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Provide two scholarly references to support your response

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Provide two scholarly references to support your response. Examples of critical discussion include:

1. Comparing your post and your peer’s post, how did theories differ in the guidance provided to design interventions and address the topic?
2. Were there any major limitations with the theory selected by your peer?
3. Each posting is to be in the Correct APA forma
4. Here is my peers post that I would like to compare ….
5. Topic: Work environment, nurse burnout, and patient outcomes
6. Theorist: Sister Callista Roy
7. Level of theory: Grand theory
8. Purpose of the theory, major concepts and relationship statements and usefulnessThe Adaptation Model of Nursing is a grand theory developed by Sister Callista Roy, this conceptual theory focuses on an individual’s ability or inability to adapt to changes that can be internal or external. Individuals respond to changes physiologically and emotionally; those responses can either be inherent or acquired. The theory gets its name from the four adaptive modes Roy describes that occurs while the individual copes with the changes that are occurring. Callista Roy described three different adaptation processes which are integrated, compensatory, and compromised (Roy, 2011, pg. 347). Roy also described the modes as “physical, group-identity, role function, and interdependence” (Roy, 2011, pg. 347). These adaptive modes were developed to be used for the individual, however, as our world becomes more globalized the modes have been enhanced to be applied to “the family, organizations, communities, and global society (Roy, 2011, pg. 347). Roy additionally described three adaptation processes which are “integrated, compensatory, and compromise” (Roy, 2011, pg. 347). At the integrated level there are no changes to the individual's response to external stimuli. At the compensatory level, the individual uses a coping mechanism to reestablish the integrated level. Lastly, the compromised level is developed when coping mechanisms are no longer adequate. The ultimate goal of Roy’s theory is to achieve adaptation in all four modes.According to Roy’s adaptation model nurses who are experiencing burnout are at the compromised level, where coping mechanisms are no longer effective. Burnout does not only affect the nurses on an individual level; it also affects the organizational group level as burnout is prevalent throughout the nursing profession. Each of Roy’s four adaptive models can be related to nursing burnout. The physical level includes aspects that affect the individual in their personal life such as healthcare, finance/compensation, nutrition, childcare, transportation, and protection (Roy, 2011, pg. 347). The role function mode “at the group level focuses on the need for role clarity” (Roy, 2011, pg. 348), where the nurses know their role, the work is fairly divided/distributed, and there is shared governing. To improve patients outcomes healthcare systems need to address nurse burnout and actively take steps to mitigate it. Generally, nurses spend a great deal of their time caring for their patients and families while juggling other duties. Due to the high-stress environment, long shifts, staffing shortages, strained relationships with management, doctors, and the health care system (Schlak et al., 2021); nurses have a high rate of burnout. Burnout is described as “feeling emotional exhaustion, cynical, and ineffective in relation to one’s work, colleagues, and clients” (Schlak et al., 2021, pg. 1). It can be inferred that burnout is a result of a nurse’s inability to adapt to relationships with managers, peers, patients, workload, and work environment. Burnout is a consequence of a poor working environment, it is less about the type of work and more about how the work is devised, divided, and managed (Schlak et al., 2021). Patient’s lives and wellbeing are directly affected if the nurses caring for them are burnout. Interdependence and role function are the modes that relate closely to the chosen topic. The main concept of interdependence mode is establishing meaningful relationships by building trust and mutual respect. As for role function, it focuses on having a clear understanding of one’s responsibilities, shared governance, and equity. When trying to prevent negative patient outcomes secondary to nurse burnout it is essential for there to be a good working environment, appropriate staffing levels, low nurse to patient ratio, having supportive higher management, feeling appreciated, and autonomy.Level of TheoryThe adaptation model does not provide operational definitions. It is considered a grand theory, therefore the concepts are broad and can be tailored to many situations and settings.Specific Interventions
   1. Name/phrase: Improving patient outcomes by reducing nurse burnout.
   2. Purpose/Foundation: The purpose is to improve patient outcomes by ensuring nurses are properly coping with external stressors and if they are at the compromised level taking the appropriate steps to get them back to either compensatory or integrated level. When applying Roy’s adaptation model it is important to remember the three levels which are integrated, compensatory, and compromised.
   3. What: Nurses and the healthcare system need to recognize the levels of adaptation and the four modes. Thereafter nurses should identify the areas in their personal and professional life that are suffering low levels of adaptation. The ultimate aim is to provide the nurses with a healthy coping mechanism to achieve the integrated level or the compensatory level. By providing educational workshops that emphasize the importance of identifying maladaptive behaviors and providing resources for nurses to get the help they are seeking. To assess the level of burnout pre and post-assessment the questionnaire should be filled out by the nurses.
   4. Who: Nurses and the healthcare system.
   5. How: The healthcare system would offer a combination of in-person and virtual classes. In-person, classes can be costly for many reasons but it would probably be the most effective method, as people tend to be more invested and attentive in this type of setting. Virtual classes are the most convenient and cost-effective since they can be pre-recorded from a previous live session and can be watched at any time, the downside of the virtual sessions is not being able to interact with the presenters.
   6. Where: The live sessions could be held in an auditorium (if available), large classroom, or conference room. The virtual sessions would be accessible anywhere, as long as the device is connected to the internet.
   7. When and how much: The in-person classes should be held at a minimum monthly, offered at different times throughout the year to accommodate different work schedules, it should be free of charge to the attendees, and should last no more than 2 hours. The virtual sessions would be available at any time and should be accessible to any device with the internet.
   8. Tailoring: Extensive research needs to be done by the healthcare system and they need to be knowledgeable on mental health, substance abuse, coping mechanisms, and most important factors that are contributing and triggering nurse burnout. The healthcare system needs to have a good understanding of Roy’s adaptation model, the conceptual model, and levels of adaptation. Along with medical coverage, mental health should also be covered, offering well-being classes, and promoting the importance of self-care to combat burnout and improve patient outcomes. Provide incentives for the nurses who attend the in-person sessions such as getting paid for the day to attend or gift cards. It is also important for the healthcare system to de-stigmatize nurse burnout, by doing this nurses will be more likely, to be honest on how burnout they are and accept the help without fear of repercussions.
   9. Outcomes: The outcome can be measured by seeing a decrease in patient negative outcomes, a decrease in burnout, an increase in nurse retention, and longevity. The healthcare system can use surveys to measure burnout levels, pre and post-assessment for the nurses who attend the in-person sessions and follow up on the nurses who score higher on the burnout surveys. They can even customize a survey based on Roy’s adaptation levels, that way they can follow up on the nurses who fall in the compromise level getting them the much-needed help.