Reducing Work Hours for Nurses
Nurses form a valuable and integral part of every hospital or medical clinic. Nurses work for long hours in the day and attend to patients who are admitted in the hospital, for treatment or surgery. Nurses also assist doctors and surgeons with the work that they do and are seldom known to take a break in between their tasks, demonstrating great dedication and efficiency in the work that they do. They move from one task to another in an almost effortless fashion. As a result, the problem of stress and fatigue for nurses, both male as well as female, is one that tends to be quite high. Almost all the nurses working in Australia are known to suffer fatigue in some form or the other. This essay undertakes a literature review on the issue of nurse stress and fatigue in hospitals and nursing homes, with the aim of the review being to uncover strategies to combat the problem of nurse fatigue and stress in the best way possible.
Peter Griffiths and others (2014), have raised the concern of nurse fatigue and high stress levels in their recent research on the subject. They argue that nurses who are made to work for a shift that is longer than twelve hours are more likely to report problems like patient safety failure than nurses who are made to work for less than twelve hours. According to them, most hospitals today opt for the twelve to thirteen hour shift timing in order to avoid the confusion that occurs at the time of shift handover from one nurse to another. Nurses are also made to work twelve hour shifts in order to help hospitals and medical setups cut down on costs on the pay of healthcare professionals. This in turn has an adverse effect on their health and they end up feeling highly stressed and failing in their duties, the primary one being patient care and safety so only by making them work for under twelve hours can be the problem of nurse fatigue be adequately addressed. According to Samra et al. (2015), the relation between shift hours and the health of nurses is quite a complex one and it is dependent on a number of important factors such as type of shift, patient acuity, workload as the effective manner in which fatigue is managed. They argue that in order to reduce nurse fatigue, shift hours should be reduced to only twelve hours or less than that. The number of consecutive days with twelve hours as shift timing should be kept at three days. The problem of nurse fatigue is one that should be incorporated in the nurse curricula or orientation and there should be at least two days of rest given to nurses in between the three consecutive days of working twelve hours per shift. They also argue that a lunch break of thirty minutes should be made available to nurses and they should not be made to work for more than forty-eight hours in a week.
Recognition of Nurse Fatigue by Hospital Administration
Stacie Hunsaker et al. (2015) in their research on nurse fatigue point to how nurses working in the emergency department of a hospital tend to be more fatigued or overworked and more stressed than nurses in general. By carrying out a descriptive, predictive and non-experimental study, using an entirely self-administered survey, they have discovered that fatigue and burnout stand at very high levels for nurses working in emergency departments while for other nurses, the level of fatigue ranges from low to average. They argue that improving awareness and recognition of nursing fatigue in the business department is something that can help nurses to overcome exhaustion at both the mental and physical levels.
Scott et al. (2014), have studied the relation between nurse fatigue and decision regret. They have discovered through their research that long work hours in hospitals have a direct impact on the health of nurses. They become fatigued and at times even suffer from cognitive impairment. What Scott and others have established through their research is that nurses who suffer from fatigue as a result of working long hours are more like to report decision regret than nurses who are not working long hours and who are not so fatigued. They state that the lack of sleep is what is particularly responsible for such fatigue in nurses and recommend more rest and sleeping hours for nurses to combat the problem of nurse fatigue. Smith-Miller et al. (2014), have carried out research on the relationship between long work hours in acute medical situations and nurse fatigue. They have demonstrated in their research that nurses who are made to work in critical care units are overworked and they suffer from fatigue a lot more than nurses who are not involved in any acute care. According to them, if nurse fatigue is to be addressed effectively, then the entire clinical unit, and the medical organization will have to be involved, in addition to the individual. They all have to collectively address the problem of nurse fatigue by drawing up a schedule that enables nurses to work in emergency care situations without having to become over burdened in terms of health and physical wellbeing.
According to Boyle (2015), the cost of caring is one that is very high. She argues in her work that nurses are made to work overtime almost all the time and they are seldom allowed the rest or the breaks that they need to recuperate and to get back their energy. In her view, nurses need to be given enough time to get their breath back if they are to work efficiently and effectively for the hospital that they are employed at. If they are not given sufficient rest, nurses will suffer from poor health and huge stress and will not be able to attend to their patients with dedication, which in turn will put the health of their patients at extreme risk. Ball et al. (2017) call for the optimization of twelve hour shifts in order to address the problem of nurse fatigue. Through their research which involved undertaking a cross sectional study, they have discovered that there is a direct correlation between working twelve hour shifts or longer and nurse fatigue. They recommend that other solutions have to be developed in order to combat the problem of nurse fatigue, such as reducing timings of the twelve hour shifts or giving nurses more breaks for rest and relaxation when they work the twelve hour shifts.
More Rest and Flexible Shift Timings for Nurses
Hall et al (2016), argue that the safety of patients tends to be lower when they are served or attended to by nurses who are overworked and who are consequently very stressed and tired when doing their work. They recommend in their research that nurses need to be given more time to relax and unwind if the quality of their services is to be assured. According to Hall and others, if nurses are made to recover their energies through rest and relaxation, then this will have a direct impact on the quality of the care that they give to their patients.
While the literature discussed above has successfully identified why nurse fatigue and stress is caused and strategies that ought to be undertaken by hospital staff and administration to address this problem, no mention is made about the role that proper nutrition can play in helping nurses to reduce fatigue, combat stress and stay healthy while working long hours. Research out to be carried out on how the provision of nutritious food at hospital canteens for nursing staff can go a long way in ensuring their physical and mental wellbeing while they work their shifts.
Thus, the research that has been done on nurse fatigue, stress and burn out in hospitals is one that is quite extensive. Many of the strategies that have been suggested by the researchers in order to address the problem of nurse fatigue are those that harp on one main point, this being that nurses need to be given enough time to relax and to rest if they are to avoid getting becoming fatigued and do their work well. Researchers particularly seem to believe that if the twelve hour shifts are done away with and if nurses are given enough rest in between these shifts, then they can do a good job of attending to their patients. It is only by giving nurses enough time to relax, rest and do rewind that the problem of nurse fatigue can be successfully combated. As mentioned by some researchers, the hospital administration and staff apart from the nurses have to get involved in this matter too and have to see to it that nurses are given the provision of relaxing and resting in between working long shifts if they are to give their optimum to the hospital they serve while ensuring good quality care and patient wellbeing at the same time.
References
Ball, J., Day, T., Murrells, T., Dall’Ora, C., Rafferty, A.M., Griffiths, P. and Maben, J., 2017. Cross-sectional examination of the association between shift length and hospital nurses job satisfaction and nurse reported quality measures. BMC nursing, 16(1), p.26.
Blouin, A.S., Smith-Miller, C.A., Harden, J. and Li, Y., 2016. Caregiver fatigue: implications for patient and staff safety, part 1. Journal of Nursing Administration, 46(6), pp.329-335
Boyle, D.A., 2015. Compassion fatigue: The cost of caring. Nursing2018, 45(7), pp.48-51.
Griffiths, P., Dall’Ora, C., Simon, M., Ball, J., Lindqvist, R., Rafferty, A.M., Schoonhoven, L., Tishelman, C. and Aiken, L.H., 2014. Nurses’ shift length and overtime working in 12 European countries: the association with perceived quality of care and patient safety. Medical care, 52(11), p.975.
Hall, L.H., Johnson, J., Watt, I., Tsipa, A. and O’Connor, D.B., 2016. Healthcare staff wellbeing, burnout, and patient safety: a systematic review. PloS one, 11(7), p.e0159015.
Han, K., Trinkoff, A.M. and Geiger-Brown, J., 2014. Factors associated with work-related fatigue and recovery in hospital nurse
Hunsaker, S., Chen, H.C., Maughan, D. and Heaston, S., 2015. Factors that influence the development of compassion fatigue, burnout, and compassion satisfaction in emergency department nurses. Journal of Nursing Scholarship, 47(2), pp.186-194.
Kunaviktikul, W., Wichaikhum, O., Nantsupawat, A., Nantsupawat, R., Chontawan, R., Klunklin, A., Roongruangsri, S., Nantachaipan, P., Supamanee, T., Chitpakdee, B. and Akkadechanunt, T., 2015. Nurses’ extended work hours: patient, nurse and organizational outcomes. International nursing review, 62(3), pp.386-393s working 12-hour shifts. Workplace health & safety, 62(10), pp.409-414.
Samra, H.A. and Smith, B.A., 2015. The effect of staff nurses’ shift length and fatigue on patient safety and nurses’ health: From the National Association of Neonatal Nurses. Advances in neonatal care, 15(5), p.311.
Scott, L.D., Arslanian-Engoren, C. and Engoren, M.C., 2014. Association of sleep and fatigue with decision regret among critical care nurses. American Journal of Critical Care, 23(1), pp.13-23
Smith-Miller, C.A., Shaw-Kokot, J., Curro, B. and Jones, C.B., 2014. An integrative review: fatigue among nurses in acute care settings. Journal of Nursing Administration, 44(9), pp.487-494.
Wolf, L.A., Perhats, C., Delao, A. and Martinovich, Z., 2017. The effect of reported sleep, perceived fatigue, and sleepiness on cognitive performance in a sample of emergency nurses. Journal of Nursing Administration, 47(1), pp.41-49.
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