Legal Professional Issues in Nursing: Impact of Nurse Workload on Patient Safety and Strategies for Workload Management

This article discusses the impact of nurse workload on patient safety and strategies for workload management in nursing profession. It also highlights the significance of nursing workload to nursing profession and its effects on patient’s safety.

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Legal professional issues in nursing
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Nursing Workload
Nurse workload has been associated with the volume of the nurses' work. Attempts have
been also made to quantify the work of nurses relatively to health human resource management.
Studies indicate that there is a shortage of nurse globally and as a result, the healthcare provision
is widely affected. Nurse workload typically arise when the ration of work or service demanded
is more than the number of staff offering thus making the nurses to increasingly play versatile
roles to meet the increasing demands (Alghamdi, 2016) The nurses workload also can be caused
by inadequate supply of nurses, reduced staffing overtime and the reduction in the length of stay
of the patient. Poor technology with healthcare facilities also forms key factor in nurse
workload.
It is an indication that nurses in the majority of the healthcare facilities perform lots of
work beyond the established standards. Due to increasing number of population, the ration of
nurses to that of patients is worrying. However, the hard economic conditions have made many
health facilities to reduce the number of nurses being employed and increase the overtime
(Carrara, et al., 2016). Increasing cost pressure made majorities of hospitals to reduce the length
of stay of patients in hospitals. This means that it is only the sicker patients that are cared,
therefore their work is much intensive and need lots of time.
Significance of Nursing Workload to Nursing Profession
The nursing workload is a big issue in nursing profession because it curtails set standards
of nursing practice in Australia. It does not give chance to the nurses to perform their duty well
and eventually falling into legal constraints (Pearson et al., 2006). The nurse workload has
ruined reputation of many healthcare facilities due to its outcome. Many types of research have

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indicated that heavy workload among nurse leads to job dissatisfaction of more than 20% of the
nurses in the country. The move would lead to low morale, turnover, poor performance,
absenteeism and eventually risking the quality of patient care and effectiveness of the
organization.
High nurse workload is one of the key job stress creator in the majority of healthcare
facilities. It can result in emotional exhaustion, anger and cynicism, and burnout (Hayes et al.,
2015). Nurses who are experiencing these issues may not in full capacity to perform efficiently
and effectively due to the fact that their cognitive and physical resources could have reduced thus
affecting the safety of the patient. Nursing workload do not only affects individual nurses. It can
also have effects on other nurses and other medics. It reduces the time which nurses have to
assist other nurses. Due to inadequate time to help each other, it may result in inadequate training
or supervision of new nurses under training.
Furthermore, the nurse workload has brought in delays in patients admissions. Lots of work
make them slow in taking details of the patients and may delay those who are in the waiting bay
(Blay et al., 2017). Long queues make the hospital inefficient and some patients with serious
conditions have in the past died under such circumstances. Studies have further indicated that
nurses are facing threat of violence within their work station due to lots of workload. Majority of
the questioned nurses indicated that they have turned violent more than once in a period of one
month. It is a fact that nurses are psychologically disturbed hence they are at risk of turning
violent. Generally, the nurse workload in NSW has slowed provision of healthcare. Due to lots of
works on nurses, health care facilities faces lots of long queue of patients. 34% of the patients in
NSW indicated that they were not satisfied with health care provisions within the state

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(Henderson, et al., 2016). Patient’s dissatisfaction has affected nursing profession because the
errors and deaths linked ton nurses failures have made profession to lose its meaning among
people. The nursing profession has been put into spotlight for many years for issues brought by
nurse workload. Different organizations have raised lots of concerns and nurses currently work
under lots of pressure. The move would further frustrate the nurses and more injuries would be
expected. The new nurses under training have not been getting enough time to learn what they
are taught in classes rather they are overworked thus making them to get discouraged in the line
of duty (Hendersonet al., 2016).The move would slowly kill nursing profession because they
would be no more people willing to pursue nursing profession.
Impacts on Patient’s Safety
The nursing workload has got lots of impacts on patient’s safety. First and for most, when
nurses are overworked, they are not in good position to offer good services to the patients. The
outcomes of the patient are greatly affected by the workload of the nurse (Henderson, et al.,
2016). If there is lots of work needed to be done by few nurses in the healthcare facility, there
are high chances that patients would not get enough attention as required. Those who need to
deliver would face lots of complications because the service providers are not there to assist
them. Furthermore, the patients in wards would be at high risk of complications. Studies done
have indicated that nursing workload contributed to 30 percent of patients’ falls in bed (Ross et
al., 2018). This is as a result of poor inadequate care provided to those particular patients.
Workload in nursing profession has further contributed to lots of medical errors. When a nurse
works for over 8 hours, his or her mind would be completely tired to perform easy tasks. At this
instant, the nurse would not be in a position to remember well thus can confuse patients resulting

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in wrong medication. Additionally, overworked nurses can get asleep while attending critical
emergencies thus compromising the safety of the patient.
The heavy nursing workload is linked to suboptimal patient care which can result in
reduced patient satisfaction. Studies from the agency for healthcare research and quality
indicated that there is a significant linked between nurse workload and high rates of infection in
the hospitals for instance, 2.6% of the infections in NSW hospitals were as a linked of nurse
workload (Twigg and Duffield, 2009) Nursing workload implicates the time which the nurse can
set to different tasks. When nurses are under workload, they may not have enough time to do
tasks which can have a direct impact on the safety of the patient. However, the heavy workload
can influence the care provider to perform several procedures.
Additionally, heavy workload can reduce the time spent by nurses communicating to
physicians thus work eventually affect the quality of nurse-physician collaboration. Furthermore,
the heavy workload can result in poor communication between nurses and the patients thus
resulting in reduced quality of health care provided. It is also evident that nurses have not been
having enough time to meet the family members of the patients (Ross et al., 2018). The move has
reduced the quality of the health care provided because it prevent them from knowing what the
patient would need at home. In this regard, the patient would not receive care as expected.
However, there is fear that majority of the nurses in NSW have been giving patients wrong drugs
when under lots of work. Studies conducted indicates that 1 of 10 patients have reported to have
been issued with wrong drugs by nurses in wards (Henderson, et al., 2016). The move has put
lots of questions on how nurses have been contributing to deaths and poor medications. It is an
indication that patients are not guaranteed of their safety.

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Workload management Strategies
Nurse workload is an unhealthy task which put the lives of nurses and patients at risk.
There exist diverse strategies which can be used to minimize the impact caused by nurse
workload in healthcare facilities. First and for most, the NSW healthcare facilities should
consider hiring enough nurses (Davidson and Everett, 2015). This is one of the ways to ensure
that patients are given full attention while in hospital. Enough staff is of great importance
because nurse-patient communication would be enhanced thus facilitation healing process to be
faster. Well-staffed health care facility would ensure a good relationship between nurses
themselves and also other medical practitioners. The role of the nurses should be clearly
specified. They should not be carrying trays and food to the patients. The management should
consider staffing social workers to assist them in delivering such services to avoid workload.
There would be smooth workflow which results in quality health care provisions within the
hospital.
Not all hospitals in Australia have got fewer nurses compared to a number of patients.
Patients transfer is one of the strategies which can be used to reduce the workload of the patient
within the hospital facility. It is widely used in Australia and it ensures that a patient is
transferred to the facility which would be in good position to be offered quality care (Mcmillan
et al., 2016). The hospital facilities should reduce the length of stay within the hospital. The
move would ensure that number of nurses within that particular facility would meet the services
of the patients admitted. Additionally, health care facilities should ensure that they only admit
patients who meet the ratio of nurses within the facility to avoid much workload. In regards to
this idea, the use of e-health should be employed by the management of the hospital to facilitate

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the work of the nurses. It works lessen work and facilitates patient discharge in order to pave
room for the new patients. According to Australia midwife board, the nurse should ensure
nursing ethics prevail of which failure would lead to deregistration. In this regards, nurses should
avoid working for extra hours which exceed the stipulated time. According to Australian Nursing
Federation, an average nurse should work for 32.8hours per week. The hospital management
should ensure that no nurse is allowed to work for more than such hours per week. The move
would make sure that nurses are not overworked thus saving them from undergoing stress,
burnout and psychological torture (Brunetto et al., 2016). On this note, it is very crucial for the
nurse leadership to make sure that each and every nurse is scheduled for a leave in a year. The
idea would assist them to get refresh and get relaxed and gain energy to perform the task.
On the other hand, training them on the importance of working within specified time and
overload is crucial because it would impact them with a better understanding of why they should
be overload. Medical errors are the key killer of patients within hospitals in Australia. One of the
contributors of this situation is fatigue and lack of concentration by the nurses. Nurse leadership
should put in place measures to ensure that nurse who is handling patients undergoing certain
surgical procedures are evaluated before the task, it is one of the ways to affirm that they are fit
and they have put in place the correct measures for the operation.

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Reference list
Alghamdi, M.G., 2016. Nursing workload: A concept analysis. Journal of nursing
management, 24(4), pp.449-457.
Blay, N., Roche, M., Duffield, C. and Gallagher, R., 2017. Intra‐hospital transfers and the Impact
on Nursing Workload. Journal of clinical nursing.
Brunetto, Y., Xerri, M., Trinchero, E., Farr-Wharton, R., Shacklock, K. and Borgonovi, E., 2016.
Public-Private Sector Comparisons of Nurses' Work Harassment Using Set: Italy and Australia.
Public Management Review, 18(10), pp.1479-1503.
Carrara, F.S.A., Zanei, S.S.V., Cremasco, M.F. and Whitaker, I.Y., 2016. Outcomes and nursing
workload related to obese patients in the intensive care unit. Intensive and Critical Care
Nursing, 35, pp.45-51.
Davidson, P. and Everett, B., 2015. Managing approaches to nursing care delivery. Transitions
in nursing: preparing for professional practice. Chatswood, New South Wales, Australia:
Elsevier Health Sciences, pp.125-142.

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Duffield, C., Diers, D., O'Brien-Pallas, L., Aisbett, C., Roche, M., King, M. and Aisbett, K.,
2011. Nursing staffing, nursing workload, the work environment and patient outcomes. Applied
nursing research, 24(4), pp.244-255.
Hayes, B., Douglas, C. and Bonner, A., 2015. Work environment, job satisfaction, stress and
burnout among hemodialysis nurses. Journal of nursing management, 23(5), pp.588-598.
Henderson, J., Willis, E., Blackman, I., Toffoli, L. and Verrall, C., 2016. Causes of missed
nursing care: qualitative responses to a survey of Australian nurses. Labour & Industry: a
journal of the social and economic relations of work, 26(4), pp.281-297.
Mcmillan, K., Butow, P., Turner, J., Yates, P., White, K., Lambert, S., Stephens, M. and Lawsin,
C., 2016. Burnout and the provision of psychosocial care amongst Australian cancer
nurses. European Journal of Oncology Nursing, 22, pp.37-45.
Pearson, A., Pallas, L.O.B., Thomson, D., Doucette, E., Tucker, D., Wiechula, R., Long, L.,
Porritt, K. and Jordan, Z., 2006. Systematic review of evidence on the impact of nursing
workload and staffing on establishing healthy work environments. International Journal of
Evidence
‐Based Healthcare, 4(4), pp.337-384.
Ross, C., Rogers, C. and King, C., 2018. Safety culture and an invisible nursing
workload. Collegian.

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Twigg, D. and Duffield, C., 2009. A review of workload measures: a context for a new staffing
methodology in Western Australia. International Journal of Nursing Studies, 46(1), pp.132-140.