More Evidence: Should We Get Rid of 12-Hour Nursing Shifts, Despite Their Popularity?

By Shawn Kennedy, AJN editor-in-chief

A new study in Health Affairs provides yet more support that reliance on 12-hour nursing shifts (or longer—we all know that shifts often extend a bit longer than scheduled) should be reconsidered. The study supports previous findings of increased burnout among nurses who work shifts longer than eight hours, but finds as well that longer shifts (13 hours or more) are associated with increased levels of patient dissatisfaction.

Despite these negatives for both nurses and patients, 80% of nurses surveyed across four states said they were happy with their hospitals’ scheduling practices.

I imagine that, with all the recent emphasis on patient satisfaction scores, this study will make nurse executives and hospital administrators take notice—especially as consumers become more aware of the research through coverage like this story at the U.S News & World Report site.

We’ve had evidence for a while that the 12-hour shift is not a best practice. For example, in 2004, Anne Rogers and colleagues also published research in Health Affairs. In their national survey of over 1,000 nurses, they found that most nurses generally worked longer than their actual shifts; nearly 40% of shifts were longer than 12 hours, and 14% of respondents had worked “16 or more consecutive hours at least once during the four-week period.” More importantly, they found that “the likelihood of making an error increased with longer work hours and was three times higher when nurses worked […]

2016-11-21T13:08:51-05:00November 27th, 2012|nursing perspective|19 Comments
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Veterans, Nurses, and PTSD

By Maureen Shawn Kennedy, AJN editor-in-chief

Vietnam Women’s Memorial, Washington, DC. Courtesy of Kay Schwebke.

Veteran’s Day was officially yesterday, November 11, but many will mark it today with a day off from work and school and for some reason, shopping. I’m not sure when or why Veterans Day became associated with bargains, but it seems especially out of place this year, as we hear more and more about the issues being faced by the thousands of new veterans. As I note in my November editorial, an Institute of Medicine report estimates that 13% to 20% of returning veterans from Iraq and Afghanistan “have or may develop PTSD.”

Last month, I had the opportunity to spend some time with Brigadier General (Ret.) Bill Bester, former chief of the Army Nurse Corps. I interviewed General Bester about his career and veterans’ health issues. The general was engaging and candid about the difficulties returning veterans face and he spoke about the post-deployment transition period that can be difficult for returning veterans.

He also spoke about his current activities as a senior advisor for the Jonas Foundation’s Veterans Healthcare Program, which supports scholarships for nurses pursuing doctoral degrees related to veteran-specific health issues. The program supports nurses pursuing both PhD as well as DNP degrees and hopes to focus on researching the issues as well as implementing best practices.

With many veterans accessing care outside the VA system, it’s important for nurses in all […]

2016-11-21T13:08:55-05:00November 12th, 2012|Nursing|0 Comments
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Best Care at Lower Cost: New IOM Report Spotlights Crucial Role of Nurses

By Mary D. Naylor, PhD, FAAN, RN. Dr. Naylor is the Marian S. Ware Professor in Gerontology and director of the NewCourtland Center for Transitions and Health at the University of Pennsylvania School of Nursing. She is also the National Program Director for the Robert Wood Johnson Foundation program, Interdisciplinary Nursing Quality Research Initiative, aimed at generating, disseminating, and translating research to understand how nurses contribute to quality patient care. She was appointed to the Medicare Payment Advisory Commission in 2010. 

Building on the Future of Nursing report’s call for nurses to fully engage with fellow health care professionals, a new report from the Institute of Medicine, Best Care at Lower Cost, calls on nurses and others in the health care system to apply emerging tools, technologies, and approaches to yield lower costs and better health outcomes. I had the great fortune to serve as a member of the study committee.

The complexity problem. The report couldn’t be more timely or relevant, particularly for nurses and the patients they serve, given the complexity of the current health care system. Administrative and workflow inefficiencies limit hospital nurses from spending more than about 30% of their time on direct patient care. With increasing specialization, modern medicine now includes nurses in more than 50 specialties. To successfully coordinate a patient’s care, nurses need to communicate and collaborate with patients, family caregivers, physicians, pharmacists, social workers, and many other team members.

The complexity […]

2016-11-21T13:09:23-05:00September 6th, 2012|career, nursing perspective|1 Comment
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The NLN: Where Nursing Teachers Go to Learn

By Shawn Kennedy, AJN editor-in-chief

As a nursing student, I was always awestruck when an instructor could rattle off a few points that keyed me into what I should be thinking about when I approached a patient, or use questions to lead me through a thought process that ended with the discovery that I’d known the answer all along. It never dawned on me that those were teaching skills, tools of the trade that she’d learned as an educator.

Last week, I spent a few days in Orlando, Florida, attending the 2011 Education Summit of the National League for Nursing, or as most nurses know it, “the NLN.” I’d venture that if you asked most nurses (who aren’t faculty, that is) what they know about the NLN, they’d answer that it’s the body that accredits nursing schools (key information when deciding what nursing program one should attend). While that’s partially correct, that’s only one part of the NLN’s mission. […]

2016-11-21T13:11:51-05:00September 27th, 2011|Nursing|0 Comments
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Feel the Power (What Nursing Can Learn from the Dancing Man)

By Shawn Kennedy, AJN editor-in-chief—Writing in a recent blog post on NursingTimes.net (a UK-based site), Mark Radcliffe poses this question:

“Do you, as a nurse, feel you have any collective power to influence policy? Are we as well versed as other professional groups in articulating loudly and clearly why nursing needs to be the foundation stone of any health service?”

I thought it was a good question for us here in the United States. Most U.S. nursing associations, nurse executives, and deans are invested in politics. The recent Institute of Medicine Report on the Future of Nursing is the most recent example of how nursing is collectively trying to influence health policy.

But I still wonder how many nurses involved in direct care feel that the politics of health is something they need to pay attention to. It seems that it’s only when it becomes part of the job, directly affects one’s ability to perform a job, or has an impact on one’s financial well-being that many people get involved.

When I was a young nurse, I and many in my cohort didn’t pay attention to things like politics or getting involved in associations. We were new and intent on acquiring skills and becoming competent in our jobs, and politics seemed esoteric and something we needn’t be concerned about.

But within two years, I found myself in court on a workmen’s compensation claim for an illness I’d contracted from a patient. I was going to be out of work for four to six […]

2016-11-21T13:12:29-05:00July 5th, 2011|career, nursing perspective|1 Comment
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