Resuscitation in general medical wards: who decides?

Ganz, Freda DeKeyser; Kaufman, Nechama; Israel, Sima; Einav, Sharon

doi:10.1111/j.1365-2702.2012.04240.x

Cited by 8 publications

(3 citation statements)

References 25 publications

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“…post-code stress) and the use of ineffective coping behaviors (Mealer, et al, 2007). Existing literature confirms that critical care nurses who participate in CPR report feelings of anxiety, grief, regret, anger, futility and helplessness, which may further exacerbate their subsequent levels of postcode stress (McMeekin, et al, 2017;Ganz, et al, 2013;Hinderer, 2012;Kelly, et al, 2008). The literature also documents a variety of coping behaviors to alleviate or often suppress emotions created by stress.…”

Section: Discussionmentioning

confidence: 99%

Experiencing Stress among Nurses during Resuscitation Procedure and Legal Obligations for Healthcare Workers in Slovenia

Koželj

Strauss

Strnad

2020

mls

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Nurses are always part of the team that performs resuscitation procedures. In this paper the authors explore the influence that resuscitation procedures on nurses who perform them. For data collection, the authors used a survey with a convenience sample of nurses who work in emergency settings. For statistical processing of data, the authors used the calculation of frequency, standard deviation, means, and median. Authors used Spearman's rank correlation coefficient and calculated the p-value. The respondents in the survey completed the Post-Code Stress Scale. The results show that the majority of the respondents experienced resuscitation cases as burdensome situations; however, the level of stress was moderate. Nurses still experience some physical and psychological symptoms during resuscitations.

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Section: Discussionmentioning

confidence: 99%

Experiencing Stress among Nurses during Resuscitation Procedure and Legal Obligations for Healthcare Workers in Slovenia

Koželj

Strauss

Strnad

2020

mls

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“…14 In the extant literature, critical care nurses who participate in cardiopulmonary resuscitations report feelings of anxiety, grief, regret, anger, futility and helplessness, which may further exacerbate their subsequent levels of postcode stress. 3,14,[19][20][21] Critical care nurses demonstrate a variety of coping behaviors to alleviate or often suppress emotions created by stress. 15,22,23 Critical and acute care…”

Section: Introductionmentioning

confidence: 99%

Stress and Coping of Critical Care Nurses After Unsuccessful Cardiopulmonary Resuscitation

McMeekin

Hickman

Douglas

et al. 2017

American Journal of Critical Care

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Background Participation by a critical care nurse in an unsuccessful resuscitation can create a unique heightened level of psychological stress referred to as postcode stress, activation of coping behaviors, and symptoms of posttraumatic stress disorder (PTSD). Objectives To explore the relationships among postcode stress, coping behaviors, and PTSD symptom severity in critical care nurses after experiencing unsuccessful cardiopulmonary resuscitations and to see whether institutional support attenuates these repeated psychological traumas. Methods A national sample of 490 critical care nurses was recruited from the American Association of CriticalCare Nurses' eNewsline and social media. Participants completed the Post-Code Stress Scale, the Brief COPE (abbreviated), and the Impact of Event Scale-Revised, which were administered through an online survey. Results Postcode stress and PTSD symptom severity were weakly associated (r = 0.20, P = .01). No significant associations between coping behaviors and postcode stress were found. Four coping behaviors (denial, selfdistraction, self-blame, and behavioral disengagement) were significant predictors of PTSD symptom severity. Severity of postcode stress and PTSD symptoms varied with the availability of institutional support. Conclusions Critical care nurses show moderate levels of postcode stress and PTSD symptoms when asked to recall an unsuccessful resuscitation and the coping behaviors used. Identifying the critical care nurses most at risk for PTSD will inform the development of interventional research to promote critical care nurses' psychological well-being and reduce their attrition from the profession. (American Journal of Critical Care. 2017; 26:128-135) [1][2][3][4] It is estimated that between 40% and 84% of all resuscitation attempts within critical care units result in immediate or imminent death of the patient within 24 hours. [1][2][3]5,6 Because critical care nurses have frequent and cumulative exposures to unsuccessful cardiopulmonary resuscitations, psychological trauma often ensues. 7 The literature in this area is nascent. Despite a growing workforce demand for registered nurses in critical care, turnover and vacancy rates are high.7,8 Investigation of the cumulative psychological injuries associated with unsuccessful cardiopulmonary resuscitation is warranted and may offer new insights on strategies to attenuate the psychological morbidity associated with providing life-sustaining care and highlight a need for psychological support processes that may aid in the retention of critical care nurses in the workforce.The influence of postcode stress and coping behaviors on the psychological health of critical care nurses is unclear. However, it is hypothesized that critical care nurses who are exposed to the psychological trauma of cardiopulmonary resuscitation efforts that fail to prolong the patient's life will perceive heightened states of postcode stress, coping behaviors, and lower states of psychological health. Therefore the aims of this art...

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“…[8] Despite this, only a small part of nurses reports that they were actually consulted. [9] Regarding the consent to the DNAR order, nurses claim the need to involve patient and family members in the decisionmaking process and the necessity to provide them all the informations relating the resuscitation policies from the moment of the admission in the ward. [10] The responsibility to inform and receive the patient's consent for the DNAR order is attributed only to physicians.…”

Section: Introductionmentioning

confidence: 99%

Nurses and guideline for interrupting or not initiating CPR: An exploratory survey

Agnoletto

Gastaldo

Padrin

2019

CNS

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Objective: An area that still causes difficulties and a sense of inadequacy in healthcare providers is related to Do Not Attempt Resuscitation decision (DNAR). The aim of the study is to investigate knowledge, opinions and behaviors of nurses about DNAR in order to plan appropriate improvement interventions. Methods: An anonymous questionnaire was administered to 207 nurses belonging to four Medicine Departments and to four Intensive Care areas. The questionnaire, which consists of 29 items, collects some information related to work experience and investigates opinions and behaviors of nurses about DNAR decision. Results: 55% of the nurses in the sample say they do not know the meaning of the acronym DNAR. It was noted a statistically significant association both between training and knowledge of DNAR (p-value = .038) and between years of work and knowledge of the acronym (p-value = .004). There was also a statistically significant difference between knowledge of the acronym and some opinions and behaviors of nurses, including the importance of informing the patient about DNAR decision (p-value = .028). Conclusions:The study shows that the sample investigated, regardless of the work area of afference, does not know DNAR decision adequately. The lack of knowledge influences opinions and attitudes of nurses in relation to DNAR decision, constituting a barrier for an appropriate management of the patient. The need for more training on the topic and the formulation of clear protocols on DNAR decision emerges.

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Resuscitation in general medical wards: who decides?

Abstract: Nurses should be given the opportunity to become an essential component of resuscitation decision-making to avoid the pre-emption of medical resuscitation decisions.

Cited by 8 publications

References 25 publications

Experiencing Stress among Nurses during Resuscitation Procedure and Legal Obligations for Healthcare Workers in Slovenia

Experiencing Stress among Nurses during Resuscitation Procedure and Legal Obligations for Healthcare Workers in Slovenia

Stress and Coping of Critical Care Nurses After Unsuccessful Cardiopulmonary Resuscitation

Nurses and guideline for interrupting or not initiating CPR: An exploratory survey

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