DINERO, ELLA MAE BSN 4-B Journal Reading

TITLE: Managing a Stressful Work Environment through Improved Teamwork - A Qualitative Content Analysis

of Nurses Working Environment within Emergency Care

AUTHORS: Djanda Horn, Maddeleine Lindström and Kristina Rosengren

SUMMARY:

Medical errors are a concern in emergency departments, which are classified as hectic and unpredictable care

units with poor working conditions. Emergency room nurses face difficulties such as increased patient traffic

and nurse shortages, resulting in a heavy workload. The goal of this study is to explain nurses' experiences of

working in emergency departments at a general hospital in Manila, Philippines, given the lack of understanding

about Asian nurses' working environments. The following topics are covered: To explain and analyze how

Filipino nurses deal with patient safety in emergency rooms; to describe and assess how Filipino nurses

interact with one another in emergency rooms and; to explain and analyze the burden that Filipino nurses face

in emergency rooms.

This research took place in a tertiary state-owned hospital in Manila, Philippine. Because of the high volume of

patients (2000-3000 each day) and the severity of the diseases, this hospital's ED is one of the busiest in the

Philippines. To comprehend nurses' perspectives, views, and feelings about the working environment in the

Philippines, a qualitative method was combined with an inductive approach. All of the interviews were taped

and the verbatim were transcribed. All of the participants were registered nurses (n = 9), three men and six

women between the ages of 26 and 58 (median = 38), with four years of education, three to 33 years of

nursing experience, and three to 27 years of emergency care experience.

Results revealed that lack of resources, such as time due to manpower shortages, results in a high patient

ratio resulting in a stressful work environment with high demands. Because acute and/or severe care is

prioritized, low-quality care necessitates constraints in an attempt to provide a caring environment for the

patients. Some employees travel to other countries in search of a better working environment. The nurses'

emotional reactions revealed their awareness of the excessive workload which has an impact on care quality

making it harder to work with empathy for patients and relatives, as well as having a detrimental impact on

patient safety. On the other hand, patient’s recovery, appreciation and gratitude were reported to be
important aspects of the nurses' working environment that generated positive emotions. Furthermore,

research reveals that nurses who employ positive coping strategies have lower stress levels, which leads to

good attitudes and a motivation to provide the best quality care. In the current study, the nurses reported

dissatisfaction with the hospital's collaboration with other units. Lack of collaboration across care units, such as

radiology and the laboratory, causes delays in ED care and unnecessary work, compromising patient safety. As

a result, inter-care unit collaboration increases comprehension of each other's tasks and results in high-quality

treatment. Teamwork as well as a supportive managerial perspective are important to improve the working

environment for nurses in order to prevent burnout (disengagement). Nurses are responsible for fostering a

healthy environment (in the physical, social, and mental aspects) based on a loving connection in order to

increase patient recovery and care quality.

REACTION:

The article shows us how important teamwork for nurses is, especially to those working in a fast-paced and

exhausting department just like the ER which necessitates excellent assessment abilities, adaptability, and the

capacity to work in a high-level of stress environment. You will need to stay calm and in control of urgent and

complex situations, and that will be very hard. Burnouts are always possible given the shortage of resources

and lack of manpower, and the article tells us how important it is to be creative and be an innovative nurse

given the circumstances. As a student nurse, I have now realized the value of groupworks that we have in

nursing school, having people to share your feelings and ideas with, and innovating solutions together. When

we work as a team, we learn to appreciate our strengths and weaknesses, we see the good from other team

members and we try to imitate it, we see the bad ones and we avoid doing the same. Teamwork improves not

just our skills and abilities but also helps us realize our full potential, making us aware of ourselves. And these

I believe are an important part of the journey to becoming a competent and efficient nurse, improving patient

safety, reducing clinical errors, and reducing waiting times, not just in the ER but in other areas as well.

REFERENCE:
Horn D., et al (2018). Managing a Stressful Work Environment through Improved Teamwork - A Qualitative Content

Analysis of Nurses Working Environment within Emergency Care. Int Arch Nurs Health Care 4:109. Retrieved from

doi.org/10.23937/2469-5823/15100109