How to nurse daily job difficulty

A neonatal intensive care unit nurse's ability to provide optimal care is influenced by a variety of factors-not just how many babies or caring for or how sick they might be, a new study suggests.

The study, which appears in the journal JAMA PediatricsHeather Tubbs Cooley of the Ohio State University, said lead researcher at Heather Tubbs.

The study found that a nurse's perception of the difficulty of the workday-everything of being squeezed for the best possible care, regardless of how many patients the nurse was tending to.

"We were surprised to discover how important this work is, and it's something we typically do not really care about." "This is really the nurse's voice telling us how intense things were," said Tubbs Cooley, an associate professor of College of Nursing's Martha S. Pitzer Center for Women, Children & Youth at Ohio State.

The study data collected during 332 12-hour shifts from 136 neonatal intensive care nurses. During each shift, the objectives of the infant-to-nurse ratio are measured.

Nurses also completed a simple questionnaire that measured perceived workload based on mental demand, physical demand, temporal demand, and overall effort to achieve patient care. The tool, called the NASA Task Load Index, was developed in the United States, and is used in other industries.

The nurses in the study also gave the researchers reports on "essential care" that they missed during shifts.

The research team compiles all of this information and makes multiple statistical models to evaluate the relationships between the objective and the subjective workload measures and quality of care.

Regardless of the model, the nurses 'perceived workloads had a strong influence on missed essential care-activities that included hourly assessments of patients' intravenous sites, oral feedings, collection of laboratory results and safety checks of equipment and alarms. This study does not evaluate patient outcomes, but other research has established that the patient is affected.

Some of the models showed that higher patient ratios contributed to missed care, which has been demonstrated in other studies. But the researchers saw this connection between the severity of patients' health status and missed care.

"Subjective workload has been a lot of attention and it's important-but nurses' in-the-moment workload judgments matter much more," she said. .

NICU nurses care for the most fragile infants but the study's implications are likely to extend beyond that setting, said Tubbs Cooley. "I think this is likely to be a universal phenomenon among front-line caregivers in hospitals and even those in outpatient and community settings."

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