Relationship between Workload and Effectiveness in the Nursing Practice - Research Paper Example

Introduction The assigned work of a nursing professional is one that is considered as human centered because it deals vitally with the life of people. At every point in time, the nurse has a lot at stake as far as the chances of survival of a patient are concerned. This task becomes even more urgent when the nurse has to work on expectant and nursing mothers. This is because pregnancy in itself puts expectant mothers at certain degree of danger and risk that demands regular attention. Such attention is obviously not imminent in a regular woman who is not pregnant. In essence, the nurse who is catering for expectant and nursing mothers has a lot at stake in the delivery of his or her work. Unfortunately though, there often arise factors such imbalanced nurse-patient ratio, lack of motivation, ill-resourced facilities and absence of on-the-job training that prevent nurses from working as effectively as they are expected to. It is against this background that the present project is being carried out to ascertain how a properly planned nurse-to-patient ratio can help in improving the service delivery given by nurses to patients (Anderson, 1988). Some emphasis will be given to nurse-to-patient ratio though the other factors mentioned shall be considered. At the end of the project, it is expected that there will be a clear outline of new responsibilities expected of nurses even as their duties will be adjusted. There will also be a major recommendation to cut down the couple-per-nurse from four mothers and four babies to three mothers and three babies per nurse. The work of the nurse is undoubtedly one of the most stressful professions. This is because it entails working with different people with different needs and attitudes. Regardless of the health needs of the patient and the patient’s personal attitude, the nurse is expected to fit in squarely without fail. This indeed is a very challenging situation for any nurse at all. In light of this, researchers have come to study the relationship between the workload of a nurse and effectiveness at the workplace. According to a recent study, nurses work best if the workload they have to handle per day (8 hours) is minimal enough to attract full attention (Davis-Floyd, 2001). This means that overcrowding of patient population would automatically stress the nurse up and affect her effectiveness at work. Such nurses may either resort to falling on inexperienced nursing assistance or abandoning certain core aspects of their work. In essence, there exists the relationship between workload and effectiveness in the nursing practice is that the higher the workload, the lower the effectiveness. The immediate prompt that this conclusion gives is that there is the need to cut down on the nurse-patient ratio. Presently, nurses have complained bitterly that the four couple per nurse they handle is too much for them. This section of the project has proved that indeed the number is large and needs to be cut down to a recommended three couples per nurse. Promoting effectiveness in the face of nurse-patient ratio cut-down Provision of Training Resources for new Era Though the need to cut down on the nurse-to-patient ratio has been identified as a key element in reaching effectiveness, it is important to point out that the cut down alone cannot be depended on for promoting better delivery of work. Noting that the nursing profession is one that is dynamic and subject to modern and current changes, it is important that nurses receive constant training resources to equip them with the changing paradigm. Once we point to resources, all attention must not be given to physical materials that the nurse uses in working. Training resources must also be considered critically. As a new era is to be created whereby nurses will be dealing with lesser number of patients, it is important to give them training that would maximize the new avenue that is being created. These training could come in several forms including seminars, conferences, on-the-job orientation, higher education and so on (Engelstad, 2005). These training segments should be made accessible to all nurses in the facility without any discrimination of a kind. There could however be special regimes like the provision of scholars to hardworking nurses to serve as motivation for all nurses to give off their very best at post. Availability of Working Resources for Nurses As nurses receive the needed training and become professionally equipped, it would be time to make available the needed working resources to accompany their training and experience. The care of nursing mothers and their babies is a complicated responsibility that requires the use and presence of a number of working resources. In the absence of these resources, the delivery of work becomes inadequate and undermined. It is in light of this that a call is being made to management to ensure that nurses will have every bit working resource they need to make their service delivery effective and forthcoming. In the provision of these working resources it will be very important for management to understand and appreciate the different working requirements of nurses and ensure that it will be only resources that are suitable for particular nurses that are provided. The needs of mothers and their newly born babies also ought to be taken into consideration. For instance distinction has to be made between mothers and babies who need special and intensive care and those who do not (Fleming, 1994). This way, the unique and peculiar needs of each person who visits the facility shall be met squarely. Effect of Condition of Service on new Nurse-Patient Ratio Provision of Intangible Motivation to Nurses In any professional institution such as nursing, it is important to understand that motivation is a very important factor to boost productivity and ensure expected results. Experts say motivation comes in two major forms. These are tangible and intangible motivation. Each of these forms of motivation is as important as the other. In the case of intangible or intrinsic motivation, they are given as a means of urging a person’s natural abilities to give off his or her best. Intrinsic motivation are not normally given because of anything unique a worker has done but because of something unique a worker is expected to do. In light of this, the facility is expected to put in a number of intrinsic motivational mechanisms to enable nurses accept the new reforms and changes pertaining to their working schedules. It is advised that among other things, there should be the provision of holidays and vacations, employee of the week award, verbal appraisal of duties and so on (Gaski, 1997). Though these may not be touched or stored directly by nurses, they have the potential of serving as reinforcement to push nurses to giving off their best at work. The Role of Tangible Motivation in Driving Work Output Like intangible motivation, tangible motivation or extrinsic motivation can also play the same role of boosting productivity in the facility. The only difference that exists between the ways these two forms of motivation works is that for tangible or extrinsic motivation, they are given because of what a worker has done special. This is to say that intangible motivations are used as appreciative mechanisms rather than reinforcement to get nurses on their toes. In this regard, the facility would have to have a way of assessing the performances of all nurses even as the new scheme of work schedule is to be introduced. Then after, very tangible presents and motivation such as monetary allowances, provision of accommodation and so on need to be provided to these nurses. Though workers may be entitled to their stipulated remunerations, these minute forms of motivation would continue to remain very important if any higher levels of productivity are to be expected. It is worth noting that in an institution where the special efforts of workers are not appreciated, there is the tendency that on-looker staffs would have no motivation to learn from their colleagues who may be committing a lot of their attention and time to the success of the facility. Specific nursing duties on assigned mother and child couple As nurses take a new dimension in their roles by taking up three (3) couples per nurse, it is important to define their new duties and responsibilities in a very clear format. Such definition of duty is important so that nurses will not mistake or misunderstand the cut down for a reduction or change to their duties and roles. In this regard, it is important for nurses to appreciate the fact that they remain responsible for all pre-delivery care and counseling. This means that for all women in labor who are brought to the facility, nurses shall be responsible taking care of their medical needs until they are sent to the theatre. Depending on the kind of delivery these expectant mothers are going to have, nurses are also expected to counsel mothers to psyche them for the new experiences they will be going through. This counseling will be particularly suitable for mothers who will be going to the labor ward for the very first time (Hopers, 2002). What is more, the role of nurses as safety attendants and lieutenants to doctors during delivery must not seize. As regularly as possible, nurses must be up an doing in the delivery of task by preparing the environment and setting for delivery and assisting doctors or midwives whiles the delivery is taking place. At such a point as duty demands, nurses must act as rapid response officers to curtain any emergencies that are related to delivery in women. Some of these may include bleeding, shortage of oxygen, poor breathing and suffocation. At such times, nurses must be on top of their duty to respond rapidly by making all necessary materials, tools, equip and information available to doctors. At the post-delivery stage also, nurses should be assigned as guidance and counseling officers who would give new mothers specific instructions as to how they should conduct themselves in other to avoid any post-delivery risks and complications. Nurses must also supervise the medication of mothers and their newly born babies to ensure that mothers take their medicines as and when it is expected of them. The point at which issues of medication monitoring should be of prime importance to nurses should be at the stage where nursing mothers may feel that they are recovering and therefore have no need to sticking strictly to their medications. This is said because in most cases, patients who are recovering have a mentality that they no longer have to attend to their medications because they feel better (Langer, 1998). Nurses should check this situation critically so that there will not be any long term effects for mothers. Still on the specific duties of nurses in this era where changes are being made to the nurse per patient ratio, nurses ought to understand that child care remain their unchanged duty and responsibility. Care for babies play very paramount role in defining the concept that each nurse is entitled to three couples. Couple as used here thus refers to mother and child (baby). Especially for the first early days after delivery, it is expected that the newly born babies will be at the strict custody of nurses. While the babies remain in their customer, it is expected that nurses will give the babies all the needed care and medical supervision. Breastfeeding should also be regulated and monitored to ensure that nursing mothers do not have their own way as some nursing mothers often have misconceptions that do not make them give their babies the needed and required amounts of breast milk. Assessment plan for nursing officers in the new 3 couple per Nurse System Internal assessment All new changes should be subject to constant assessment and evaluation to monitor their levels of progress. In this present circumstance, the assessment should be focused on the nurses themselves to regulate how well they are adjusting themselves to the new changes. In this regard, an internal assessment system is recommended. This means that matrons, managers and senior officers of the facility should be in a position to regularly monitor the performance and output of nurses to ensure that they perform all stipulated duties and in a manner that is expected of them. As with all assessment programs, there should be a code of conduct in place to ensure that nurses have specific scope within which they operate. There should also be a reward and punishment scheme that identifies and appreciates hard working nurses and reprimands non-performers respectively. The internal assessment system would also work best if there is a feedback mechanism in place (Isenalumbe, 1990). With a feedback mechanism, an advocacy is being made for the need to have system through which nurses will be given fair idea of how their superiors envision their performances and any other changes that are expected from them. External quality assessment plan Apart from the internal assessment system which will give superiors the opportunity to check nurses within the facility, it is also important to have a system that is based on third-party and neutral assessment from people who are not directly involved in the affairs of the facility. However, these external quality assessment officers are advised to be experts in the health sector. Preferably, these are to be professional health supervisors in the health ministry who will assess nurses based on professional standards needed in the training of nurses. This is to say that the standards by which nurses are trained in their various nursing training institutions must be continued and not abused in any way (Kleinman, 1980). It is indeed common knowledge that as soon as nurses complete college, they refuse to stick to basic standards and prescribed quality assurance mechanisms. Such an external quality assessment would therefore help in maintaining the pedestal and keeping up to the required standard of work. Conclusion The theory of work input against work output has been dealt with into detail in this paper. Generally, it has been established that there is a core need to ensuring that nurses are not overstretched in the amount of work that is allocated to them. It is therefore prudent that the staffing system in the present facility be considered to pave way for an immediate redirection of patient assignment so that nurses will be spared the pain of handing more than necessary. The cut down in number of couples each nurse attends to should however not be misunderstood to mean that there is being a change in the task required of nurses. The change has been necessitated only because the higher the number of patients a nurse has to attend to, the lower the nurse’s rate of effectiveness would be. The project also established the fact that the cut down in number of patients a nurse attends to is not the only factor needed to ensure effectiveness. Rather, it is important to put in place other factors like motivation and provision of resources to ensure that nurses will have an internal reinforcement to push them to give off their best at work. Another important area that the project looked at was the need to have a well defined allocation of duties and responsibilities. These duties would range from pre-delivery tasks to post-delivery tasks. As all these steps are put in place, keen attention should be given to the need to have a systematic assessment program that ensures that nurses do not abuse the cut-down to relax at work. It is important to have a well regulated assessment mechanism that will not only be internal but external as well. Such external assessment will ensure that nurses work according to the very standards with which they were trained in their various nursing training institutions. REFERENCE LIST Anderson, S. (1988). "Traditional midwives in Bostwana:strengthening links between women." Health Policy and Planning. Davis-Floyd, R. (2001). "The Technocratic, Humanistic, and Holistic Paradigms of Childbirth." International Journal of Gynecology and Obstetrics Vol.75. Engelstad, E., Ed. (2005). Challenging Situadedness, gender, culture and the production of Knowledge, Eburon academic publishers. Fleming, J. (1994). "What in the world is being done about TBAs? An overview of international and national attitudes to traditional birth attendants." Midwifery 10. Gaski, H., Ed. (1997). Sami Culture in a new era: The Norwegian experience. Seattle, University of Washington Press Hopers, C., Ed. (2002). Indigenous knowledge and the integration of knowledge systems, towards a philosophy of articulation. Claremont, New Africa Books. Isenalumbe, A. (1990). "Integration of traditional birth attendants into primary health care." World Health Forum vol.11. Kleinman, A. (1980). Patients and Healers in Context of Culture. Los Angels, University Of California Press. Langer, A. (1998). "Effects of psychosocial support during labour and childbirth." British Journal of Obstetrics and gynecology 105(10). Read More