Staffing Challenges in Elderly Dementia Wards

During my time in practice placement I worked on an elderly dementia ward I noticed there was a lot of shortage in staffing levels. Registered nurses had to work overtime as there were not many qualified on the ward; there was also a shortage of healthcare assistance on most of the shifts I witnessed. At times I felt like a burden to the nursing staff, there were times when I felt the need to ask a question but the nurses were so busy and snowed under with paper work and attending to the patients that they simply did not have time to give me attention as a student nurse. Whilst I was on placement on the ward there was 4 arm’s length observations on the ward, due to lack of staff the nursing team did not get a break from constant observations

and attending to the other patients and their needs.
Due to people living longer the elderly population in the world is increasing, the average age of nurses is also rising.

So there is a higher demand for nurses due to more demand for health care services (Hessler, 2005). Working overtime is very common in hospitals from my own experience due to shortage in staff. With not having any time to recover after shifts fatigue and stress could potentially cause human errors which is very hazardous for nurses especially with medical and decision making issues. This affects patient safety and the reputation of nurses Andrews (2005). Due to working overtime a lot of nurses become unwell therefore shortage of staff increases even further. Temporary staffing is commonly used in hospital as a quick fix, however the temporary staff may not be familiar to the patients on the ward or they may not have the same level of skills as the organization staff. Nurses should work together in order to support each other in finding approaches to resolve problems which can drive nurses away from the nursing field and discourage people from entering it (Cohen et al.,

2006).
I am now going to research and try to find any studies relating to issues regarding staffing levels in nursing and how that makes an impact on their performance. I will also try to see if I can find ways in which this can be prevented. The research method I looked into using was PICO; population/patient/problem, intervention, comparison, and outcome (Richardson et al, 1995). The PICO format is used widely in nursing and health research to help manage and break down research questions. Applying this will help me to identify the key concepts in my question, develop appropriate search terms to describe these and determine my inclusion and exclusion criteria. PICO is most widely used in quantitative research. My search: Hospitals, nurses, short staffed, staffing issues, impact. 5405 results came up. Narrowed down to searches from years 2000 – 2016 reduced to 4546 results came up. Changed search to academic journals 3658 results came up. Changed to papers in Britain only 110 results came up. Changed subject to nurses 15 results came up.

The results showed that there were many challenges in regards to providing care on older people’s wards. The findings illustrate the challenges of providing care on older people’s wards today, and the enormous demands that are placed on today’s nurses. Adequate staffing, with the right number of RNs, is essential to meet the challenge. Staffing issues are complex, requiring local solutions, but the RCN (2012) guidance and recommendations can be used by nurses at all levels to review the situation in the area they work and consider all the factors necessary to support good care. Application of the guidance may support nurses to challenge inadequate resources and to work with colleagues to identify solutions. Further work is needed to develop appropriate metrics and measures that capture the full extent of complex care for older people, including the time needed to deliver care with compassion. Although care can be compromised on wards where staffing is insufficient, many nurses and teams in hospitals demonstrate excellent, innovative practice, but possibly lack sufficient platforms to publicise and share their work. Nurses and the public may now view and share examples of good practice through a number of routes including the RCN website (Nicky Hayes and Jane Ball 2012).

Now what
The nursing shortage is very significant around the country; based on my experience a lot of the time there is a high patient to nurse ratio which negatively impacts patient mortality.

Ideally nursing managers should try their best in order to improve the workplace environment in order to decrease stress and fatigue in order to improve nurse’s ability to provide quality care and to ensure their health and safety. By doing this I feel that job satisfaction would increase in nursing and there would be less staff members becoming ill or wanting to leave the field. However due to working full time on an elderly acute ward and on placement I know from experience this never really happens. I feel that staff members feel pressured to work over time when short staffed. For me, I used to worry about the staff on shift and how they would be struggling due to being short staffed, therefore I would go on shift on my day off and it seems this is the case with most staff members. Yes I have found out ways to improve staffing levels, but it’s nothing I didn’t know before and I don’t feel as though there is anything I can do to improve this apart from not working overtime. However obviously by working overtime there isn’t any time to recover which leads to staff members becoming

ill.