Barriers
There are several barriers that have an influence on nurses’ continuously working overtime. There have been laws initiated in banning mandatory overtime and has been implemented in many states in hopes to decrease the number of overall extra hours worked by nurses. But there are no laws in place when it comes to working voluntary overtime, which the hospital may use to fill in the staffing gaps. After the ban of mandatory overtime, nurses reported being obligated into working voluntary overtime in a survey constructed by American Nursing Association (Bae & Brewer, 2010). There can be an increase on the number of voluntary overtime hours worked as managers’ can use voluntary overtime to fill in for staff shortage following the ban in
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Nurses in West Virginia reported working overtime and were unaware that the law against mandatory overtime was initiated even thought it had been over six years that the law had existed. It was also discovered that health care facilities were not obeying the new law of banning mandatory overtime as many nurses in West Virginia reported working mandatory overtime in the absence of a catastrophic event (Bae, 2012). The American Hospital Association (AHA) stated having a shortfall in nursing faculty in order to teach nursing students, leading to the rejection of many competent candidates applying to get into nursing school. This may lead to a decline in nursing students being enrolled into the program, as there aren’t enough faculty members to teach contributing to the nursing shortage (Palmer, 2003). Nurses can also act as a contributor to the increasing use of overtime. Nurses may choose to work overtime because of the downfall in the economy to alleviate financial crisis. Nurses that work fewer shifts but extended hours may use their days off working a second job rather than recovering from the lengthy shifts (Stimpfel, Sloane & …show more content…
A research done by the Canadian Nursing Advisory Committee suggests that when nurses working part-time are modified into full time workers, the nursing staff requirements are met (as cited in Drebit et al, 2010). This saves some of the extra finances that the healthcare system invests on paying for overtime hours (Drebit et al., 2010). The nursing managers can limit and keep a record of the hours of voluntary overtime worked by registered nurses, ensuring excessive amount of voluntary overtime is not being worked (Bae and Brewer, 2010) including the hours being worked at other jobs (stilpfel, 2012). The government needs to inspect the compliance of law against mandatory overtime by the health care organizations (Bae & Brewer, 2010). The federal agency should introduce an anonymous system allowing nurses to report mandatory overtime to oversee healthcare system’s adherence to the law (Bae, 2012, p.). Unit managers and nursing management should recognize, educate and emphasis the importance of adequate rest to nurses working longer shifts and multiple jobs (Bae & Brewer, 2010). Occupational health nurses should promote the health of staff nurses by advocating in relation to mandatory overtime (Bae, 2012). Transformational leadership should be practiced by nursing leaders respecting nurses decisions to deny overtime, leave after the end of shift and nurses rest days
In 2011 The Joint Commission called attention to healthcare worker fatigue and the impact it was having on patient safety. They found a direct link between healthcare worker fatigue and adverse events. They recommended healthcare facilities assessed their policies to identify fatigue-related risks, such as off-shift hours and consecutive shift work, and review their staffing to address areas that may be contributing to nurse fatigue (Martin, 2015).
A considerable amount of literature has been published on the impact of working hours (8 vs. 12 hour shifts) on fatigue among the nurses. These studies revealed that twelve-hour shifts increase the risk of fatigue, reduce the level of alertness and performance, and therefore reduce the safety aspect compared to eight-hour shifts (Mitchell and Williamson, 1997; Dorrian et al., 2006; Dembe et al., 2009; Tasto et al., 1978). Mills et al. (1982) found that the risk of fatigues and performance errors are associated with the 12-hour shifts. Beside this, Jostone et al. (2002) revealed that nurses who are working for long hours are providing hasty performance with increased possibility of errors.
It is my position and with no doubt many other nursing positions that Ohio lawmakers need to pass laws to stop this mandatory overtime practice for nurses in the state. Failing to do so, Ohio will continue leaving both the nurses and the patients at risk. The cost of any mistakes or medical errors resulted from nurses’ fatigue and tiredness can be unprecedented. We need action now, to protect the patient as well as our staff nurse in the state of Ohio.
In the recent past, nursing has come to the forefront as a popular career amongst students across the globe. The demand for nurses has kept increasing gradually over the years. In fact, the number of registered nurses does not meet the demand of the private and public health sector. This phenomenon has resulted in a situation where the available registered nurses have to work extra hours in order to meet the patients’ needs. With this in mind, the issue of nurse fatigue has come up as a common problem in nursing. According to the Canadian Nurses Association (CNA), nurse fatigue is “a feeling of tiredness” that penetrates a persons physical, mental and emotional realms limiting their ability to function normally. Fatigue does not just involve sleepiness as has been assumed before. It involves utter exhaustion that is not easily mitigated through rest. When nurses ignore the signs of fatigue, they risk the development of chronic fatigue and other health problems that may not be easily treated. Additionally, fatigue may cause nurses to lose more time at work as they may have to be away from work for several days to treat it. The issue of nurse fatigue has permeated the nursing profession to the extent of causing errors in the work performed by nurses. Fatigue causes a decrease in a nurse’s ability to make accurate decisions for themselves and their patients. It is therefore important to find ways to curb nurse fatigue such that it is no longer a problem. Nurse fatigue is a danger to the patients, organizations and to the nurses themselves and must be mitigated adequately.
There is a shortage of all health care professions throughout the United States. One shortage in particular that society should be very concerned about is the shortage of Registered Nurses. Registered Nurses make up the single largest healthcare profession in the United States. A registered nurse is a vital healthcare professional that has earned a two or four year degree and has the upper-most responsibility in providing direct patient care and staff management in a hospital or other treatment facilities (Registered Nurse (RN) Degree and Career Overview., 2009). This shortage issue is imperative because RN's affect everyone sometime in their lifetime. Nurses serve groups, families and individuals to foster health and prevent disease.
The shortage of registered nurses (RNs) in the United States has been a cyclical topic dating back to the 1960s. Only recently have employers in certain regions of the nation stated a decline in the demand for RNs. Consequently, according to the American Association of Colleges of Nursing’s (American Association of Colleges of Nursing [AACN], 2014) report on 2012-2013 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing, American nursing schools denied admission to 79,659 qualified applicants from baccalaureate and graduate nursing programs in 2012. The reported decrease in job availability and rejected admissions has left many individuals to question if the nursing shortage still exists. On the other hand, some experts project that the United States will be short more than one million RNs by 2020 (Dolan, 2011). Although some parts of the country are in less of a demand than others, it is undeniable that there is a national shortage of RNs.
Nurses. They are such a vital part of any hospital and in any medical offices. Their main focus is on the care of individuals, families, and communities so they can recover to perfect health. But with the constant demand, shortage staff and need for nursing, help or hurting them. During my research, I found that some people agree that overworking nurses is okay because the hospital still thrives and that an overworked is just collateral damage. Other think that overworking nurses is wrong and something should be done to change the problem. In this paper, I will discuss effects of nurses being overworked back by research.
The California Department of Health set a criterion that was unit specific, and provided mandated ratios for each unit. Some examples include that an ICU nurse should have a nurse-patient ratio of 2:1, Psychiatry 6:1, Telemetry 5:1 and Medical-surgical units 5:1. According to the research study “Implications of the California Nurse Staffing Mandate for Other States” by Aiken, L, “29 percent of nurses in California experienced high burnout, compared with 34 percent of nurses in New Jersey and 36 percent of nurses in Pennsylvania, states without minimum staffing ratios during the period of research. The study also found that 20 percent of nurses in California reported dissatisfaction with their jobs, compared with 26 percent and 29 percent in New Jersey and Pennsylvania” (2010) Aiken found that about 74% of California staff nurses thought the quality of care of their patients have improved significantly as a result of the mandated staffing
The level of job satisfaction for a nurse is a vital factor in creating positive outcomes for their patients. California RNs report having much more time to spend with patients. The hospitals are far more likely to have enough RNs on staff to provide quality patient care. In California, where hospitals have better compliance with the staffing limits, RNs report fewer complaints from patients and families and the nurses have more confidence that patients can manage their care upon discharge. California RNs are substantially more likely to stay in their jobs because of the staffing limits, and less likely to report burnout than nurses in any other state. Two years after implementation of the California staffing law which mandates minimum staffing levels by hospital unit, nurse workloads in California were significantly lower than that of any other state. The legislation of the mandated nurse patient ratio has achieved its goals of reducing nurse workloads, improving recruitment and retention of nurses, and having a favorable outcomes on patient
Thousands of nurses throughout the nation are exhausted and overwhelmed due to their heavy workload. The administrators do not staff the units properly; therefore, they give each nurse more patients to care for to compensate for the lack of staff. There are several reasons to why
Several other causes have been attributed to the nursing shortage. An increase in the number of nurses is needed. Sadly, there is little increase in compensation for nurses. In addition to no growth in pay, the level of stress, responsibility, and demand nurses is increasing. Unfortunately, patients are the ones who suffer. When a hospital does not have the proper nursing staff to care for patients, it results in poor patient safety and patient outcomes (Buerhaus, Donelan, Ulrich, Norman, DesRoches, & Dittus, 2007). Nursing salaries compared to other professions has remained stagnant. For example, a registered
12-Hour Shifts and Nurse Fatigue” looked at 12-hour shifts compared to 8 hours and what effects fatigue from shifts can play. Some of the advantages of the longer shift for nurses is that it decreases the time the nurse spends traveling to and from the hospital, the cost for someone to watch their child because they are working fewer days; it also allows them to hold multiple jobs. It also can decrease hand-off errors as there due there only being two per 24 hours which might help to prevent errors. Other services also work more than 8 hours such as truck drivers, railroad workers, aviation, and the military. All of these have rules for the amount of time they are allowed to be working or deployed. ⁵“The Department of Transportation [DOT) and the Federal Aviation Administration (FAA) each regulates the duty schedules for pilots, air traffic controllers, engineers, flight attendants, air mechanics, and other employees to maintain airline safety standards and protect the crew and passengers.” Truck drivers also have a set number of hours that they are allowed to work straight before they are mandated to take a break or stop. ⁶“There is not state or federal regulation of the hours that a nurse may work, although some states have passed legislation prohibiting mandatory overtime.” Facilities continue to offer, and some require nurses to work 12-hour shifts, even though there is evidence that shows adverse outcomes for patients. A study that was conducted
Recent literature reports that there is a nursing shortage and it is continually increasing. Data released by the American Association of Colleges of Nursing (2011) projects that the shortage, would increase to 260,000 by the year 2025. AACN (2011) also reported that 13% of newly registered nurses changed jobs and 37% were ready to change within a year. A study conducted reports that there is a correlation between higher nursing workloads and nurse burnout, retention rates, job dissatisfaction and adverse patient outcomes (Vahey & Aiken, 2004). Among the nurses surveyed in the study, over 40% stated that they were suffering from burnout while 1 in 5 nurses intended
These articles have many similarities when discussing the issue of staffing shortages. For patients, their loved ones and the general population, they don’t understand the ramifications and strain that staffing shortages have on nurses. People expect and deserve complete, competent and safe care when they are patients. These articles bring to light all the struggles that nurses have to deal with. Nurses are fearful that they will make mistakes, will harm patients, and will harm themselves. (Bae, 2012; Erlen, 2001; Martin, 2015) Overtime can be overwhelming and exhausting, which can lead to errors being made. (Bae, 2012; Erlen, 2001) These articles perceive that it may be beneficial for nurses, patients, and healthcare facilities to decrease the nurse-to-patient ratio, however, this option is not always
Factors such as, heavy workloads, stress, job dissatisfaction, frequent medical errors, and intention of leaving the job are all common for nurses to experience, especially during the nursing shortage crisis. Not only do the nurses suffer during a shortage, but the patients ' health outcomes suffer even more. For instance, there are higher rates of infectious diseases and adverse patient outcomes, such as urinary tract infections (UTIs), upper gastrointestinal bleeding, shock, pneumonia, prolonged hospital stays, failure to rescue, and mortality. As a result, this leads to higher re-admission rates for patients. Furthermore, high patient-to-nurse ratios cause heavy workloads due to an inadequate supply of nurses, an increased demand for nurses, a reduction in staffing and an increase in overtime, and a shortened length of stay for patients. Without the heavy workloads that nurses have to endure on a daily basis, there would more time for nurses to communicate more effectively with physicians, insurance companies, and patients and their families. Those heavy workloads are the result of hospitals reducing the nursing staff and implementing mandatory overtime policies just to meet unexpectedly high demands. Unfortunately, the nursing shortage has affected nurses ' mental and physical health. For example, the most common health concerns for nurses include cardiovascular health, occupational injuries and illnesses, and emotional and physical exhaustion. Therefore, safe-staffing ratios/levels have to become the main