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Effects of burnout in nurses
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Effects of burnout in nurses
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Medication Error Case Study
Over the past several years extended work shifts and overtime has increased among nurses in the hospital setting due to the shortage of nurses. Errors significantly increase and patient safety can be compromised when nurses work past a twelve hour shift or more than 40 hours a week. Hazardous conditions are created when the patient acuity is high, combined with nurse shortages, and a rapid rate of admissions and discharges. Many nurses today are not able to take regularly scheduled breaks due to the patient work load. On units where nurses are allowed to self-schedule, sixteen and twenty-four hour shifts are becoming more common, which does not allow for time to recover between shifts. Currently there are no state or federal regulations that restrict nurses from working excessive hours or mandatory overtime to cover vacancies. This practice by nurses is controversial and potentially dangerous to patients (Rogers, Hwang, Scott, Aiken, & Dinges, 2004). Burnout, job dissatisfaction, and stress could be alleviated if the proper staffing levels are in place with regards to patient care. Studies indicate that the higher the nurse-patient ratio, the worse the outcome will be. Nurse Manager’s need to be aware of the adverse reactions that can occur from nurses working overtime and limits should be established (Ford, 2013).
Working Understaffed
Nurses have a responsibility and duty to provide safe and effective care to every patient. In order for the nurse to cover themselves while working understaffed, they must report their concerns to the supervisor. In addition, the nurse should document and complete the appropriate form regarding safety concerns. It is very important to put all concerns in writ...
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...nce the nurse-patient relationship.
References
Bae, S. (2012). Nursing Overtime: Why, How Much, and Under What Working
Conditions? Nursing Economics, 30, 2, 60-71. Retrieved from http://www.nursingeconomics.net/ce/2014/article30026071.pdf
Ballard, K. (2003). Patient Safety: A Shared Responsibility. The Online Journal of
Issues in Nursing, 8, 3. Retrieved from www.nursingworld.org
Ford, S. (2013). Exclusive: Nurses feeling under pressure, understaffed and undervalued. Nursing Times. Retrieved from www.nursingtimes.net
Hughes, R., & Wolfe, Z. (n.d.). Error Reporting and Disclosure. Retrieved from http://www.ahrq.gov Rogers, A., Hwang, W., Scott, L., Aiken, L., & Dinges, D. (2004). The Working
Hours of Hospital Staff Nurses and Patient Safety. Health Affairs, 23,
202-212. Retrieved from http://content.healthaffairs.org/content/23/4/202.full
For my research paper, I will be discussing the impact of medication errors on vulnerable populations, specifically the elderly. Technology offers ways to reduce medication errors using electronic bar-coding medication administration (BCMA) systems. However, skilled nursing facilities (SNFs) are not using these systems. Medication is still administered with a paper or electronic medication administration record (eMAR), without barcode scanning. In contrast, every hospital I have been in: as a patient, nursing student, and nurse uses BCMA systems. The healthcare system is neglecting the elderly. Nursing homes should use BCMAs to reduce the incidents of medication errors.
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.
Medication Errors one of the biggest issues happening in an acute care setting today . Although, Medications are given based on the five rights principles: the right patient, right medication, right route, right dose, and right time. Even with the five rights principles medication errors are still happening. However, some of the errors that are occurring are due to poor order transcriptions and documentation, drug interactions, proper drug name and not paying enough attention and environment factors.
The nursing profession is a profession where people put their trust in you to provide care that is not only effective, ethical, and moral, but safe. Not all health situations are simple or by the book. Not all hospitals have the same nurse-patient ratios, equipment, supplies, or support available, but all nurses have “the professional obligation to raise concerns regarding any patient assignment that puts patients or themselves at risk for harm” (ANA, 2009). When arriving at work for a shift, nurses must ensure that the assignment is safe for not only the patients, but also for themselves. There are times when this is not the situation. In these cases, the nurse has the right to invoke Safe Harbor, because according the ANA, nurses also “have the professional right to accept, reject or object in writing to any patient assignment that puts patient or themselves at serious risk for harm” (ANA, 2009).
...hological preparation. After a nurse is done working their regular shift being forced to work overtime can out them a greater right of medical mistake in part due to fatigue and tiredness consequently putting the patient at high risk of complications.
Witkoski Stimpfel, Amy , Douglas M. Sloane, and Linda H. Aiken. "The Loger the shifts for hosital nurses, the higher the levels of burnout and patient disstisfaction." Health Affairs 31.11 (2012): 2501-2509. Proquest. Web. 11 Mar. 2014.
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
Nurse staffing ratios have been a topic of debate for many years. Inadequate staffing ratios can lead to patient, and staff endangerment, a decrease in patient and staff satisfaction, and a high turnover rate, along with employee burnout. Thus, sever staffing models have been implemented to aid with staffing rations, and federal and state requirements have been implemented. Although, nursing managers and leaders my approach nurse staffing differently, a professional approach should always be used to ensure satisfaction and safety.
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
Patient’s safety will be compromised because increase of patient to nurse ratio will lead to mistakes in delivering quality care. In 2007, the Agency for Healthcare Research and Quality (AHRQ) conducted a metanalysis and found that “shortage of registered nurses, in combination with increased workload, poses a potential threat to the quality of care… increases in registered nurse staffing was associated with a reduction in hospital-related mortality and failure to rescue as well as reduced length of stay.” Intense workload, stress, and dissatisfaction in one’s profession can lead to health problems. Researchers found that maintaining and improving a healthy work environment will facilitate safety, quality healthcare and promote a desirable professional avenue.
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
Patients Safety is the most crucial about healthcare sector around the world. It is defined as ‘the prevention of patients harm’ (Kohn et al. 2000). Even thou patient safety is shared among organization members, Nurses play a key role, as they are liable for direct and continuous patients care. Nurses should be capable of recognizing the risk of patients and address it to the other multi disciplinary on time.
Notably, having higher proportions of nurses working shorter shifts—8–9 hours or 10–11 hours—resulted in decreases in patient dissatisfaction” (Stimpfel et al.). This is essentially saying that the longer the shift length, the more negative outcomes result. This study proves that eight to nine-hour shifts are more effective, and should, in turn, be worked more than longer shifts. This is a problem because hospitals are likely to continue to schedule nurses for twelve hours shifts out of
This literature review was conducted to determine the impact on the health status of registered nurses who work rotating shifts compared to those who work one consistent shift. Hans Selye’s General Adaptation Syndrome theory identified three stages of a stress response: alarm, resistance, and exhaustion. Rotating shift work is an impactful stressor on the human body, and the nurses who follow these fluctuating schedules endure Selye’s three stages of responding to stress. The four articles that were reviewed exposed similar themes regarding the effects of rotating shift work. Poor sleep quality, chronic fatigue, illness, biochemical changes, and safety concerns are all consequences of the harsh nature of rotating shift work. It has been suggested that recovery time be allotted to allow nurses to recuperate between the changing of shifts. Nursing care has been and will continue to be an around the clock necessity. It is vital to prioritize the physical and mental well being of nurses so they may provide the highest quality of safe patient care