Nurses Case 1990

In the 1990's the nursing profession, and hospitals in general, experienced a huge change in the work place including overworked and under paid nurses. Many reasons came into play resulting in nurses leaving the profession or rethinking their careers. At this time, nurses were dissatisfied with their jobs. An average eight hour shift, my time was spent running up and down the halls, tasks only, with no time to talk to the patients and or their families. We performed the mundane tasks, which in my eyes is not nursing. At the end of my shift and once I was at home, there were many times I had to call to double check items to make sure I had completed them, the stress was tremendous. Technology was just over the horizon promising higher paying jobs, normal hours and less stress. Most teachers, during this same era had all holidays off and summer off to be with their children, something that most nurses did not enjoy. Hospitals were suffering from being understaffed. There were too many critical patients with inadequate and unhappy staff.

The Change That Caused the Conflict?

The unit I worked included adolescents/teens, renal (including transplants), endocrine (including Type 1 diabetes), and cardiac (including transplants) and the patients were critically ill. The eight hour shifts were actually 12 hour plus, charting, and reporting , there was not time to complete until end of the shift. Administration reviewed overtime, sick time and medication/procedure errors, and involved high numbers, which at the time was thought to improve with implementation of 12 hour shifts. The desired to have more flexibility in the schedule with access to quality time off, it was decided by the staff and mangers, to pilot a group of six nurses to implement 12 hour shifts. The pilot was to last six months and then there would be an assessment of the pros and cons.

The Reasons for the Change?

The reasons for this change were the nursing shortage that was affecting hospitals, clinics, MD offices, and all other areas of nursing. The hope was to create a decrease in overtime hours, less staff turnover and burnout in the nursing arena. There was increase fatigue in the eight hour shift then the 12 hour shift. Staff would have to take less vacation and abuse of sick time, with improved time to rejuvenate. The requirement would be 36 hours or three 12 shifts in a week and the pair nurses to design their own schedule, full time status and benefits were in the package. In addition to less travel time, fumes, and admissions into the air to benefit the environment. Administration and staff felt it would lead to continuity of patient care, including improved communication among the staff with less disruption to the patients and families. The patients and families would have familiar faces and fewer names to recall, you would be present with them for 12 hours. While I was working 12 hour shifts, the patients and their families became my family. I believe I was better equipped to take care of the child by knowing their routines and exactly how they were feeling. The change also allowed more time with my own family and social activities, which for those of us who are Mom's it was an excellent plan and for the single nurses it improved their free time for social life.

Why did the Change Cause Conflict?

There were a number of mature nurses who had health issues and 12 hours shifts were just too difficult for them to be running the halls and the emotional stress was taxing. They felt more errors would occur in administration of meds, documentation, and fatigue. The more mature nurses also thought change would be a danger to the patients. One nurse in particular worked 3:00pm-11:00pm, which allowed her to care for her child during the morning and then Dad would arrive home by the time she needed to leave for work, so they required no outside child care. Others who had children who needed child care, found it difficult to find care for a 12 hour shift. We had to arrive at 6:30am/pm and report to your replacement, then left by 7:30am/pm if all went well