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Introduction - Nursing Workloads In Contemporary Healthcare And Patient Care
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Nursing workload is defined as the allocation of enormous tasks within a short time. Due to that, the nurse may not have enough time to do each task properly, which can have a serious impact on the patient's health. In the contemporary world, the healthcare industry is increasing. However, not all healthcare institutions have enough staff to perform their duty. Hence, it is important to discuss the issues in order to find a suitable solution. In this essay, all the factors regarding the issues are covered such as the reason for workload and the specific nursing segment where the workload is higher than others. The impacts of nursing workload on nurses and patients are also discussed here.
Discussion on nursing workloads in contemporary healthcare and patient care
A sustainable health system can be developed by optimizing the deployment of human resources. However, despite human resources management in the healthcare system, nurses are still facing many challenges in the workplace. “Unbearable workload” is one of the major challenges (Moghadam et al. 2021). Various studies show the patients to nursing ratio, which is one of the beneficial techniques to understand the workload. Besides the organizational structure and nursing managers, contribute to the workload as well. On the contrary, the nursing workload is also explained as the mandatory level of clinical skills needed in order to perform daily activities in the health care institution. Hence, the workload can come in many different ways. According to De Groot et al. (2022), in some organizations the patient-to-nursing ratio is good. However, increasing the number of complicated patients can increase the workload because they need to give more time to each patient. On the contrary, in some organizations number of skilled nurses is low, which increases the workload of nursing managers. However, no matter the type of workload both patients and the nurses are suffering.
The nursing workload is seen in many parts of nursing care, which can be in the patient care, administration level, unit level, and others. However, in order to understand it properly, it can be categorized into four parts: those are unit level”, “job level”, “situation level” and “patient-level” (Borges, Caruso, & Nassar Júnior, 2021). At the unit level, the nurse and patient ratio are measured. In this case, the number of patients assigned to each nurse is increased. However, this issue is explained at the macro level in this case. At the job level, the types of jobs are performing by the nurses are discussed such as workload varies between the OT nurse and ICU nurse. As stated by the authors Anggraini, Pamungkas & Purwat, (2021), an investigation of burnout and performance can provide an idea about the current workload in that segment. However, the workload is multidimensional and complex. The facilitators or the performance obstacle also contributes to that. In terms of patient-level workload, the clinical condition of the patient is observed. The therapeutic variables related to the patient’s condition can also develop workload. The situation level of burnout can be seen due to the healthcare microsystem design. According to Fasoi et al. (2021), no specific reason is found for that, as most situations are uncertain, such as the global pandemic due to “COVID-19”.However, this unexpected situation in the health care system created an excessive workload for the nurses.
It is also important to find the root cause of nursing workloads. Root cause could help to find the solution as well. “Mismanagement” at the administration level is one of the main reasons for the workload (Utomo et al. 2022). The hospital management system is very much important for increasing the quality of work. Though nurses take care of the patient, the distribution of work is done by the administration. Each nurse has some unique skill, which can be utilized to enhance the health of the patient. However, false recognition of skill and excessive allocation of work can increase the workload. Lack of coordination in the administration system is also seen in some healthcare organizations. Besides, according to De Groot et al. (2022), lack of rewards or recognition, and less leave reduce the motivation for work, which can also contribute to burnout and stress. Long duty hours and overtime can also be added to the list (Moghadam et al. 2021). Due to the ineffective work distribution, many nurses have to work for long hours. In some cases, due to the presence of critical patients, they have to assist the other nurses and have to do overtime duty.
Ineffective communication and lack of understanding also increase the workload in many cases (Borges, Caruso, & Nassar Júnior, 2021). Effective communication is easy for any organization even in healthcare. Proper communication between the nurses and patients or clinicians is important to perform the task effectively. Due to the lack of communication, the chances of error increase in the work, and the nurses have to redo the same work. The nurses who are involved with the administration work or paperwork mostly face this. On the other hand, there is much work in the hospital, which has to be in collaboration. As stated by the researcher Anggraini, Pamungkas & Purwat, (2021), without proper communication, it is impossible to increase coordination and these results in excessive work pressure. In addition, communication barriers are also seen at the time of shift changes, when the responsibility of the care for one patient is handed over to another. Hence, without communication, the complication of work will increase leading to excessive workload for the nurses.
Another important reason for the nursing workload is the Lack of human resources (Borges, Caruso, & Nassar Júnior, 2021). In the past 15 to 20 years, health care facilities have improved a lot. Besides, the health care industry is also increasing rapidly due to the increasing number of patients. Despite that, the lack of nurses is a very common problem in most hospitals. The shortage of nurses is seen globally and recognized by the world health organization. According to them, 9 million nurses need to recruit globally within 2030 in order to meet UN sustainable goal 3 (World health organization, 2022). This can clearly provide an idea about the shortage of nurses in the hospital. The lack of human resources means more workload for each person, which is happening in the health care sector now.
The impact of nursing workload is huge on both the patient and the nurse. Various nurses have identified excessive workload as the main reason for job dissatisfaction (Nasirizad Moghadam et al. 2021). Hence, they are switching or retiring, which is reducing the employee retention rate in health care. Another impact is stress and burnout. The stress rate of nurses is very high these days. As stated by Hoogendoorn et al. (2021), especially at the time of the pandemic, the workload and stress among healthcare workers increased. However, it is hard to say the exact reason for it. Excessive workload could be a reason for it. On the contrary, some nurses manage to handle the excessive workload and show progress in the work. Working in a stressful environment can help people to increase their stress management capacity (Nasirizad Moghadam et al. 2021). However, in most cases, the impacts are negative, and proper workload management is needed to handle the situation properly.
The workload of the nurses has some serious impacts on the patient as well. It has been seen from many studies that excessive workload can reduce the work quality of the nurses, which results in a low patient service rate (Almenyan, Albuduh, & Al-Abbas, 2021). Especially in critical patients, the impact is deadly. Accidents in the work and errors increase due to work pressure. In the health care sector, a minor error causes a life-threatening situation for the patient. Besides, due to the huge list of tasks, it is common for nurses to forget some tasks or are not able to perform the task within the assigned time. In addition, along with treatment, showing empathy to the patient is another characteristic of nurses. According to Zanini et al. (2021), due to stress and burnout, a lack of empathy is also seen among the nurse. However, as the nurses are taking workload, it is beneficial for the patient to get the treatment on time.
It can be concluded from the above discussion that increase of the workload of nurses is a genuine concern in the healthcare industry. Some of the common reason for the workload is identified here, such as a lack of nurses in hospitals due to a global shortage of medical professionals. On the other hand, mismanagement in the administration also contributes to this. Though the job of nurses is stressful, they do not get enough recognition for that. Besides, the financial benefits and leaves are not available enough to give them enough time to recharge themselves. Hence, stress and burnout the very common among nurses. In addition, during the pandemic, the situation becomes worse than ever. Due to the stress, errors in work increase, which is life threatening for the patient. Hence, it can be said from the above discussion that workload of the nurse is increasing and it have some destructive consequences on healthcare industry.
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