Response of nursing staff to burnout in burn centers of Tehran

Nursing care in a burn center is demanding intensive care which provokes emotional responses among staff. Every nurse who cares for a patient with burn injury, knows that stress is a part of working in this field and organizational problems and issues related to the patients in these centers leads to intense reactions in the staff which finally results in burnout and exerts negative influences on nursing care. Therefore, the objective of this paper as part of an extensive research was identifying the nature of burn nurses' responses to burnout. Grounded theory was used in this study. Thirty- eight participants were recruited by purposeful and theoretical sampling and data were generated by unstructured interviews and participant observations. Constant comparison was used for data generation in this study. Participants represented negative dimensions in response to stress and burnout. These responses emerged as emotional, attitudinal, psychosomatic; behavioral, and organizational dimensions. Emotional dimension included personal and professional desperation; attitudinal dimension included depersonalization and negativity; psychosomatic, responses included physical and psychological attrition; behavioral response included intolerance and justification; and organizational dimension included irresponsiveness care and declining performance. Burnout impressed all dimensions of participants' entities and in this way, influenced quality of nursing care negatively. The process of actions and interactions of the nursing staff emerged as a response to situations and context of burn centers during time period. These responses sometimes were represented spontaneously, and sometimes as means for reducing the influence of environmental stressors. Some of these responses focused on the kind of care, and some involved feelings and emotions of the participants. But the participants' bodies were also the target of some responses. Modifying macro and micro conditions governing burn centers is necessary. Nurse administrators concerning about signs and symptoms of burnout, and also executing stress management programs will reduce stress and distress in the nurses and also improve the quality of nursing care

Caring behaviors of student nurses following clinical experience through role play and traditional method

Caring is a multidimensional nursing concept that can be actualized within the baccalaureate nursing curriculum through the purposeful teaching and student-centered learning of core values. Teaching interpersonal issues is possible through various methods such as role-play. The current study was conducted with the aim of describing the caring behaviors of two groups of sophomore-level student nurses after implementing either role-play or traditional method as teaching method of choice. The researchers used quasi-experimental study design using an equivalent control group and post-test. Fifty one nursing students were randomly assigned in either experimental or control group. After that members of the experimental group performed their clinical experience using role play and members of control group did practice as routine, caring behaviors of two groups were observed using CBI. In general, findings indicated that caring behaviors related to subscales "respectful difference to other" and "professional knowledge and skill" were, respectively, the most and the least frequent caring behaviors in both groups. More frequent occurrence of interpersonal aspects of caring in two groups indicates that in the beginning of professional nursing care, the sophomore-levelstudents give priority to altruistic values. So, using approaches to develop and maintain interpersonal aspects of caring in nursing curriculum, coupled with changing the teaching methods of practical aspects of nursing care and appropriate integration of theory and practice is recommended

Conditions affecting quality of nursing care in burn centers of Tehran

Nursing care in burn centers requires a heavy work which is influenced by many factors. The quality care of nurses as the largest group care providers in burn centers is of great importance and complexity and pan dimensionality of the care in these centers requires multiple interpretations that necessitate exploring and describing the perspectives of whom involved in care giving to understand the factors affecting the quality of care. The study was carried out with the aim of exploring and describing the factors involved in quality nursing care in burn centers of Tehran. Grounded theory was used as method. Thirty- eight participants were recruited through purposeful and theoretical sampling. Data were generated by unstructured interviews and participant observations. Constant comparison was used for data analysis. Data revealed that two categories of structural factors including intra and extra organizational conditions have influenced the quality of care. Intra organizational conditions included conditions related to administrators, staff, financial problems, workload, team members, facilities and equipments, environmental elements, and patients. Extra organizational conditions included self-management of burn centers, lack of supportive organizations for patients and heavy expenses of treatment, high living expenditure and low salary of governmental personnel, lack of employment permission, inattention of senior managers and inspectors to the work processes and their over attention to documentation, troublesome rules related to official violations, physicians governorship, and negative social perspective into nursing profession. Interaction between intra and extra organizational conditions resulted in physical and psychological stress, loss of motivation and dissatisfaction of staff nurses and poor quality of care. Findings were suggestive of correcting and modifying the intra and extra organizational factors and implementing stress reduction programs