Overworking Nurses Results On Negative Patient Outcomes

According to Suzanne Gordon “ whether young or old, nurses are disillusioned because they believe that health care systems guided by bottom-line concerns simply don’t recognize the specificity of their work” (234). Nursing is more demanding than many other professions or occupations, due to the combination of difficult patients, exhausting schedules and arduous physical work (Gordon 235). It can take a significant emotional toll on many, hence the higher levels of burnout. Job dissatisfaction as a result of increased workloads and unreasonable demands, such as inappropriate nurse staffing levels, was cited as the number one reason that drives many experienced nurses to leave the profession (Sanford 38+). Studies have shown that such working conditions also affected the retention of new graduate nurses by leaving their first hospital jobs within two years of graduating (Sanford 38+).

Nursing shortages have always occurred in cycles. Recently, the shortage has become worse due to the implications of managed care as a way of controlling escalating health care costs. While the shortage did ease some during the recession of 2009, there is still a shortage in some areas of the country (Cherry & Jacob, 2014). Increased student enrollments and government policies have helped with the shortage, but the occupational outlook for nursing jobs is expected to grow faster than any other occupation through 2018. So it is essential that the supply of nurses increases to keep up with the demand. The current shortage is due to several factors. First, new nurses are needed to replace “baby boomers” who will be retiring in the near future. Second, as the population ages, there will be a demand for more healthcare, leading to a demand for more nurses. Third, new advances in patient care will lead to more people in the healthcare system needing more specialized care, and lastly, the affordable care act places a large emphasis on preventive care, leading to more people desiring wellness visits (Cherry & Jacob, 2014). Finally, according to Dall’Ora, Chiara, Griffiths, Peter, Ball, Jane, Simon, Michael Aiken, Linda H. (2015), “shifts lasting 12 hours or longer were associated with a 40 percent greater level of job dissatisfaction and a 31 percent higher risk of planning to quit. Job satisfaction and burnout in the nursing workforce are global

There will be a few challenges ahead for our healthcare system and the nursing profession: 1. The Aging Population- (baby boomers will be hitting retirement age). 2. Poverty-“the increasing numbers of disenfranchised people and pressure to limit health care expenditures will collide to create an intense values conflict for nurses of the future”. (Chitty & Black p.382) 3. Unhealthy Lifestyles- (obesity, tobacco use, lack of exercise, stress, HIV/AIDS and drug abuse). 4. Faculty and Student shortages- making nursing shortage worse. Nurses as

Nursing to patient ratio can have a direct impact on patient safety. Studies have been done that show that these ratios impact patient outcomes and mortality rates when nurses are understaffed and are given a larger patient load than they can handle safely. Nursing education level has also shown to play a role in patient outcomes. Whether they are an unexperienced nurse or the patients are at a higher acuity and require more time for care, these larger ratios can be detrimental to the nursing quality of care that can be provided. These larger nurse to patient ratios can also play a part in nurse burnout leading to medical errors, negative patient outcomes, and higher health care costs in the future.

For over a decade researchers have been performing studies examining the effects patient-to-nurse ratios have on adverse outcomes, mortality rates, and failure-to-rescue rates of patients and on job dissatisfaction and burnout experiences of nurses. Aiken, Sloane, Sochalski, and Silber (2002) performed a study which showed that each additional patient per nurse increased patient mortality within 30 days of admission by 7% and increased failure-to-rescue by 7% as well. This same study also showed that each additional patient per nurse resulted in a 23% increase in nurse burnout and a 15% increase in job dissatisfaction. Additionally, Rafferty et al. (2007) performed a study in which the results showed that patients in hospitals with higher patient-to-nurse ratios had a 26% higher mortality rate and nurses were twice as likely to have job dissatisfaction and experience burnout. Blegen, Goode, Spetz, Vaughn, and Park (2011) performed a study where results showed that more staffing hours for nurses resulted in lower rates of congestive heart failure morality, infection, and prolonged hospital stays. The same study also showed that increased nursing care from registered nurses resulted in lower infection and failure to rescue rates and fewer cases of sepsis.

When nurses experience fatigue due to excessive overtime, effects that can occur are reduced decision making ability, reduced communication skills, increased forgetfulness, increased tendency of risk taking, reduced ability to handle stress on the job, decreased ability to do complex planning, and inability to recall details which can all danger patients wellbeing. Unfortunately even with all the

Nurse staffing have an effect on a variety of areas within nursing. Quality of care is usually affected. Hospitals with low staffing tend to have higher incidence of poor patient outcomes. Martin, (2015) wrote an article on how insufficient nursing staff increases workload and job dissatisfaction, which in effect decreases total patient care over all. When nurse staffing is inadequate, the ability to practice ethically becomes questionable. Time worked, overtime, and total hours per week have significant effect on errors. When nurses works long hours, the more likely errors will be made. He also argued that inadequate staffing not only affects their patients but also their loved ones, future and current nursing staff, and the hospitals in which they are employed. An unrealistic workload may result in chronic fatigue, poor sleep patterns, and absenteeism thus affecting the patients they take care of.

Typically, when someone hears ‘medical field’, automatically you think of people with white lab coats and a stethoscope around their neck ready to take your vitals. Obviously this comes to mind because these doctors and surgeons are the face of the medical field, but in reality there is so much more. There are actually about 300 different occupations one can have in the health care field. A large part of that is nurses. Nurses are the basis of the medical field; they are almost as important as the patients themselves. They have always been a major part of our lives. Nurses have been with us since we first opened our eyes, from birth to broken bones, nurses were there. They have very difficult and extensive careers, they dedicate their lives to their work and to their patients. Some nurses spend long nights away from their family and friends to help others, at times their shifts can last as long as 24 hours. In my opinion nurses are the real super heroes, for this reason I have decided to pursue a major in nursing. I still have a lot to learn and many years of schooling to go, but personally its worth the wait.

The social system becomes more and more demanding, needing us to deal with social and government resources, once we learn the newest of trends. We need to be emotionally supportive when these occur and often hold patients while they die and cry along with their families and loved ones. Budgets are becoming tighter, requiring us to work with less and less resources to function effectively in our jobs. There is an increase in demand for professors in the nursing schools, requiring nurses to achieve higher nursing degrees to qualify them to teach. Nursing schools today have long waiting lists due to the fact that there are inadequate instructors to have adequate teacher-student ratios in the classroom.

Additionally, the study found that a high patient to nurse ratio resulted in greater emotional exhaustion and greater job dissatisfaction amongst nurses. Each additional patient per nurse was associated with a 23% increase in the likelihood of nurse burnout, and a 15% increase in the likelihood of job dissatisfaction. Moreover, 40% of hospital nurses have burnout levels exceeding the normal level for healthcare workers, and job dissatisfaction among hospital nurses is four times greater than the average for all US workers. 43% of nurses involved in this study that reported job dissatisfaction intended to leave their job within the upcoming year. (Aiken et al.)

Patients in a hospital and/or healthcare facilities have to be cared for all day and all night, everyday of the week by nurses. The usual way to fulfill this need is to divide up the day into three 8-hour shifts. Different shifts have been put into place to help improve nurse satisfaction, decrease the nursing shortage and save the hospital money. The 24-hour day is made up of two 12-hour shifts; 12 hours in the day and 12 hours at night. There has been quite an ongoing debate over the years regarding this issue of nurses working over 8 hours in a single day. Many people, such as hospital nursing administrators, have reason to believe that working long hour shifts causes more errors in

The broad research problem leading to this study is the belief that nursing shortage in facilities leads to patient safety issues. The review of available literature on this topic shows strong evidence that lower nurse staffing levels in hospitals are associated with worse patient outcomes. Some of these outcomes include very high patient to nurse ratio, fatigue for nurses leading to costly medical mistakes, social environment, nursing staff attrition from the most affected facilities. The study specifically attempts to find a way to understand how nurse

Limited attention has been paid to the hours worked by nurses, or the effects of these hours on patient safety (Rogers, 2008). Even though most nurses favor 12- hour shifts and overtime, it is associated with difficulties staying awake during times of duty, reduced sleep times, and triple the risk of making an error (Rogers, 2008). The most significant risk of making an error occurred when nurses were scheduled to work 12.5 hours or more.

In today’s society, the medical field is constantly thriving with technological improvements and the growth of educated individuals that contribute to the well-being of others. Nurses make up the largest majority of the industry, and with that, nursing is the fastest growing occupation. Nursing is a job that allows people to not only take care of the sick but also to experience, learn, and further their interests of the human body.

The risks of making an error were significantly increased when work shifts were longer than twelve hours, when nurses worked overtime, or when they worked more than forty hours per week. (Trossman, 2009). Working longer hours in a high stress area will always increase the error rate. Designating an adequate number of RN positions to ensure nurses work an appropriate schedule without overtime and that their workload allows for breaks. Managerial staff must work to develop specific policies about the length of work times based on the setting, patient and provider needs. Those policies should limit nurses from working more than 12.5 consecutive hours. Provide education for all care providers on the hazards and causes of fatigue. Continue to document unsafe staffing conditions and work with others to change the current work culture so that it recognizes the effects of fatigue on patient safety, as well as the nurse. (Berger, et al. 2006)