Need help on spelling, if it stays on topic and three things I could work on.
The Disappearance of Nurses
Nurses are disappearing from all around the globe due to burnout, abuse, injuries sustained while working, and the ever daunting possibility of accidentally harming a patient. Nursing is a field that one would never think of as having such problems, as an outsider looking in, but the sad truth is that this is the creation of the shortage of nurses in medicine. The high demand of nurses in the medical field stems from issues that are being created within the profession. The issues of verbal abuse, physical abuse, nursing shortages and injuries are making nurses leave the profession of medicine earlier in their careers than what was originally planned by nurses that have spent a great amount of time and money getting the degree that they so longed for to become the Great R.N.!
Becoming a registered nurse does take a great amount of time and with the experience that one achieves after receiving their degree, makes them a great commodity for a hospital to obtain. With all this being said hospitals are not protecting the great asset that they have acquired. "This shortage of RNs influences the delivery of health care and negatively affects patient outcomes; an insufficient nurse staffing level is associated with negative patient outcomes [8, 9] and decreased nurse job satisfaction "(Flinkman, Isopahkala-Bouret, and Salanterä). The shortage of nurses to patient ratio creates problems for the nurse from being overburdened by staffing issues, leading to a lack of time for patients to be properly cared for as the physician has prescribed and families demand. This is an issue in nursing all around the world not just in the United States.
Registered nurses dealing with insufficient staffing issues leads to less teamwork between the nurses. Since there is minimal time to care for their own patients, the nurses are reluctant and unable to help other nurses with the care of another nurses patients. This again will lead to no breaks, and possible missed lunches which would give the nurse the opportunity time to rest and refocus on their patient care load for that day. Nurses that are working in a setting that has created a fearful work environment could add to more errors being made with patients. This is where medical drug errors, patient safety errors, and missed physician orders can come into play.
"A new study suggests that nurses are regularly sacrificing their breaks and meal periods to provide patient care. The researchers found that nurses took a break or ate a meal free of patient care responsibilities in less than half (47 percent) of the shifts they worked over a 1-month period. During the remaining shifts, they either worked nonstop throughout the entire shift (10 percent of shifts) or were able to sit down for only a short period, while remaining responsible for patient care activities during their breaks or meals (43 percent of shifts)" (Skipping Meals or Breaks May Contribute to Nurse Burnout and Jeopardize Nurses' Health).
Once again causing both nurses and patients to be put in a poor position to where injury is likely to occur.
As the shift hours of the nurses grow longer as the months go on, nurses become tired and exhausted and accidents are more likely to occur. The downfall of these accidents is that they can be a matter of life and death for the patient involved.
"Although nearly 40 percent of the shifts exceeded 12 hours, nurses working longer shifts were no more likely to be able to take a break than nurses working shorter shifts. There were 189 errors (most of them medication errors) reported by 30 percent of the nurses during the 28-day period" (Skipping Meals or Breaks May Contribute to Nurse Burnout and Jeopardize Nurses' Health). Airline pilots, truck divers and many other long-travel jobs require that their employees keep a log of how long they work, and are not allowed to exceed a certain amount of hours within a certain timeframe. They are required to work only a set about of hours because it can be dangerous, and many people could be hurt or killed if they do not get rest. Nurses have many patients in their care, and are made to work even longer hours then pilots or truck drivers and for some reason they do not have mandated hours like many others do. Their lack of sleep could be just as dangerous, and even more deadly as a pilots or a truck drivers. The lack of nurses in the medical field is a serious issue that is causing nurses to work longer hours and deal with more patients which could be causing patients harm or death.
The nursing shortage is not just a problem in the United States, but all around the globe which leads to insufficient patient care. "In a time of global nursing shortages an alarming number of young registered nurses have expressed a willingness to leave the profession" (Flinkman, Isopahkala-Bouret, and Salanterä). Nurses cannot care for every patient that is in there charge equally when they are being made to care for four or more patients all at the same time. The ratios of patients change with the critical situations of each patient. Two patients in the intensive care units are not looked at in the same way. One might be more critical that requires a one to one ratio. Where a medical surgical floor might have two patients that are very stable and ready to go home. The care ratios are not adjusted at times due to the nursing shortage and this can create a serious situation for the patients, and a fearful nurse. Some things can start to slip to the wayside and may even be missed by the nurse due to he or she being with another patient at that time. This missed sign or symptom could cause the patient permanent damage or even worse, their life. This is all because nurses are in such short supply and must stretch themselves so thin in order to care for ever patient to the best of their abilities, and deal with the hand that they have been given.
Some reasons for the disappearing nurses in medicine listed above also include problems with abuse on the job. This can be verbal or physical abuse that can come from other medical professionals or from patients themselves. "Aggression towards nurses is common around the world and can be the impetus for nurses leaving the profession or developing anxiety when working in particular settings"(Edward, Stephenson, Ousey, Lui, Warelow, and Giandinoto).Working conditions where abuse is an issue causes increased anxiety for the nurse, and job dissatisfaction. It also can accelerate the problems with the abuse already a standing problem in the working area. This is harmful to the hospital regarding retention of nurses on staff and potential good reputations of that hospital.
Abuse on the job can be quiet serious for the patients and medical personnel. Other staff members discovering an issue like this can create an evacuation of an entire unit. As for nurses the abuse can come from anywhere. Once again leading to loss of nursing personal. If the abuse is between staff members it not only can be a legal issue, but can cause the loss of a job, and even their Registered Nurse license. The fear and insecurity of working in this type of environment can cause nurses to feel unsafe and the need to leave the medical profession. "The concept of workplace bullying entails situations in the workplace where an employee persistently and over a long time perceives him- or herself to be mistreated and abused by other organization members, and where the person in question finds it difficult to defend him/herself against these actions (definition provided by: )" (Verkuil, Atasayi and Molendijk). The abuse that goes on every day for many nurses can really take a toll on their mental and even physical health. This can contribute to pushing nurses toward their breaking point and even cause them to decide to leave the medical profession forever.
Healthcare professionals including nurses are having to leave the medical field due to disabling injuries sustained on the job. These injuries are happening to nurses forcing them to leave the medical field before retirement age. Injuries are becoming more common unfortunately due to the shortages in healthcare, lack of teamwork, and the working environment. "Currently, the average nurse is in her forties. The daily stress of bedside nursing, including back pain and emotional and mental fatigue, takes a toll. Moreover, hospitals recurrently have mandatory in-services on new equipment or techniques, and continuously changing policies. There is not enough compensation for these stresses and this will lead many aging nurses to leave the profession. Newly graduated nurses will also leave the profession for the same reasons"(Daphne Conis). This is one of the greater reasons and saddest ones for nurses to leave a profession that they have worked so hard to achieve.
In an interview conducted with Angela Anderson a registered nurse her story reflects on how an injury can force a nurse to retire early. Ms. Anderson R.N. states:
"I was at work in the hospital helping a physician who was performing out patient procedures. I was responsible for the conscious sedation aspect of the procedure for the patient. The patient was brought into the procedure room, all the important information was given to the patient and all appropriate questions were answered to ensure that nothing was missed. The patient was positioned appropriately on the surgical table, and covered with warm blankets. The I.V. was started without any problems and the patient was given certain medications to put her asleep. This is a form of anesthesia called conscious sedation. The procedure went well and the patient tolerated all the medications that were given to her. The surgical nurse that was responsible for the patient was very focused on cleaning up the surgical cart and not on the patient. After the patient was waking up, and all the anesthesia records were completed I walked out of the room to give my part of the procedure record to the physician so that he could complete his dictation and start on the next patient. The surgical nurse was not paying attention to the patient, and was not at her bedside. She was distracted with arranging the surgical cart and other things instead of patient care, which was her responsibility. As I walked back into the procedure room, and past the patient out of the corner of my eye I saw her climbing upward on top of the O.R. table and heard her say, 'I feel so much better nothing hurts now. Im getting off here'. With that she lunged off the table not realizing that her hip and leg were completely numb causing her to fall on me. With this one accident it changed my life and my families lives forever. The patient injured my right shoulder and my back causing me to have to under go multiple surgeries on my shoulder and back. Even with all the healthcare I received I was disabled forever. I lost one of the greatest loves I had and that was Nursing"(Angela Anderson, R.N.)
Ms.Anderson's story demonstrates how lack of teamwork, and nurses not focusing on their job, can lead to the injury of a fellow nurse. This injury however, resulted in a nurse being forced to retire early, contributing the issue of the nursing shortage.
A serious concern of many nurses is the safety of both themselves and their patients. Nurses work many twelve hour shifts which can sometimes be extended to a twenty-four hour shift if their is a lack of nurses for the next shift or they are drawn at the nurse on call for the night. They are expected to work all twenty-four hours straight without any rest and very few breaks if they manage to get a break at all. Nurses must also be as focused and sharp-minded throughout their entire shift, however long that may be, as they were when they first arrived for work. On top of their seemingly-endless hours they must also deal with an abnormally large number of patients that are in their charge and ensure their safety and care. "A recent study published in JAMA (October 23/30, 2002) proves what nurses have been telling us--that working too many hours while caring for too many patients leads to increased patient deaths and increased job dissatisfaction"(Hon. Fortney Pete Stark). Nurses are only human and mistakes do happen, but the incident rate of these accidents will surely increase with the exhaustion and number of hours worked by nurses.
Nurses are aware of how lack of sleep and exhaustion can effect their ability to focus and truly concentrate on what they are doing. They are fearful of how their own inabilities might effect those around them and their patients. One wrong move or the improper dosage of a medication can cause the death of a patient. Not being experienced enough can also cause that nurse not to understand the risk and danger that he or she is putting themselves in or the patients in their charge. In turn a nurse could lose their license or ability to practice medicine due to such a mistake that might not have happened had they had more rest.
As testified by the following statement:
"It is difficult to tell you how terrible it is to ''work scared'' all the time. A mistake that I might make could easily cost someone their life and ruin mine. Every night at work we routinely ``face the clock.'' All of us do without lunch and breaks and work overtime, often without pay, to ensure continuity of care for our patients. Yet, we are constantly asked to do more. It has become the norm for us to have patient assignments two and a half times greater than the staffing guidelines established by the hospital itself"(Hon. Fortney Pete Stark).
nurses are fearful of themselves because of the demand the hospital are requiring they meet without complaint. Nurses do not want to cause harm to their patients and because of the fear that they might possibly cause them harm, many nurses are electing to switch to administration jobs or even leave the medical field altogether.
The disappearing nurses are not just a figment of the populations imagination. Based on the above information it is a serious and concerning issue for the current and future population. The lack of nurses not only effects staffing in the hospitals, but also the home care patients in our society. Patients in third world countries don't even seem to have a fighting chance at good healthcare due to the severe lack of nurses able to care for them in comparison to the seemingly large number of nurses we have in America. The issues creating the disappearing nurses are that the nurse to patient ratios are too high, abuse of the nurses, fatigue due to extreme hours, injury and fear of injuring the patient or ones self. All these concerns can make anyone fearful unless they are uneducated about the situation or just ignorant.