Nursing fatigue and overtime hours is a major issue in the nursing sector in the present times. Studies indicate more than half of the registered nurses work overtime. Working overtime consistently makes the nurse tired compromising their work. According to Hugman (2003), fatigue compromises the ethics registered nurses follow. Registered nurses should be attentive, competent, and responsive when caring for patients (Meahger & Patron, 2004). The American Nurses Association (2012) argues registered nurses have a responsibility of taking overtime assignments when they are sure they can deliver to the ethical demands of their work. Although the American Nurses Association tasks nurses to take overtime when they can deliver, the nurses have no option. Nurses are few while the demand for their services is extremely high. There is need to have a legal framework preventing nurses from working overtime so they can deliver to the ethical demands. It is, therefore, truthful nurses work overtime and are fatigued because there is no legal policy or framework protecting them. This paper will discuss how lack of policy for protecting nurses influences nurses’ overtime assignments and fatigue, compromising the ethical demands of the nursing profession.
Registered Nurses work schedules
Registered nurses work for eight –hour or twelve-hour shifts in most countries. In countries with high demand for nursing services, registered nurses work for twelve-hour shifts. Jennings (2008) asserts nurses working in the twelve-hour shifts exhibit signs of fatigue and burnout compared to nurses taking the right-hour shifts. Jennings (2008) quotes research studies done among nurses in hospitals across the United States. The research studies indicate nurses working in twelve-hour shifts experience chronic fatigue, emotional exhaustion, and cognitive anxiety. Most nurses would prefer to take the eight-hour shifts but the demand cannot allow. The American Nurses Association (2012) asserts approximately 60% of the nurses have to work overtime.
Jennings (2008) claims the registered nurses’ profession is not the only thing making nurses to experience burnout and fatigue. Most nurses have family obligations that complicate their work further. Even when the nurses work for twelve-hour shifts, they have to take care of their personal issues. At the end of the day, the nurses work for more hours when they get home. It is normal to find nurses who sleep for just four hours or less because of their personal and nursing profession issues. In addition, nurses rarely get rest. It is normal for hospitals to call nurses who are off duty when there is high demand for nursing services, which occurs when there are major accidents and natural catastrophes.
Effect of burnout on patient care
Registered nurses burnout affects the patient care in many ways. Hugman (2003) claims burnout and fatigue in registered nurses compromises the ethical demands of the nurses. Registered nurses should be attentive, responsive, and competent at all times. When nurses work overtime, they become fatigued affecting their attentiveness and responsiveness. As such, nurses are unable to work well as required. Scott and colleagues (2006) argues registered nurses are less vigilant when they are emotionally exhausted and chronically fatigued. Registered nurses are unable to assist patients accordingly when they are fatigued.
Scott and colleagues (2006) assert patient safety is at compromise when nurses are fatigued. The American Nurses Association (2012) states fatigue leads to impaired problem-solving skills, slow response, and slow reaction to situations. As such, fatigued nurses may be responsible for escalation of medical conditions in patients. Rodgers (2004) claims medical errors are inevitable when medical professionals are nurses are fatigued. Barger and colleagues (2006) assert patient safety and care is at stake leading to possible adverse health effects and fatalities when registered nurses are fatigued.
Vahey and colleagues (2004) asserts nurses’ burnout leads to patient dissatisfaction. Burnout nurses are unable to meet the ethical demands of their jobs because they are tired and cannot think straight. As such, the nurses will not care for the patients, as they ought. In most cases, the nurses fail to understand what the patients require because they have alertness issues. Patients feel as though the nurses are neglecting them. Patient dissatisfaction can be very costly as it can lead to adverse health effects especially in the case when a patient is feeling unwell and the nurses are unable to comprehend their need fast enough. Patient dissatisfaction can lead to poor rating of hospitals (Vahey et al, 2004).
Legislations and policies
The overtime working among nurses is a major concern to the healthcare industry. The nursing associations across the world have to come up with a solution to the issue. In most states and countries, Nursing associations are coming up with legislations to protect the nurses from the overtime working and fatigue. Bae, Brewer, and Kovner (2011) argue nurses should work overtime voluntarily without pressure from the management. The American Nurses Association (2012) support the claim that nurses should only work overtime when they feel they can work comfortably meeting the ethical demands of the profession. Before the year 2003, most American states implemented regulations where nurses only work overtime when they want to (Bea, Brewer, & Kovner, 2011).
Although there are regulations in place regarding overtime, conditions may not allow the nurses to work within the regulations. Bae (2013) states most hospitals in the United States have fewer nurses than the requirement. Since most nurses love their job and considering the ethical vows, the nurses take to care for the patients, the nurses are likely to volunteer to work overtime to meet their ethical demands. As such, most nurses work overtime voluntarily getting fatigued. McDonald (2008) claims the regulatory issues regarding nurses working overtime faces many challenges. The major challenge the policy faces is the number of hours nurses should work per day and the best time to work. Working timelines are challenging because nurses may have to work odd hours depending on the demand for their services especially when there are natural disasters or fatal accidents (McDonald, 2008).
Recommendations
The challenge the regulatory overtime policy faces requires the regulatory agencies and policy makers to come up with ways to address the issue. Gladwell and colleagues (2008), assert nurses should receive alertness management classes to be alert in their workstations. According to a National Institutes of Health (2009), limiting the number of hours nurses work could be very costly for the entire healthcare sector. The National Institutes of Health (2009) proposes other avenues to regulate the nursing sector. The best thing the government should do is employ more nurses to address the issue of burnout among nurses. Joint Commission on Accreditation of Health Care Organizations (2008) argues the solution to fatigue among nurses is employing more nurses. With more nurses, the nurses would work less hours and they would work better. Bae (2013) asserts nurses should work for at most forty hours a week just like other sectors. Working fewer hours allows the nurses to have enough time for their personal issues, sleep more, and work better ensuring patient safety.
Conclusion
Nursing fatigue and overtime hours is a controversial topic in the world today. Nurses are working long hours and there seems to be no solution to the issue now. Regulations to limit the number of hours nurses work face many challenges because the regulators fail to address the root of the problem, fewer nurses. Experts recommend policy markers employ more nurses, so nurses can work less hours. With more nurses, there would be no need for nurses to work overtime because there would be enough nurses throughout. As it is, limiting the number of hours nurses work would only cost the healthcare sector more because the number of nurses currently does not allow nurses to work fewer hours. Even if nurses wanted to work less hours, they have an ethical obligation to care for the patients. The only real solution to the nursing fatigue and overtime is employing more nurses, which is a challenge in the current times. Alertness management classes seem to be the best option as the policy makers try to address the nursing fatigue issue. The government, the health care sector, and the Nurses association should work together to come up with a sustainable solution to the problem. Only time will tell whether the three stakeholders will work together to address the nursing overtime and fatigue problem rampant in the healthcare sector.
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