New Zealand nurses use of humour in surgical nursing practice

<p>Humour is a tool that can build rapport, establish communication and enable a therapeutic relationship: all of which are essential skills for nurses. For nurses to use humour in their practice they need to know when it is appropriate and when it could be beneficial for patients. However, much of the literature on nursing humour focusses on when not to use humour or provides contradictory messages about the use of humour. This is problematic as with little guidance, nurses may be hesitant to deploy humour with patients, potentially missing important opportunities to deliver more effective care. The lack of evidence-based guidance about use of humour for nurses was a key driver for this study. Furthermore, with even less research in the surgical care setting, a stressful environment for patients and staff, the need to explore how and when humour is used in surgical nursing practice was important. A qualitative descriptive methodology was used to explore how registered nursing working in a surgical environment decide when and how to use humour within nurse-patient interactions, and the use of humour during nurse-patient communication is assessed. Data collection was carried out in two surgical wards within a single site tertiary hospital in New Zealand. Nine registered nurses participated in group or individual interviews that were conducted using an interview guide incorporating semi-structured questions. Data were analysed thematically. Findings demonstrate the humour is a significant feature of practice for surgical nurses with its use being purposeful and undertaken after careful consideration and assessment. Within three themes (assessing openness, building a connection, protection against vulnerability), humour was described as enabling nurses to quickly connect with patients and establish a therapeutic relationship. Humour facilitates communication, even under difficult circumstances, and provides an outlet for the perceived physical and emotional vulnerability experienced by both patients and nurses within the surgical environment. Humour forms an integral part of surgical nursing practice. This thesis challenges surgical nurses to place an emphasis on raising the profile of humour in practice and develop skills to assess when to use, and when not to use humour. This will require the development of specific educational and professional strategies.</p>

New Zealand nurses use of humour in surgical nursing practice

<p>Humour is a tool that can build rapport, establish communication and enable a therapeutic relationship: all of which are essential skills for nurses. For nurses to use humour in their practice they need to know when it is appropriate and when it could be beneficial for patients. However, much of the literature on nursing humour focusses on when not to use humour or provides contradictory messages about the use of humour. This is problematic as with little guidance, nurses may be hesitant to deploy humour with patients, potentially missing important opportunities to deliver more effective care. The lack of evidence-based guidance about use of humour for nurses was a key driver for this study. Furthermore, with even less research in the surgical care setting, a stressful environment for patients and staff, the need to explore how and when humour is used in surgical nursing practice was important. A qualitative descriptive methodology was used to explore how registered nursing working in a surgical environment decide when and how to use humour within nurse-patient interactions, and the use of humour during nurse-patient communication is assessed. Data collection was carried out in two surgical wards within a single site tertiary hospital in New Zealand. Nine registered nurses participated in group or individual interviews that were conducted using an interview guide incorporating semi-structured questions. Data were analysed thematically. Findings demonstrate the humour is a significant feature of practice for surgical nurses with its use being purposeful and undertaken after careful consideration and assessment. Within three themes (assessing openness, building a connection, protection against vulnerability), humour was described as enabling nurses to quickly connect with patients and establish a therapeutic relationship. Humour facilitates communication, even under difficult circumstances, and provides an outlet for the perceived physical and emotional vulnerability experienced by both patients and nurses within the surgical environment. Humour forms an integral part of surgical nursing practice. This thesis challenges surgical nurses to place an emphasis on raising the profile of humour in practice and develop skills to assess when to use, and when not to use humour. This will require the development of specific educational and professional strategies.</p>

"Getting on Top of Pain": a Critical Analysis of Surgical Nurses' Talk About Their Work with Hospitalised Patients Reporting Pain

<p>This thesis investigates the relationship between language, 'discourse' and professional knowledge and power in a specific context; that of surgical nurses' "talk" about their work managing pain in hospitalised patients. This thesis argues that the work of 'caring for' hospitalised surgical patients who report pain is influenced by discourses which are predicated on different readings/understandings of the body/patient, and from which different knowledge is constructed. Of interest to this thesis are the discourses of biomedicine and nursing, and their role in constructing a particular reality/ies which determine the ways in which surgical nurses talk about their work managing pain. Using the method of critical discourse analysis, the "texts" of transcribed audio-taped conversations with four registered nurses working in surgical specialties were analysed to uncover 'discourses of pain management'. The results of the analysis indicate that the biomedical construction of pain, and approaches to pain management, remain the dominant influence over surgical nurses' practice. There was evidence of nursing discourses with an emphasis on nurse-patient relationships also playing a role. These discourses were critically examined for what they reveal about relations of professional knowledge and power in this specific context of the nurses' practice. The implications for nursing and nursing research are considered significant because the study critically (re)presents a different perspective on, and reality for surgical nurses' pain management practices. In so doing, it elucidates an explanation for, and understanding of, why surgical nurses take care of patients reporting pain in particular ways.</p>

"Getting on Top of Pain": a Critical Analysis of Surgical Nurses' Talk About Their Work with Hospitalised Patients Reporting Pain

<p>This thesis investigates the relationship between language, 'discourse' and professional knowledge and power in a specific context; that of surgical nurses' "talk" about their work managing pain in hospitalised patients. This thesis argues that the work of 'caring for' hospitalised surgical patients who report pain is influenced by discourses which are predicated on different readings/understandings of the body/patient, and from which different knowledge is constructed. Of interest to this thesis are the discourses of biomedicine and nursing, and their role in constructing a particular reality/ies which determine the ways in which surgical nurses talk about their work managing pain. Using the method of critical discourse analysis, the "texts" of transcribed audio-taped conversations with four registered nurses working in surgical specialties were analysed to uncover 'discourses of pain management'. The results of the analysis indicate that the biomedical construction of pain, and approaches to pain management, remain the dominant influence over surgical nurses' practice. There was evidence of nursing discourses with an emphasis on nurse-patient relationships also playing a role. These discourses were critically examined for what they reveal about relations of professional knowledge and power in this specific context of the nurses' practice. The implications for nursing and nursing research are considered significant because the study critically (re)presents a different perspective on, and reality for surgical nurses' pain management practices. In so doing, it elucidates an explanation for, and understanding of, why surgical nurses take care of patients reporting pain in particular ways.</p>

P072 ARTICULATED LAPAROSCOPIC INSTRUMENTS. BENEFITS ON LAPAROSCOPIC HERNIOPLASTY

Aim To present initial experience using 5 mm articulated laparoscopic instruments in tapp laparoscopic hernioplasty that emulated the benefits attributed to robotic surgery. Material and Methods We report data from the first 42 procedures using 5 mm articulating instruments. A retrospective analysis was performed in patients who underwent tapp laparoscopic hernioplasty using novel articulated graspers, needle holders, and scissors. The surgeons and surgical nurses were trained in the handling and operation of the articulating instruments, before the first surgical procedure. In all cases, articulating instruments were inserted through 5 mm trocars. Data collected included patient demographics, details related to the surgical procedure, postoperative outcomes, and complications. Results Over a period of one month, were repaired 78 inguinal hernias. 36 patients had a bilateral hernia, and the mean age was 45 years (SD 15.1), with a mean BMI of 28.6 (SD 6.1). 32 male and 4 female patients. The mean operative time was 90 min. The articulated head of the clamp allowed traction, dissection, and suture in different directions. In addition, was not detected a significant learning curve due to its intuitive applicability. Surgical complications included two serohematomas. All patients discharge during operation day. The procedures performing without intraoperative complications nor conversion to open surgery occurred. Conclusions The use of an articulated instrument has a promising future. It would meet some benefits of robotics without increasing costs. We need randomized comparative studies for a better conclusion.

ANALYSIS OF RELATIONSHIPS OF EMOTIONAL BURN OUT FEATURES AND INDICATORS OF EMOTIONAL INTELLIGENCE AMONG MEDICAL WORKERS

Purpose - the aim of this article is to present the results of a statistical analysis of the relationship between the features of emotional burnout and indicators of emotional intelligence among medical workers. Material and methods - 4 groups of respondents (110 medical workers) took part in the study: surgical doctors, therapeutic doctors, surgical nurses, therapeutic nurses. Evaluation of the features of emotional burnout and emotional intelligence was carried out using diagnostic methods of emotional burnout (V.Boyko), the questionnaire of emotional burnout by K. Maslach and S. Jackson (adaptation by N. Vodopyanova) and the method of emotional intelligence (N. Hall). The study consisted of two stages. The purpose of the first stage was to determine the level and characteristics of the manifestation of emotional burnout of medical workers according to the following symptoms: (emotional exhaustion; depersonalization; reduction of personal achievements; "stress" (experiencing traumatic circumstances, dissatisfaction with oneself, caged, anxiety and depression); "resistance" (inadequate selective emotional response, emotional and moral disorientation, expansion of the sphere of saving emotions, reduction of professional duties); "exhaustion" (emotional deficit, emotional detachment, psychosomatic and psychovegetative disorders). The level of manifestation of emotional intelligence of medical workers was also assessed according to the following indicators: emotional awareness, emotion management, self-motivation, empathy, recognition of other people's emotions The second stage of the study was aimed at determining the characteristics of the relationship of individual indicators of emotional benefit screaming with specific indicators of the emotional intelligence of health care workers. Mathematical processing of the research results was carried out using Spearman's correlation coefficient by means of the SPSS 17 computer program. Results and discussion. The results of our research have shown that: 1) the overwhelming majority of the test subjects have high and medium levels of reduction of personal achievements, and such a phase of emotional burnout as resistance” (inadequate selective emotional response, emotional and moral disorientation, expansion of the sphere of economy of emotions, reduction of professional duties); 2) half of respondents have high and medium levels of emotional exhaustion, depersonalization; 3) a quarter of the respondents formed such a phase of emotional burnout as “exhaustion” (emotional deficit, emotional and personal detachment, psychosomatic and psychovegetative disorders). The following levels of development of emotional intelligence were revealed in different groups of medical workers: a) high and medium - among doctors of a surgical profile and doctors of a therapeutic profile; medium - for surgical nurses; low - for therapeutic nurses. Conclusion. Medical workers with high and medium levels of emotional intelligence have a low level of manifestation of symptoms of emotional burnout (dissatisfaction with oneself; feelings of being caged; anxiety and depression; reduction of professional duties; emotional deficit; personal detachment; psychosomatic and psychovegetative disorders), as well as a low level of development phases of tension, resistance, exhaustion, depersonalization and reduction of personal achievements.

Experiences of surgical nurses in providing end-of-life care in an acute care setting: a qualitative study

Background: The number of deaths occurring in hospitals is rising, and many occur in settings other than specialist palliative care, oncology or critical care. Nurses working outside these specialist environments report end-of-life (EoL) care as a source of stress. This research aimed to explore these experiences. Aims and methods: This qualitative study, using semi-structured interviews as a research technique, aimed to investigate the experiences of surgical nurses caring for dying patients. Results: Five themes emerged: understanding of and preference for EoL care; perceived barriers while providing EoL care; robust support from the team as a facilitator while providing EoL care; symptom management; future training and support. Conclusion: Participants considered providing EoL care as part of their professional role and reported that they were able to provide appropriate physical care. Participants identified challenges in providing emotional and psychological support to dying patients and their families in an acute surgical setting.