Write abstract/summary to the presented paper.

 

Introduction

This essay will present an interpretive account of a drawing that relates to nursing profession. It is apparent that certain factors affect the development of nursing, as we move to the future. Therefore, the selected drawing (Figure 1) is quite symbolic and rich of meanings associated with the direction of nursing, the roles and responsibilities of nurses, as well as with others’ perceptions of nursing profession in today’s dynamic reality. The medium for the drawing’s creation was chosen in order to provoke a bigger interest among the public about the different face of nursing. Society imposes its strict demands on nurses at all times, but they lack the respect they need to receive as professionals. The purpose of this essay is to explore the drawing from different aspects, mainly related to the gradual transformation of nursing profession into an unoptimistic job.

Description of the drawing (Figure 1)

The drawing ensures quite deep and important implications to the field of nursing. It is apparent that nursing profession is associated with numerous challenges in today’s highly dynamic society. Therefore, the author of the drawing selected predominantly dark colours for representing the major theme of the work, which is the huge degree of depression and sadness pertaining to nursing profession. The colours mostly used are blue, black, and dark grey, and such a combination of colours definitely suggests negative associations that generally come to mind. Clearly, the overall setting depicted in the drawing indicates overwhelming feelings related to the constant pressure encountered by nurses. The chosen colours introduce the observer to the daily intensive world of today’s nurse practitioners.

 

Apart from the dark colours of the drawing, the author depicted a female nurse at the foreground in order to emphasise on the impact of the most important representative of nursing profession. This nurse is holding a needle and is captured at a moment of her work shift. Moreover, the drawing implies a certain concept of space in the sense that the viewer can see a long corridor leading to an emergency room at a hospital. In the background of the drawing, other figures of nurses or other hospital personnel can be observed. The depicted walls and ceiling are wide, but such an aspect does not create any comfort or relaxation. On the contrary, the simple observation of such wideness leads to greater frustration and a lack of concentration on performing particular job tasks. The observer’s thought is jumping from one angle of the drawing to another in persistent attempts to find a satisfactory explanation of the work.

Inspiration

Indeed, the author was inspired to create the drawing by the challenging current situation in nursing profession. This situation reflects in the persistent lack of respect from doctors, patients, colleagues, managers, and supervisors. It appears that individuals fail to recognise the important role played by nurses in the health care system. The lack of respect as a professional definitely creates personal psychological problems that reflect in the intensity and quality of work. It is important to mention that “there are also greater expectations from patients and carers for clear information and understanding of their health, illness and health care experience, and an increasing expectation of participation in decision making about their case” (Alexander, Tonks, Fawcett and Runciman, 2006). As result of such a lack of respect and changing expectations, nurses view their voice as extremely limited in the health care field. Such awareness also deteriorates nurses’ self-esteem, as they feel that their voice cannot have a significant impact on making important strategic decisions in health care. Nolan and Smojkis (2003) discuss the following factors that intensify nurses’ daily schedules, “increasing bureaucratisation of health care, unattractive working conditions, poor pay and the emotionally exhausting nature of the work” (Nolan & Smojkis, 2003). These main aspects have provoked the author of the drawing to illustrate depression as a major theme of the work.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Discussion and analysis of the main themes presented in the drawing

Nurses no longer feel happy and optimistic about their job, which is clearly seen in the sad face of the depicted nurse. Although there is a significant increase in accountability for patient outcomes, there is no a corresponding increase in salaries of nurses. Such a condition contributes to the intensified pressure at the work environment for nurses. The lack of solid salaries decreases the overall quality of offered health care services. Jason and Wagner (1998) indicate “self-reported persistent or recurrent impairment in short-term memory or concentration severe enough to cause substantial reductions in previous levels of occupational, educational, social, or personal activities” (Jason & Wagner, 1998). In this way, nurses become simply mechanised objects with the sole purpose to fill shifts. The drawing illustrates this overwhelming aspect of mechanisation, along with the notion of indifference and exhaustion.

In today’s working environment at hospitals, nurses are placed in dangerous positions in the process of providing care to patients (Eberhardie, 2009). For instance, nurses in some health care facilities have many patients to care for, and thus nurse practitioners sometimes feel overwhelmed and unable to deal with such an extensive pressure. This is actually a personal experience that due to the scarcity of nurses they work for longer hours and handle a lot of ceases hence they are exhausted and more likely to not pay attention or respond to a patient’s concerns, wishes and beliefs. Unfortunately, this is an example of issues experienced by most professionals by most public organisations (Baillie et al., 2008).

With the constant advancement and technological improvements of health care, it is expected that the cost of health care services is increasing. Nurses demonstrate a belief that their salaries do not correspond to the care they provide (Alexander, 2011). In addition, “Higher nurse workloads are associated with burnout and job dissatisfaction, precursors to voluntary turnover that contribute to understaffing of nurses in hospitals and poorer patient outcomes” (Vahey et al., 2004). Therefore, the nurse from the drawing can be perceived as both sad and unsatisfied from her wage. She performs certain tasks with obvious apathy and indifference. Likewise, nurses are not secure with their jobs, which imply that such a constant fear decreases the quality of their work. Sometimes health care employers fail to provide long-term employment relationships, and this reflects in unwillingness to perform their job functions as well as to handle many patients at the same time.

Of course, the mentioned feelings are unacceptable on the behalf of nurses because society puts significant pressure on them in terms of quality, high requirements and demands. Yet the drawing catches the unfavorable moment of desperation and sadness related to fulfilling the roles and responsibilities of nurses. Exhaustion occurs “when the individual has expended all of his or her physical and emotional resources” (Boswell, 1992). It is clear that when individuals are exhausted, they are not productive and efficient in accomplishing their job responsibilities. Nurses consider the immense difficulties referred to the limited impact nurses have on hospital administrators and physicians. Nurses frequently believe that the only reliable way that their voice is heard is to join a union, where they can share important insights about work processes and responsibilities. However, such an answer is not always essential for making positive changes in nursing profession.

One of the ways to help nurses regain their confidence and self-esteem is to assist them in the process of overcoming any signs and symptoms of depression or anxiety. As it has been indicated in the drawing, the long dark corridor additionally creates a persistent feeling of depression. It is crucial to help nurses deal with any early depressive signs so that they can regain trust in their own capacities to undertake various tasks at the workplace (Imai et al., 2004). This requires coordinated efforts, adequate collaboration and understanding. Yet the corridor is perceived as an important symbol of nursing job in the sense that when nurses start their shift/ work, they never stop. Their work is similar to a constant race in which they persistently deal with numerous pressures related to the health condition of patients. However, “Changes in medical care systems and working environments can act as stressors on medical professionals” (Imai et al., 2004). Sometimes changes are perceived quite negatively especially if they are unexpected or occurring at improper times.

This long corridor in the drawing is depressing, as it suggests common, monotonous movements and activities. In other words, it refers to a situation when someone starts something and never stops. Such a repetitive cycle apparently makes individuals indifferent, exhausted, and extremely frustrated with their present schedules. Nurses are normal human beings like anyone else, but the pressures they encounter at the work environment are huge and sometimes unbearable. In a study by Dickinson and Wright (2008), common pressures encountered by nurses related to “inter professional conflicts, workload, and lack of involvement in decision-making” (Dickinson & Wright, 2008). The lack of solid support systems also has a negative impact on the well being of nurses. Thus, the long corridor symbolises nursing profession because the nursing shift does not seem to have ending. There is always something to do, and one can perceive the corridor as a metaphor for nurses’ overwhelming feelings. The enclosed space pertaining to the corridor implies certain boundaries that nurses find difficult to overcome at times.

One of the problems that individuals can associate with the depressive aspects of the drawing is the low workplace morale observed at plenty of health care facilities. The lack of important moral and ethical values definitely deteriorates the work of nurses. Their negative attitude may reflect in their interactions with patients, and thus nurses may not provide high-quality health care services (Barnard et al., 2006). Ignoring the human aspects of nursing profession can create certain problems in the respective work environment. The fact that the depicted in the drawing nurse seems extremely tired and sad indicates a high risk for developing irrelevant thinking patterns and inappropriate reactions towards patients.

A simple observation of the drawing makes people sad and unwilling to enter a hospital because they fear an inappropriate, unfair treatment on the behalf of nurses. Of course, such generalisations may be irrelevant under certain circumstances, but the overall impression is that most nurses tend to lose an interest in their job due to long working hours and inadequate salaries (Newbold, 2007). The nurse from the drawing clearly belongs to the mentioned category of nurses in the sense that she has lost an interest in maintaining her daily responsibilities at work. The author of the drawing relies on the strong parameters of the face expression in order to discuss major problems and challenges facing nursing profession (Scott, 2003). Human face, especially eyes, represents a mirror to one’s soul and feelings experienced at a particular moment. The tired physical appearance of the nurse from the drawing is obvious from the dark circles around her eyes and the grimace of her mouth (Grzymowicz, 2009).

This drawing may also relate to the low self-esteem and passive aggression of some nurses. They feel like moving in a circle, as their daily intensive routine makes them stressed and helpless at the same time. Their self-esteem is gradually decreasing, which creates unfavorable conditions to develop passive aggression. A reliable explanation of such passive aggression can be found in the fact that “Nurses are just cogs in a huge uncaring bureaucracy and have been robbed of the language of compassion” (Scott, 2003). It is clear that the depicted nurse in the drawing is helpless. Although she is not happy and optimistic at her work environment, she has no other choice especially in the conditions of the current financial crisis. Indeed, the possibility to find appropriate employment opportunities diminishes. The drawing dominates with passive aggression, which is not directed towards a particular person, but it rather indicates the overall problems in nursing profession.

Moreover, the drawing imposes a revolutionary way of considering nursing profession because the public generally demonstrates a quite outdated perception of nurses, their roles, and responsibilities in an ever changing and dynamic work environment. The drawing requires that individuals observe nursing profession from a different angle in the sense of considering nurses as normal human beings with their pains and suffering. From this perspective, nurses apparently reach their limit of physical and psychological strength and capacities to deal with the strict demands of doctors, patients and the entire community. Another factor contributing to such exhaustion among nurses pertains to the following aspect, “Aggression and violence towards nursing staff in UK health care is a growing problem” (Bonner & McLaughlin, 2007). Such aggression, along with the extensive working hours makes it challenging for nurses to concentrate at the necessary high level. They simply wait the ending of their shift so they can go back home to relax and do other activities.

The lack of concentration may have quite serious consequences associated with the health condition of patients. The author of the drawing conveys the message that nursing profession is in an emerging need to change certain aspects that could improve the well being of nurses and their capacities to provide relevant health care services to patients. Something definitely should be done regarding the tiring long hours and the multi-task roles that are generally fulfilled by nurses (Eberhardie, 2009). The drawing has certain implications about the lack of common ground for educational standards to enter nursing profession. I can observe certain chaos in the sense of seeing nurses rushing through the corridor and sometimes unaware of what they need to do. The fact that nursing lacks a real common entry-level creates such chaos and confusion.

The author of the drawing demonstrates the purpose to initiate an ongoing, flexible discussion about the future direction of nursing profession. The impression of the drawing is problematic in the sense that the observer may consider the ambiguous nature of nursing. From one side, this humanistic and noble profession is expected to generate quite positive outcomes. It should be considered that “over the years, the education and general welfare of nurses and nursing care delivered to patients has improved as a direct result of various nursing organizations” (Castledine, 2010). From another side, the problems faced by nurses accelerate, which calls for immediate attention to suggest reliable methods and strategies that could improve nurses’ contributions to the field. The lack of nurses willing to work more extensively with patients is clear from this meaningful drawing. Nursing shortage is not identified as the biggest problem in the profession, but the greatest challenge that emerges is the unwillingness of registered nurses to work in compromising situations in health care.

An aging population is another disturbing problem in nursing profession even though this aspect does not relate to the nurse from the drawing because she appears to be young. Despite her young age, she seems exhausted physically and mentally. In this way, people may question her efficiency at work and her proneness to make certain mistakes. Indeed, mistakes are unacceptable in nursing profession because of the urgency to deal with human lives (Beasley, 2011). Yet tiredness, anxiety and immense stress increase the probably of mistakes, and this requires drastic measures to be undertaken in the field in order to improve the working conditions for nurses. Another important measure is to decrease the female domination of nursing profession. Male potential should be adequately explored in order to balance gender roles within the workplace.

In addition, the practice to recruit new nurses complicates the situation with quality in health care because these nurses may lack experience and significant skills to deal with various patients and specific health conditions. Thus, it is more important to consider the retention of highly experienced nurses who can provide optimal care to patients, as well as to comply with requirements for patient safety (Whitehead et al, 2007). Nurses are a part of an interdisciplinary team, but the main problem is the lack of integrity. The nurse from the drawing clearly shows such disturbing lacks in the health care system. She is left alone under extreme stress, and the inability or unwillingness to interact with other staff worsens the situation.

The drawing shows a nurse who is doing her job, but doubts remain whether she is highly productive and creative in terms of time management, dealing with patients and attitude towards work processes. I definitely think that the depicted nurse is uninspired even when it comes to further her education or move up to a higher position in the health care field. This can be explained with the fact that not all hospitals and health care facilities offer significant monetary reward or funds for education and training. For instance, nurses with Associates Degree in Nursing, which presents the 3-year degree, are not given extra salary reward, which impedes their job motivation and enthusiasm. Canham and Bennett (2001) write, “Despite the principle that post-registration education should be linked to service need, many specialist practitioner students find themselves in a restricting grade on qualification”. Therefore, a reliable measure for improving the working conditions for nurses is to increase their salaries. It is important that nurses feel that their contributions are appreciated accordingly.

Likewise, the posture of the figures in the background implies sadness, as one can feel the immense suffering of patients and the persistent efforts of nurses to provide health care services despite the outlined challenges. Yet the impression remains that nurses are highly dissatisfied day after day. Work stress increases due to the challenges of accepting acutely ill patients. The drawing clearly demonstrates the occurrence of stress in the depicted hospital environment. It seems that most of the sources of stress for nurses appear organizational in nature (Yam, 2004). Job demands constantly increase in nursing profession mainly due to the implementation of sophisticated technologies and fierce competition among hospitals (Malone, 2001). In addition, “Despite the importance that can be attributed to nursing values, acknowledgment of them is difficult to find in the current debate about how inter professional working is changing the healthcare system in which nurses currently work” (Kenny, 2002). The author of the drawing illustrated the major themes of sadness, depression and exhaustion of nurses in order to initiate relevant actions. Individuals and organisations need to rethink the specific roles of nurses, as well as the aspects of nursing shortage, high work overload and insufficient support from colleagues and doctors (Scott, 2003).

As it has been suggested, the nurse from the drawing is mostly emotionally exhausted, which is clear from her face expression. She definitely experiences imbalance between efforts spent at her workplace and obtained rewards. This nurse represents the negative and stressful situation for many other nurses. The physical environment plays a key role in determining one’s motivation for work (Barnard et al, 2006). From what it has been discussed, the physical environment in the drawing is negative and depressing. Instead of working with a friendly, smiling face, the nurse is at her limits of physical and emotional strength. I can imagine how she is constantly checking her watch in anticipation of the shift’s ending, which will stop partly her worries or fears. The routine character of the work makes the person dissatisfied, and thus the field needs certain innovations in order to generate better outcomes.

The drawing implies that major work stressors for nurses include role ambiguity and role conflict. Role ambiguity refers to a lack of clarity about particular tasks and goals, or in other words, unpredictability associated with role performance of nurses takes place (Jason & Wagner, 1998). Such a definition can be extended by including information deficiency. I obviously make a connection between role ambiguity and job dissatisfaction, as I observed the face expression of the nurses from personal clinical experience and the nurse from the drawing. At the same time, role conflict is defined as a lack of certain expectations between specified roles of nurses. Role conflict mainly includes contradictory requirements, improper demands and insufficient resources. Role ambiguity and role conflict determine the occurrence of burnout in nursing profession. The burnout syndrome refers to fatigue directed towards patients, as the major perception is of having failed professionally.

The individual in the drawing apparently fails to cope with such persistent sources of stress. The emotional exhaustion of the nurse implies a loss of concern for the well being of others, and similar feelings further progress into inadequacy and failure in performing common job tasks. Another unfavorable experience that is possibly encountered by the nurse from the drawing relates to depersonalisation, which generally takes place when nurses tend to treat patients as objects and develop inappropriate attitudes towards them (Barnard et al, 2006). Moreover, I think that the author of the drawing tried to show the lack of personal accomplishment concerning the intention to help others in the health care field.

Clearly, the emotional exhaustion dimension is perceived as the initial step of the burning out process. Such a process is overwhelming and ongoing in the sense that it will continue over time because pressures are not likely to decrease in nursing profession. The drawing calls for adequate actions of the respective health care authorities in order to find optimal solutions to emotional exhaustion and depression among hospital nursing staff. It is important to consider efficient personal coping resources that can strengthen emotional reactions of nurses (Alexander et al, 2006). Social support systems need to be carefully designed so that they can correspond to nurses’ challenging situation in health care.

Likewise, I would like to pay adequate attention to the aspect of silence pertaining to the drawing. Silence is quite meaningful in the sense that it represents overwhelming emotions encountered by nurses in today’s working environments. The nurse from the drawing is silently suffering, which means that she does not seem to share the concerns, fears and anxiety that she may experience. At the same time, silence intensifies pressure at hospitals and contributes to the impression of mechanisation associated with nurses’ roles and responsibilities (Finlay et al, 2006). Persistent silence is unfavorable because it prevents professionals in the nursing field to take relevant actions to improve the working conditions for nurses. Specific role identification appears quite problematic to nurses who gradually become passive in terms of claiming their voice in certain decisions.

Conclusion

This paper presented a relevant interpretation of a drawing depicting an exhausted, depressed nurse at her work environment. The interpretative analysis focused on various aspects of the drawing. Indeed, the author of the drawing selected an appropriate medium in order to share important insights about the status and challenges of nursing profession. By analysing the drawing, I could pay significant attention to major factors that cause stress and anxiety among nurses. I believe that the drawing provides certain guidelines for undertaking drastic measures in the nursing field. It is important to consider the numerous challenges encountered by nurses, as well as the fact that they work under constant pressure, which obviously decreases the quality of the care they provide to the patients.

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