Explain The Evidence Of The Malpractice Of Nonmalificence

Durning, (2010) tells how nurses are limited in giving quality care due to the number of patients they have on their shift. It also explains the huge difference in the task of caring for a post-partum mother and a patient recovering from a major trauma surgery. When nurses are too busy because they have too many patients to care for, they are more likely to overlook an important change in their patient. This will cause the patient to deteriorate unnecessarily and could potentially result in death (Durning 2010). “Nurses are the main surveillance system in hospitals” (Queensland Nurse, 2010, p.14). If they have too many patients to look after, something is more likely to be missed. There was a study done last year by Nursing Times, that showed the more nurses a hospital had per bed, resulted in fewer patient deaths, and actually lowered the patient’s length of stay (Queensland Nurse, 2010). The state of Victoria in Australia, like California actually has government mandated nurse-to-patient ratios. Since its implementation of the ratios 10 years ago, Victoria’s health system has been made considerably better. There is a safer environment for the patients, the workplace morale is better, and there are less complaints from the public about the quality of care they receive while hospitalized (Holmes, 2010).

In the recent past, nursing has come to the forefront as a popular career amongst students across the globe. The demand for nurses has kept increasing gradually over the years. In fact, the number of registered nurses does not meet the demand of the private and public health sector. This phenomenon has resulted in a situation where the available registered nurses have to work extra hours in order to meet the patients’ needs. With this in mind, the issue of nurse fatigue has come up as a common problem in nursing. According to the Canadian Nurses Association (CNA), nurse fatigue is “a feeling of tiredness” that penetrates a persons physical, mental and emotional realms limiting their ability to function normally. Fatigue does

Significance: Because nursing is the largest health care profession and nurses provide most of the patient care, and as an acute nurse, I can relate to how unsafe nurse staffing/low nurse-to-patient ratios can have negative impact on patient satisfaction and outcome, can lead to medical and/or medication errors and nurse burnout. It can also bring about anxiety and frustration, which can also clouds the nurses’ critical thinking. Most patients might not know the work load on a particular nurse and can assume that her nurse is just not efficient. Doctors also can become very impatient with their nurses because orders are not being followed through that can delay treatments to their patients. There is also delays in attending to call lights resulting in very unhappy patients who needed help.

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.

The continued shortage of registered nurses will be a catalyst for the increasing stress placed upon practicing nurses now and in the future. Mandatory overtime has been an incessant problem within the nursing profession. When lives are at risk, alertness is a critical part of a nurse’s job performance. Fatigue impairs one’s judgement directly affecting patient and nursing safety or outcomes. This author’s typical six week work schedule consists of eighteen-twelve hour shifts, nine “required” twelve hour call shifts, and three-four hour back-up shifts. A nurse that accepts a patient assignment in the operating room cannot legally or ethically leave when their shift has ended without proper relief. Inevitably, without proper staffing departure is not an

Within the recent years, hospitals and medical facilities have been experiencing nursing shortages that necessitate more nurses to be present to compensate for the care needed to be given. This requires nurses to be dealt with imperative extended work hours along with their normal shifts with no denial or excuse accepted. Working extra hours are accompanied with negative effects that have an impact on the nurse, coworkers, and patients. A major concern that occurs with overtime is that nurses become fatigued or burnout. Fatigue that is experienced is a result of sleep deprivation from working overtime that is associated with arduousness neurobehavioral functioning

As a certified nursing assistant (CNA) on the medical-surgical unit at Meritus Medical Center, the shortage of staff from CNA to registered nurses have increased. It has become noticeable the amount of stress the staff endures and how it affects patient care. It has also affected their overall satisfaction with their careers. At least five nurses have left the job since last year and that is only from night shift. It makes a big difference when there is adequate staffing because everyone is able to work efficiently. Sometimes there are four nurses with seven patients each and only two aides. Therefore, it makes it harder to offer help because of the workload. According to Martin (2015), patient outcomes are less likely to be adequate when there

A nurse’s typical day isn’t without stress; it is usually a lot of complex planning, critical thinking, time management, an abundance of communications with all departments of the hospital, and documenting events that have happened throughout the day on their entire patient assignment. “Nurses who are mandated following the completion of their regular shift are often ill-equipped to continue working. They have not planned for that situation with: proper advanced rest, arrangements for

In addition, the lack of regulatory standards or mandated nurse to patient ratios will be detrimental to nurses. Nurses who experience heavy or excessive workloads tend to be afflicted with fatigue, this leads to nurse burnout, job dissatisfaction and a harmful working environment. According to Connie Garrett (2008), “the effects of extreme fatigue can be compared to being under the influence of alcohol”. Fatigue is known to slow or impede reaction time and alter attention to detail. These are major contributing factors related to errors of omission. Reaction time and attention to detail are important factors required for problem solving techniques, personal motivational skills and energy.

In addition to understaffing, health care professionals are also placed within a setting where they are overworked. According to a research study by Imai et, al. (2004), “Excessive work demands, particularly for emergency overtime work, and low job control for community psychiatric nurses appear to represent work environment factors contributing to burnout”. When institutions are understaffed, it often means that nurses are then over worked. When this occurs, they no longer have the ability to upkeep their self-emotional and physical health. According to an article by USA Today (2015), “A steady stream of studies link fatigue to errors, increased risk-taking, declines in short-term memory and a reduced ability to learn – with researchers likening the performance of someone awake for at least 17 hours to that of a drunk person”. A common work shift currently for nurses in these settings are at least 12 hours at a time. Fatigue can also increase if workers have 12 hour shifts, for multiple days in a row. When an individual reaches this level of fatigue, it can be difficult for them to then care for another individual to the best of their abilities.

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.

Barry Hill (2017) performed studies related to the quality of care that patients receive and what factors are associated with those perceptions. One area that was noted to be of importance and directly related to quality of care provided to patients is staff dissatisfaction and burnout. This study also found that longer shifts contributed to increased amounts of emotional exhaustion leading to decreased quality of care for patients. Addressing staffing needs early and intervening can decrease the amount of nurse burnout and dissatisfaction that is often seen. This study has shown that hiring additional competent nurses reduces medication errors, falls, infections, wounds, and decreases hospital litigation costs, while improving staff morale, patient experience and care, and cost-effectiveness for the hospital.

To provide high-quality care for the patient it is essential for the nursing staff to have enough time for recovery from long hours of demanding work. Eight-hour shifts for hospital nurses have become a standard of the past. Nowadays, 12-hour shifts for three days a week have become typical in most hospitals as recommended by the Institute of Medicine (IOM) (Stimpfel, Sloane & Aiken, 2012). The length of the shifts and the working days; however, are often unpredictable due to increased demand for patient care and high census episodes. Nursing shortages, along with a weak economy, have left hospital nurses with no choice, then to work extended hours and overtime. Long hour shifts, as well as mandatory overtime, has become an increasing

Author Robert Dent, chief nursing officer, is a part of the Midland Memorial senior executive team and has led a team for over a year, which involved translating registered nurses fatigue risk evidence into a clinician guideline for all healthcare professionals. Dent led a council and focused on creating a fatigue management guideline to protect nurses and patients. In 2008, Dent created a task force in which he challenged nurses and nurse managers to review literature, create a guideline, and implement that guideline throughout the hospital. The task review of literature revealed that after 12 hours of work, mental and physical response times are sluggish, often leading to nurse and patient safety being compromised. This guideline provided the hospital with a strategy that recognizes RN fatigue and the negative consequences associated with fatigue and extended work hours on patient outcomes. The guideline implements parameters involving a restriction on the number of hours worked in a single shift and the maximum number of hours per week. These strict parameters prevented nurse managers from scheduling nurses to cover in excess of 12 hours per shift, which prevented nurses from working overtime during one 12-hour shift. The third parameter implemented the number of consecutive 12-hour shifts to three. The task force created the fatigue guideline and gained approval through

One of the many goals of the nursing profession is to provide high-quality, safe patient care. There are many responsibilities that come with a nursing career and when the nurse to patient ratio increases, there is a possibility that it may hinder the safe care that patients deserve, and this may result in negative patient outcomes and level of satisfaction. Staffing is one of the many issues that healthcare facilities face. In many facilities, there never seems to be enough nurses per shift to provide high quality, thorough patient care which often leads to burnt out staff, and frustrated patients and families. This review discusses the findings of quantitative studies and one systematic review that involves patient outcomes in relation to nurse staffing.