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The paper will discuss how working more than a 12-hour shift in nursing practice endangers both the nurse and the patient's safety. The relevance of the subject addressed in this article is that working longer than 12 hours a day in medical facilities has resulted in serious life-threatening conditions among nurses and patients in the majority of cases. According to Stimpfel, Sloane, and Aiken (2012) research, lengthy shifts of more than twelve hours are prevalent among hospital staffs. Unfortunately, little research has been conducted to determine its impact on patient care and the well-being of nurses. Additionally, the survey data gathered in four states on nurses discovered that at least 80 percent remained contented with their hospital programming practices. Nonetheless, as the working hours increased to more than 12 hours the patients’ discontent with care became outstanding.
Moreover, the study revealed that nurses who worked for more than ten hours had a higher likelihood to experience job dissatisfaction and burnout than their fellow who used to work for fewer hours a day. One notable feature of nursing practice is that actual nurse shift intervals are often irregular because of the understaffing in hospitals as well as the unpredictable patients’ needs (Dembe, 2009; Snow, 2012). The combination of these long working shifts with mandatory overtime leads to fatigue and burnout thus affecting the care provided to patients.
Burnout is the mental complication that results from overworking among staffs within a hospital facility.
A cohort study conducted by Manzano-Garcia and Ayala (2017) revealed the prevalence of burnout complication in nurses is a variable that associates to their working shifts. Poncet et al., 2007 revealed in a sample of 2,392 nurses working in 165 ICUs; 28.4 percent indicated chronic burnout level while 60 percent had a high degree in more than one its dimensions. The particular clinical question guiding this search is: In nursing how does working more than 12 hours shift negatively affect patient and nurses’ safety?
P- Nurses giving care
I- Reducing the number of hours of working to less than 12
C- Maintaining the hospital scheduling practice on mandatory overtime
O- Reduction in burnout among nurses and increased patient satisfaction
Working more than 12 hours is the independent variable (IV) in the question while safety is the dependent variable (DV). The population that the study will focus on is nurses who work for more than 12hours. The particular question that will guide the search for the qualitative research article is: What is the experience of patients who have received care from nurses with burnout?
O- experience of patients who have received nursing care
The object of the report is to illustrate the systematic explorations for the relevant evidence associated with the topic of how working more than 12 hours shift negatively impact on patient and nurses’ safety.
Level of Evidence
The study will significantly concentrate on the clinical question: the effects of nurses’ working for more than 12 hours this will help in evaluating the complications and difficulties experienced by these staffs. Understanding effects of mandatory overtime will have on the quality of care provided to patients. Additionally, this research will benefit the medical community to increase the number of nurses and doctors to improve the hospital scheduling practice and reduce burnout associated with overworking past 12 hours in a shift. The most appropriate level of evidence to answer the clinical question are Level II (Evidence gathered from more than one well-designed RCT) and V (Evidence from systematic reviews of descriptive and qualitative studies). The reason for considering the level of evidence for the study is that issue of burnout is a global problem among nurses thus affecting a huge population of patients who need extensive medical care. When hospitals establish a well-defined scheduling program for nurses on duty, it will increase patient care and reduce the degree of nurses experiencing burnouts. Therefore, when all responsible stakeholders of the economy can devise means of reducing mandatory overtime in nursing practice, health complications such as burnout will substantially reduce.
In completing this research, I used Google search and EBSCOhost database to get the articles and materials reviewed. When using EBSCOhost database, I employed three search steps to meet the minimum number of materials to use in the study. Firstly, I typed a section of the clinical research question: working more than 12 hours and the result of this search was quite massive approximately 5,166,928. As per my understanding regarding the number of material this was not appropriate. Secondly, I used keywords through the CINAHL search as the heading to get the required number of materials for reference. I, therefore, input the words “working for more than 12 hours shift” and the result reduced.
Thirdly, I added the words “negatively affect the patient and nurses’ safety” to the initial terms and the outcome reduced to 89,104. Finally, I used the whole question as my search words, and the result was reduced to 58,890 although still huge. Since the search still offered me a huge volume of materials, I input “effects of mandatory overtime among nurses” and narrowed down the quest to 29,038 results. I decided to reduce my search results to 23,532 by adding patients’ safety in the “AND” field “effects of mandatory overtime for nurses and patients’ safety.” I went through the nearly 100 of the total results obtained and assessed their suitability concerning the topic and discovered only 50 relate to the subject.
Additionally, I used Google Scholar to search for the materials. In this case, I typed the whole clinical question and the result yielded was huge, and therefore, I decided to narrow my search to materials published between 2010-2016. I ensured the materials are trustworthy and reliable by confirming from the author’s professional information and integrity column. I ruled out all articles with the “.com” suffixes and pursued those with “.gov,” “.edu” and “.org.” From the search result, I selected two books one is a government publication while the other is a non-governmental organization publication.
In summary, nurses have a significant role to play in ensuring the safety of the patients as well as theirs. However, understaffing in most health facilities has forced most staffs particularly nurses to work for more than 12 hours a shift which has impacted their safety and those of their patients negatively (Fearon & Nicol, 2011). Burnout has increased patients’ dissatisfaction in most hospitals in both developed and emerging economies which adversely impact on the quality of health care provided by doctors and nurses. The American Nursing Association asserts that the only sure way to deal with inadequate health care and patients’ dissatisfaction is by eliminating the mandatory overtime. The policy forces the health staffs to work for more hours than other civil servants who are working between 8 am to 5 pm.
Dembe, A. (2009). Ethical Issues Relating to the Health Effects of Long Working Hours. Journal of Business Ethics, 84195-208.
Fearon, C., & Nicol, M. (2011). Strategies to assist prevention of burnout in nursing staff. Nursing Standard, 26(14), 35-39.
Manzano-Garcia, G., & Ayala, J. (2017). Insufficiently studied factors related to burnout in nursing: Results from an e-Delphi study. Plos ONE, 12(4), 1-20.
Poncet MC, Toullic P, Papazian L, Kentish-Barnes N, Timsit JF, Pochard F, et al. Burnout syndrome in critical care nursing staff. Am J Respir. Crit Care Med. 2007; 175(7):698–704. https://doi.org/10.1164/rccm.200606-806OC PMID: 17110646
Snow, T. (2012). Cameron's care forum chair calls for research into effects of long shifts. Nursing Standard, 27(3), 7.
Stimpfel, A. W., Sloane, M. D., & Aiken H. L. (2012). The Longer the Shifts for Hospital Nurses, the Higher the Levels of Burnout and Patient Dissatisfaction. doi: 10.1377/hlthaff.2011.1377. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3608421/
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