Sunday, 17 November 2013

Week 9: The eShift Model of Care


Course Content and Class Discussions

            The occupation of nursing is inherently filled with a variety of stressors, such as demanding patients, lack of time, and work overload, (Demerouti, Bakker, Nachreiner, & Schaufeli, 2000). These nurses are usually available to patients on a one-on-one basis within hospitals and long-term care settings. As a result, many nurses experience what is known as ‘burnout’, defined as a specific type of an occupational stress-reaction as a result of the high demand of the job, which makes them particularly susceptible, (Demerouti et al., 2000). With the number of nurses decreasing, the stress and emotional demands associated with their jobs are passed on to family members who are required to care for their own loved ones at home. This often results in what is known as caregiver burnout, (South West LHIN, 2011).  The result of caregiver burnout is often a decreased ability to care properly for their loved one as they are no longer ‘well’ themselves. Providing care to family members can be exhausting, (Ralph, 2012), and so the SouthWest CCAC and LHIN have started a revolution in the home health care field. A program directed at palliative clients, the eShift Model of Care, has been implemented to help reduce the caregiver burnout by supplying health care professionals to help in the homes overnight, so the caregivers can receive a proper night’s sleep and be able to care for their loved one during the day, (South West LHIN, 2011). The program allows for what is known as an ePSW – the ‘e’ standing for enhanced, (South West LHIN, 2011) to work with families in the home to provide overnight care as needed. Every ePSW (enhanced personal support worker) performs under the direction of a nurse through an application on a mobile device, (South West LHIN, 2011).
With regards to the nurses, instead of working one on one with clients, they are now able to manage care for up to four locations at a time, (South West LHIN, 2011). This allows for a broader range of care without the stress of job demand on nurses – a service delivery model.

Videos/Learning Tools

eShift Video:





A World without Nurses:




The eShift Model of Care:

  

Nursing Implications

             The idea of the eShift model raised several questions in class – as people are curious what exactly this ‘stranger’ would be doing in their home when immediate care is not required? Some students also questioned the safety of the client’s information, while others considered what implications may be involved in the event that a mistake is made by the ePSW? The answer to the latter is that the nurses are not responsible for mistakes made by the PSW as nurses are not their governing body!

            The thing that I take away from this new program is that it allows for clients at their end of life to die peacefully within their own home. Often times, these clients are stable in terms of what care they can receive and can be cared for just as well at home. As I am someone who’s always pictured myself working in a hospital setting, having a program like this would help to significantly decrease that type of care within the hospital allowing for more patients with more immediate issues to be cared for. This would save resources both in the form of hospital expenses but also in the way of nurses whose population, as mentioned earlier, is steadily declining.

            When addressing the issues of the responsibilities of the PSWs it is reasonable to believe that during the times that the ePSW is not attending to the client, he/she may be providing other care within the home, such as cleaning, or laundry. This would help to relieve some of the daytime stress on the caregiver as well.

Readings and Additional References

Demerouti, E., Bakker, A., Nachreiner, F., & Schaufeli, W. (2000). A model of burnout and life satisfaction amongst nurses. Journal of Advanced Nursing, 454–464.

Issa, A. M. (2007). Personalized medicine and the practice of medicine in the 21st century. McGill Journal of Medicine, 53-57. Retrieved from: http://www.med.mcgill.ca/mjm/

Lawson Health Research Institute. (2012). Announcing the mental health engagement networks (MHEN). Mental Health Engagement Network.  Retrieved from: http://www.lhsc.on.ca/About_Us/LHSC/Publications/Features/MHEN.htm

Ralph, A. (2012). Informal caregivers’ experience of caring for a palliative family member. Western University, 1-117.
South-West Local Health Integration Network. (2011). EShift Helps Patients and the SouthWest CCAC. Retrieved from: http://www.southwestlhin.on.ca/newsletter.aspx?id=60

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