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The issue of life-threatening conditions in emergency medicine
KELBLOVÁ, Kateřina
Issues relating to life-threatening conditions in emergency medicine The purpose of this bachelor?s thesis was to determine how nurses in Intensive Care Units cope with common emergency situations. The theoretical part explains acute care, its three stages, staff/bed rate, and education and skills of the nurses. It also contains descriptions of possible acute life-threatening conditions, which may result in sudden cardiac arrest. It also describes specifics of cardiopulmonary resuscitation, and stress the nurses experience in intensive care. The target was achieved through four sub-goals: To determine the level of preparedness of nurses to work in such departments. To determine whether specialized study program can influence preparedness for crisis situations. To determine whether nurses change their attitudes to crisis situations after a period of practice. To determine how nurses in this field experience and cope with crisis situations. The practical part contains a qualitative research based on semi-standardized interviews held with eight nurses, and consequent content analysis accomplished through open coding. There were determined 23 categories and other sub-categories. For better clarity, data in categories 2,3,7,9,10 and 19 were put into categorization tables. The conclusion is: half of the nurses that claimed secondary school of nursing had been their only completed study program said this education prepared them inadequately for real situations. Only one nurse who had completed the specialized program felt ready for ICU. Partial preparedness was found in the nurse who had completed a higher vocational school. Preparedness can also be assessed from feelings the nurses experienced soon after they started their careers at ICU. Only one nurse felt all right; the others felt anxiety and stress. This means, nurses are not sufficiently prepared on theoretical level when they start their careers; and it results in negative feelings, eg. stress. The hypothesis No. 1 is: Nurses are insufficiently prepared on theoretical level when they start their careers. The survey showed that 6 nurses had completed specialized study program; one before she joined ICU, and one is currently in the program. All nurses who finished the study program find it helpful; only the nurse with no program completed feels she is not ready for crisis situations now. Therefore, the hypothesis No. 2 is: Specialized study program has a positive impact on how nurses handle crisis situations. Reaching the third objective, the survey looked at how nurses dealt with crisis situations at the start of their careers and at the time of the survey. Three nurses had identical answers. Two found no situation critical, and one still finds the fight for patient?s life burdensome. Two nurses replaced ?resuscitation? with ?no crisis situation?; one mentioned ?conflicts in the workplace?, and two remaining nurses described insignificant changes. Yet, all nurses but one responded that the length of their practice has positive impact on how they handle crisis situations. Even though the length brings safety and peace, it does not necessarily improve the care provided. Objective No. 4: What feelings do nurses have when they handle crisis situations? Most frequent answer was staying balanced and composed, rational thinking, and speed in decision-making process; also a certain form of stress. Interestingly, if asked about possible reasons for leaving the department, nurses mentioned general management, problems in the team and in relationships; only two nurses were fully happy with their jobs. The results and conclusions of this bachelor?s thesis may serve as inspiration to managers in nursing.
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