February 24, 2020

Morning Vitals: Where Is the Escape Hatch for Unmanageable Nursing Workloads?

Well, I’m off to the races so far in 2020. This month has a particularly full slate of professional tasks for me. In addition to full-time nursing, I’m in the midst of obtaining certification in wound and ostomy care. I’m working on a couple of nursing quality-related assignments–for which I volunteered. I hope to attend the Indiana State Nurses Association policy conference later this month. Obviously, I’m also producing content for Morning Vitals and hope to work in additional posts as I’m able.

Like every other nurse at times, I fear I must’ve forgotten something important that should’ve made it onto the list above. As you can imagine, nursing is a 24-hour business. In the midst of chaos, there are bound to be tasks and information that fall by the wayside or slip through one’s fingers. Sometimes these things can be picked up at a later date; sometimes they can’t. In the end, I’d rather forget to list a task than forget to accomplish it.

Last week, I wrote about the problem of task overload in professional nursing. I was mainly writing about acute care nursing, but I sense that other nursing careers experience some of the same difficulties with finding enough time in a shift or in a day to do all that is expected or required or would be prudent or ethical to do.

To reiterate and extend what I said last week, a major problem in nursing–because it is a problem in health care in general–is that nurses are so often burdened with such unmanageable workloads that choices must be made, they believe, to neglect some tasks in order to preserve the essentials.

Just what are the essentials? Some would say the essential tasks are obvious, but that’s only true some of the time. I won’t even begin to list the so-called essentials here. While I expect most nurses would agree on the things I have in mind, I can think of nurses who would disagree, and I myself can think of scenarios in which I might be inclined to disagree as well.

The meaning of the ethical milieu of nursing is difficult to grasp. Is patient care important? Yes. Is the viability of the health care organization important? Yes. Is maintenance of one’s license important? Yes. Is ensuring nurses take adequate time out for breaks or lunch important? Yes. Is seeing nursing practice as a ministry important? Yes. How these principles interact and sometimes compete with each other presents difficulties, though.

How do nurses escape the all too frequent ethical dilemmas of nursing life? How many different kinds of escapes are there? Are certain escapes more commonly utilized than others? Do some nurses utilize certain escapes more frequently than others? In other words, do individual nurses have favorite escapes?

I hope to define and explore these escapes in the future on Morning Vitals. I hope you’ll join me. You may find yourself somewhere in the discussion. You may even have an escape to contribute to the list, even if only to caution the rest of us against taking advantage of it. Thank you in advance for joining in.

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