A friend of mine had the eagerness of child awaiting an ice cream truck while going through nursing school. She squealed to me with excitement every time she learned a new nursing skill or practiced in a hospital. She eventually graduated and landed a nursing job right out of college. When I called her a few months later to see how things were going, she responded by saying, “Well, I didn’t cry on my way home from work today, so I’m making progress.” Wait a minute — what changed? Why was nursing not everything she had hoped and dreamed it would be?

Her passion and love had not changed, but she was suddenly exposed to the harsh work conditions of nursing. Nurses typically adapt to the intense work conditions after a year or so and then embrace a superhero-like mentality. This means that a nurse will begin to believe that he or she can do it all. They believe they can go without sufficient sleep, survive long shifts, skip breaks and lunch, and handle extensive workloads all while providing an excellent standard of patient care.

When you think about it, nurses may as well be superheros. It takes a special kind of person to become a nurse. It takes someone who understands the demands of nursing and still decides that helping and treating others is what they want to dedicate their life to. So why is it then that these passionate, caring nurses are forced to work in hard work conditions? Even if the nurses have a severe case of the superhero mentality and believe they can handle the conditions, the work conditions also greatly influence the patients.

After doing research on the matter, it seems as though there are two dominant culprits in the nursing profession that are creating less than desirable work conditions: long work hours and a heavy workload. Both of these factors have been set in place due to a shortage of nurses. Below I have analyzed these two aspects by determining the problem, the effects and a solution that should be implemented, but will probably only be carried out if our society becomes a utopia.

The Long Work Hours

Problem:

On average, nurses work three 12-hour shifts throughout the week. Of these nurses, a recent study revealed that 40 percent engage in working overtime. Not only is this an extended amount of time to work, but it is also not a typical job where you sit at a desk and spend a quarter of the time checking social media. Nursing jobs are highly intense and require the nurse to run around and complete any medical action that helps the health of a patient throughout the entire shift. Nurses are meant to have breaks throughout their shifts, but according to American Nurse Today, many nurses skip this crucial break due to a lack of time.

Effect:

Twelve-hour shifts and no time to recuperate with food and rest results in fatigue and over-exhaustion. This negatively affects the overall health and burnout rate of a nurse.

Researchers Natasha Khamisa, Karl Peltzer and Brian Oldenburg described a burnout by saying a “burnout is typically characterized by emotional exhaustion, depersonalization (negative attitudes and feelings as well as insensitivity and a lack of compassion towards service recipients) and a lack of personal accomplishment (negative evaluation of one’s work related to feelings of reduced competence).”

Some may refute this occurrence by saying that they are passionate about helping others and are therefore more motivated to continue in this line of work. However, Science Daily published a study that showed that nurses who do work to help others are more likely to burn out on the job compared to the nurses who do it due to their interest in the medical field or the lifestyle nursing can provide.

Not only does it affect the nurses, but it also affects the patients. In fact, American Nurse Today reports that “the odds of making patient errors increase three-fold when nurses work 12-hour vs. 8.5-hour shifts.”

Solution:

The last finding makes the solution seem very clear: decrease nurse hours to 8-hour to 9-hour shifts. One of the issues that comes with this decrease in hours is the decrease in pay. With reducing a 12-hour shift to roughly a 8.5-hour shift, the nurse then misses out on 3.5 hours worth of pay. However, with these decreased hours, a nurse may feel rested enough to handle four shifts a week as opposed to three, making up the difference in hours. As of now, nurses are already sometimes asked to do four shifts due to the shortage.

If four shifts is too strenuous, though, the employer may be able to raise the pay a nurse receives due to the money they will save in “health care and workers’ compensation costs, early disability, recruitment and training cost, and legal fees,” according to the American Nurse Association.

As mentioned before, though, long shifts are a result of a shortage of nurses. So is this hour reduction even possible or will the hospital suffer and the patients be turned away? Well, it is actually a vicious cycle as shown in the graphic below.

As of now, the turnover rate for nurses is particularly high. A study conveyed that one in five nurses leaves within their first year, while one in three nurses leaves within their second year. In general, the turnover rate for nurses is 16.4 percent. The reduction of hours has the ability to reduce the burnouts, which will reduce the turnover rate. This will ultimately alleviate the shortage of nurses.

The Heavy Workload

Problem:

Due to the shortage of nurses, nurses are not only facing long shifts, but also an intense workload. This workload creates burnouts and increases turnover rates, which then adds to the shortage of nurses (the same vicious cycle).

However, there are also other factors that increase the intense workload. The book “Patient Safety and Quality: An Evidence-Based Handbook for Nurses” reveals that the workload has also increased throughout the years due to the aging population that requires more health care than the younger generations and the increased cost of health care has decreased the patient's stay. These shorter stays result in sicker patients, which intensifies the workload.

Effects:

With this more intense workload, a nurse then spreads him/herself too thin and is not able to dedicate a proper amount of time to each action.

According to the author of “Patient Safety and Quality: An Evidence-Based Handbook for Nurses,” “Nurses who have a heavy workload may not have sufficient time to perform tasks safely, apply safe practices, or monitor patients, and may reduce their communication with physicians and other providers.”

This also increases medical errors and negatively affects the stress levels and emotional health of a nurse.

Solution:

In regards to the causation of the intense workload, the aging population is one factor that is out of my hands. However, the increased cost in medical care is one issue that countries like Canada and Australia have already figured out how to solve. This is a topic on its own, however, and involves many factors such as taxes, the overall health of the country’s population and government spending.

The next few factors are the shortage of nurses, the burnout of nurses and the turnover rate. However, with fewer hours and a less intense workload, more nurses will remain in this line of work, and the burnout and turnover rates will decrease. This will then allow the workload to be spread more evenly.

This transition of both reduced hours and more manageable workload will not be an easy one. However, it seems to be a necessary one that could prevent a significant number of medical errors, which have the potential to end a patient’s life, and improve the health and mental stability of nurses.