1
Interventions for Risk for Suicide and Risk for Violence.
Nursing Diagnosis
1- PURPOSE. To review the research bases for interventions for risk for suicide and risk for
violence.
SOURCES.
Literature
planning books.
review
of
research-based
interventions;
review
of
care
CONCLUSION. The scientific base for nursing interventions published in common sources used by
nurses needs to be strengthened. There is a need for further research on interventions for these two
nursing diagnoses.
Key words: Interventions, suicide, violence
In the 1980s, the U.S. Surgeon General identified violence as a national mental health
10 - problem and focused attention on the development of strategies to prevent violence (Cron,
1986). The U.S. Public Health Service considered violence a critical public health problem and
included a set of objectives on violent and abusive behavior in the Healthy People 2000 guidelines
for national health care (U.S. Department of Health and Human Services, 1990). The reported
national homicide rate for 1996 was 9.4 per 100,000 resident population, and the
rate for suicide was 11.2 per 100,000 resident population (Bureau of Justice Statistics, 1997).
An editorial in the Journal of the American Medical Association cited violence as a
worldwide health problem.
Aggression continues to threaten the safety of staff and patients in healthcare
settings (Carmel & Hunter, 1989). Thousands of assaults occur each year in mental health
20 - settings, and are the leading cause of injuries for staff who work in these areas (Martin, 1995).
Managing violence has become a priority for nurses in healthcare settings (AAN, 1993; Littrell,
1998). The need for aggression management programs to decrease violence in all healthcare
settings was cited in the Report of the Task Force on Clinical Safety (American Psychiatric
Association, 1993). Healthcare professionals are challenged to provide high-quality
care in the most efficient and effective manner. This challenge is intensified
by several
factors--patients are more acutely ill, length of stay is dramatically
decreasing, resources are shrinking, and costs are closely monitored (Hamel & Prahalad, 1994;
Snyder, 1994).
Nurses
are
actively
intervening
with
clients
with
diagnoses
of
30 - risk for suicide and risk for violence. Definitions for these diagnoses are given in Table 1. The
extent to which interventions used by nurses are based on research findings has not been
assessed. Interventions discussed in this article for both risk for suicide and risk for violence are
listed
in
Table
3.
The
purpose
of
this
article
is
to
review
the
nursing research on interventions for the nursing diagnoses, risk for suicide
and risk for violence. The popular use of interventions from care planning
books is examined for evidence of research bases. Recommendations are made for further research
on interventions for these two diagnoses.
2
Part I:
1. Para uma compreensão geral do texto: Complete a seguinte afirmação:
O texto que segue trata sobre Diagnósticos da Enfermagem com foco sobre Intervenções
nos riscos de suicídio e violência. O estudo é fundamentado por meio de pesquisa, cujas
fontes foram: revisão de literatura sobre intervenções baseadas em pesquisas e revisão de
livros sobre planejamento de cuidados.
2. Para uma compreensão dos pontos principais do texto, responda as questões
abaixo:
a) O estudo é conclusivo sobre os diagnósticos em questão? Assinale:
(SIM )
(NÃO)
Transcreva em Português o extrato (trecho) do texto para confirmar a
sua escolha: O uso popular de intervenções a partir de livros de planejamento sobre
cuidados é examinado para as evidências nas bases de pesquisas. Recomendações são
feitas para futuras pesquisas sobre intervenções nestes dois diagnósticos.
Part II
3) Para a compreensão de detalhes ou pontos específicos, assinale a alternativa correta:
3.1. A palavra further , linha 6 e 36 é usada na comparação:
a)
b)
c)
d)
Superioridade para fur
Superlativo de far
Superioridade furth
Superioridade para far
3.2. A mesma palavra pode ser traduzida como:
a)
b)
c)
d)
Mais adiante
Posterior
Futuro/a/s
Todas podem ser usadas
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3.3. A palavra rate nas linhas 14 e 15 . Pode ser sinônimo para:
a)
b)
c)
d)
Tax
Fee
Ratio
Rather
3.4. A melhor reescrita para the leading cause of injuries, linha 20 :
a)
b)
c)
d)
Causa liderando as injúrias
Causa líder nas lesões
Causa principal de lesões
Causa que lidera as injúrias
3.5. Para evidências com base nas pesquisas. Qual fonte é a mais utilizada?
a)
b)
c)
d)
Artigos científicos
Livros especializados
Livros de planejamento para cuidados
Artigos de cuidados especializados
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21st Century Nursing Shortage
RNBuilder.com, a directory of nursing schools
There is a nursing shortage. Since Florence Nightingale professionalized nursing in the 19th
century, we have had cyclical nursing shortages, especially during times of war. In the past,
whenever the demand for nurses exceeded the supply, more nurses were
recruited and trained, and the shortages were quickly repaired. Today’s 21st
5- century nursing shortage is different. It is more severe and much more difficult to fix
than previous nursing shortages.
Reasons for the Nursing Shortage
Estimations vary according to the type of analysis used, but nearly all experts agree
that US healthcare will have a shortfall of somewhere around 1 million registered
nurses by the year 2020.
Today, there are over 120,000 unfilled openings for
nurses in hospitals and other healthcare settings, despite the fact that as recently as
12- the 1990’s we had a relative surplus of nurses.
There are several reasons for the suddenness and severity of the current nursing shortage:
Fewer people choosing nursing as a profession. Nursing has traditionally been one of the
few female professions. Today, women have more and better professional opportunities
and fewer are choosing nursing. There are more men in nursing than ever before, but it is
difficult to attract men to the profession because of the relative pay scale deficit of a
traditionally female profession.
Retirement of nurses. At the same time that fewer nurses are entering the profession, many
20- are leaving due to retirement. One source says that 55% of today’s nurses will retire by
2020, and there are not enough new nurses available to replace them.
Nurses leaving the profession. Nursing burnout is reaching epidemic proportions for the
same reasons that it is difficult to attract new nurses to the profession. Nursing is
exceedingly stressful, physically demanding and exhausting.
Shortage of nursing faculty. Until late in the 20th century, nurses were mostly taught by
26 -physicians and nurses with hospital diplomas or bachelor’s degrees. There were few
graduate-level programs and virtually no doctoral programs in nursing and most nurses
were trained in hospital-based programs. Today, there are very few hospital programs;
most nurses are college educated. The minimum educational requirement for a nursing
educator is a MSN (Master of Science in Nursing). MSN level nurses are also in demand as
nursing leaders, clinical specialists and nurse practitioners—and those positions are much
more lucrative than teaching is. Thus, there is a critical shortage of nursing educators, and
that shortage is the greatest barrier to relieving the current nursing shortage.
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This nursing shortage is a global shortage. In the past, hospitals have been able to fill
nursing vacancies by hiring “foreign nurses” who were educated in other countries. Today’s
shortage is global; all developed and undeveloped countries are experiencing a shortage of
nurses, so there is nowhere to import them from.
What Can Be Done
Strategies to address the critical shortage of nurses must remedy at least some of the
reasons for the shortage. We can address some issues that contribute to the nursing
shortage and it is essential that we do so, as quickly as possible some strategies such as:
42- Attracting new people to the profession. Although this has been the first and only
strategy needed to correct past nursing shortages, it is not the first thing we need to do this
time. We currently have more qualified applicants to nursing schools than we can educate.
As we correct other problems, however, we will need to attract bright young people—and
especially men—to the profession. Nursing must become as attractive a career option as
other professions.
Educating educators. The lack of nursing educators is a huge bottleneck in solving the
nursing shortage. We must create incentives that will attract graduate-level nurses into
education. That includes increasing educator salaries so that colleges can compete with
other employers and subsidizing advanced education for nurses who commit to teaching for
a period of time.
Improving nursing’s image. There are two national media campaigns that focus on
attracting people to the nursing profession. Both are educating people about the nursing
55- profession and eliminating inaccurate stereotypes about nurses. These are an excellent
first step toward improving nursing’s image. We must also improve salaries and benefits
and allow nurses more control over what they do.
58- The 21st century nursing shortage is, indeed, different from all previous nursing
shortages. It is more severe and, unless we act quickly to correct it, it will cause a
healthcare crisis of cataclysmic proportions. Hospitals and other healthcare organizations
cannot continue to provide services without nurses. As the shortage worsens, more and
more people will be denied access to healthcare simply because there will be no one to
provide it. The nursing shortage can be solved, but only if we act quickly and decisively to
increase the number of nursing educators, recruit inactive nurses and solve the problems
that cause people to choose other professions instead of nursing.
6
Part I:
1. Para uma compreensão geral do texto:
Faça uma leitura rápida e resumidamente ou em poucas palavras escreva qual é o
assunto do texto?
O assunto do texto aborda a escassez da Enfermagem no século 21. Relata que
desde Florence Nightingale, no século 19, a Enfermagem como profissão tem tido certa
escassez, principalmente em época de guerra. No passado, quando a demanda excedia o
número de profissionais, mais enfermeiros eram contratados e treinados e, assim, a
escassez era reparada. Hoje, no século 21, esta escassez é diferente. É mais séria, pois o
seu reparo está sendo mais difícil do que em épocas anteriores.
2. Para uma compreensão dos pontos principais do texto, responda as
questões abaixo:
2.1. Enumere e escreva na forma de tópicos as razões prováveis para o problema
em questão.
1) Poucas pessoas estão escolhendo a Enfermagem como profissão;
2) Muitos enfermeiros estão se aposentando;
3) Enfermeiros abandonando a profissão; pois é uma profissão desgastante e muito
estressante
4) Tanto a escassez de faculdades quanto de educadores de Enfermagem para as
faculdades específicas.
2.2. Quais propostas são sugeridas para resolver a questão?



Atrair novas pessoas para a profissão, principalmente os jovens e os
homens;
Criar incentivos para que possam atrair os enfermeiros, como melhores
salários principalmente para educadores; assim as faculdades podem
competir com outras profissões na formação;
Melhorar a imagem do enfermeiro: educando as pessoas sobre a
profissão e eliminando certos estereótipos .
7
Part II: Para a compreensão de detalhes ou pontos específicos, assinale a alternativa
correta:
1) Na linha 5 o verbo to fix significa:
a) fixar
b) transpassar
c) reparar
d) colaborar
2) Qual estimativa é correta de acordo com especialistas:
a) Em 2020, queda aproximada de 1 milhão de profissionais
b) Por volta de 1 milhão , em 2020, de profissionais registrados
c) Haverá, em 2020, 120 mil vagas abertas para enfermeiros
d) Compara-se com certa excedência os anos 90 e o ano de 2020
3) Para o melhoramento da imagem do enfermeiro destaca(m)-se:
a) Campanha na mídia que foca a profissão enfermeiro e o salário
b) Dupla campanha na mídia atraindo pessoas para a enfermagem
c) Campanhas na imprensa para melhorar o salário e atuação
d) Campanha única como primeira etapa para melhorar a imagem
4) Na linha 11: healthcare settings significa:
a) serviços de saúde
b) instituições de saúde
c) contextos de saúde
d) todas alternativas corretas
5) Although, linha 42, é sinônimo para:
a) Therefore
b) However
c) Instead of
d) By no means