Working Conditions for Nurses Impact Patient Health

This post was authored by Sarah Keogh and posted to The Eye Opener on May 3rd, 2011.

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I suspect that anyone who has spent even as much as one day or night in a hospital knows just how critical the nursing staff is in the , health, care and comfort of a patient. A compassionate and personable nurse can put a patient at ease and help them feel better in ways that go beyond just medicine.

Recently, I wrote about how different schedules impact nurses’ lives and how they cope with shifting from day to night schedules. This week, I was drawn to write about nurses again after seeing an article on medicalnewstoday.com that spoke about a study done by the University of Maryland School of Nursing.

According to the article, the study determined that “[b]etter working conditions and better staffing of nurses can significantly improve the care of patients with serious conditions…” The study examined the psychological demands and work schedules of nurses:

…they measured high psychological demands by very fast work, lack of time to complete work, excessive required work, being slowed by delays from other workers, and frequent interruptions.

The data showed “…pneumonia deaths were significantly more likely in hospitals where nurses reported increased psychological demands and more adverse work schedules.” Equally troubling, “…patients were more likely to develop deep vein thrombosis after surgery in hospitals where nurses reported high psychological demands.” These were not the only areas in which the demands placed on nurses negatively impacted patient health.

The researchers calculated the association between job demands on nurses, both psychological and physical, and work schedule, against outcomes of patients with heart attacks, congestive heart failure, stroke, and surgeries that open a bone flap of the skull [craniotomy].

Also, they discovered that deaths from congestive heart failure were also significantly associated with long shifts and with nurses continuing to work while sick.

They found that deaths from heart attacks were associated with nurses frequently working with awkward postures and heavy weekly burdens.

Patients were more likely to experience postoperative hemorrhaging when their nurses were frequently interrupted.

And, where nurses reported a lack of time away from the job, patients were significantly more likely to develop respiratory failure and infections.

While difficult working conditions for nurses have a negative impact on patient health, the article reported that “[p]ositive aspects of the practice environment, such as peer and supervisor support, did not offset, or balance, the adverse impact of these demands.” Only, “[h]ospitals where nurses reported a focus on patient safety were less likely to have such complications or adverse patient outcomes [compared to] hospitals where patient safety was not a stated focus.”

What should be done with this information? To me, the critical lesson here is that work conditions for nurses dramatically influence patient outcomes. Attention must be paid to the conditions for nurses in terms of scheduling, interruptions, time off, and other work conditions. Do hospitals currently examine nurses’ psychological and physicals burdens as part of a comprehensive focus on patient safety? How as a patient do you chose a hospital – do you look only at the doctor’s qualifications or do you look also at other factors such as nursing at the hospital? Is it the duty of a hospital to provide working conditions for nurses that promote optimal patient safety?

 

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