The Problem Of Overworked Nurse

Sarah E. Jorgensen RN, left the nursing profession after being a part of the emergency field for seventeen years. In her article “Here’s why I left nursing” she talks about how the field took a toll on her. “Leaving the nursing profession is bittersweet. My heart left nursing a while ago when I came to the realization that nursing left me first. It never was a two-way relationship. The profession left me without acknowledgement of work-related stress, specifically post-traumatic stress (PTS)” (Jorgensen). Nursing gave her a lot of things in life, both in a positive and negative light. Having the right mental and physical strength to complete this job isn’t always enough when it comes to working in such a demanding field. Jorgensen talks about how nursing was never a two-way relationship and that is completely understandable. In reality the struggles nurses suffer through takes a toll on their mental and physical strength. With the intensity and the demands of having a job in the health field, the daily life, long hours and stress along with the conditoins nurses are working in, it is too critical for nurses to handle,which are causing them to leave their jobs. In the March 2005 issue of Nursing Economics, Dr. Peter Buerhaus and colleagues found that more than 75% of RNs believe the nursing shortage presents a major problem for the quality of their work life, the quality of patient care, and the amount of time nurses can spend with patients. Looking forward, almost all surveyed nurses see the shortage in the future as a catalyst for increasing stress on nurses (98%), lowering patient care quality (93%) and causing nurses to leave the profession (93%). What researchers are asking now is what can we do to stop this. A nursing shortage impacts the entire world--Something must be done.

What is a nurse? According to the Merriam-Webster dictionary A nurse is a licensed health-care professional who practices independently or is supervised by a physician, surgeon, or dentist and who is skilled in promoting and maintaining health, or simply a person who cares for the sick or infirm. But, any nurse would agree that it is so much more than that. A nurse is compassionate and caring. They are logical and good at reasoning; They are strong-minded, resourceful people who dedicate their lives towards their patients every need. Nurses teach concrete skills, such as how to apply a dressing to a wound, as well as medical knowledge, like the signs and symptoms of worsening diabetes. More and more nurses are also tasked with educating patients on how to navigate the healthcare system, especially how to access care. To many patients and their families, a nurse is their lifeline to the entire workings of the healthcare facility. By answering questions and listening to concerns, a nurse acts as an ambassador for a patient. Nursing is not just a practice that one does for money, it is a passion, a lifestyle. The amount of blood, sweat, and tears that go into being able to perform such a complicated and overworking job takes a strong person. Nurses may be healthcare professionals but they are so much more.

Even though nurses are strong willed, they are being broken down by the stress and sleep deprivation of the work they need to do to complete their jobs. Research Dan Hasson wrote an article talking about the declining sleep quality among nurses.Several studies have established that nursing is a stressful profession, and stressful working conditions for nurses have been suggested to be influential on sick leave, turnover rates and the likelihood of leaving the job. Whereas acute stress is generally adaptive, long-term exposure to stress without sufficient recovery may cause various adverse health consequences and diseases' ' (Hasson). Stress is known to take a toll on a person's well being, which in total can cause nurses to become sleep deprived or ill, which is a major problem when it comes to having a job where you care for the sick or infirmed. Being sleep deprived could seriously be threatening to a patient's life. It could cause a nurse to misread information on a patient which can lead to the wrong dosage of medicine that could cause a reaction in the patient and lead them to death. Also if a nurse is extremely tired on the job and a patient codes (goes into cardiac arrest), the nurse would not have enough physical strength to perform life saving measures that could save a patients life. In Hasson’s same article it states, “Stress disturbs homeostasis and sleep appears to be important for restoring and maintaining it. Hence, sleep is suggested to be an important “antistress” mediator that counteracts the wear and tear of stress on individuals' ' (Hasson). Stress is a negative impact on a nurses life and yes, everyone gets stressed and it affects individuals differently. As a nurse you need to get adequate amounts of sleep to be able to perform everyday work tasks to the highest standard. In an article by Jane Sumner it claims “The causes of nurses' exodus from acute health care delivery practice may lie more in intrinsic factors rather than the heretofore overtly expressed reasons. This article examines bureaucratic factors, issues related to the medical profession and medical/scientific discourse, and factors within the nursing profession itself that may contribute to a nurse's unhappiness and dissatisfaction that causes him or her to leave. Nursing as emotional work and the implications for the individual nurse, and nursing as moral and moral distress are discussed. Suggestions to facilitate retention are made for changing the work environment to feel valued for their skillfully applied humanness” (Sumner). An explanation of this article is clearly more bureaucratic than the actual factors of being able to care for the patients and take care of how they are treated. The essence of the nursing role has never changed: provide care to enhance a patient's quality of life, partner with interdisciplinary professions to create and carry out the best plan of care, and advocate for the health and wellness of patients and the community. What has changed significantly in the past 20 years is the environment in which the nurse is expected to carry out his or her role.

With the struggles of sleep deprivation and stress being piled on top of their workload, that is unfortunately not the only problem that nurses struggle with. Nurses are also leaving from frustrations about the lack of technology. In an article written by Elain Larson “One potential area of research using electronic data is the assessment of nursing workload and the intensity of care nurses must provide. Such assessment is invaluable because patient and nurse outcomes are significantly associated with care intensity. High workloads are associated with lower job satisfaction and burnout and higher turnover among nursing staff and, more importantly, with compromised patient safety, reduced quality of care, and increased adverse patient outcomes and mortality” (Larson). This article is stating that if nurses used EHR (electronic health records) to collect information regarding all the information about the patients it would reduce the level of stress and increase the level of patient care that every nurse gives their patients. Sicker patients often require more nursing care, and researchers must adjust for patient acuity using well established measures to accurately assess the relationship between nurse staffing and patient outcomes. Although there are validated tools for measuring the potential impact of patient acuity on nursing care requirements, severity of illness is just one of a number of factors that predict nursing care demands. The nursing staff must adjust their techniques that are currently used to care for patients to make sure that every single patient is given the proper care. Electronic Health records aren’t always a great way to collect information though. EHR can breach the patients HIPAA (Health Insurance Portability and Accountability Act) Rights. The Health Insurance Portability and Accountability Act provides the ability to transfer and continue health insurance coverage for millions of American workers and their families when they change or lose their jobs; it reduces health care fraud and abuse; mandates industry-wide standards for health care information on electronic billing and other processes; and requires the protection and confidential handling of protected health information. Thus when nurses use electronic health records, they are at risk for patient information getting into the wrong hands which can lead to the hospital being sued, and or the said nurse losing his or her job at the hospital they work at.

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Electronic Health Records are a smart idea when it comes to helping nurses with the struggles of having a larger quantity of patients because of this Affordable Care Act. The Affordable Care Act also known as Obamacare has more patients accessing care, many for the first time in years. In an article written by Registered Nursing.or it explains that states such as California took the opportunity to significantly change the standards to meet the low-income Medicaid acceptance policy, which added thousands of patients to the already full healthcare register. Medicaid makes it easier for low income families to be able to afford health care. Nurses are expected to do more with fewer resources in an effort to compensate for the amount of patients that are coming into the hospital. The expectations from the hospital leadership--medical directors and doctors-- as well as the patients and their families boils down to tremendous stress for the nurse.

In March 2014, Peter McMenamin, for the American Nurses Association, wrote a similar comment about the faculty shortage strain using the U.S. Department of Labor Bureau of Labor Statistics (BLS) of Employment Projections for 2012-2022.4 “BLS projects that there will need to be 35 percent more faculty members to meet the expected increase in demand. In addition, 10,200 current faculty members are expected to retire. Therefore 34,200 new nursing instructors will be needed by 2022. Could the collected colleges of nursing recruit 3,420 new nursing instructors per year through 2022”? McMenamin asks:

There are several challenges here. If nothing else, nurses recruited into teaching will spend less time treating patients when more nurses in patient care will be needed. There is also a new focus on strengthening the education of RNs, in particular, aiming to increase the proportion of RNs with a BSN education. Those colleges of nursing that are part of universities are also under some pressure to enhance their staff by recruiting more faculty members with doctorates (McMenamin).

A take on this article is that nurses-- who go into teaching other nursing students-- is being over populated and the need for patient handling nurses is going “extinct.” If we have more nurses who are willing to go into patient care, then it would take less stress on the few we have now. Nurses now are overworked. There is enough evidence to suggest there are more than enough qualified nurses in the United States. Adela Ellis wrote in her article “The Reality of the Nursing Crisis” that the problem is that hospital administrators are unwilling to spend the money required to hire enough staff. Which in all reality is the opposite of what they really need. In fact, this source claims that short-staffing nurses is not cost-effective because it costs more to rectify the problems associated with understaffing over the long term. Nurses are sometimes working double to triple shifts or sometimes twenty-four to forty-eight hours at a time which causes them to be exhausted by the time their next shift starts, which leads to improper patient care. A nurse’s primary role is to administer care to patients. When nurses have to work in an environment where there are too many patients per nurse, patients have a higher risk of injury, infections, and even death. Nurses must often care for several seriously ill patients at a time and have to choose which patient’s condition is most urgent. This is the obvious harm of the patients, but it also takes a mental and physical toll on the nurses. Nurses should not have to struggle with their passion when that is the field they wanted to go into. More nurses are leaving their said field with the hope that their stress and their physical and mental health will get better. It is completely horrible that they have to find a new job because they can not stand the struggles of their profession. In an article written by Adela Ellis it states “Hospital managers realize they need creative solutions for recruiting and retaining nurses. Some hospitals in the U.S. are offering sign-on bonuses between $1,500 to $5,000. A hospital in Buffalo, New York collaborated with an international corporation to pay prospective nurses to go to nursing school under the condition they work for them after graduation” (Ellis). The main concept taken from this article is hospitals are so in need of nurses that they are doing anything they can possibly do to get enough nurses to come and work for them. Companies are giving scholarships that offer to pay full ride for your college as long as you agree to work for them for five consecutive years after you graduate. Additionally, they are handing out sign on bonuses when it comes to getting a job. If hospitals are so desperate to pay people to work for them, that should be a light bulb going off in the back of their head telling them that maybe their working conditions are not as good as they believe them to be. A better idea would be to improve the working conditions of said hospital first so that not as many nurses are leaving. Hiring more is a good idea because it takes the stress off of current nurses having to be able to multitask and be overworked.

Along with the fact that many hospitals aren’t hiring, the poor conditions of their profession are also causing nurses to leave. In an article written by the MinorityNurse called “Why Good Nurses Leave the Profession” it talks about how one the greatest complaints nurses have is the poor support from the management team. The article says “Management may not even be aware of the stressors their staff encounters working the bedside. It could be that they are so wrapped up with their own job that they can’t focus on what would make life better for their staff. Or it could be that they just don’t care. Whatever the case, nurses do feel strongly about poor management” (MinorityNurse). A major stressor of nurses leaving their field is lack of proper work conditions and having poor management is not a way to release the stress. Nurses are one of the backbones of the hospital and health field world. Nurse’s jobs can be mentally and physically draining, and many nurses feel underpaid for the work that they do (MinorityNurses). Nurses are constantly being overworked and doing a large amount of tasks.