A multi-country perspective on nurses’ tasks below their skill level: Reports from domestically trained nurses and foreign trained nurses from developing countries
Section snippets
Background
System-level interventions like increasing nurse staffing and creating superior work environments have been associated with improved patient safety outcomes and a higher degree of nurse wellbeing (Aiken et al., 2012, Kelly et al., 2011). Also central to the efficient structuring of nurses’ work is optimizing the use of their time and effort. When asked about their last shift however, nurses across three countries (US, Canada, Germany) consistently reported high percentages of non-nursing tasks
Study design
The RN4CAST study favoured a rigorous quantitative multi-country cross-sectional design on the basis of research methods used in a five-nation study of critical issues in nurse staffing and the impact on patient care (Aiken et al., 2001). Data were gathered via four data sources (nurse, patient and hospital profile surveys and routinely collected hospital discharge data). The design of the RN4CAST-study is described in detail by Sermeus et al. (2011). For this analysis, nurse-reported
Foreign trained nurses
2107 nurses (6.2% of total sample) indicated they were trained in another country than where they were currently employed, of which 832 were trained in a developing country (2.5% of total sample). There was large variation in the share of foreign trained nurses between countries: Ireland (38.6%), Switzerland (22.1%) and England (16.7%), Norway (5.5%), Germany (5.1%), Greece (5.1%), Belgium (3.1%), Netherlands (2.4%), Sweden (2.3%), Spain (1.3%), Finland (.9%). In Poland, all nurses that
Discussion
This study documented high proportions of nurses across twelve countries indicating they had performed tasks below their skill level during their last shift. These findings support the previous studies of Aiken et al. (2001), Desjardins et al. (2008) and Hendrich et al. (2008) in which nurses reported much time spend on non-nursing tasks or much time wasted during their last shift.
Findings also revealed that, while a high share of all nurses reported having performed tasks below their skill
Conclusion
The findings suggest that there remains much room for improvement to optimize the use of nurses’ time and energy. Human resources management should give more attention to professional socialization and life-long learning for nurses to improve their priority setting and time management as well as ensuing that non-nursing resources are designated to carry out tasks that do not require the unique training of professional nurses. Nurses from developing countries may be particularly in need of
References (18)
- et al.
Nurses’ reports on hospital care in five countries
Health Affairs
(2001) - et al.
Patient safety, satisfaction, and quality of hospital care: cross-sectional surveys of nurses and patients in 12 countries in Europe and the United States
British Medical Journal
(2012) - et al.
Factors contributing to nursing task incompletion as perceived by nurses working in Kuwait general hospitals
Journal of Clinical Nursing
(2009) The Hospital Nursing Workforce in New York: Findings from a Survey of Hospital Registered Nurses
(2008)A work sampling study of variations in nursing work load
Hospitals
(1961)- et al.
Reorganizing nursing work on surgical units: a time-and-motion study
Nursing Leadership
(2008) - et al.
Does international nurse recruitment influence practice values in U.S. hospitals?
Journal of Nursing Scholarship
(2002) - et al.
A 36-hospital time and motion study: how do medical-surgical nurses spend their time?
The Permanente Journal
(2008) - et al.
Career Progression of Migrant Nurses in Ireland: Nurse Migration Project Policy Brief 5
(2009)
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2021, International Journal of Nursing StudiesNon-nursing tasks as experienced by nursing students: Findings from a phenomenological interpretative study
2019, Nurse Education TodayCitation Excerpt :Therefore, students may perceive themselves as not being in the best position to delegate tasks, and performing the task themselves may help them avoid stress. Some external forces reflect the culture of the organisation that expects great flexibility and adaptation from nurses by performing a wide range of activities (Bruyneel et al., 2013): although nursing students were considered supernumeraries, and so not part of the organisation, they were expected to be useful and to function as extensions of the regular staff. In evaluating the impact of non-nursing tasks, our students also reported positive effects, contrary to previous studies, which suggested that individuals in the early stages of their careers, when called to perform “inferior” assignments, tend to experience the greatest discrepancy between their expectations and organisational reality (Tims et al., 2016; Wang et al., 2016).
U.S. Hospital Employment of Foreign-Educated Nurses and Patient Experience: A Cross-Sectional Study
2017, Journal of Nursing RegulationCitation Excerpt :We were not able with our data to explore the reasons why patient satisfaction may be less favorable when a greater proportion of their nurses are educated outside of the United States. In related work in Europe, we found that FENs from developing countries were significantly more likely to spend their time on tasks that, in the developed host countries, were not responsibilities of RNs, thus potentially eroding FEN productivity and resulting in missed nursing care (Bruyneel et al., 2013). Another possible explanation we are unable to examine is subtle language differences and accents that could interfere with nurse-patient and nurse-physician communication that are important for good patient outcomes.
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For the RN4CAST consortium, see Appendix A.