An Exploration of How Nurses' Workload Affects Their Everyday Practice

Monday, July 11, 2011: 10:15 AM

Ming Yi Hsu, PhD, MSc, RPN, RN
School of Nursing, Chung Shan Medical University, Taichung, Taiwan

Learning Objective 1: The learner will be able to understand using observation and nurses self-report could reveal the degree of nursing practice environment deterioration.

Learning Objective 2: The learner will be able to understand the impact of deteriorated nursing practice environment on nursing competency maturity and care quality.


In the past few years, the turnover rate for hospital nurses with less than three months service was from 30-70% in Taiwan. Considerable research in this area has investigated nurses’ work stress, nurses’ workload and work overloaded, intent to leave, career development, work place health promotion, working conditions, work-family conflict, and job satisfaction. Results showed that high turnover rate increase interpersonal conflict, job accidents, workload, and lower nursing care quality. Suggestions were made from these studies; however, problems still persist. Investigation nurses’ everyday practice in terms of working time allocation to patients and nursing competency utilization could help understanding the problems. Therefore, it is important to explore how nurses’ workload affects their everyday practice.


 The purpose of this research is to explore how nurses’ workload affects their everyday practice.


Data collection used self-report nurses daily practice dairy and observer observation by using the nurses daily practice dairy. Sampling criteria were hospital nurses who work in surgical and medical wards and position below nurse manager. Content analysis was used for qualitative data analysis. Independent t-test, ANOVA, Pearson product moment correlation coefficient, chi-square were used to determine the relationship among variables.


The findings indicated the impact of deteriorated practice environment has made the nurses spending most of their time on basic routine care which diminished nursing competency maturity. Results also showed that the discrepancy between data collected by observation and nurses self-report indicated how ratio of different grading nurses in a ward, nurse-patient ratio and nursing assessment skills affect nursing care quality.


 The results help nurse managers understand the overall scope of nurses work contents and its relationship with nursing care quality. The results also help to improve nurses work conditions and set up healthcare delivery enhancement programs.