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Nursing shortage and workload
Nursing shortage and workload
Nursing shortage and workload
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Nursing Workload: A National Priority
Nursing Workload Concerns
The nursing profession has changed significantly over the years. In our fast-paced world of health care and technologically-advanced society, nurses are experiencing higher workloads than ever before. According to a survey done by the Agency for Healthcare Research and Quality’s ([AHRQ], 2012), more than 50% of nurses work in a crisis mode trying to do too much too quickly, and safety is sacrificed to get more work done.
In reviewing the literature on nursing workload definitions I found no definition that captures the complexity of nursing workload. Morris et al. defined workload as “the amount of performance required carrying out those nursing activities in a specified time period” (as cited in Neill, 2011, p.
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An overview of the literature highlights that there are a number of approaches to measure nursing workload. Studies show that nursing workload is not necessarily just nurse-patient ratios. Traditionally in the literature, job demands have been measured as amount of time it takes nurses to deliver care, patient acuity, and patient-to-nurse ratio.
For instance, Upenieks, Kotlerman, Akhavan, Esser, and Ngo (2007) report data collected from 40 medical-surgical and telemetry units in regards to the amount of time nurses spend in direct-patient care and indirect care activities. Evidence showed that nurses spend just about 30-55% of their time in direct care activities, while the remaining percentages they are involved in indirect activities (i.e. reviewing charts, care rounds, communication with family, etc). Therefore, a nurse’s workload as far as time spent carrying out nursing activities, consists of not only direct patient care factors, such as medication administration, but also indirect and non-patient care
Nurses have a considerable amount of responsibility in any facility. They are responsible for administering medicines and treatments to there patient’s. While caring for there patients, nurses will make observations on patient’s health and then record there findings. As well as consulting with doctors and other healthcare professionals to plan proper individual patient care. They teach their patients how to manage their illnesses and explain to both the patient and the patients family how to continue treatment when returning home (Bureau of Labor Statistics, 2014-15). They also record p...
Human factors are derived from construction and adapted to a system of development in health care by carefully examining the relationship between people, environment, and technology. The consideration of human factors acknowledges the capability or inability to perform a precise task while executing multiple functions at once. Human factors provide an organized method to prevent errors and create exceptional efficiency. Careful attention must be exercised in all levels of care such as the physical, social, and external environment. It is also vital to carefully consider the type of work completed and the quality of performance. Applying human factors to the structure of healthcare can help reduce risks and improve outcomes for patients. This includes physical, behavioral, and cognitive performance which is important to a successful health care system that can prevent errors. A well-designed health care system can anticipate errors before they occur and not after the mistake has been committed. A culture of safety in nursing demands strong leadership that pays attention to variations in workloads, preventing interruptions at work, promotes communication and courtesy for everyone involved. Implementing a structure of human factors will guide research and provide a better understanding of a nurse’s complicated work environment. Nurses today are face challenges that affect patient safety such as heavy workloads, distractions, multiple tasks, and inadequate staffing. Poor communication and failure to comply with proper protocols can also adversely affect patient safety. Understanding human factors can help nurses prevent errors and improve quality of care. In order to standardize care the crew resource management program was
Working in long-term care can be overwhelming. Imagine you are a new graduate nurse putting your new found knowledge and skills to practice for the first time. Your orientation lasted three days which is standard for nurse home orientation compared to hospital orientation that last approximately six to eight weeks for new grads. The shift has just begun and already you have a new admit, new found pressure ulcer to assess, a possible medication reaction, several new orders to take off and eight patients to document on for varying reasons. Feelings of frustration and confusion take over as you are the only nurse on the unit along with a Certified Medication Technician (CMT) and three Certified Nursing Assistants (CNAs) taking care of 47 patients. Ideal nurse-to-patient ratio continues to be a national issue in both the hospital and long-term care setting (LTC). In the LTC setting there is no official nurse-to-patient ratio; there is a suggested staff-to-patient ratio. This issue not only affects the new licensed nurses but the seasoned nurse as well. Recently, there has been controversial debates as to whether heavy workloads are detrimental to patients. The federal, state, and local government regulates many aspects of healthcare. However, it is the physicians, nurses and other healthcare professional that provide care directly to patients. Consequently, does insufficient staffing, heavy workloads, and unsupportive work environment directly contribute to poor patient satisfaction, nurse burnout, high turnover and job dissatisfaction?
I am interested in this topic because when I graduated from nursing school last year, I accepted a job where I am comfortable with my workload, while many of my classmates ended up in work environments where they are responsible for taking care of as many as 9 patients at a time while working as the Charge Nurse on the unit. Several have expressed to me that they feel their patients aren't safe because of the workload they face as nurses.
I think shortages of nurses can also be a factor in why nurses are overworked and stressed. In most hospitals you can’t even tell if there is a nurse shortage, the nurses run around from patient to patient I’m trying to still provide the same quality care. My aunt is a registered nurse for Northeast medical center and I asked her out of the previously 11 listed reasons nurses are stressed which do you experience the most. She replied, “I have to say that I experience number one which is work overload the most. When I started working as a nurse 37 years ago there were three separate shifts throughout a day and there’s could work instead of the two 7am-7pm. The nursed patient ratio was a lot lower we got to spend time with the patients we had during the day and provide individual attention. You didn’t feel overwhelmed because the hospital had enough nurses. Now they nurses doing e same amount of work as two or three nurses combined, and are still expected to do
Nurses Joe and Sarah have been working in a medical surgical unit that has been experiencing a nursing shortage, which has led to an increase in the workload. Sarah has been feeling the physical effects of the stress and feels there is a lack of management support, while Joe experiences some feelings of being overwhelmed, but tries to use it as learning experiences. Joe has developed positive methods of coping, while Sarah is quickly heading towards burnout. Implications and Conclusions The information provided in the literature has great implications for practice in many units, including the writers. It is with great hopes that the research published can be presented to the committees on the unit in hopes that some of the workloads can be decreased to help with staffing and retention rates.
Nurses are the largest and the most trusted professional group in the health care system. They are highly educated and skilled in their areas of practice. However, today’s nurses are experiencing an ever increasing workload, which negatively impacts their ability to deliver safe patient care (Berry & Curry, 2012). This paper explores four published journals that report on survey results on nursing workload and their direct correlation with patient care outcomes. The purpose of this paper is to address the ongoing nursing workload issues and explore the reasons behind it.
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.
Current literature continues to reiterate the indicators of a major shortage of registered nurses (RNs) in the United States. The total RN population has been increasing since 1980, which means that we have more RNs in this country than ever before (Nursing Shortage). Even though the RN population is increasing, it is growing at a much slower rate then when compared to the rate of growth of the U.S. population (Nursing Shortage). We are seeing less skilled nurses “at a time of an increasingly aging population with complex care needs and an increasingly complex technological care environment” (Mion). According to recent data from the Bureau of Labor Statistics and the Department of Health and Human Services, it is estimated that “more than a million new and replacement nurses will be needed over the next decade” (Diagnosis: Critical).
Richards argues multitasking is not helping nurses. Richards expresses, “Instead of actually helping us, busy multitasking works against us” (3). Multitasking is not helping, it is creating more work. Yet, multitasking is not against nurses. In fact, being a multitasker is essential for a nurse because a nurse has to be capable of dealing, with even ten or more patients she/he has to take care of. The problem comes when nurses are not capable of dealing with multitasking. Some nurses are not really prepared. Studies show some nurses do not have the professional preparedness to deal with some tasks because they didn’t receive enough education and knowledge. Thus, some patients lack some information about their disease, leading to nursing negligence.
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
Nurse to patient ratios are extremely paramount in assisting with overall patient mortality and wellness of our nurses. It is an issues which unfortunately affected by legislation of our government (which is affect specifically on a monetary basis). My research via Academic Search Complete allowed me to identify topics that assist my PICOT question, and enables me to further analyze and research to find out what issues directly affect is matter. Proper nurse to patient ratio, operational costs, government regulation, nurse work life and health, patient wellness, and nursing procedures and duration of those procedures are all affected by this topic and we must ensure that all are properly balanced.
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
An activity report can provide operational statistics such as occupancy rate, average daily census, and average length of stay (Finkler, Jones & Krover, 2013). Though these numbers are important and have a great influence on the operational budget, a nurse leader needs more information in order to justify staffing. Nurse leaders can obtain additional information from workload reports. Patient classification system measure workload by assigning each patient a classification level based on his or her unique care needs and then determine the number of care hours required per patient per day. Many organizations express this in hours per patient day (HPPD) or relative value units (RVU) (Finkler et al., 2013). Workload reports are useful because they can identify changes in patient mix that can increase or decrease the need for nursing personnel. Bi-weekly fulltime equivalent (FTE) reports are also useful because they convey to nurse leaders exactly how many man-hours were used by each FTE (Liberty University, 2015). Furthermore, the report provides a breakdown of productive time; contract hours, paid time off (PTO), and overtime. It also accounts for nonproductive time such as time spent on education, training, and orientation (Liberty University,
Several consequences of high nursing workload have been proven to hinder the quality of patient care. Carayon and Gurses’s research (2008) indicates that heavy workload can contribute to errors, shortcuts, guideline violations, and poor communication with physicians and other providers, thus compromising the quality and safety of patient care. In addition, the research not only implies that patients may not receive proper care, but also they can experience less satisfaction with