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such as developing support networks, increasing awareness, while also improving ones’ ability to respond and rebound from the stress related to their work. Additionally, educating on and reinforcing the need for self-care strategies, the value of debriefing meetings for events that require more than the typical bereavement opportunities through the team meetings, and also upon ones’ spirituality and representatives who may be able to encourage or educate further in this area. While it is also essential for nurses to know that they can say no, however that may be difficult for some, and reinforcing this from the department'sleaders can be valuable. This article supports the PICO(T) question in various ways, however; it specifically looks at the issues from a Hospice perspective as opposed to all nursing, which one key factor for the PICO(T) question. Kavalieratos, D., Siconolfi, D., Bull, J., Steinhauser, K., & Kamal, A. (2016). It’s Like Heart Failure: Its Chronic and It Will Kill You: Exploring Hospice and Palliative Care Clinicians Experiences with Burnout (SA538B). Journal of Pain and Symptom Management,51(2), 404-405. doi:10.1016/j.jpainsymman.2015.12.299This research study takes a closer look at burnout within various caregivers working in palliative care and with end of life patients. More precisely, the researchers looked at the caregivers’ experiences with burnout, what they perceived to be the sources of their burnout, and the various solutions for
4-3 MILESTONE THREE - ANNOTATED BIBLIOGRAPHY13managing burnout. Three focus group studies were employed during an annual convention for hospice and palliative care nurses, analyzing reported symptoms ofburnout, how it may be different for hospice and palliative care nurses as compared to others, and strategies this group utilized to decrease or manage their reported burnout. The sample size consisted of various team members including Nurse practitioners, providers including physicians and physicians’ assistants, as well as social workers. The research study utilized phenomenological methodology to attract participants and to also learn about their individual accounting of burnout, as opposed to the participants’ diagnosis of burnout. An interview guide was developed to use in this study, while involving the participants in conversation related to three key areas including their experiences with burnout and the sources, as well as strategies utilized for alleviating or preventing burnout for each individual. The sample size was 1357 caregivers, from various institutions, and included both men and women. The groups were broke into categories based the number of years employed in the field, zero to fiveyears, size to twenty years, and twenty-one years or more. Sources of burnout included a number of sources or triggers from boundary issues, self-judgement concerns, to regulatory issues and many other specific factors. The effects of burnout included created mental health concerns, performance issues and job dissatisfaction, and impacted interpersonal relationships. There were also various protective mechanisms that were utilized by the participants such as relying on theteam members to support one another, establishing boundaries, and incorporating family sessions into the care of the patients to ensure better support and care.
4-3 MILESTONE THREE - ANNOTATED BIBLIOGRAPHY14This research study and the article support the PICO(T) question as it directly accounts for the causes of burnout as well as the strategies to prevent, minimize, or resolve burnout among caregivers in palliative care and hospice. The participants however were not bedside nurses, although there were nurse practitioners who participated. Including more nurses who perform more of the care for this patient population, as well as looking at other than a self-reporting tool for gathering the data could change the outcome of the study perhaps with more profound information.