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
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For the RN4CAST consortium, see Appendix A.