Care Left “Undone” During Nursing Shifts

‘Care left undone’ during nursing shifts: associations with workload and perceived quality of care

This study, performed in the UK, shows the correlation between tasks left undone during a nurse’s shift and staffing on a hospital unit. Tasks that are most often left undone include talking with and educating patients.  This affects patients far after they leave the hospital, especially if they do not receive vital instructions for maintaining their health, such as how to care for wounds, when to take (or not to take) medication, and when to call a doctor. This is yet another study that shows nurse staffing affects patients not just while they are in the hospital, but also when they have left.

On my unit we try to keep the mentality that it’s a 24 hour job and the next shift can get to things if we cannot get to them ourselves. But this primarily addresses tasks that a nurse is not able to get to, not patient education and counseling. It would be so nice to have adequate time to talk to my patients and educate them thoroughly. Currently this feels like the exception rather than the rule.  I know busy nurses everywhere are suffering from the same chronic disappointment in our jobs. We got into nursing for the patients, it is upsetting when you are forced, due to staffing, to give only the care written down on paper and not the vital care that nurses are trained to give every patient: emotional support and comfort. The ability to spend time with your patients and care for their emotions is part of what makes nursing a rewarding occupation, and the inability to do so is what causes many nurses to develop compassion fatigue, burnout, and to leave the profession.

About Grimalkin, RN

Trying really hard to be a decent person. Registered Nurse. Intersectional Feminism. Poet. Cat. Political. Original recipes. Original Stories. Occasionally Questionable Judgement. Creator of #cookingwithjoanne and #stopcock. Soulless Unwashed Carrot. This blog is dedicated to my grandmother, my beloved cat Grimalkin, and my patients.

Posted on January 24, 2014, in Uncategorized. Bookmark the permalink. 2 Comments.

  1. Molly Cipriani RNC

    Sadly, I have to agree with you. I am a retired mother/baby nurse and worried myself into an early retirement due to several factors. This is one of them and at my hospital, it was directly related to poor staffing and the lack of cooperation between the hospital nursing staff and the providers we worked with. I think patients should have come into their delivery and postpartum experience more prepared. It’s impossible to teach the amount of information in 2 days. We used to have group classes with nurses who were eager and prepared to teach parents about newborn care, feeding, and mom’s recovery but the hospital didn’t staff us for that anymore! Not only did we have patients going home with little discharge instructions, we didn’t have a standardized teaching plan ( that could be individualized) so that the correct evidenced based information would be taught! I became too stressed and decided my health was being affected so after 35 years of nursing, I left. I sure miss my patients.

  2. I agree. Between treatments, medications and call bells it’s hard to squeeze in that ever important care and medication instructions. Teaching is ongoing and can be started as soon as possible about medications they are currently taking at home and their conditions. I used to begin with a question and answer time during med administration. But, lets face it, these people are sick or recovering from surgery and may be awake but not able to absorb what the nurse or doctor is saying.
    Being on the other side of the bed, I remember being quizzed on meds and wound care when I was seeing double from medication. She sounded miles away and the room was spinning. I felt “forced fed” and didn’t remember everything. I was grateful for discharge instructions when leaving.
    I guess we can just the best we can in the time given.

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