Interview: Jennifer Ball
ER Nurse
ER Nurse
- Why did you decide to become a nurse?
- First I was an EMT and got interested in nursing through that. I expected this answer because I knew that she was an EMT before she started nursing and liked nursing more so she pursued that career.
- Do you often feel stressed while at work?
- Yes, most days. This answer was also expected because the hospital is an intense place and the actions of nurses could make a difference between life and death.
- What are some factors that affect your stress level at work?
- The amount of patients, the type of illness or injury, how much help I have with the patients. The answer that I was aiming for was the amount of patients and how much help she has because that deals with my subject of understaffing.
- Do you feel that you are always able to reach your full potential at work?
- I feel that I am only able to reach my full potential sometimes. I expected this answer because she said her job is stressful and when you are over stressed it is hard to reach your full potential.
- Does the number of people you work with affect your ability to perform well?
- Yes, because I am able to spend more time on each patient. I was hoping for this answer because it proves that having more nurses influences the well-being of patients.
- Are you able to work better with some people?
- Yes some people work more like me than others. I think this answer is typical because all people usually get along better with some people than others.
- Do you feel that the hospital is ever understaffed?
- Yes, sometimes there aren’t enough people to cover all the patients quickly enough. I expected this answer because there is a significant understaffing of nurses issue in my research.
- When the hospital is understaffed is your job more stressful?
- Yes. This answer is obvious because it is less stressful when there a more nurses for the abundance of patients.
- Do you think there is a way to relieve job stress?
- Yes a little bit. This answer is truthful because there is no way to completely eliminate job stress in a hospital, but there is a way to alleviate some of the stress.
- If so, how?
- If there were more nurses, and the nurses worked better with each other and the doctors. I hoped for this answer because it supports my thought of the problem of the understaffing of nurses.
ANNOTATED BIBLIOGRAPHIESSource #__1__ Bibliography
Lowth, Mary. "Using Triage to Manage Demand in Practice." Practice Nurse 45.6 (2015): 44.
AP Source. Web. 5 Nov. 2016.
Annotation:
In this source, the author first explains what triage is. She defines triage as a means in prioritizing clinical need to deliver the most effective care. In the beginning the Lowth explains that triage originated during the war, when doctors quickly assessed the level of help they could provide for injured soldiers. Next, the author explains how triage is used. The article says that it is used to manage urgent demand and educate patients. Also, the article explains the steps that must be taken in good triage, 1. Assess the patient, which includes looking at the urgency of the patient and determining what the correct pathway for treatment is, 2. Background Knowledge, which is having a clear picture of what can be offered to the patient, 3. Knowing your demand, 4. Protocols, which is what the nurse should do for a patient given their condition. Next, the article explains that in good triage you must have adequate staffing, nursing skills, and record-keeping. Last, the article explains ineffective triage because If we don't triage patients, someone else will do it by default and that causes inefficiency. Potential Quotes:
“As general practice struggles to meet unprecedented levels of demand, practice nurses are increasingly involved in triage.” (1).
“However good triage needs skilled assessment, communication, risk management and good clinical skills.” (1).
“Then, as now, triage is a means of prioritising according to clinical need, in order to deliver the most effective care overall.” (1).
“Assessment for triage differs from the normal diagnostic process in that what you are aiming to do is assess and assign, not diagnose and treat.” (1).
“The practice should have provided and agreed protocols to support your decision-making and ensure consistency and good practice.” (1).
“Primary care triage is needed because we cannot offer every patient exactly what they want, in terms of timing, length and urgency of appointments.” (1).
It is vital that nurses always practise within their own limitations and competence.” (1).
“This is not at all easy, and can involve a hard look at staffing levels in order to back up the system - but with good teamwork, clear protocols, focused training and clear audit it is possible to set up a system that benefits staff and patients alike.” (1).
Assessment:
This article is a credible source for the benefits of the use of triage because the author uses trustworthy references to provide information, 1. NICE. Feverish Illness in Children: Assessment and Initial Management in Children Younger Than Five Years CG47,2007, 2. Barron S. Modifying the 'Manchester triage system' in practice. Primary Health Care 2002;12(2): 37-39. Also, the author herself is a credible source because she is a practice nurse, therefore she has firsthand experience in dealing with practice demand and how triage contributes in the real world.
Reflection:
I will use the information in the article to show how triage is beneficial. I will use the explanation of what triage is in order to inform people about the process of triage. Then i will use the information of the steps of a triage to further the understanding of the process. Then I will use the information in the article on how triage helps in a practice and what will happen if triage is not properly performed, in order to show that triage is necessary in helping the patients and nurses be the most efficient and have the best outcomes for each of them.
Source #2
Burkholder, Nicholas C., Preston J. Edwards, and Libby Sartain, eds. On Staffing: Advice and Perspectives from HR Leaders.
Hoboken, NJ: Wiley, 2004. Questia School. Web. 19 Jan. 2017.
Annotation:
This book is about the important parts of staffing an organization. The book includes what techniques business leaders are using in order to staff organizations well, in that the employees work well together and are able to reach their full potential. This would be important to my essential question because it directly connects to the importance of appropriate staffing and the benefits of staffing an organization properly. It also directly mentions nursing and how the nurses were unhappy because of the staffing problem, so the management increased number and the benefits from productivity outweighed the cost of the increased staff.
Potential Quotes:
“The strength and success of organizations in the future, in an increasingly information and service-based economy, will be determined largely by the ingenuity, productivity, and effectiveness of the workforce” (199).
“Indeed the annual rate of growth of the U.S. workforce has steadily declined since the early 1980s” (200).
“According to a Conference Board (2000) study, the percentage of people reporting they were happy with their jobs fell from 59 percent in 1995 to less than 50 percent in 2000; for baby boomers aged 45 to 54, the decline was even more dramatic, from 57 percent to less than 47 percent” (200).
“One organization I spoke with in the health care sector was experiencing high attrition of nurses. This certainly isn't unusual in a sector that is experiencing severe people shortages” (202).
“The HR department did a good job listening to the organization and knew that its orientation and integration processes were inadequate… the financial savings from this far outweighed the additional costs” (202).
Assessment:
This source is credible because it was found on Questia. Also, it was written by Human Resource professionals and many many examples from other organizations that have successfully used the techniques that they explain in the book. Reflection:
I will use the quotes as evidence that inadequate staffing does affect the productivity of an organization. I will also use them as evidence that there is a problem with the understaffing of nurses, and that the benefits of fixing that problem will surpass the cost of fixing the problem.
Source #3
Burling, Stacey. "More Nurses, Less Death": The Philadelphia Inquirer on Penn's Nurse Staffing Ratio Study." "More Nurses,
Less Death": The Philadelphia Inquirer on Penn's Nurse Staffing Ratio Study. N.p., n.d. Web. 18 Feb. 2017.
Annotation:
The University of Pennsylvania conducted a study about the understaffing of nurses. The study focused on the states California, Pennsylvania, and New Jersey. California has laws about the minimum patient to nurse ratio and the study conducted revealed that if Pennsylvania and New Jersey had the same laws then 10-13% of surgical deaths in New Jersey and Pennsylvania could have been prevented. The study also showed that nurses in California were happier in their jobs than in New Jersey and Pennsylvania. The study further prove that a low nurse to patient ratio causes increased mortality. It explains that these are the ratios that California has in place...
Medical-surgical 1:5
Pediatric 1:4
Intensive-care units 1:2
Oncology 1:5
Labor/delivery 1:3
Potential Quotes:
“When nurses have to care for too many patients, they may not be able to deliver pain drugs on time or keep a close enough eye on patients with troubling symptoms, Eakin said. It can take 90 minutes to stabilize one patient whose heart stops. "Then you're behind on everything else”
“there is support for the idea that better staffing can actually cut overall costs by preventing errors and complications and reducing nurse turnover”
“Ten to 13 percent fewer surgical patients in New Jersey and Pennsylvania would die if hospitals in those states had as many nurses as California law requires”
“It also found that nurses in California liked their jobs better and were less likely to feel burned out”
“Bills have been introduced in Pennsylvania that would either set minimum ratios or require hospitals to establish committees that would develop a "safe staffing plan" for nurses. New Jersey last year began requiring hospitals to report staffing ratios to the Department of Health and Senior Services.”
Assessment:
This is a credible source because it has real case studies and evidence. There is also a nurse’s opinion which is a first hand account. Also, the source is a .org source, meaning it is a valid source with little bias.
Reflection:
I will use this to show what the solution for understaffing of nurses is. Also, I will use it to show that the solution does work and has worked in real life, and that the solution is spreading because of its positive impacts on patients and nurses.
Abstract:
Bailey Gravitt: Amy Robertson Guilford Immediate Care
A career in the healthcare field comes with an enormous amount of responsibility. Each day, nurses have the lives of dozens of people in their hands. In order to do this job well, each nurse needs to be able to perform to their highest capability. However, there is a major issue with achieving this, because of the understaffing of nurses. The annual rate of growth of the U.S. workforce has steadily declined since the early 1980s, especially in the healthcare system. This is an issue because with less nurses comes less time with each patient and more stress on the nurses. When nurses have to care for too many patients, they may not be able to deliver drugs on time or keep a close enough eye on patients. Some hospitals in California have set a required ratio of nurses to patients and 10-13 percent fewer surgical patients in New Jersey and Pennsylvania would die if they had the same law as California. Also, nurses in California tend to feel less burnt out and more productive in their jobs. As a future nurse, it is important to me to understand and solve this issue, not only to better the outlook on nursing, to also save lives.
Lowth, Mary. "Using Triage to Manage Demand in Practice." Practice Nurse 45.6 (2015): 44.
AP Source. Web. 5 Nov. 2016.
Annotation:
In this source, the author first explains what triage is. She defines triage as a means in prioritizing clinical need to deliver the most effective care. In the beginning the Lowth explains that triage originated during the war, when doctors quickly assessed the level of help they could provide for injured soldiers. Next, the author explains how triage is used. The article says that it is used to manage urgent demand and educate patients. Also, the article explains the steps that must be taken in good triage, 1. Assess the patient, which includes looking at the urgency of the patient and determining what the correct pathway for treatment is, 2. Background Knowledge, which is having a clear picture of what can be offered to the patient, 3. Knowing your demand, 4. Protocols, which is what the nurse should do for a patient given their condition. Next, the article explains that in good triage you must have adequate staffing, nursing skills, and record-keeping. Last, the article explains ineffective triage because If we don't triage patients, someone else will do it by default and that causes inefficiency. Potential Quotes:
“As general practice struggles to meet unprecedented levels of demand, practice nurses are increasingly involved in triage.” (1).
“However good triage needs skilled assessment, communication, risk management and good clinical skills.” (1).
“Then, as now, triage is a means of prioritising according to clinical need, in order to deliver the most effective care overall.” (1).
“Assessment for triage differs from the normal diagnostic process in that what you are aiming to do is assess and assign, not diagnose and treat.” (1).
“The practice should have provided and agreed protocols to support your decision-making and ensure consistency and good practice.” (1).
“Primary care triage is needed because we cannot offer every patient exactly what they want, in terms of timing, length and urgency of appointments.” (1).
It is vital that nurses always practise within their own limitations and competence.” (1).
“This is not at all easy, and can involve a hard look at staffing levels in order to back up the system - but with good teamwork, clear protocols, focused training and clear audit it is possible to set up a system that benefits staff and patients alike.” (1).
Assessment:
This article is a credible source for the benefits of the use of triage because the author uses trustworthy references to provide information, 1. NICE. Feverish Illness in Children: Assessment and Initial Management in Children Younger Than Five Years CG47,2007, 2. Barron S. Modifying the 'Manchester triage system' in practice. Primary Health Care 2002;12(2): 37-39. Also, the author herself is a credible source because she is a practice nurse, therefore she has firsthand experience in dealing with practice demand and how triage contributes in the real world.
Reflection:
I will use the information in the article to show how triage is beneficial. I will use the explanation of what triage is in order to inform people about the process of triage. Then i will use the information of the steps of a triage to further the understanding of the process. Then I will use the information in the article on how triage helps in a practice and what will happen if triage is not properly performed, in order to show that triage is necessary in helping the patients and nurses be the most efficient and have the best outcomes for each of them.
Source #2
Burkholder, Nicholas C., Preston J. Edwards, and Libby Sartain, eds. On Staffing: Advice and Perspectives from HR Leaders.
Hoboken, NJ: Wiley, 2004. Questia School. Web. 19 Jan. 2017.
Annotation:
This book is about the important parts of staffing an organization. The book includes what techniques business leaders are using in order to staff organizations well, in that the employees work well together and are able to reach their full potential. This would be important to my essential question because it directly connects to the importance of appropriate staffing and the benefits of staffing an organization properly. It also directly mentions nursing and how the nurses were unhappy because of the staffing problem, so the management increased number and the benefits from productivity outweighed the cost of the increased staff.
Potential Quotes:
“The strength and success of organizations in the future, in an increasingly information and service-based economy, will be determined largely by the ingenuity, productivity, and effectiveness of the workforce” (199).
“Indeed the annual rate of growth of the U.S. workforce has steadily declined since the early 1980s” (200).
“According to a Conference Board (2000) study, the percentage of people reporting they were happy with their jobs fell from 59 percent in 1995 to less than 50 percent in 2000; for baby boomers aged 45 to 54, the decline was even more dramatic, from 57 percent to less than 47 percent” (200).
“One organization I spoke with in the health care sector was experiencing high attrition of nurses. This certainly isn't unusual in a sector that is experiencing severe people shortages” (202).
“The HR department did a good job listening to the organization and knew that its orientation and integration processes were inadequate… the financial savings from this far outweighed the additional costs” (202).
Assessment:
This source is credible because it was found on Questia. Also, it was written by Human Resource professionals and many many examples from other organizations that have successfully used the techniques that they explain in the book. Reflection:
I will use the quotes as evidence that inadequate staffing does affect the productivity of an organization. I will also use them as evidence that there is a problem with the understaffing of nurses, and that the benefits of fixing that problem will surpass the cost of fixing the problem.
Source #3
Burling, Stacey. "More Nurses, Less Death": The Philadelphia Inquirer on Penn's Nurse Staffing Ratio Study." "More Nurses,
Less Death": The Philadelphia Inquirer on Penn's Nurse Staffing Ratio Study. N.p., n.d. Web. 18 Feb. 2017.
Annotation:
The University of Pennsylvania conducted a study about the understaffing of nurses. The study focused on the states California, Pennsylvania, and New Jersey. California has laws about the minimum patient to nurse ratio and the study conducted revealed that if Pennsylvania and New Jersey had the same laws then 10-13% of surgical deaths in New Jersey and Pennsylvania could have been prevented. The study also showed that nurses in California were happier in their jobs than in New Jersey and Pennsylvania. The study further prove that a low nurse to patient ratio causes increased mortality. It explains that these are the ratios that California has in place...
Medical-surgical 1:5
Pediatric 1:4
Intensive-care units 1:2
Oncology 1:5
Labor/delivery 1:3
Potential Quotes:
“When nurses have to care for too many patients, they may not be able to deliver pain drugs on time or keep a close enough eye on patients with troubling symptoms, Eakin said. It can take 90 minutes to stabilize one patient whose heart stops. "Then you're behind on everything else”
“there is support for the idea that better staffing can actually cut overall costs by preventing errors and complications and reducing nurse turnover”
“Ten to 13 percent fewer surgical patients in New Jersey and Pennsylvania would die if hospitals in those states had as many nurses as California law requires”
“It also found that nurses in California liked their jobs better and were less likely to feel burned out”
“Bills have been introduced in Pennsylvania that would either set minimum ratios or require hospitals to establish committees that would develop a "safe staffing plan" for nurses. New Jersey last year began requiring hospitals to report staffing ratios to the Department of Health and Senior Services.”
Assessment:
This is a credible source because it has real case studies and evidence. There is also a nurse’s opinion which is a first hand account. Also, the source is a .org source, meaning it is a valid source with little bias.
Reflection:
I will use this to show what the solution for understaffing of nurses is. Also, I will use it to show that the solution does work and has worked in real life, and that the solution is spreading because of its positive impacts on patients and nurses.
Abstract:
Bailey Gravitt: Amy Robertson Guilford Immediate Care
A career in the healthcare field comes with an enormous amount of responsibility. Each day, nurses have the lives of dozens of people in their hands. In order to do this job well, each nurse needs to be able to perform to their highest capability. However, there is a major issue with achieving this, because of the understaffing of nurses. The annual rate of growth of the U.S. workforce has steadily declined since the early 1980s, especially in the healthcare system. This is an issue because with less nurses comes less time with each patient and more stress on the nurses. When nurses have to care for too many patients, they may not be able to deliver drugs on time or keep a close enough eye on patients. Some hospitals in California have set a required ratio of nurses to patients and 10-13 percent fewer surgical patients in New Jersey and Pennsylvania would die if they had the same law as California. Also, nurses in California tend to feel less burnt out and more productive in their jobs. As a future nurse, it is important to me to understand and solve this issue, not only to better the outlook on nursing, to also save lives.