Part I: Research Questions
Nursing is a dynamic career. Through nursing research, doors to improved, quality healthcare are paved open from time to time. In practice-based studies, human subjects are inevitable; thus, a researcher must be sensitive, aware and compliant to the regulations set by the Department of Health and Human Services (HHS) (Wolf, Walden, and Lo, 2005; NIH, n. d.; American Nurses Association, n. d.). In this regard, the author of this study was inspired to formulate the following practice-based research questions:
Quantitative. Quantitative approach explains using objective facts, eliminating bias and error (Firestone, 1987). Research, especially quantitative method, should avoid false findings (Ioannidis, 2005).
1. What is the relationship between the transport of newborns via a transporter vs. other mode of transport after birth and thermoregulation?
2. What is the relationship between history of general depression and postpartum depression in postpartum mothers?
3. What is the relationship between mandatory nurse-patient ratio and job stress or burnout?
Qualitative. Firestone (1987) stated that qualitative approach is best for phenomenological studies where “multiple realities that are socially defined” and readers are given “enough detail to “make sense” of the situation.”
1. Why do children born to teenaged mothers become teenage parents themselves?
2. What are birthing plans that are essential to a successful labor and delivery experience?
To determine if these are viable topics for further research, the help of the nurse clinician, the senior staff nurse, a staff nurse, and clinical manager was consulted.
On the relationship between the transport of newborns via a transporter vs. other mode of transport after birth and thermoregulation, it has been noted that infants that are transported from Labor and Delivery to the Well Baby Nursery via a bassinette or in mother’s arms experience hypothermia while those that are transported via a transporter maintain normal temperature.
From the consultation with the other healthcare providers, there was a research study on infant remaining with the mothers after birth but not on the mode of transport, which influenced the practice by allowing infants to remain with mother after both vaginal and cesarean deliveries until their transfer to postpartum. According to the nurse clinician, this is a good topic as they noted that the infant’s of vaginal delivery are transported in the mother’s arms or in an open bassinette and they usually have low temps while the infants of cesarean deliveries are transported in a transporter and they usually have normal temperatures; thus, there may be correlation between the two.
For the relationship between history of general depression and postpartum depression in postpartum mothers, it was noted that mothers with a history of general depression are usually anxious and weepy and have difficulty coping. However, studies for evidence are not sure. The only data that may be readily available for this topic are those referrals of any mother with a history of depression to Social Services for postpartum depression education and resources.
On the relationship between mandatory nurse patient ratio and job stress or burnout, the healthcare givers observed and agreed that its implementation is much better and beneficial because the nurses make less mistakes and patient care is better. However, supporting studies are a little bit hard to find.
On the other hand, it is noted that significant numbers of teenage mothers are 15 to 18 years younger than their own mothers and considerably, these young mothers will have their second child within one to two years of the first, which means having multiple children within their teenage years. From the consultation, the study is an interesting one but lacks available supporting data.
Meanwhile, the study on birthing plans was commended by the healthcare givers during the consultation as it has been noted that the outcome of the facility is usually the opposite effect: Majority of patients with birthing plans experience emergency delivery situations regarding themselves and/or their newborns resulting in cesarean sections for themselves and/or admittance to the Neonatal Intensive Care Unit (ICU) for the newborn. But again, the problem with this topic is on the availability of references that will be used.
From the conferred ideas, the author then was enlightened and selected the quantitative study on the relationship between mandatory nurse-patient ratio and job stress or burnout. The author will not have difficulties on supporting information on the topic as lots of research works had been conducted on the matter from all over the world. Job stress or burnout has always been a problem of nurses from time immemorial until now and from the different parts of the world.
Part II: Research Study
The relationship between mandatory nurse-patient ratio and job stress or burnout
Nursing is a career that requires lots of activities. With what their jobs require, nurses cannot avoid adverse outcomes related to their nursing care activities and daily patient load which are noted to be increased, shift rotation, and staffing that is short such as skipping their tea or coffee breaks, “feeling responsible for more patients than they could safely care for, inadequate help available, inadequate time to document care, verbal abuse by a patient or a visitor, and concern about quality of care” (Al-Kandari and Thomas, 2008).
A great problem nowadays in nursing is on staffing. Mantese, Pfeiffer, and Mantese (2005-2006) stated that “in this age of trying to maximize limited personnel to undertake expanding workloads, there is a risk of a detrimental increase of mistakes, misjudgments, and harm.” Flynn and McKeown (2009) support this with their research that focused on “the impact on patients and nurses of ‘poor’ nurse staffing levels”. From these, burnout or job stress has been found out to be on of the major nursing practice problems (Mrayyan, 2007). In relation to this, the author was inspired and interested to find out more on the relationship between mandatory nurse-patient ratio and job stress or burnout.
Statement of Purpose
The purpose of the study is establish a practice-based study which can be utilized by nurses and other concerned people as baseline data for the improvement of their practice or for further understanding of the nursing practice. Job stress or burnout in nurses should be addressed immediately as they are dealing with the lives of their patients. The findings of this study look forward to help uplift nursing management.
Courtney from Study Moose
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