La psychodynamique du travail et le paradigme du stress : une saine et utile complémentarité en faveur du développement des connaissances dans le champ de la santé au travail

Feelings of nurses faced with death: pleasure and suffering from the perspective of psychodynamics of Dejours

OBJECTIVES

To analyze the feelings of nurses confronting death, according to the Dejourian psychodynamic.

METHODS

This is a qualitative, exploratory study, analyzed, interpreted and discussed emphasizing the suffering and pleasure, proposed by Dejours.

RESULTS

Participants were 11 nurses, mostly woman, single, white, Catholic, between two sixteen years of profession. The analysis of responses allowed finding some driving and potentiating factors of feelings of pleasure and suffering. It was identified as pleasure: feeling of accomplishment, comfort and relief; as suffering, sadness, frustration, difficulty with grief, impotence and incapacity. They also have defense mechanisms to prevent suffering, as not to think about suffering and death, taking refuge in work.

CONCLUSIONS

The factors related to the pleasure and the pain of Nurses when facing death were identified. Therefore, education is necessary regarding the process of death in academic training and studies that approach the nurse to this natural process.

Critical Review on Suicide Among Nurses

Background: Research shows that there is a high prevalence of suicide among nurses. Despite this, it has been 15 years since the last literature review on the subject was published. Aim: The aim of this article is to review the knowledge currently available on the risk of suicide among nurses and on contributory risk factors. Method: A search was conducted in electronic databases using keywords related to prevalence and risk factors of suicide among nurses. The abstracts were analyzed by reviewers according to selection criteria. Selected articles were submitted to a full-text review and their key elements were summarized. Results: Only nine articles were eligible for inclusion in this review. The results of this literature review highlight both the troubling high prevalence of suicide among nurses as well as the persistent lack of studies that examine this issue. Conclusion: Considering that the effects of several factors related to nurses' work and work settings are associated with high stress, distress, or psychiatric problems, we highlight the relevance of investigating work-related factors associated with nurses' risk of suicide. Several avenues for future studies are discussed as well as possible research methods.

[Difficulties/suffering experienced by nurses : strategies for maintaining their mental health, the calling of the profession and their job performance]

The nursing profession is faced with an issue of growing concern, that of the mental health of its practitioners. The many difficulties that nurses experience in the workplace may prove to be detrimental to the maintenance of an optimal mental state. With respect to these difficulties, several strategies can be implemented and used by nurses and managers. The present literature review aims to identify the difficulties and suffering experienced by nurses and the strategies employed to ensure the preservation of mental health, as well as maintaining the calling of the profession and job performance. It also aims to provide nurses and managers of the health care system with ideas to promote optimal mental health for nurses. In this context, « psychodynamique du travail » was chosen as the framework to structure the analysis of the literature dealing with elements surrounding the suffering and difficulties experienced by nurses. The use of this theoretical framework deepens and supports the relationship between the suffering experienced at work and the mental health of nurses.

[Depression in the workplace]

Depression is the object of a dense literature, and synthesizing it is more of a utopian ideal rather than a concrete possibility. Several specific risk factors for mental health are found in the workplace: work overloads, defective communications, role conflicts, competitive climate, and tolerance of violence. At the same time, few preventive measures have been implemented against mental disorders at work, nor are many protective factors present. One worker in ten suffers from depression, anxiety, stress, or overwork. To be distinguished from "burnout", depressive symptoms must induce clinically significant suffering with substantial deterioration in functioning at work. For depression to be recognized as a workplace accident, the employee must show that it was triggered by an unforeseen and sudden event (or at least one certainly) due to or at work. The causal link between an event at work and the depression must be shown (in particular by expert medical testimony about stress factors and indicators of vulnerability to depression). Its recognition as an occupational disease can be based on the presence of psychosocial factors described by models of workplace stress and on its description by the occupational physician.