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13. Perceptions of nursing workloads and contributing factors, and their impact on implicit care rationing: A Queensland, Australia study.

Author

Hegney, Desley Gail, Rees, Clare Samantha, Osseiran‐Moisson, Rebecca, Breen, Lauren, Eley, Robert, Windsor, Carol, and Harvey, Clare

Subjects
*CHI-squared test, *COMMITTEES, *CRITICAL care medicine, *FISHER exact test, *GERIATRIC nursing, *JOB satisfaction, *RESEARCH methodology, *MEDICAL quality control, *MEDICAL personnel, *NURSES' attitudes, *PSYCHOLOGY of nurses, *NURSE supply & demand, *NURSING, *PERSONNEL management, *QUESTIONNAIRES, *RESEARCH, *RESEARCH funding, *STATISTICAL sampling, *SELF-evaluation, *TIME, *EMPLOYEES' workload, *PRIVATE sector, *PUBLIC sector, *PEER relations, *THEMATIC analysis, *CROSS-sectional method, *DESCRIPTIVE statistics
Abstract

Aims: To explore nurses' perceptions of factors affecting workloads and their impact on patient care. Background: Fiscal restraints and unpredictable patient illness trajectories challenge the provision of care. Cost containment affects the number of staff employed and the skill‐mix for care provision. While organisations may acknowledge explicit rationing of care, implicit rationing takes place at the point of service as nurses are forced to make decisions about what care they can provide. Method: A self‐report cross sectional study was conducted using an on‐line survey with 2,397 nurses in Queensland, Australia. Results: Twenty to forty per cent reported being unable to provide care in the time available; having insufficient staff; and an inadequate skill‐mix. The respondents reported workload and skill‐mix issues leading to implicit care rationing. Over 60% believed that the processes to address workload issues were inadequate. Conclusions: Institutional influences on staffing levels and skill‐mix are resulting in implicit care rationing. Implications for Nurse Managers: Adequate staffing should be based on patient acuity and the skill‐mix required for safe care. Managers should be more assertive about adequate clinical workloads, involve staff in decision‐making, and adopt a systematic planning approach. Failure to do so results in implicit care rationing impacting on patient safety. [ABSTRACT FROM AUTHOR]

Published
2019
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31. Casualisation in the nursing workforce : the need to make it work

Author

Becker, Susanne Elaine, McCutcheon, Helen, and Hegney, Desley Gail

Subjects
ComputingMilieux_GENERAL, InformationSystems_GENERAL, flexibility, non‑standard work, ComputingMilieux_THECOMPUTINGPROFESSION, nursing workforce, casualisation
Abstract

Objective: The aim of this paper is to highlight some of the challenges faced by the nursing profession in response to increased casualisation of its workforce and why the presence of casualisation needs to be viewed in a positive light. Setting: The nursing workforce worldwide. Subjects: Nurses who need or want to work as casuals. Conclusions: An ageing nursing workforce coupled with a worldwide shortage of nurses means that employers need to ensure options are available to accommodate nurses requiring flexible rosters in order to encourage recruitment and retention. Policies are needed to ensure that all staff, regardless of their contribution in hours, feel valued and supported and are able to contribute to their profession. Maintaining a portion of the workforce in a flexible form will allow increased staffing options and ensure that sufficient experienced staff are available in order to maintain quality patient care and outcomes. Primary argument: The care‑giving responsibilities of a predominantly female workforce and the ageing of the nursing workforce worldwide means some nurses are choosing or need to work as casual employees in order to remain in the workforce. Historically, casuals have been viewed in a negative light particularly in discussions around commitment and continuity‑of‑care. Without a change in attitude towards nurses who work as casuals, a significant portion of the nursing workforce may be lost. Refereed/Peer-reviewed

Published
2010

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