It is not a secret that working as a nurse in the emergency department is a physically and mentally taxing occupation which holds many responsibilities. Nurses that work twelve hour shifts and longer are shown to report increased concern over failing patient safety, due to fatigue (Griffiths et al., 2014). If a nurse is unable to obtain punctual arrival to the work environment, it may prolong the shift of another nurse already on the unit. In this essay, I would like to discuss how professional nursing responsibilities, patient safety, and punctuality of oncoming staff nurses could interact to become a risk factor for low quality care.
It is important to understand the responsibilities and consequences of nursing procedures to grasp the nurse’s role in patient safety. There are many areas where nurses may choose to work, and the more demanding of these areas is critical care units. These departments require the nurse to work at a much faster pace, with patients’ lives at risk if they are unable to do so. The high demand placed on nurses in these units places them at an especially high risk for fatigue. If done improperly, nursing responsibilities like medication administration, peripheral line insertion, and rapid assessments can have grave consequences for the patient. For example, if a patient received the wrong dose of a medication, it could result in chronic impairment or death. At the very least, perpetual tardiness may affect professional reputation with the employer.
Patient safety is a responsibility largely held by the primary nurse of a patient. Ninety-six percent of nurses and ninety percent of physicians, pharmacist and administrators report that nurses hold the responsibility of preventing patient harm in the hospital setting (Ramanujam, Abrahamson, Anderson, 2008). This number is quite staggering considering the fact that nurses receive a flow of information from several multidisciplinary team members. For example, a nurse on a rapid response team must think quickly and critically to ensure physician orders are implemented correctly, that a CNA is performing proper compressions and that other staff nurses are giving the right amount of medication. In situation situations like this, fatigue may cause a human error that decides whether a patient will survive or not.
A possible correlation for fatigue and patient safety is the punctuality of oncoming nurses. If an oncoming nurse is prolonged with arrival to work, a nurse on the existing shift may be asked to work past the standard twelve-hour shift. With time worked increasing past twelve hours, nurses become more concerned about the failure of safety precautions, and more tasks are left incomplete, compared to a nurse who has worked a fewer number of hours (Griffith et al., 2014). It is vital to patient safety that administrators and nurses ensure punctual arrival times.
Nursing is a career path that places high demand on professional, physical, mental, and emotional capabilities. The long hours and heavy workload contribute to fatigue, which could place a nurse at risk for human error and negatively impact patient care. What is crucial to tying this essay together is the concept of punctuality. The inability of a nurse to arrive on time places patients at an unnecessary risk for poor quality care. As a professional, the nurse should make every effort to not just arrive on time, but to be early.
Griffiths, P., Dall’Ora, C., Simon, M., Ball, J., Lindqvist, R., Rafferty, A., . . . Aiken, L. H. (2014). Nurses’ Shift Length and Overtime Working in 12 European Countries. Medical Care, 52(11), 975-981.
Ramanujam, R., Abrahamson, K., & Anderson, J. G. (2008). Influence of workplace demands on nurse’s perception of patient safety. Nursing & Health Sciences, 10(2), 144-150.
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