Increased levels of stress among the nurses have heightened cases of burnout among the nurses. Workplace stress is considered to be among the leading causes of burnout among employees. According to Riethof (2019), Freudenberger coined the term burnout in 1974 to refer to the way employees react to enduring work-related stress. Burnout is characterized by lowered productivity, emotional exhaustion, and depersonalization (Gnerre et al., 2017). Nurses are exhibiting symptoms of decreased productivity, emotional exhaustion, and depersonalization now than ever. The main reason for increased burnout among the nurses could be attributed to work stress that results from an imbalance between work life and family life, as well as the constantly changing roles of nurses. The nursing profession is predominated by females. Therefore, the increased cases of burnout among the nurses could be due to the multiple roles that nurses, especially the female workers, perform. It is hard to strike a balance between work responsibilities and family duties. Consequently, a nurse would be discouraged and worn-out if either work or family does not function as expected, hence exhibit symptoms of burnout syndrome such as emotional exhaustion and reduced productivity. Besides, the changing roles in nursing have contributed to high cases of burnout. Nurses are now charged with more responsibilities than ever which is increasing work-related stress. High demands in the workplace lead to stress. Consequently, nurses suffer burnout while trying to cope with stress.

Over time, the roles of nurses in society have changed thus transforming nurses from simply caregivers to agents of social change in society. Social change refers to the alterations that occur in human relationships and interactions that affect social and cultural institutions (MacDonald, De Zylva, McAllister, & Brien, 2018). Therefore, nursing practitioners could positively impact human interactions and relationships in society through their role of advocacy. Advocacy is core in nursing since it helps in promoting ethics in the practice. Nurses could make the lives of patients and their families better by solving their challenges during and after hospitalization. The healthcare system has become more complex and fragmented hence most patients lack important information regarding access to quality care. Therefore, a nurse could promote social change by providing essential information regarding access to quality care. Consequently, nurses will have enhanced social change since challenged patients would become more informed and start accessing quality care. Nursing advocacy also helps in promoting a lasting nurse-patient relationship (Oliveira & Tariman, 2017). Patients would start trusting the nurses more through their advocacy roles. This way, nurses will have made society a better place by positively improving the relationship between nurses and patients, and passing vital health care information. 

References

Gnerre, P., Rivetti, C., Rossi, A. P., Tesei, L., Montemurro, D., & Nardi, R. (2017). Work stress and burnout among physicians and nurses in Internal and Emergency Departments. Italian Journal of Medicine, 11(2), 151-158.

MacDonald, K., De Zylva, J., McAllister, M., & Brien, D. L. (2018). Heroism and nursing: A thematic review of the literature. Nurse education today, 68, 134-140. Retrieved January 14, 2021, https://www.researchgate.net/profile/Margaret_Mcallister2/publication/325664214_Heroism_and_nursing_A_thematic_review_of_the_literature/links/5ecef480299bf1c67d23b4ec/Heroism-and-nursing-A-thematic-review-of-the-literature.pdf/

Oliveira, C., & Tariman, J. D. (2017). Barriers to the patient advocacy role: An integrative review of the literature. Journal of Nursing Practice Applications & Reviews of Research, 7(2), 7-12. Retrieved January 14, 2021, from https://pdfs.semanticscholar.org/6989/d252691b3cc86b2e20b319cfc10ec6121913.pdf#page=9/

Riethof, N. (2019). Burnout syndrome and Logotherapy: Logotherapy as useful conceptual framework for explanation and prevention of burnout. Frontiers in Psychiatry, 10, 382. Retrieved January 14, 2021, from https://www.frontiersin.org/articles/10.3389/fpsyt.2019.00382/full/

Discussion#1

    Quality and Safety Education for Nurses (QSEN) focuses on addressing the difficulties faced in training nurses with vital competencies for continuously enhancing care quality and safe health care systems in the workplaces. QSEN competencies include teamwork and collaboration, informatics, patient-centered care, evidence-based practice, safety, and quality improvement (Institute of Medicine, 2003). The competencies are used to define the qualities of a respected and competent nurse. Therefore, this is a discussion of patient-centered care using the Knowledge, Skills, and Attitude (KSAs) statements. 

References

Institute of Medicine. (2003). Health professions education: A bridge to quality. Washington DC: National Academies Press. Retrieved January 14, 2021, from https://www.ncbi.nlm.nih.gov/books/NBK221528/

National Council of State Boards of Nursing. (2009). Nursing Pathways for Patient Safety E-book. Elsevier Health Sciences. Retrieved January 14, 2021, from https://books.google.co.ke/books?hl=en&lr=&id=MM1G77dPAHQC&oi=fnd&pg=PP1&dq=nursing+pathways+for+patient+safety&ots=Z4XMGwIPyf&sig=236Gvb7amCKcwMHC_jk5WFiYUS0&redir_esc=y#v=onepage&q=nursing%20pathways%20for%20patient%20safety&f=false/

You are working with a teenager whose friends vape.  You realize that this patient is at risk for vaping and you want to implement interventions aimed at prevention.  Which middle range theory would you use, and how would you apply it to this situation?

The middle range theory that I would use to implement interventions aimed at prevention is the theory of planned behavior. Montano and Kasprzyk (2015) stated that the theory of planned behavior enables the researcher or practitioner to obtain the basis of actions and decisions made by an individual or group. Theory of planned behavior also provides adequate information for evidence-based practices to be implemented properly because data collected about a patient or client is derived from precedents or prior cases (McEwen & Wills, 2019; Watters, Moore, & Wallston, 2016). Theory of planned behavior is also a good tool to learn about the technology and industry of vaping, and how individuals and groups are influenced to consume or use the product (Chu & Chen, 2016). The concept of caring, where the patient’s welfare and wellbeing is the focus of healing, interventions, and preventions, is similarly found in the middle range theory of planned behavior (McEwen & Wills, 2019).

To apply the middle range theory of planned behavior, I would determine the source of the vaping and then understand the motivations as to why the young teenager is keen on using vaping products. Vaping or e-cigarettes refers to products that heat a particular substance using an electronic gadget that simulates smoking, but the technology uses vapors or evaporated liquid molecules rather than gases that can be inhaled (Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, 2019). Vaping is highly addictive because of the nicotine found in the products, and may also pose major health threats because of other substances that can be toxic and harmful to the lungs, heart, throat, and other parts of the human body (Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, 2019).

 The source of the vaping would most likely be either peer pressure coming from friends and or loved ones who are also into vaping. Another source could be the acceptance of vaping from the people who surround the teenager. Both circumstances make the teenager vulnerable to vaping because he/she is immersed in the environment that allows vaping and all its related products to be used. The theory of planned behavior can be observed and studied based on socio-economic context where the individual or group is exposed to the influences and inputs of others in a shared set of values and norms (McEwen & Wills, 2019; Schüz, Li, Hardinge, et al., 2017). 

After identifying the source of the vaping, I would then attempt to encourage the teenager as well as his/her loved ones and friends, to avoid being in the midst of a vaping environment. The aim is to change the paradigm or culture of the teenagers who are exposed to vaping from many or even a handful of sources. By taking away the influences of vaping coming from other individuals and groups, the teenager would not have a model or a reference point for vaping. That takes away the practice and routine of vaping, and will then lead to a more productive path towards a healthy lifestyle.

Another intervention or prevention that would come from informing the teenager about the health concerns and possible toxic substances that may be found in vaping. By educating and informing the teenagers, they will hopefully understand why vaping is not a healthy product and will convince the teenagers from vaping. Social influence can affect the health practices of individuals and groups because cleanliness and wellbeing are shared values that both arise and influence based on the theory of planned behavior (Piras, Minnick, Lauderdale, et al., 2018). The prevention objective may also come from showing the cost of vaping and the benefits, or lack thereof, of vaping. Based on the theory of planned behavior, e-cigarettes and vaping arises from the introduction of new technology combined with the known effects of addiction to nicotine (Scheinfeld, Crook, & Perry, 2019). 

References

Chu, T. H., & Chen, Y. Y. (2016). With good we become good: Understanding e-learning adoption by theory of planned behavior and group influences. Computers & Education, 92, 37-52.

McEwen, M., & Wills, E. M. (2019). Theoretical basis for nursing. Philadelphia, PA: Lippincott Williams & Wilkins.

Montano, D. E., & Kasprzyk, D. (2015). Theory of reasoned action, theory of planned behavior, and the integrated behavioral model. Health behavior: Theory, research and practice, 70(4), 231.

Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion (2019). About Electronic Cigarettes (E-Cigarettes). Retrieved from https://www.cdc.gov/tobacco/basic_information/e-cigarettes/about-e-cigarettes.html

Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion (2019). Quick Facts on the Risks of E-cigarettes for Kids, Teens, and Young Adults. Retrieved from https://www.cdc.gov/tobacco/basic_information/e-cigarettes/Quick-Facts-on-the-Risks-of-E-cigarettes-for-Kids-Teens-and-Young-Adults.html

Piras, S. E., Minnick, A., Lauderdale, J., Dietrich, M. S., & Vogus, T. J. (2018). The effects of social influence on nurses' hand hygiene behaviors. JONA: The Journal of Nursing Administration, 48(4), 216-221.

Scheinfeld, E., Crook, B., & Perry, C. L. (2019). Understanding Young Adults' E-cigarette Use through the Theory of Planned Behavior. Health Behavior and Policy Review, 6(2), 115-127.

Schüz, B., Li, A. S. W., Hardinge, A., McEachan, R. R., & Conner, M. (2017). Socioeconomic status as a moderator between social cognitions and physical activity: Systematic review and meta-analysis based on the Theory of Planned Behavior. Psychology of Sport and Exercise, 30, 186-195.

Watters, R., Moore, E. R., & Wallston, K. (2016). Development and validation of an evidence-based practice instrument for nursing students based on the theory of planned behavior. Journal of nursing measurement, 24(1), 1E-17E

The use of social mobility theory can help prevent tobacco smoking among teenagers, due to the fact that tobacco use is characterised by a social gradient in which the social and economic status is often correlated with tobacco smoking. In this way, most teenagers are bound to join the habit when watch their friends Vape. According to the social mobility model, the vaping epidemic often spread among the most powerful groups, which begins with the middle class students then continues to become more common across all class of men and women (Srd, 2019). Once the habit continues, then the least powerful may continue with the habit, in this way, the social mobility model can be used to predict the models stages in regard to the tobacco epidemic which makes it easier to implement measures that can reduce the spread of the condition further.  The model is thus relevant in accounting on ways in which the student will depart from the class habitus as a manner of generational rebellion. The model thus has the potential to unsettle other practices that are looked at as cross class youth practices, thus questions the relevance of youth as being one of the most useful category of independent class and analysis (Srd, 2019).  There is also need to put more emphasis on the active of the peer tension among the teenagers through putting more energy on peer responsibility, rationality and care as part of the neglected aspects of the teen groups when fighting addiction to vaping. 

References

Srd. (2019). Vaping Prevention. Retrieved from https://srhd.org/programs-and-services/vaping-prevention