Nursing Practice Executive Summary

Congress on Nursing Practice and Economics. (n.d). Assuring patient safety: The employers’ role in promoting healthy nursing work hours for registered nurses in all roles and settings. ANA. Retrieved June 07, 2016, from http://www.nursingworld.org/MainMenuCategories/Policy-Advocacy/Positions-and-Resolutions/ANAPositionStatements/Archives/AssuringPatientSafety.pdf.
• Audience:employers of registered nurses
• Context:the position of American Nurses Association in regards to nurses and patients’ safety
• Purpose: encouraging employers of nurses to develop specific policies and regulations that will promote healthy work hours of nurses.
The authors of the article argue that all employers of registered nurses must pay attention to nurses’ fatigue
and errors, and therefore, they must follow ANA’s position related to establishing new work schedule.
To support their argument, ANA describes previous positions related to this issue and provides evidence (results of prior researches) that shows the negative outcomes of nurses’ working long shifts. This article is an important source that gives much relevant information concerning the problem of nurses’ long working hours. This source will help to support the argument against 12-hour shifts. Khamisa, N., Peltzer, K., & Oldenburg, B.
(2013). Burnout in relation to specific contributing factors and health outcomes among nurses: A systematic review. International Journal of Environmental Research and Public Health, 10(2013), 2214-2240.
• Audience: health care professionals and policymakers
• Context: burnouts and satisfaction resulting from different working environments
• Purpose: to identify a research that has examined the links between burnouts, satisfaction, stressful working environment, and nurses’ poor health.
The argument of this review is that nurses experience burnouts more often in comparison with other health care professionals, but there is not enough evidence concerning the relationships between such factors as stressful working environments and other work-related aspects causing nurses’ poor health.
After analyzing different sources related to this topic, the authors concluded that further research was needed to acquire a better understanding of relations between burnout, work-related stress, job satisfaction, and nurses’ health. In addition, this review demonstrated contradictory evidence concerning job satisfaction. This review highlights important researches that have been conducted to better understand the causes of nurses’ burnouts and other work-related
problems. Eldevik, M., Flo, E., Moen, B., Pallesen, S., &Bjorvatn, B. (2013). Insomnia, excessive sleepiness, excessive fatigue, anxiety, depression and shift work disorder in nurses having less than 11 hours in-between shifts. PLOS. Retrieved June 07, 2016, fromhttp://journals.plos.org/plosone/article?id=10.1371/journal.pone.0070882.
• Audience: health care professionals and policymakers
• Context: negative health outcomes of quick returns for nurses
• Purpose: to find out whether quick returns (less than 11 hours between shifts) cause negative health outcomes for nurses.
The authors hypothesize that high number of quick returns lead to multiple problems with health including insomnia, anxiety, excessive fatigue, etc.
By using a specific questionnaire, which measures sleepiness, insomnia, fatigue, shift work disorder, and anxiety/depression and working with 1990 nurses, the researchers concluded that there was a positive relationship between quick returns and excessive sleepiness, shift work disorder, insomnia, and excessive fatigue, while there were not such relationship between quick returns and depression/anxiety. This article is of great importance for the future argumentative essay, as it shows another negative impact of shift work in regards to nurses. Thus, this article is closely related to the one discussing ANA’s position. Stimpfel, A., Sloane, D., & Aiken, L. (2012). The longer the shifts for hospital nurses, the higher the levels of burnout and patient dissatisfaction. Health Affairs, 31(11), 2501-2509.
• Audience: nursing leaders and policymakers
• Context: nurses’ working environment in the U.S.A.
• Purpose: encouraging policymakers and nursing leaders to develop better working environment for nurses and to establish shorter shifts.
Stimpfel, Sloane, and Aiken(2012) discuss two negative outcomes of nurses’ long shifts. First, they argue that shifts exceeding 12 hours result in nurses’ burnouts and poor health. Second, they find positive relationship between nurses’ long shifts and patients’ dissatisfaction.
Survey data gathered in 4 states proved that nurses working long shifts were more likely to suffer from burnouts and provide patients with poorer care than their colleagues working shorter shifts. Like the article discussing ANA’s position, this source also gives much information about impropriety of nurses’ long shifts. Department of Government Affairs. (n.d.). ANA on Mandatory Overtime. ANA.Retrieved June 07, 2016, fromhttp://www.nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursing/NurseStaffing/OvertimeIssues/Overtime.pdf.
• Audience: nursing leaders and policymakers
• Context: supporting the Safe Nursing and Patient Care
Act
• Purpose: to prove that mandatory overtime is harmful for both nurses and patients.
This article discusses ANA’s negative attitude towards the increased use of mandatory overtime and ANA’s supporting the Safe Nursing and Patient Care Act, which can limit the number of nurses’ overtime hours.
To support its position, ANA provides the evidence confirming authorities’ unfair attitude towards the health care system in regards to decreasing the amount of working hours. Thus, ANA compares health care to other industries that have a direct impact on public safety.
In addition, ANA discusses reports commissioned by the Institute of Medicine and the Agency for Health Care Research and Quality that prove the impropriety of nurses’ long shifts. Oldsa, D., &Clarkeb, S. (2010).The effect of work hours on adverse events and errors in health care. Journal of Safety Research, 41(2), 153-162.
• Audience: policymakers, nursing leaders, nurses
• Context: nurses’ working environment
• Purpose: to study the relationship between extended work duration of registered nurses and errors.
Oldsa and Clarkeb(2010) argue that extended duration of nurses’ working hours results in their fatigue and burnout, and thus, causes multiple problems like medication errors, needlestick injuries, nosocomial infections, etc.
Researchers examined work hours, nurse characteristics, and errors/adverse events related to long working hours. They conducted a survey that included more than 11,000 registered nurses. Their study supported their argument. In other words, it was proved that nurses’ working more than 40 hours per week increased the number of work-related errors affecting patients’ well-being. This article has much in common with Stimpfel, Sloane, and Aiken’s (2012) article, as they both discuss not only nurses’ health problems, but also patient’s dissatisfaction caused by nurses’ errors. Smith, L., Folkard, S., Tucker, P., &Macdonald, I. (1998). Work shift duration: a review comparing eight hour and 12 hour shift systems. Occupational and Environmental Medicine, 55(1998), 217–229.
• Audience: employers, nursing leaders, registered nurses
• Context: comparative analysis of different nurses’ work shift durations
• Purpose: to find evidence concerning the effects of 8-hour and 12-hour shifts on nurses’ performance and fatigue.
The authors aim to provide interested readers with relevant information associated with the links between the duration of nurses’ shifts and adverse events.
The review of different sources related to the topic discussed demonstrated that 12-hour shifts can lead to certain positive effects, but fatigue and safety risks are unavoidable. This source helps to understand how the problem of nurses’ long shifts was viewed in the past. Besides, it also shows that 12-hour shifts can even have certain advantages.