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Nursing Research, AIDS, Topics of NOLF Meeting
AORN J O U R N A L
FEBRUARY 1986, VOL. 43, NO 2
Nursing Research, AIDS, Topics of NOLF Meeting
T
he Nursing Organization Liaison Forum (N0LF met in Kansas City, Nov 22, to discuss issues concerning the nursing profession and national health policy with the President of the American Nurses’ Association (ANA), Eunice Cole. Thirty-four national specialty nursing organizationswere represented at this third annual meeting. Ruth Vaiden, president, and Clifford Jordan, executive director, attended from AORN. Cynthia Chrystal, manager of membership services, National Intravenous Therapy Association, Inc, began a discussion on nursing’s role in the care of patients with acquired immune deficiency syndrome (AIDS). All organizations represented recognize the AIDS hysteria problem and the need for more education concerning the transmission of the HTLV-111 virus. Ronnie Liebowitz, director of the Association for Practitioners in Infection Control said, “We have a very strongresponsibilityto educatepeople about AIDS.” Many of the organizationswill be offering seminars on AIDS during their annual meetings. The Centers for Disease Control’s “Recommendations for Preventing Transmission of Infection with Human T-Lymphotropic Virus Type III/ Lymphadenopathy-Associated Virus in the Workplace” was acknowledged by all present as the best guidelinesto follow. None of the specialty groups are attempting to develop separate ones. ANA’s Cabinet on Human Rights and Cabinet on Economic and General Welfare are surveying the state nurses’ associations to learn how AIDS is affecting employment rights of nurses. Also included in the survey are questions about insurance company coverage, state legislature activities, and workers compensation claims related to AIDS. Ada Sue Hinshaw, chairperson of ANA‘s Cabinet on Nursing Research, gave a report on last year’s work. The majority of time was spent 554
supporting legislation for a National Center for Nursing Research at the National Institutes of Health (NIH). She was happy to announce that their efforts were successful and that the center was finally approved. Hinshaw reported that many officials of the NIH are not sure what topics nursing research should address. To solve the dilemma, the Cabinet solicited research priorities from state nurses’ assoCiations and specialty nursing groups and developed a list of proposed nursing research priorities. Hinshaw stressed that the list was designed for specialty nursing organizations and members of the ANA Cabinet to use when talking with the various NIH directors. She said the list would have little meaning for NIH officials or legislators unless it was interpreted by nurses knowledgeable in the different clinical specialties, and therefore, it should only be used as a basic reference. Col Annie Spurlin, deputy director of training and education, US Air Force Nurse Corps, gave a report on the recommendationsof the Task Force on Disaster Preparedness. She will serve as the Department of Defense contact for exchanging further information regarding the progress of those recommendations. (See “National Disaster Preparedness Task Force” in the January AORN Journal.) In other business, Susan Yates, president of the American College of Nurse-Midwives, discussed the malpractice insurancecrisis as it affects certified nurse-midwives. Nurse-midwives are now trying to develop a self-insurancepolicy but may resort to appealing to Congress to enact emergency legislation to provide insurance. In a report of the ANA divisionof governmental affairs, Pamela Mittelstadt, ANA senior staff specialist, outlined the latest developments in Medicare legislation and regulations. She said the
FEBRUARY 1986, VOL. 43, NO 2
ANA went on record as opposing the Medicare payment freeze; the Prospective Payment Assessment Commission will be adding one nurse member; and the House and Senate are conducting hearings on the quality of care under the prospective payment system. So far, she is not aware of nurses being held liable for early patient discharge caused by the federal Medicare system and she does not expect that to happen because patient discharge is considered a medical decision. The member organizations of NOLF reelected
AORN J O U R N A L
Marie Infante, past president of the National Association of Orthopaedic Nurses, Inc, as their coordinator for a two-year term. As coordinator, Infante has joint responsibility with the ANA President for agenda preparation. She also reports to the ANA Board of Directors and reports related board action to NOLF. The next meeting of NOLF is scheduled for Nov 21, 1986 in Kansas City. PATNIESSNER PALMER, RN, MS EDITOR
‘Hardy’ Nurses Cope Best With Stress Because a high degree of stress is associated with working in intensive care units (ICUs), a study was conducted to ascertain if ICU nurses experienced burnout more than non-ICU nurses. The latest data shows that there is no difference. Two primary questions were addressed in the latest study: (1) Do nurses in ICUs experience more burnout than those in non-ICUs? and (2) Across hospital units, do nurses who have higher levels of hardiness experience less burnout than those lower in this trait? Several studies have been conducted on burnout in the intensive care unit, resulting in a wide range of answers. A study in 1972 found that ICU nurses showed significantly more depression, imtability, and resentment. However, a study in 1979 found no difference between ICU and non-ICU nurses. A 1982 study then found that ICU nurses were actually less anxious than their counterparts. Burnout has been defined in terms of fatigue, frustration and anger, negative selfconcepts, lack of enthusiasm, and a general feeling of hopelessness and entrapment. The underlying factor in burnout is “powerlessness,” according to an article in the July/August issue of Nursing Research. People with the three Cs, “challenge,” commitment,” and “control,” have been described as stress-resistant. They have a specific set of atti-
tudes toward life-an openness to change, a feeling of involvement in whatever they are doing, and a sense of control over events. To sum it up, a person with these characteristics can be called “hardy.” Nurses who participated in the study were asked about the “hardiness” factor. Hardiness did prove to be a key variable as nurses who were more committed to their job, who felt more in control of their job, and who felt challenged by their job were less burned out. This was true for ICU nurses as well as non-ICU nurses. Four different groups of nurses were compared to gather test results: (1) surgical intensive care init (SICU) versus medical intensive care unit (MICU); (2) SICU and MICU versus intermediate surgical and intermediate medicat (3) SICU and MICU versus general surgical and general medical; and (4) intermediate surgical and intermediate medical versus general surgical and general medical. None of the contrasts proved to be significant, so the researchers concluded nursa in ICUs do not experience more burnout than nurses in non-ICUs.
555
FEBRUARY 1986, VOL. 43, NO 2
Nursing Research, AIDS, Topics of NOLF Meeting
T
he Nursing Organization Liaison Forum (N0LF met in Kansas City, Nov 22, to discuss issues concerning the nursing profession and national health policy with the President of the American Nurses’ Association (ANA), Eunice Cole. Thirty-four national specialty nursing organizationswere represented at this third annual meeting. Ruth Vaiden, president, and Clifford Jordan, executive director, attended from AORN. Cynthia Chrystal, manager of membership services, National Intravenous Therapy Association, Inc, began a discussion on nursing’s role in the care of patients with acquired immune deficiency syndrome (AIDS). All organizations represented recognize the AIDS hysteria problem and the need for more education concerning the transmission of the HTLV-111 virus. Ronnie Liebowitz, director of the Association for Practitioners in Infection Control said, “We have a very strongresponsibilityto educatepeople about AIDS.” Many of the organizationswill be offering seminars on AIDS during their annual meetings. The Centers for Disease Control’s “Recommendations for Preventing Transmission of Infection with Human T-Lymphotropic Virus Type III/ Lymphadenopathy-Associated Virus in the Workplace” was acknowledged by all present as the best guidelinesto follow. None of the specialty groups are attempting to develop separate ones. ANA’s Cabinet on Human Rights and Cabinet on Economic and General Welfare are surveying the state nurses’ associations to learn how AIDS is affecting employment rights of nurses. Also included in the survey are questions about insurance company coverage, state legislature activities, and workers compensation claims related to AIDS. Ada Sue Hinshaw, chairperson of ANA‘s Cabinet on Nursing Research, gave a report on last year’s work. The majority of time was spent 554
supporting legislation for a National Center for Nursing Research at the National Institutes of Health (NIH). She was happy to announce that their efforts were successful and that the center was finally approved. Hinshaw reported that many officials of the NIH are not sure what topics nursing research should address. To solve the dilemma, the Cabinet solicited research priorities from state nurses’ assoCiations and specialty nursing groups and developed a list of proposed nursing research priorities. Hinshaw stressed that the list was designed for specialty nursing organizations and members of the ANA Cabinet to use when talking with the various NIH directors. She said the list would have little meaning for NIH officials or legislators unless it was interpreted by nurses knowledgeable in the different clinical specialties, and therefore, it should only be used as a basic reference. Col Annie Spurlin, deputy director of training and education, US Air Force Nurse Corps, gave a report on the recommendationsof the Task Force on Disaster Preparedness. She will serve as the Department of Defense contact for exchanging further information regarding the progress of those recommendations. (See “National Disaster Preparedness Task Force” in the January AORN Journal.) In other business, Susan Yates, president of the American College of Nurse-Midwives, discussed the malpractice insurancecrisis as it affects certified nurse-midwives. Nurse-midwives are now trying to develop a self-insurancepolicy but may resort to appealing to Congress to enact emergency legislation to provide insurance. In a report of the ANA divisionof governmental affairs, Pamela Mittelstadt, ANA senior staff specialist, outlined the latest developments in Medicare legislation and regulations. She said the
FEBRUARY 1986, VOL. 43, NO 2
ANA went on record as opposing the Medicare payment freeze; the Prospective Payment Assessment Commission will be adding one nurse member; and the House and Senate are conducting hearings on the quality of care under the prospective payment system. So far, she is not aware of nurses being held liable for early patient discharge caused by the federal Medicare system and she does not expect that to happen because patient discharge is considered a medical decision. The member organizations of NOLF reelected
AORN J O U R N A L
Marie Infante, past president of the National Association of Orthopaedic Nurses, Inc, as their coordinator for a two-year term. As coordinator, Infante has joint responsibility with the ANA President for agenda preparation. She also reports to the ANA Board of Directors and reports related board action to NOLF. The next meeting of NOLF is scheduled for Nov 21, 1986 in Kansas City. PATNIESSNER PALMER, RN, MS EDITOR
‘Hardy’ Nurses Cope Best With Stress Because a high degree of stress is associated with working in intensive care units (ICUs), a study was conducted to ascertain if ICU nurses experienced burnout more than non-ICU nurses. The latest data shows that there is no difference. Two primary questions were addressed in the latest study: (1) Do nurses in ICUs experience more burnout than those in non-ICUs? and (2) Across hospital units, do nurses who have higher levels of hardiness experience less burnout than those lower in this trait? Several studies have been conducted on burnout in the intensive care unit, resulting in a wide range of answers. A study in 1972 found that ICU nurses showed significantly more depression, imtability, and resentment. However, a study in 1979 found no difference between ICU and non-ICU nurses. A 1982 study then found that ICU nurses were actually less anxious than their counterparts. Burnout has been defined in terms of fatigue, frustration and anger, negative selfconcepts, lack of enthusiasm, and a general feeling of hopelessness and entrapment. The underlying factor in burnout is “powerlessness,” according to an article in the July/August issue of Nursing Research. People with the three Cs, “challenge,” commitment,” and “control,” have been described as stress-resistant. They have a specific set of atti-
tudes toward life-an openness to change, a feeling of involvement in whatever they are doing, and a sense of control over events. To sum it up, a person with these characteristics can be called “hardy.” Nurses who participated in the study were asked about the “hardiness” factor. Hardiness did prove to be a key variable as nurses who were more committed to their job, who felt more in control of their job, and who felt challenged by their job were less burned out. This was true for ICU nurses as well as non-ICU nurses. Four different groups of nurses were compared to gather test results: (1) surgical intensive care init (SICU) versus medical intensive care unit (MICU); (2) SICU and MICU versus intermediate surgical and intermediate medicat (3) SICU and MICU versus general surgical and general medical; and (4) intermediate surgical and intermediate medical versus general surgical and general medical. None of the contrasts proved to be significant, so the researchers concluded nursa in ICUs do not experience more burnout than nurses in non-ICUs.
555