ABSTRACT
Objective:Job satisfaction is a major determinant of performance in the workplace. Studies have shown that job dissatisfaction can intensify emotional exhaustion, and this can influence nurses to perceive their work as tiresome and repetitive, leading to frustration and discouragement. The purpose of this study was to investigate the relationship between job satisfaction and absenteeism at Georgetown Public Hospital Corporation (GPHC), and to explore the parameters that may impact on job satisfaction among nurses in3 different units (Paediatric High Dependency Unit (PHDU), ICU, Paediatric Medicine ward), at GPHC.Methods:The study was a retrospective audit of the nurses’ timesheets of 3 departments at GPHC to determine the level of absenteeism among the various levels of nursing staff (RNS, NAs). The nurses of each unit were then given an anonymous Lickert job satisfaction survey to complete to ascertain the potential impact of various parameters on their level of satisfaction. The data was analysed to determine if there was any correlation between the level of job satisfaction and the level of absenteeism. Results:The absent days of the PHDU was 48 (31 official sick leave) for 11 staff members (360 shifts).The absent days on the ICU was 193 (51 official sick leave) for 27 staff members (540 shifts).The absent days on the Paediatric Medicine ward was 323 (136) for 22 staff members (540 shifts).The level of job satisfaction across most parameters related to supervision, support and teamwork was significantly better in the PHDU than the other two units. General parameters related to promotion and administrative support remained low among all 3 units.
ABSTRACT
Purpose:Blunt abdominal trauma in children results in renal injury in approximately 10 to 20% of cases. In about 20% of these patients, significant complications may arise; for example urinoma(1%) and post trauma extravasation (2-18%). Urinomas and persistent hematuria were traditionally managed surgically by partial or total nephrectomy. Today, nonoperative management is well accepted for the majorityof high grade renal injuries, as organ preservation is highly desirable due to patients’ projected lifespan. We present a retrospective review of two cases of high renal injuries seen at GPHC’s Paediatric Surgical Department.Methods:In February and April 2019, two patients met the criteria for grade four renal injury. All medical records were reviewed. Cause of injury, complications, interventions and hospital stay were analyzed. These patients were followed up post discharge, clinically and radiologically. Results:Two males, ages 11 and 10 years, sustained blunt abdominal trauma and presented to GPHC with hematuria and abdominal tenderness. On initial assessment, they were hemodynamically stable and were diagnosed with grade four renal injuries by computed tomography. Complications developed after one week of hospitalization. One patient had persistent hematuria lasting over a week, requiring blood transfusions in excess of 4 units, and the other developed a urinoma, urinary tract infection and deep vein thrombosis. Both patients hadparalytic ileus and acute hypertension. These complications were all managed nonoperatively. The very large urinoma was successfully treated with percutaneous drainage after 25 days. Average hospital stay was 35 days and both patients had complete resolution of their renal injuries within 90 days post trauma. Conclusion:Nonoperative management of high-grade renal injury is highly successful and safe in children. Even in the presence of significant complications, preservation of renal tissue should be considered