ICU. Therefore, staffs uses various strategies for coping with these stressors at work. However, in case, staffs do not know about coping with their stress at work, it creates problem for them to work in the ICU. This has been main reason for the retention of staffs from ICU and hospitals in the UAE.

The aim of the research is to analyze stress management for ICU staff in hospitals.

The objectives of the research are as follows:

  • To identify stress factors for staffs in the ICU in the UAE
  • To analyze causes for stress in staffs in the ICU
  • To recommend strategies for mitigating these issues related to stress of staffs in the ICU

The research questions has been listed below:

  • What are the stress factors for staffs in the ICU in the UAE?
  • What are causes for stress in staffs in the ICU?
  • How these issues related to stress of staffs in the ICU can be mitigated?

As commented by Katinakis & Spronk, (2016), stress is a non-specific response of the body in contact with any unfavorable condition. Stress is a physical and emotional response to an experience that can create imbalance between expectations and reality. Stress is defined as the pressure from some environment which may be workplace or family. Experiencing stress can be a risky procedure for an individual. The negative outcome of the stress can affect mental condition of a human being in society (Kemper et al., 2016). In most in the case, stress acts as a negative response of an individual to a condition. Several conditions have created conditions for an individual for changing the mental health of an individual. Stress can come from any situation that can affect an individual in different ways. However, stress is a normal part of life. As argued by Bannon et al., (2018), stress can motivate people to bounce back from the unfavorable condition in life. Various mental condition can help in maintaining the stress and recover from it.

It is important to make people understand that, the stress is part of everyone's life and management of stress can help them to improve their personality as problem solvers and have more control on their life as well as on their emotions. Stress can be triggered due to some unexpected positive or negative events in someone's life. With increasing and continuous stress at workplace, employees develop physiological and psychological dysfunctions in their attitude. In addition to that decreased motivation due to the stress acts as a hindrance in excelling in their career.   One of the major reasons that generate stress for an employee includes hostile work environment, increased workload, and downsizing of the organizational workforce as well as shift. Moreover, uncertainty about job security in private organizations, interpersonal conflicts between the employees (as well as with supervisors) at the workplace, and lack of job abilities also reasons for occupational stress. Generic symptoms that affect people include headaches, muscular aches, fatigue, sleep disturbances, body pains, chronic illness and most importantly eating disorders due to the hectic work schedule.

Aim, Objectives and Questions

Research methodology is a scientific approach that helps in providing proper approach to complete the research. Research methodology consist of research philosophy, approach, design, data collection method, sample size, data analysis, limitations and ethical consideration. The research philosophy is of two types including positivism and interpretivism. Positivism refers to analysis of the hypothesis and scientifically methods included on the research. Positivism depends on the true facts of the theories and models of research. On the other hand, interpretivism is just opposite of the positivism philosophy. Therefore, the researcher will select the positivism philosophy in this research (Taylor, Bogdan & DeVault, 2015). The research approach is of two types including inductive and deductive approach. Deductive approach focuses on the objectives and questions of the research (Alvesson & Sköldberg, 2017). This helps in maintaining a correct path for the completion of the research. Inductive research does not focuses on the objectives of the research. Therefore, the researcher have selected deductive research approach. There are three sorts of research design including explanatory, exploratory and descriptive research design. The exploratory research design focuses on the long-term procedure of the research. Therefore, thus research design is linked with the inductive research approach. Explanatory research design focuses on connecting to the different ideas and thoughts related to the research topic (Lewis, 2015). The use of the explanatory research design helps in identifying new techniques to be used in order to find out the factors of the stress in the staffs. On the other hand, descriptive research design helps in providing extra detail to the research topic. Descriptive research design will be used in this research that might help in providing a better strategy for the completing the research on time. This research design helps in providing a better picture of the overall research (Mackey & Gass, 2015).


Data and information can be collected from two methods including primary and secondary data collection method. Primary data collection method helps in collecting data form the primary sources including respondents in the survey. On the other hand, secondary data helps in collecting data from the secondary data sources including online journals, books, reports and governmental databases. The researcher will use primary data collection method in this research for collecting data and information (Silverman, 2016).

Online survey will be conducted in order to collect raw data related to the stress management. Online survey questionnaires are will be created using the google forms and will be uploaded over the website (Smith, 2015). There will be 100 staffs selected as respondents for the online survey. These staffs have been working in the ICU units of various hospitals. There will be 10 close-ended survey questions related to the stress management of staffs in the ICU will be included in the survey questionnaires. Answers of the respondents will be taken as data and information for the research. Qualitative data will be collected by conducting interview with three managers of hospitals. The views and answers of the managers will be taken as data and information for the research (Ledford & Gast, 2018).

Understanding Stress

Data analysis is of two types’ including quantitative and qualitative data analysis. The quantitative data analysis method refers to analysis of the data and information from the primary sources. The qualitative data analysis data analysis method refers to the analysis of the data and information collected from the secondary data collection method (Vaioleti, 2016). Therefore, the researcher will use the quantitative data analysis method. The online survey questionnaires will help in collecting data and information rejected to the stress management in the staffs of the ICU. Data will be properly analyzed with the help of the tables, charts and graphs. The presentation of the results and outcomes of the analysis will be done with the help of Likert scale ranging from 1 to 5.

However, there might be some limitations during the data collection method. Online survey firm might not be properly filled by the respondents. The answers if the questions might be filled haphazardly by the participants. Respondents might fill the survey form by getting affected by the current form of the sector. Some of the participants might not provide proper answers to each questions (Neuman & Robson, 2014). The time and budget of the research might create a problematic situation for the researcher. The timeline for the research might be enough to complete properly on time. However, the researcher will try to complete the research on deadline. The budget of the research might be a problem for the researcher due to which the researcher might be able to use advanced techniques for data analysis (Ary, Jacobs, Irvine & Walker, 2018). The research will follow all the ethical consideration. Data and information of the survey participants will not be revealed to anyone under the Data Protection Act 1998. The results and outcomes of the research will not be published before the completion of the research.

Stress management has been an important for individuals at work. The step for managing the stress in the organization is to identify the sources and causes of stress in the organization (Sharma et al., 2014). Various interventions needs to be taken by the organization to maintaining and control the stress in the company. There are various techniques by which the stress can be minimized and a change can be made using the HSC model.

Prevention: As commented by West et al., (2016), prevention helps in addressing the cause of the problem. The removal of the work-stressor needs to be initiated to change different aspects of the management. However, there are various effective preventive activities based on targeted employees. Stress can be defined as a scientific term for representing force that constrain excessive pressure on mental condition of human being. It might result in poor quality of care services provided to the patient. Stress negatively affect the person working in the ICU (Oh et al., 2015).

Proposed Research Team

Timely action: Timely actions helps in improving the organization ability in the market. The stress in the individual destroys the mental condition of the individual. Therefore, training of managers and other high level management of the organization. The management needs to be aware of the actions and styles of the management (Becker, Wright & Schmit, 2017). The change in the organizational structure might help in maintaining the stress factors in the staffs of the organization. The use of various factors in the organization helps in taking actions for the change in the management implications. Various policies and procedures have been implemented in the organization for the improvement of managing policies.


Treating the effects: As commented by Manwatkar & Mathew (2016), treatment of the employees for helping them to cope out of the stress. Some rehabilitation policies needs to be implemented in the organization for the development of the emotional strength of staffs.

Motivation sessions needs to be implemented in the organization that might help in motivating employees in the organization. The use of motivational factors provided by the managers of the organization needs ti be maintained by the staffs of the organization.

As commented by Katinakis & Spronk, (2016), signs and symptoms of stress can be depended on several factors in the external environment.

There are various external and internal factors creating stress in an individual. Stress can affect very badly to an individual.


Therefore, it is necessary to manage stress in proper way. Management of stress requires identifying signs and symptoms of stress. This might help in minimizing serious effect of stress on the health of an individual.

There are some signs and symptoms of stress have been listed below:

Cognitive Symptoms:

·       Memory Problems

·       Inability or difficulty concentrating

·       Poor judgment

·       Seeing only the negative

·       Anxious, racing, or ruminating thoughts  Constant worrying

Emotional Symptoms:

·       Moodiness

·       Short-tempered

·       Agitation, inability to relax

·       Feeling overwhelmed

·       Sense of loneliness or isolation

·       Depression or general unhappiness

Physical Symptoms:

·       Aches and pains, muscle tension

·       Diarrhea or constipation

·       Nausea, dizziness, or butterflies in the stomach

·       Chest pain or rapid heartbeat

·       Loss of sex drive

·       Frequent colds

·       Shallow breathing and sweating

Behavioral Symptoms

·       Eating more or less

·       Sleeping too much or too little

·       Isolating yourself from others

·       Procrastinating

·       Using alcohol, cigarettes, or drugs to relax 


Table 1: Signs and symptoms of stress

These signs and symptoms help in minimizing stress of an individual. These symptoms and signs are all indications of level of stress, which is not healthy. These signs and symptoms are necessary for maintaining the stress of an individual and providing them solution to mitigate these stresses.

Task Name

Duration

Start

Finish

Stress Management for ICU staff

93 days

Mon 6/4/18

Wed 10/10/18

   Study Initiation

11 days

Mon 6/4/18

Mon 6/18/18

      Study Requirements Analysis

2 days

Mon 6/4/18

Tue 6/5/18

      Approval of Research Topic from Supervisor

1 day

Wed 6/6/18

Wed 6/6/18

      Development of Research Plan Charter / Document

2 days

Thu 6/7/18

Fri 6/8/18

      Development of Research Framework

4 days

Mon 6/11/18

Thu 6/14/18

      Prepare Draft Research Proposal

2 days

Fri 6/15/18

Mon 6/18/18

   Research Planning

21 days

Tue 6/19/18

Tue 7/17/18

      Formation of Research Team

2 days

Tue 6/19/18

Wed 6/20/18

      Analysis of Research Requirement

1 day

Thu 6/21/18

Thu 6/21/18

      Identification of Research Questions

4 days

Fri 6/22/18

Wed 6/27/18

      Identify Scope of Research

4 days

Thu 6/28/18

Tue 7/3/18

      Estimate Research Timeline

4 days

Wed 7/4/18

Mon 7/9/18

      Allocation of Resources and Time for the Research

2 days

Tue 7/10/18

Wed 7/11/18

      Initiation of Research

4 days

Thu 7/12/18

Tue 7/17/18

   Research Development

26 days

Wed 7/18/18

Wed 8/22/18

      Determination of Research Problems

4 days

Wed 7/18/18

Mon 7/23/18

      Access to Necessary Media

1 day

Tue 7/24/18

Tue 7/24/18

      Access to Online Library

1 day

Tue 7/24/18

Tue 7/24/18

      Selection of Literary Sources

2 days

Wed 7/25/18

Thu 7/26/18

      Literature Review

4 days

Fri 7/27/18

Wed 8/1/18

      Collection of Necessary Data

10 days

Thu 8/2/18

Wed 8/15/18

      Collection of Secondary Data

5 days

Thu 8/16/18

Wed 8/22/18

   Data Analysis

8 days

Thu 8/23/18

Mon 9/3/18

      Analysis of Primary Data

4 days

Thu 8/23/18

Tue 8/28/18

      Analysis of Secondary Data

4 days

Wed 8/29/18

Mon 9/3/18

   Research Evaluation

13 days

Tue 9/4/18

Thu 9/20/18

      Evaluation of Data

6 days

Tue 9/4/18

Tue 9/11/18

      Reflection on Research Undertaken

2 days

Wed 9/12/18

Thu 9/13/18

      Documentation of Learning Outcomes

2 days

Wed 9/12/18

Thu 9/13/18

      Issues Identification and Future Planning

5 days

Fri 9/14/18

Thu 9/20/18

   Research Closure

14 days

Fri 9/21/18

Wed 10/10/18

      Complete All Activities in Research

1 day

Fri 9/21/18

Fri 9/21/18

      Documentation of Entire Research

10 days

Mon 9/24/18

Fri 10/5/18

      Validation of the Research and Learning

2 days

Mon 10/8/18

Tue 10/9/18

      Team Sign Off

1 day

Wed 10/10/18

Wed 10/10/18

References

Alvesson, M., & Sköldberg, K. (2017). Reflexive methodology: New vistas for qualitative research. Sage.

Ary, D., Jacobs, L. C., Irvine, C. K. S., & Walker, D. (2018). Introduction to research in education. Cengage Learning.

Bannon, L., McGaughey, J., Clarke, M., McAuley, D. F., & Blackwood, B. (2018). Designing a nurse-delivered delirium bundle: What intensive care unit staff, survivors, and their families think?. Australian Critical Care.

Becker, C. A., Wright, G., & Schmit, K. (2017). Perceptions of dying well and distressing death by acute care nurses. Applied Nursing Research, 33, 149-154.

Bernstein, A. M., Kobs, A., Bar, J., Fay, S., Doyle, J., Golubic, M., & Roizen, M. F. (2015). Yoga for stress management among intensive care unit staff: A pilot study. Alternative and Complementary Therapies, 21(3), 111-115.

Chiang, V. C. L., Chien, W. T., Wong, H. T., Lee, R. L. P., Ha, J., Leung, S. S. K., & Wong, D. F. K. (2016). A brief cognitive-behavioral psycho-education (B-CBE) program for managing stress and anxiety of main family caregivers of patients in the intensive care unit. International journal of environmental research and public health, 13(10), 962.

Denzin, N. K. (2017). The research act: A theoretical introduction to sociological methods. Routledge.

Hall, L. H., Johnson, J., Watt, I., Tsipa, A., & O’Connor, D. B. (2016). Healthcare staff wellbeing, burnout, and patient safety: a systematic review. PLoS One, 11(7), e0159015.

Kapoor, S., Morgan, C. K., Siddique, M. A., & Guntupalli, K. K. (2018). “Sacred Pause” in the ICU: Evaluation of a Ritual and Intervention to Lower Distress and Burnout. American Journal of Hospice and Palliative Medicine®, 104.

Katinakis, P. A., & Spronk, P. E. (2016). The Effects Of Structural Crew Resource Management (CRM)/Medical Team Work (MTW) Training In The ICU, The MTW Impact And Evaluation Study. In B35. INNOVATIONS IN MEDICAL EDUCATION (pp. A3207-A3207). American Thoracic Society.

Kemper, P. F., de Bruijne, M., van Dyck, C., So, R. L., Tangkau, P., & Wagner, C. (2016). Crew resource management training in the intensive care unit. A multisite controlled before–after study. BMJ Qual Saf, bmjqs-2015.

Ledford, J. R., & Gast, D. L. (2018). Single case research methodology: Applications in special education and behavioral sciences. Routledge.

Lewis, S. (2015). Qualitative inquiry and research design: Choosing among five approaches. Health promotion practice, 16(4), 473-475.

Mackey, A., & Gass, S. M. (2015). Second language research: Methodology and design. Routledge.

Manwatkar, S., & Mathew, S. (2016). A Study To Assess The Effectiveness Of Self Instructional Module Among Staff Nurses Regarding Stress Management In Selected Hospitals Of The City. IOSR Journal of Nursing and Health Science, 5(4), 01-03.

Neuman, W. L., & Robson, K. (2014). Basics of social research. Pearson Canada.

Oh, H., Lee, S., Kim, J., Lee, E., Min, H., Cho, O., & Seo, W. (2015). Clinical validity of a relocation stress scale for the families of patients transferred from intensive care units. Journal of clinical nursing, 24(13-14), 1805-1814.

Pruskowski, K. A., Rizzo, J. A., Shields, B. A., Chan, R. K., Driscoll, I. R., Rowan, M. P., & Chung, K. K. (2017). A Survey of Temperature Management Practices among Burn Centers in North America. Journal of Burn Care & Research.

Sandhu, G., Colon, J., Barlow, D., & Ferris, D. (2016). Daily informal multidisciplinary intensive care unit operational debriefing provides effective support for intensive care unit nurses. Dimensions of Critical Care Nursing, 35(4), 175-180.

Sharma, P., Davey, A., Davey, S., Shukla, A., Shrivastava, K., & Bansal, R. (2014). Occupational stress among staff nurses: Controlling the risk to health. Indian journal of occupational and environmental medicine, 18(2), 52.

Silverman, D. (Ed.). (2016). Qualitative research. Sage.

Smith, J. A. (Ed.). (2015). Qualitative psychology: A practical guide to research methods. Sage.

Taylor, S. J., Bogdan, R., & DeVault, M. (2015). Introduction to qualitative research methods: A guidebook and resource. John Wiley & Sons.

Vaioleti, T. M. (2016). Talanoa research methodology: A developing position on Pacific research. Waikato Journal of Education, 12(1).

West, C. P., Dyrbye, L. N., Erwin, P. J., & Shanafelt, T. D. (2016). Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis. The Lancet, 388(10057), 2272-2281.

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