Duties Under Extreme Conditions Within Nursing

Many things influence one’s personal perceptions of the great profession called nursing. According to the American Nurses Association, nursing is defined as “protection, promotion, and abilities, prevention of illness and injury,

Nursing is one of the most intimate health care professions. They are connected to their patients as soon as they are admitted into their care right through until they are discharged into someone else’s care. With this, nurses have a strict professional identity and scope of practice to prevent a nurse from over stepping their professional boundaries. A nurses’ duty of care does go beyond the average healthcare professional but still does not impair the

I define my philosophy of nursing within the three nursing domains of person, health, and environment. My goal is to communicate the importance of nursing as a knowledge-based career, depending not only on the nurse fulfilling her role but also on the patient’s compliance. A patient must learn to provide self-care at home in the same capacity as the nurse would provide care in the clinical setting. I discuss various subjects within nursing. I explain why I want to be a nurse, what I believe a nurse’s role is, the different domains of nursing, and where I believe nursing will be in the future. My philosophy demonstrates the interdependence of the nursing domains. You cannot fully evaluate a person without evaluating their health,

The Ohio house bill 346 also protects nurses by providing laws on staffing. HB 346 “requires hospitals to establish staffing plans, with meaningful input from direct patient care nurses, which are consistent with the principles of safe staffing developed by the American Nurses Association and other nationally recognized organizations” (Ohio Nurses Association, 2011). The American Nurses Association as well as other nursing organizations should continue to advocate for nurses to work towards decreasing nursing workload and preventing burnout.

“Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all settings. Nursing includes the promotion of health, prevention of illness, and the care of ill, disabled and dying people. Advocacy, promotion of a safe environment, research, participation in shaping health policy and in patient and health systems management, and education are also key nursing roles” (ICN 2010)

Nurses have a professional obligation to be informed about staffing as part of their concern and obligation to patients that they are caring for. Why? As nurses, having enough staff to cover all patients, and possible patients that are coming in are very important to make sure that nurses are not overloaded. However, nurse managers, charge nurses and other administration staff of the hospital or organization are responsible of staffing, all nurses are still held responsible to their patients and the profession as a nurse.

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.

Mandatory overtime in the field of nursing is described as forced overtime to maintain an adequate amount of staff present to meet the needs of the hospital. With a normal work schedule, a nurse usually works 12-hour shifts, usually three times a week. With the obligatory hours that are extended with overtime due to the continuation of nursing shortages, a nurse’s shift can be continued ranging from 12 to 16 hours, with very short notice. This mandatory action is related to putting not only nurses, but also patient’s health at risk. The advantages that accompany mandatory overtime are overshadowed by the disadvantages that surpass the benefits of working extended hours, therefore, mandatory overtime should not be allowed in the nursing work place.

The determination of the sufficient number of nurses is complicated and requires proper coordination between the management and nursing. Patient acuity and turnover and skill mix are among the factors that are considered in the process (“Nursing and Patient Safety,” 2017). MacPhee, Dahinten, and Havaei (2017) note that workloads for nurses are measured at three levels, these are unit, job, and task. Concerning the unit-level, the assessment of workload is usually based on staffing and skill mix considerations. The perception of RNs, concerning the quantity of work they

Mandatory overtime has become an increasing problem for nurses who work in many hospital settings. Mandatory overtime is defined as additional hours added to a nurse’s current shift, making the nurse feel as if it’s a threat of being fired or disciplinary action will be taken in some form if they refuse to stay and work. Extensive overtime studies have established and confirmed that there are serious dangers to both the nurse and the patient being cared for in all types of healthcare settings.

Stressful work environments, long work hours and inadequate sleep all contribute to an increase in physical and mental exhaustion amongst nurses. Typically, people choose nursing as a career to help others and to make a difference in their lives, without realizing the number of duties this career demands. Nurses may suffer in silence when they are experiencing stress. The effects can impact safe and reliable care by decreasing job satisfaction, decreasing productivity, causing poor personal health, and compromising patient care. Many facilities would benefit from implementing evidence-based strategies to address nurse fatigue and burnout.

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)

American Nurses Association defines nursing as “the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and population”( Potter,P.,& Perry, A. 2005,1-5). Thus making nursing dynamic and ever changing. However, when nursing

The physical strain on the body that a nurse endures in a 12-hour shift is exhausting. Most nurses in a hospital setting typically work 12-hour shifts. During a shift you are required to be on your feet taking care of multiple patients at once. Because the doctor and patients rely on their nurse so much, they rarely take a much needed break. They must find time to take a bathroom break, or grab a sip of water, or eat a protein bar. The stress the body endures during a shift can strain the body. Nurses can become extremely fatigued, and also dehydrated. There is also potential to be injured on the job. Nurses have to do a lot of heavy lifting like moving a patient. Nurses are at risk for injuring their back or shoulder if a patient moves the wrong way or falls on them. All of these factors affect the nurses overall health and will eventually cause burnout.