NR 351 Week 5 Discussion: Evidence to Support Nursing Practices (Graded)

The article I selected is from the ABNF Journal titled, “An Investigation of Job Satisfaction among Nurses in the Emergency Department”. These authors surveyed a total of 89 registered nurses across the United States. The objective was to determine the satisfaction of emergency department nurses. The hypothesis was the overall satisfaction would be between 34-67%. There are a multitude of factors that play into job satisfaction amongst nurses. This article also discusses how nursing turnover has a detrimental impact on organizations which then leads to further job dissatisfaction amongst the nurses that remain. This article from 2017 projects that by 2020 there would be a shortage of one million nurses. As nurses mature in their careers and because nursing is so diverse, nurses are moving into other specializations and leaving the bedside. The projection for this survey was surpassed with an overall job satisfaction of 72%. Some of the demographics that were interesting was that the job satisfaction rate was highest amongst associate degree nurses (82%). Followed by BSN (67%) then masters degree graduates (63%). One question that was not asked in the survey was how long these nurses have been practicing, only how long they had worked in the emergency department. This survey also asked nurses to report factors that impact their job satisfaction in an effort to show hospitals and organizations things they can do to retain dedicated nurses. Hopefully using this survey will help shed some light on not only retaining experienced nurses, but keeping them satisfied in their job so they can give their best level of care to the community they serve.

I chose this article because I have worked in an Emergency Department for almost four years and have see job satisfaction at every level. This past year with the global pandemic, emergency rooms and intensive care units have been pushed to the maximum and it has come back and hurt the nurses and ancillary staff. In talking to nurses at my hospital, they are satisfied with the job and the flow of the emergency room, but the enormous amounts of death and destruction brought on by covid have taxed these departments heavily. Wearing PPE for 12 or more hours straight with only a thirty-minute lunch break in between has taken its toll physically and mentally on these nurses. Recently we have experienced a huge nursing shortage from a combination of poor management and the toll of covid where ER nurses are moving on to pursue other opportunities. This change is bittersweet but it has given rise to newer nurses entering the profession in an effort to help the community.

References

Chamberlain College of Nursing (2021). NR351 Transition in Professional Nursing: Week 5 lesson. Chicago, IL: Online Publication.

Erin Helbing, M. T. (2017). An Investigation of Job Satisfaction among Nurses in the Emergency Department. ABNF Journal, 103-108.

This article really hits home for me.  I do not work in the ED, but our department truly feels as if it is falling apart.  In the last 2 years they decided to combine our pre post and Cath lab.  When this happened we lost 6 of the seven nurses that worked in the pre post area.  On top of that we have lost 14 of the Cath lab staff, this was not all at once, but four of these people stayed less than a year and the others were there around a year and half.  There has been a huge turnover of staff.  The job satisfaction has been very low.  Most of the staff that have left feel like there concerns  were not heard, they feel like they are treated like bodies that are there instead of nurses that have been specially trained and some that have had years of experience.  

After covid hit the staffing was never returned to pre-covid levels.   Staff that left we’re not replaced and the burden has been great for those left as the case loads has inceased.  In the last 6 months alone we have lost 8 employees, 2 of those were just today.   My last day will be July 4, I’ve been offered a job in the PACU, which has far less call, and will be more conducive to finishing school.  Now they will only have 1 seasoned nurse in the lab to train all of these new nurses that they have hired.  Now management is scrambling to offer incentives to staff to try to get them to stay.  The problem is that the call burden will still be there for some time.  One of our RN’s is a traveler and said that there was on average about 170 open Cath lab positions to choose from in her agency.  Post covid there are 370 jobs to choose from in her agency.  

Our department is not the only one with staffing issues.  The ED has all travel RN’s in place for the night shift.  The ICU’s have had 3-4 patients at times per nurse.  The cardiac stepdown unit which is supposed to be an intermediate care unit is primarying 6-7 patients on some days. There truly is a nursing shortage.  

Your APA format looks good except I would add issue and volume of the journal and the DOI if available.

According to Luo et al. (2016, p. pg 104) “pancreatic cancer has become one of the most fatal diseases over the past years. The 5‑year survival rate is 4%, which is the lowest for all types of cancer.” In this article, they compare using multi-drug chemotherapy to single drug chemotherapy and the effects that it has on the progression, response and the one-year survival rate of pancreatic cancer. A newly diagnosed pancreatic cancer patient typically has either an advanced cancer locally or the disease has become metastatic stage 4, and the prognosis is 6-10 months or 3-6 months respectively (Luo et al., 2016, p. pg 104). Luo et al. (2016, p. pg 104) compared gemcitabine (GEM), a well-known standard for pancreatic cancer treatment, to the combination of GEM and cisplatin (CIS) regarding the overall survival of the patients. The research suggests that the multi-drug chemotherapy using GEM and CIS improved tumor response, slowed disease progression and improved stability the disease (Luo et al., 2016, p. pg 105). However, due to the having such an advanced disease upon initial diagnosis neither the single drug chemotherapy nor the multi-drug therapy had a significant impact on the one-year survival rate (Luo et al., 2016, p. pg 108).

I selected this article because of my family history of pancreatic cancer. My mother lost her 20-month battle to this cancer in 2020, and since her diagnosis in 2018, I have devoted a lot of time to researching treatments, early detection devices, trials and trying to raise the overall 5-year survival rate from the 4% that it was in 2016 to the 10% that is today. In this weeks’ lesson Chamberlain College of Nursing (2021) stated that the “identification of evidence and best practices results in the development of clinical guidelines to provide the best care to patients.” I believe this to be true and it shows in this short research study that evidence of multi-drug chemotherapy provides better results in cancer treatment than single drug therapies. With more research, trials and evidence-based practices, cancer patients can have the best tools at their disposal to help fight not only pancreatic cancer, but all cancers.

Luo, G., Huang, D., & Fang, J. (2016). Meta-analysis of gemcitabine and cisplatin combination chemotherapy versus gemcitabine alone for pancreatic cancer. Journal of Cancer Research and Therapeutics, 12(5), 104–108. https://doi.org/10.4103/0973-1482.191616

Chamberlain College of Nursing (2021). NR351 Transitions in Professional Nursing: Week 5 lesson. Chicago, IL: Online Publication.