Effects of shadowing and supervised on-the-job inductions on mental health nurses (original) (raw)

KEY POINTS 1.Personnel in palliative care wards and hospices are at risk of chronic stress, burnout, anxiety, depression and substance/alcohol abuse because working in end-of-life care involves frequent grief, death anxiety and feelings of professional helplessness. 2.This commentary discusses the reported labour shortage in palliative care, and why some occupations are particularly at risk of quitting (e.g., care workers). 3.Most healthcare organizations are not providing palliative staff with training or orientations (inductions) about how to cope with the psychosocial risks of the profession. 4.This commentary discusses evidence that training interventions trialled on palliative staff are effective solutions. 5.The conclusion is a call on healthcare organizations to implement orientation or training programmes that help palliative personnel cope. KEYWORDS cancer; oncology; psychosocial risks; staff inductions; workplace coping. REFERENCES 1.Asai, M, Morita, T, Akechi, T, Sugawara, Y, Fujimori, M, Akizuki, N, Nakano, T, Uchitomi, Y. Burnout and psychiatric morbidity among physicians engaged in end-of-life care for cancer patients: a cross-sectional nationwide survey in Japan. Psycho-Oncol 2007;16:421-428. 2.Pereira, SM, Fonseca, AM, Carvalho, AS. Burnout in palliative care: A systematic review. Nurs Ethics 2011;18:317-326. 3.Dougherty, E, Pierce, B, Ma, C, Panzarella, T, Rodin, G, Zimmermman, C. Factors associated with work stress and professional satisfaction in oncology staff. Am J Hosp Palliat Med 2009;26:105-11 4.Trinkoff, AM, Stoor, CL. Substance use among nurses: differences between specialties. Am J Public Health 1998;88:581-585 5.Vachon, MLS. Staff stress in hospice palliative care - a review. Palliative Med 1995;9:91-122. 6.Bourbonnais, R, Brisson, C, Vinet, A, Vézina, M, Lower A. Development and implementation of a participative intervention to improve the psychosocial Work environment and mental health in an acute care hospital. Occup Environ Med 2006;63:326-334. 7.Swetz, KM, Harrington, SE, Matsuyama, RK, Shanafelt, TD, Lyckholm, LJ. Strategies for avoiding burnout in hospice and palliative medicine: peer advice for physicians on achieving longevity and fulfilment. J Palliat Med 2009;12:773-777. 8.Bourbonnais, R, Brisson, C, Vézina, M. Long-term effects of an intervention on psychosocial work factors among healthcare professionals in a hospital setting. Occup Environ Med 2011;68:479-486. 9.Vachon, MLS. Four decades of selected research in hospice/palliative care: have the stressors changed? In I. Renzenbring (Ed.) Caregiver Stress and Staff Support in Illness, Dying, and Bereavement 2011; Oxford:New York. 10.Gibbins, J, McCoubrie, R, Forbes, K. Why are newly qualified doctors unprepared to care for patients at the end of life? Med Educ 2011;45:389-399. 11.Dobrowolska, B, Cuber, T, Slusarska, B, Zarzycka, D, Wronska, D. Analysis of the nurses’ and physicians’ opinion regarding their end-of-life education. J Palliat Med 2011;14:126-127. 12.Jones, MC, Wells, M, Gao, C, Cassidy, B, Davie, J. Work stress and well-being in oncology settings: a multidisciplinary study of health care professionals. Psycho-Oncol 2013;22:46–53 13.Elpern, EH, Covert, B, Kleinpell, R. Moral distress of staff nurses in a medical intensive care unit. Am J Crit Care 2005;14:523-530 14.The Hospice Information Service. Directory of hospice and palliative care services in the United Kingdom and Republic of Ireland 2000; London: St Christopher’s Hospice. 15.DHSSPSNI. Review of the social services workforce 2011: Final report. Department of Health, Social Services and Public Safety (DHSSPSNI) 2011; Available from http://www.dhsspsni.gov.uk 16.Castle, NG, Engberg, J. Staff turnover and quality of care in nursing homes. Med Care 2005;43:616-626 17.Lupu, D. Estimates of the current hospice and palliative medicine physician workforce shortage. J Pain Symptom Manag 2010;40:899-911. 18.Centeno, C, Clark, D, Lynch, T, Rocafort, J, Greenwood, A, Flores, LA, De Lima, L, Giordano, A, Brasch, S, Praill, D. EAPC Atlas of Palliative Care in Europe 2007; European Association for Palliative Care, EAPC/IAHPCPress. ISBN: 0-9758525-5-8. 19.Martin-Moreno, JM, Harris, M, Gorgojo, L, Clark, D, Normand, C, Centeno, C. Palliative Care in the European Union 2008. European Parliament Policy Department: Economic and Scientific Policy: Study IP/A/ENVI/IC/2007-123.