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2/6/22, 6:26 PM Nurs440: Overstaffing

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Grace: Just look at this schedule. The Lead Nurse has placed m andatory overtim e for this m onth again! I just can’t do it again. I’m so tired, and I m ade a m edication error last m onth. I’m afraid that I m ay hurt a patient and could never forgive m yself.

Nancy: Oh no! I have a wedding I’ve already RSVP’d to on that Saturday. That’s three Saturdays in a row! And each weekend I work, I’m always the senior nurse, with all new grads or nurses with less than a year’s experience.

Narrator: Uh oh, it looks like the nurses are unhappy with their schedule.

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2/6/22, 6:29 PM Nurs440: Overstaffing

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Yes, understaffing does impact the quality of care and may lead to increased rates of infection. As registered professional nurses, we must ensure that we are all practicing safely and are not fatigued, because understaffing goes hand-in-hand with nurse fatigue.

because understaffing goes hand-in-hand with nurse fatigue. According to the Nursing Staffing Strategy, 69 percent of health care professionals surveyed said that fatigue caused them to feel concern over their ability to perform during work hours. Additionally, nearly 65 percent of participants reported they had alm ost m ade an error at work because of fatigue. The aging nurse population and nursing work shifts that are longer than eight hours can also have an im pact on errors and fatigue. When discussing the aging nurse, according to Reese, the director of Kronos ( K. Brim m er 2013) in “2008, the average age of nurses was 45.5. The average age is probably closer to 52 now and we’ve found that the aging workforce tires easily and working extra shifts doesn’t help. These highly skilled workers have to m ake critical decisions related to patient care and if doing it in a fatigued state, will only increase the risk for errors and injuries”, said Reese. We can only hope that we continue to discuss these sensitive issues including m andatory staffing.

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2/6/22, 6:25 PM Nurs440: Overstaffing

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Narrator: It is high census season for the hospital. The nurses are concerned because they have been working extra shifts for a m onth and they are tired. Click on the Nurse Schedule to view their current schedule.

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2/6/22, 6:28 PM Nurs440: Overstaffing

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Yes, understaffing does impact the quality of care and may lead to increased rates of infection. As registered professional nurses, we must ensure that we are all practicing safely and are not fatigued, because understaffing goes hand-in-hand with nurse fatigue.

Narrator: Yes, understaffing does im pact the quality of care and m ay lead to increased rates of infection. As registered professional nurses, we m ust ensure that we are all practicing safely and are not fatigued, because understaffing goes hand-in-hand with nurse fatigue. According to the Nursing Staffing Strategy, 69 percent of health care professionals surveyed said that fatigue caused them to feel concern over their ability to perform during work hours. Additionally, nearly 65 percent of participants reported they had alm ost m ade an error at work because of fatigue. The aging nurse population and nursing work shifts that are longer than eight hours can also have an im pact on errors and fatigue. When discussing the aging nurse, according to Reese, the director of Kronos ( K. Brim m er 2013) in “2008, the average age of nurses was 45.5. The average age is probably closer to 52 now and we’ve found that the aging workforce tires easily and working extra shifts doesn’t help. These highly skilled workers have to m ake critical decisions related to patient care and if doing

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2/6/22, 6:28 PM Nurs440: Overstaffing

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You know I don’t even know the staffing ratio requirements for this unit. Yesterday I cared for five babies, one who was really sick and required transferring to County General.

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Grace: You know I don’t even know the staffing ratio requirem ents for this unit. Yesterday I cared for five babies, one who was really sick and required transferring to County General. Nancy: Grace, the ratio is 1:4 on this unit for lower-risk babies and 1:1 in the NICU (neonatal ICU).

Susie: You know, there is a nursing shortage at the bedside and with the im plem entation of the new com puter charting and the im plem entation of the affordable care act, health care costs are soaring. Let’s check out the guidelines for m andatory staffing again, and speak with the director. I know that nurse fatigue is a factor when m istakes are m ade, and we are taking care of very sick babies. The hospital does not actually use acuity guidelines in real tim e. Nancy: There are classification tools that m easure the requirem ent needed for each patient. Som etim es a stated m andatory ratio does not always m eet the requirem ent for

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2/6/22, 6:27 PM Nurs440: Overstaffing

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Susie, are you sure you want to do that? I think that’s unsafe. We are already on notice from the infection control nurse about the increase of central line infections on the unit. And you were just complaining earlier about having to work short most of the time.

Nancy: Susie, are you sure you want to do that? I think that’s unsafe. We are already on notice from the infection control nurse about the increase of central line infections on the unit. And you were just com plaining earlier about having to work short m ost of the tim e. Grace: I can’t work her m andatory extra shifts. Besides, is it legal for her to do that? Isn’t it against the law to schedule overtim e? I’m going to have to see our union representative. And let’s not forget about m andatory staffing ratios. Susie: Ladies, stop whining. I’m saving for a car, so what if I’m a little tired. I get the job done. They just want a warm body here and I provide that.

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2/6/22, 6:27 PM Nurs440: Overstaffing

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Nancy: I just read this article earlier, and it points out that nurse understaffing and nurse fatigue are the two prom inent issues that negatively im pact the quality of care delivered to patients. According to the article in JAMA pediatrics—a national study found that very few neonatal intensive care units provide sufficient num bers of nurses to m eet national guidelines and that units caring for the m ost vulnerable babies are also the m ost understaffed, putting the health of critically ill newborns at risk.

We need m ore nurses.

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2/6/22, 6:28 PM Nurs440: Overstaffing

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You know I don’t even know the staffing ratio requirements for this unit. Yesterday I cared for five babies, one who was really sick and required transferring to County General.

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are m ade, and we are taking care of very sick babies. The hospital does not actually use acuity guidelines in real tim e. Nancy: There are classification tools that m easure the requirem ent needed for each patient. Som etim es a stated m andatory ratio does not always m eet the requirem ent for staffing or m ean that we are unsafe. I think this m ight be som ething we could bring to m anagem ent during the next staff m eeting. You know, becom e a part of the solution. Susie: We need to get together at the next union m eeting and talk about this m andatory staffing issue. I can’t work five days a week anym ore. I could really hurt m y patients. Nancy: I do believe an em ployer can ask us to work as m uch overtim e as needed to cover shifts. But we m ight want to check our union contract again, and always put patient safety first.

Narrator: For m ore inform ation, click the link on the screen.

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