nurse staffing issues - job satisfaction
Nurses around the world are among the least satisfied workers,
and the problem is getting worse
American consumers' trust in hospitals is not as strong as it
once was, nurses feel that they are under siege, and hospitals are
having a hard time finding enough nurses willing to work under
current hospital conditions. However, nurses in countries with
distinctly different health care systems report similar burnout,
shortcomings in their work environments, and concern about quality
of hospital care.
This international problem suggests a fundamental flaw in the
design of clinical care services and management of the hospital
workforce. Resolving these issues is essential to preserving
patient safety and quality of care, asserts Linda H. Aiken, Ph.D.,
R.N., of the University of Pennsylvania School of Nursing. In a
study that was supported in part by the Agency for Healthcare
Research and Quality, Dr. Aiken and her colleagues examined
reports from 43,000 nurses from more than 700 hospitals in the
United States, Canada, England, Scotland and Germany in 1998 and
1999.
The reports revealed that just under 30 percent to more than 40
percent of nurses in all countries except Germany had high burnout
scores on a standard burnout scale. Also, more than 3 in 10 nurses
in England and Scotland and more than 2 in 10 in the United States
planned on leaving their jobs within the next year. Only 30 to 40
percent of nurses said that there were enough registered nurses to
provide high-quality care and enough staff to get the work done.
Fewer than half of the nurses in each country reported that
management in their hospitals was responsive to their concerns,
provided opportunities for nurses to participate in decisions, and
acknowledged nurses' contributions to patient care.
Despite caring for sicker patients, U.S. and Canadian nurses
said the number of patients assigned to them had increased in the
past year. Also, in North America front-line nursing managers and
support staff have been eliminated in a number of hospitals, with
staff nurses taking up the slack at the expense of direct patient
care. Not surprisingly, only one in nine nurses in Germany and one
in three nurses in the remaining countries rated the quality of
nursing care provided on their units as excellent. To retain a
qualified nurse staff, hospitals need to develop personnel
policies comparable to those in other lines of work, conclude the
researchers.
See "Nurses' reports on hospital care in five countries," by
Dr. Aiken, Sean P. Clarke, Douglas M. Sloane, Ph.D., and others,
in the May 2001 Health Affairs 20(3), pp. 43-53.
Reprints are available from the AHRQ Publications
Clearinghouse.
These are excerpts from the AHRQ Research Activities,
you can read their full reports at
http://www.ahrq.gov/research/aug01/801RA12.htm |