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I started to wonder if the busy syndrome might be an inexplicit game in the
ward inhibiting reflecting. But what purpose might it serve and what if
nurses really were overworked? My new understanding of post-
structuralism was helping me see that both situations were possible.
Recently there has been an increasing interest in how nurses spend their
time; driven in part by the need to make best use of their knowledge and
skills through extended roles and in part by the spiralling cost of nurses‘
salaries that form a high proportion of the total hospital budget (Storfjell et
al 2008, Adams & Bond 2003, DH 1998). Adams and Bond (2003) found
no link between higher staffing levels and higher standards of nursing
practice. They argued however, the converse was not the case so that
less nurses resulted in task orientated care normally associated with
poorer levels of nursing care and hierarchical nursing attitudes.
A recent survey by the RCN (2008) of more than 1,700 nurses found that
88% believed non essential paperwork had increased over the last five
years coupled with a lack of administration support, preventing nurses
from spending time on direct patient care. Nurses received less than three
hours clerical support per week with two-fifths having no clerical staff
support. Subsequent to this inquiry an NHS Institute for Innovation and
Improvement project (2007) called ―Releasing Time to Care –The
Productive Ward Programme‖ has been piloted. It suggested that savings
of up to 40% of nurses‘ time could be better used towards direct patient
care by using its programme of 13 self directed learning modules. These
are aimed at developing ‗a well organised ward‘. Some time saving ideas
include: focusing on effective ward processes by reducing the time the
team spends on delivering meals therefore allowing more time to assist
with feeding, reducing interruptions on drug rounds, removing the rush of
admitting patients all at the same time by staggering admissions and
discharges, reducing the time spent on handovers, ensuring the dignity of
patients by providing safe, clean and responsive care, improving the
patient experience by ensuring Trust standards are adhered to and
improving ward rounds so they are quicker and more consistent.
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