Introduction
The heavy nursing workload is one of the central problems in the modern system of American healthcare. Nurses have to cope with too many tasks, that is why the overload takes place. It is obvious that something should be done. The main purpose of the paper is to identify the problems that exist in nursing workload and offer some specific methods and suggest ways out.
Identification of the problem
The main problem the nurses face in America is a heavy workload which takes place for a number of reasons. First, an increased demand for nurses may be noticed in the USA. Second, the tendency for an inadequate supply of nurses is observed. Third, the staff is reduced and overtime is increased. Finally, patients do not want to stay in hospitals and want to go home with the nurses following them and taking care of them there (Carayon & Gurses, 2008).
Why the change is needed and the driving forces: Regulatory enhancement
The change of the situation is really necessary as a heavy nursing workload influences the level of the health care the patients are provided with. The dependence is obvious, the higher level of nursing workload, the lower level of customers satisfaction which may lead to unpredictable and really harmful consequences (Carayon & Gurses, 2008). Regulatory enhancement is one of the best ways to solve the problem. Considering the Rules and Regulations of Registered Nurses (2007) it becomes obvious that there are no rules on how much work should be done and how long a nurse should work. The regulation enhancement may improve the whole system of nursing in the country where a low level of nursing is the driving force for it.
Benchmarking enhancement and driving forces
There is a specific system, Time Study RN National Benchmarking Database, which helps hospitals and their nurses to measure the time the caregivers spend at the workplace. It is natural that the measuring tool is an effective method to understand whether nurses are overloaded or not. The Time Study RN is not obligatory, still, with the appearance of the problem. Each nurse should pass the test to understand the level of his/her workload. The results may be taken as the basis for the improvement of the quality of health care and for reducing the tasks nurses are provided with.
Improved efficiency enhancement including driving forces
The measurement of the nursing workload is really necessary for improving efficiency. If a nurse is responsible for numerous tasks at one and the same time, nothing will be done in a proper way. A nurse is unable to provide the patient with efficient help, so the reduction of nursing workload is one of the ways to improve efficiency enhancement and work performance. This should be one of the driving forces for the measurement and reduction of nurses’ workload.
Patient satisfaction enhancement, including driving forces
It is obvious that being satisfied with the services provided by the nurses, the patients are eager to use the services of the nurse the next time if necessary. Thus, the level of the patients’ satisfaction is really important. The reduction of the workload of the nurses is one of the ways to enhance patient satisfaction which is going to influence “accountability among health care providers” (Guadagnino, 2003, par. 1). The higher the patient satisfaction in the specific hospital, the better image the hospital has that is considered as the driving force for enhancement.
Life safety issue enhancement including driving forces
The government should care greatly about the health and wellbeing of citizens. This is considered to be the main driving force for the enhancement of the life safety issue which is connected with the reduction of nursing workload as was mentioned above these notions are interconnected.
Timeline for change
The changes in the healthcare system may not be provided immediately. Some time should pass to structure the work of nurses and to allocate their responsibilities in order to balance their workload and reduce it to the normal level. No less than a month should be spent on the change of the current state of affairs. Thus, the research should be provided on the basis of the Time study RN where nursing workload should be measured. The research should last for one week. Then, the analysis and evaluation of the results should be conducted. The researchers should create a plan for reducing the nursing workload on the basis of the results and suggest ideas for additional help, if necessary. The plan implementation and adaptation to the new system is also going to take up about two to three weeks, depending on the obtained results and the level of nursing workload before.
Methodology to be used
The nurses in different states should be tested for gaining objective results. Time study RN test should be applied on 10 subjects from 10 hospitals in different states. The nurses should be selected randomly without referencing origin, age, and sex, but the experience should be taken into account. Only experienced nurses should be involved in the study. They should work in the hospital for no less than 5 years in the position of nurse. The research should be conducted for 7days long in the usual nurse’s environment and the responsibilities they usually perform.
Change theorist and leadership style recommended
Lewin’s change theory may be used as the recommended style of leadership. There are three stages: unfreezing, when “the nurse manager or other change agent is motivated by the need to create change” (Roussel & Swansburg, 2006, p. 63), moving, where the information is gathered and freezing, were “changes are integrated and stabilized as part of the value system” (Roussel & Swansburg, 2006, p. 63).
Research literature to support the proposed change process
Much is said about the nurses’ overload and the necessity to change the situation. Stanton & Rutherford (2004) state that “Hospitals with low nurse staffing levels tend to have higher rates of poor patient outcomes such as pneumonia, shock, cardiac arrest, and urinary tract infections, according to research funded by the Agency for Healthcare Research and Quality (AHRQ) and others” (p. 1) but the problem of low level of nurses is connected with the overloading of the nurses. Moreover, there are some more reasons which make it impossible for the nurses to do their direct responsibilities, health care (Carayon & Gurses, 2008).
PDAC cycle, implementation strategies, and evaluation process
After the research is completed, it is necessary to follow the instructions provided in the PDAC cycle, that is plan, do, act, and check. N the basis of the considered results it is necessary to plan the changes. Then, the researchers should implement those changes and analyze the differences. Furthermore, it is necessary to check whether the new system of nursing workload functions successfully.
Summary
Thus, it should be concluded that the research conducted with the help of the Time study RN should affect the whole nursing system of the USA. The heavy workload prevents nurses from performing their usual tasks and the reduction of the level of the work. The research is going to help the balance the work the nurses perform and increase the level of services they provide by reducing their workload.
Reference List
Carayon, P., & Gurses, A. P. (2008). Nursing Workload and Patient Safety—A Human Factors Engineering Perspective. In Ronda Hughes & United States. Agency for Healthcare Research and Quality (Eds). Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville, MD: Agency for Healthcare Research and Quality, U.S. Dept. of Health and Human Services.
Guadagnino, C. (2003). Role of patient satisfaction. Physician’s News Digest. Web.
Rapid Modeling Corporation. (2006). Time study RN national benchmarking database. Cincinnati, OH: Author. Web.
Roussel, L. & Swansburg, R. C. (2006). Management and leadership for nurse administrators. Sudbury, MA: Jones & Bartlett Learning.
Rules and Regulations of Registered Nurses. (2007). Rules of the Tennessee Board of Nursing. Web.
Stanton, M. W. & Rutherford, M. K. (2004). Hospital nurse staffing and quality of care. Agency for Healthcare Research and Quality. 14.